RESUMEN
INTRODUCTION: Fibrosing mediastinitis (FM) is a rare disease characterized by excessive proliferation of fibrous tissue in the mediastinum and can cause bronchial stenosis, superior vena cava obstruction, pulmonary artery and vein stenosis, etc. CASE PRESENTATION: An aging patient with intermittent chest tightness and shortness of breath was diagnosed with FM associated pulmonary hypertension (FM-PH) by echocardiography and enhanced CT of the chest, and CT pulmonary artery (PA)/ pulmonary vein (PV) imaging revealed PA and PV stenosis. Selective angiography revealed complete occlusion of the right upper PV, and we performed endovascular intervention of the total occluded PV. After failure of the antegrade approach, the angiogram revealed well-developed collaterals of the occluded RSPV-V2b, so we chose to proceed via the retrograde approach. We successfully opened the occluded right upper PV and implanted a stent. CONCLUSIONS: This report may provide new management ideas for the interventional treatment of PV occlusion.
Asunto(s)
Venas Pulmonares , Stents , Humanos , Resultado del Tratamiento , Venas Pulmonares/diagnóstico por imagen , Venas Pulmonares/fisiopatología , Venas Pulmonares/cirugía , Enfermedad Crónica , Enfermedad Veno-Oclusiva Pulmonar/terapia , Enfermedad Veno-Oclusiva Pulmonar/diagnóstico por imagen , Enfermedad Veno-Oclusiva Pulmonar/fisiopatología , Enfermedad Veno-Oclusiva Pulmonar/etiología , Estenosis de Vena Pulmonar/diagnóstico por imagen , Estenosis de Vena Pulmonar/terapia , Estenosis de Vena Pulmonar/fisiopatología , Estenosis de Vena Pulmonar/etiología , Mediastinitis/diagnóstico , Mediastinitis/terapia , Masculino , Flebografía , Angioplastia de Balón/instrumentación , Anciano , Hipertensión Pulmonar/fisiopatología , Hipertensión Pulmonar/terapia , Hipertensión Pulmonar/etiología , Hipertensión Pulmonar/diagnóstico por imagen , Fibrosis , Circulación Colateral , Circulación Pulmonar , FemeninoRESUMEN
Peripheral nerve injury is an ongoing challenge in reconstructive surgery. Adipose-derived stem cell (ADSC) application is reported to improve nerve regeneration. In the present study, we evaluated the potential benefit of 34a-ADSCs for never regeneration. Lentiviral vectors containing miRNA-34a were constructed and ADSCs were transduced. The obtained 34a-ADSCs were used to regenerate the sciatic nerve in surgically induced sciatic nerve injury rat model. Sprague-Dawley (SD) rats were randomly divided into two groups, a 34a-ADSC group and an Lv-ADSC group. Functional nerve recovery was assessed by walking track analysis at 12 weeks after surgery. In addition, histology, including light microscopy and transmission electron microscopy, and immunohistochemistry, was utilized to investigate the nerve repair effects of 34a-ADSC. Results showed that reconstruction of the injured sciatic nerve had been significantly enhanced by restoration of nerve continuity and functional recovery in the 34a-ADSC group compared with the Lv-ADSC group. Furthermore, sciatic nerve conduction velocity and compound nerve action potential in the 34a-ADSC group was much higher than that in the Lv-ADSC group (30.72 ± 2.95 m/s vs. 22.73 ± 1.91 m/s, p< 0.0001; 11.93 ± 0.76 mV vs. 9.52 ± 0.53 mV, p = 0.0418). This study raises the possibility of using miRNA-34a overexpressed ADSCs as a promising alternative for nerve regeneration.