Prolonged retention of a swallowed foreign body in the stomach following pyloromyotomy

Abstract An unusual case of prolonged retention of a swallowed, round-shaped, magnet tack in the stomach of a patient is reported. The patient had had a previous pyloromyotomy for pyloric stenosis. Patients with a history of pyloromyotomy for pyloric stenosis may present special problems for the passage of foreign bodies reaching the stomach and may be more likely to require surgical intervention.     

Decremental Accessory Pathway Conduction After Ablation and Antidromic Atrioventricular Reciprocating Tachycardia 8 Years After Successful Radiofrequency Ablation

Introduction: This is a rare case of antidromic reciprocating tachycardia developing 8 years after successful catheter ablation.
Result: A 15-year-old girl had recurrence of palpitations 8 years after the ablation of manifest right posteroseptal accessory pathway. Atrial burst pacing revealed Wenckebach atrioventricular conduction with preexcitation. Wide QRS tachycardia with identical morphology to sinus rhythm associated with retrograde His potential recorded immediately after the V-wave was induced by isoproterenol infusion. Atrial premature stimulus applied at the identical timing of His potential advanced the subsequent ventricular beat and His potential.
Conclusion: Catheter ablation may produce decremental accessory pathway conduction and rarely cause antidromic atrioventricular reciprocating tachycardia. This may be explained by a presence of "de novo" accessory pathway with decremental conduction properties that became manifest after the first ablation.     

A longitudinal study on electrophysiological properties of atrioventricular accessory pathways in infants and children

In this study the electrophysiological developmental changes of accessory pathway (AP) properties in infants and children are examined. Intracardiac and/or transesophageal electrophysiological studies were performed on seven infants (group 1, mean age 2 months) and four children (group 2, mean age 9 y; study 1), and documented orthodromic atrioventricular tachycardia in all cases. At follow-up study (study 2), supraventricular tachycardia was induced in three of seven (43%) cases in group 1 and in all four cases in group 2. Changes in antegrade conduction properties of AP were documented by loss of pre-excitation (two of four cases in group 1) or change to intermittent pre-excitation (one of two cases in group 2).     

Tachycardia Associated with Twin Atrioventricular Nodes in an Infant with Heterotaxy and Interruption of Inferior Vena Cava

We report a 12‐month‐old boy with heterotaxy and interruption of inferior vena cava who showed sustained tachycardia associated with twin atrioventricular nodes (AVNs). Atrioventricular reciprocating tachycardia with antegrade conduction through the posterior AVN and retrograde conduction through the anterior AVN were successfully ablated using an upper approach from the left internal jugular vein. (PACE 2012; 35:e302–e305)     

PAROXYSMAL ELECTROENCEPHALOGRAPHIC DISCHARGES DURING ENFLURANE ANAESTHESIA IN PATIENTS WITH A HISTORY OF CEREBRAL CONVULSIONS

The electroencephalogram (EEG) was monitored through all phasesof enflurane anaesthesia in dental outpatients with a historyof cerebral convulsions which had been well controlled withanticonvulsant drugs. Abnormal EEG activity which differed fromthe background activity was observed in three patients. Theircase reports are presented.     

Endoscopic Bilateral Hepatic Drainage with Self-Expandable Metallic Stents for Malignant Hilar Stricture

Endoscopic insertion of self-expandable metallic stents is considered to be safer and less invasive than percutaneous stenting for patients with malignant biliary strictures. However, the technique of implantation of multiple self-expandable metallic stents by endosocpic means has not yet been fully established. We evaluated the technical feasibility of endoscopic negotiation of bilateral hepatic ducts with subsequent placement of multiple self-expandable metallic stents in parallel. Bilateral hepatic ducts were negotiated with guidewires, and self-expandable metallic stents were sequentially introduced and deployed over the prepositioned guidewires in seven patients with irre-sectable malignant hilar strictures. Insertion and deployment of self-expandable metallic stents into both the right and left hepatic ducts were successful in six of the seven patients. The remaining patient was eventually treated with bilateral hepatic drainage using two wallstents; one was inserted endoscopically and the other percutaneously. The patients were followed up for 36–349 days (mean; 227). In two patients, stent occlusion due to sludge formation occurred 119 and 178 days after the treatment. However, endoscopic reintervention was easily performed with a favorable clinical outcome in both patients. Endoscopic bilateral hepatic drainage of multiple, self-expandable metallic stents in parallel is considered to be a simple, safe, and reliable for irresectable malignant hilar stricture. (Dig Endosc 1999; 11: 225–230)     

Impact of thrombocytosis and C-reactive protein elevation on the prognosis for patients with renal cell carcinoma

AIM: C-reactive protein (CRP) elevation is reportedly a prognostic factor in patients with renal cell carcinoma (RCC). Thrombocytosis has recently been reported also to be a prognostic factor in RCC and, like CRP, to be related to inflammatory cytokines such as interleukin-6. The aim of this study was to evaluate the importance of both thrombocytosis and CRP elevation in tumor recurrence and prognosis for patients with RCC. METHODS: The clinical records of 178 patients who underwent radical nephrectomy were reviewed. Thrombocytosis was defined as a platelet count >or=350,000/mm(3), and CRP elevation was defined as a CRP level >or=1.0 mg/dL. Disease-free survival and cause-specific survival rates were calculated. Independent predictors for recurrence and prognosis were determined. RESULTS: Patients with thrombocytosis and patients with elevated CRP levels had significantly higher pathological T stage, clinical stage, tumor size, histological grade, and percentage of microvascular invasion than did patients without THC and patients with CRP levels <1.0 mg/dL, respectively. There was a significant correlation between platelet counts and CRP levels. Multivariate analysis showed that distant metastasis, tumor size, grade 3 components, and CRP elevation were independent predictors for prognosis but thrombocytosis was not. In N0M0 RCC patients, tumor size, microvascular invasion, and CRP elevation were independent predictors for recurrence. CRP elevation and tumor size were independent predictors for prognosis. CONCLUSIONS: Platelet count and CRP level are strongly correlated in patients with RCC, but only CRP elevation is an independent predictor for recurrence and prognosis.