[Renal cell carcinoma in patient with situs inversus and Kartagener syndrome].
ABSTRACT A case of a adenocarcinoma renal in a patient with situs inversus complete to which was associated bronchiectasis and chronic sinusitis (kartagener's syndrome) is reported. It is the third case described in the international literature of a renal cells carcinoma in a patient with situs inversus totalis and the first in patient the one which has the triada classic of the kartagener's syndrome plus sterility. The tumor was discovered in a way incidental upon accomplishing a TAC toracoabdominal and was solved through nefrectomia for lumbotomy approach.
Article: Initial Results With Atherectomy for Non-reconstructable Limb Threatening Peripheral Vascular Disease[show abstract] [hide abstract]
ABSTRACT: BackgroundRemoval of the atherosclerotic plaque by atherectomy rather than compression by balloon angioplasty has held the interest of vascular surgeons since the introduction of remote loop endarterectomy instruments in the 1950s.MethodsWe have reviewed our experience with a directional atherotome (SilverHawk; eV3, Plymouth, MN, USA) for patients who had advanced, TransAtlantic Inter-Society Consensus Stages III and IV (Rutherford categories 4, 5, and 6) occlusive disease. The patients were not candidates for bypass operations or had failed bypass and/or stenting. From August 2007 through April 2009, we used the SilverHawk device in 16 men, aged 48 through 81, median age 66 years (standard deviation = 8.75). Risk factors include diabetes (9) and history of smoking (12). The indications for the procedure were nonhealing wounds in six, tissue necrosis in four, and ischemic rest pain in six patients.ResultsEleven patients had atherectomy of occluded popliteal or tibial arteries. There were no intraoperative complications, specifically embolization or arterial wall perforation. One patient developed a common femoral pseudoaneurysm at the arteriotomy site. In each patient, completion arteriograms showed target lesion revascularization. Follow-up was from 8 to 54 months with a median of 26.5 months. Below-knee amputations on the site of the intervention were required in two patients at 1 month and 9 months. Transmetatarsal amputations were done in two patients following the vascular intervention, one of which was planned preoperatively. Both transmetatarsal amputation sites healed. In five of six patients, relief of rest pain was obtained, and healing of wounds occurred in the remaining six patients.ConclusionUnder the special circumstances of advanced limb ischemia, atherectomy may provide limb salvage in patients who no longer have the option of a bypass operation.Journal of Experimental & Clinical Medicine.