RESUMO
Objective To investigate the effectiveness,safety of the percutaneous transluminal angioplasty and stenting(PTAS) in the management of the vertebrobasilar stenosis.Methods From April 2003 to June 2004,the PTAS was performed in 28 patients with the vertebrobasilar stenosis.Results Among the 28 patients,the unilateral significant stenosis of the dominant vertebral artery was found in 18 patients,the bilateral stenosis of the vertebral artery in 4 patients,the tandem stenosis of the vertebral artery in 1 patient,the stenosis of the basilar artery in 2 patients.According to Mori's division,the type A occurred in 24 patients,the type B in 3 patients,the type C in 1 patient.The successful rate of stent implantation was 100% without any serious complication.Twenty-eight patients underwent PTAS with a mean pre-procedural vertebrobasilar stenosis of 81.3% and the residual stenosis was less than 10%.Over a mean 6-month follow-up in 17 patients,according to Malek's scale,the scale 1 was in 15 patients,the scale 2 in 2 patients.No restenosis was in 3 patients by the cerebral angiography.Conclusion PTAS in the management of the vertebrobasilar stenosis is a safe and effective method.Meanwhile,PTAS may alleviate the vertebrobasilar ischemia and prevent stroke of the vertebrobasilar system.
RESUMO
38 cases of Benign Monoclonal Gammopathy (BMG) representing 17.9% were screened from 212 cases of M-proteinemia by laboratory examinations. Among the 38 cases, 17 cases had increase of IgG, another 17 cases of IgA and 4 cases of IgM. Their average M-proteins were 1.42, 0.88 and 1.84 g/dl respectively.The salient points of differential of benign or malignant M-proteinemia were also discussed. The recommended sequential laboratory diagnostic procedure of BMG were as follows: tatol serum protein determination, plasma protein zone electrophresis, urine protein analysis, immunoglobulin quantitation and immunoelectrophresis or selective electrophresis.
