Chronic traumatic thoracic aortic aneurysms-results of endovascular treatment. Fourteen-year single-center experience.

AIM: Chronic traumatic thoracic aneurysms are results of blunt trauma of the chest during motorcar accident. Treatment of choice is the endovascular procedure with stent-graft. METHODS: Between 2000-2012 in General and Thoracic Surgery Department 30 patients with post-traumatic aneurysms were operated. In all cases aneurysm was located below left subclavian artery and in 63% developed during road traffic accident. RESULTS: All patients were operated on with 100% technical success and no device failure was noticed. None of patients died during the endovascular procedure and no serious complications like spinal cord ischemia was observed. In one (3%) case, where left subclavian artery was covered, stroke was diagnosed treated conservatively. CONCLUSION: At long-term follow-up, one endoleak type IA was found, solved with balloon-plasty. Two patients died due to cardiac diseases.

Severity of chronic venous disease and anatomic distribution of valvular incompetence.

AIM: The aim of the study was to examine the association between anatomical patterns of valvular incompetence and the severity of venous insufficiency in patients with chronic venous disease. METHODS: A total of 211 consecutive patients (70% females) were referred from the vascular clinic to undergo a Doppler ultrasound examination. The extent and anatomical pattern of valvular incompetence was noted using CEAP criteria. Clinical classes C1-6 for each patient were expressed as a string of binary digits and translated into a clinical ordinal score. In this way, higher grade signs were not obscuring lower grade signs and non-parametric analysis could include a wider range of clinical data. RESULTS: Varicose veins were the main complaint in 33% of the patients. 54% had at least one incompetent deep vein, 80% had incompetent perforators. Clinical severity increased with age, but was not related with gender. The presence of deep venous incompetence did not account for significant increase in signs. Superficial incompetence, especially if involving two or more segments, was most commonly seen in patients with severe signs. A linear regression model for clinical ordinal score identified non-saphenous superficial reflux and small saphenous vein reflux as the strongest predictors of clinical severity. CONCLUSION: CEAP clinical classes can be translated into a clinical ordinal score, which is useful for data analysis. In a group with chronic venous disorders, clinical status is associated mostly with the condition of superficial and calf perforating veins.

Extra structurally abnormal chromosomes (ESACs)--presentation of 10 new cases.

BACKGROUND: The goal of the presented studies as a retrospective reliability assessment of classical banding cytogenetic studies and of prognosing epicrises in a group of 14 cases, affected with additional marker chromosomes. MATERIAL AND METHODS: Having collected the study material from peripheral blood, by means of trophoblast biopsy or amniocentesis, cytogenetic preparations were obtained, allowing for pre- or postnatal evaluation of the karyotype. A panel of auxiliary cytogenetic techniques accompanied the routine CTG protocol. RESULTS: In a group of 6875 persons with recommendations to pre- or postnatal cytogenetic diagnostics, 14 (0.2%) cases of ESACs were diagnosed. In 5 cases of DA/DAPI(+) inv dup (15) as observed. A presence of polymorphic interstitial RHG(+) band was found within the marker chromosome. The measured size of that band allowed associating it with either the presence or the absence of pathological signs. In 9 cases of ESACs, DA/DAPI(-), the application of banding techniques (NOR and CBG) allowed to discover bisatellite heterochromatic ESACs in 6 cases (2 non-mosaic and 4 mosaic). In three other mosaic and non-satellite cases of ESACs, a 'genetic inactivity' of the marker chromosome was observed in one case, while a 'genetic activity' was ascertained in two cases. The 'activity' of marker chromosomes was studied by means of replication banding techniques. CONCLUSIONS: At the time of the outburst of molecular techniques, still up-to-date is the use of classical banding techniques and of the replication techniques, allowing DNA replication kinetics studies at the level of single band.

Cytogenetic and molecular identification of a de novo direct duplication of the long arm of chromosome 4(q21.3-->q31.3).

We report on a 3-year-old boy with moderate developmental retardation, microcephaly, and malformations of ears, lids, mouth, and thumbs. Cytogenetic analysis demonstrated a direct duplication of chromosome subregion 4(q21.3-->q31.3). Confirmation of this specific rearrangement was performed by fluorescent in situ hybridization (FISH) with a chromosome painting probe and by means of quantitative Southern hybridization with DNA probes localized within the chromosome 4 region presumed to be duplicated.

[Diagnostic difficulties and threatening complications in arterial hypertension caused by combined vascular anomaly of the abdominal aorta]. / Trudnosci diagnostyczne i zagrazajace powiklania w nadcisnieniu tetniczym, spowodowanym zlozona wada naczyniowa brzusznego odcinka aorty.

A case is described of hypertension in a boy aged 8 years, admitted for elucidation of its cause is described. Abdominal aortography demonstrated a combined vascular anomaly-stenosis of the abdominal aorta and renal arteries.

De novo direct tandem duplication of the short arm of chromosome 7(p21.1-p14.2).

We report on a 6-year-old boy with moderate developmental retardation and unusual dermatoglyphics. Cytogenetic analysis demonstrated a duplication of chromosome sub-region 7p21.2-p14.2. Confirmation of the specific duplicated region was determined by quantitative Southern blotting by using a DNA fragment previously localized to the portion of chromosome 7 thought to be duplicated. This patient did not have the internal malformations seen with other dup(7p) patients.

Recurrences after surgical treatment of patients with post-thrombotic syndrome of the lower extremities.

A Linton flap operation was performed in 148 patients with post-thrombotic syndrome of the lower extremities. One-hundred and five patients were followed up from 6 months to 10 years and 14.5% of cases had recurrent ulcers. The most common causes of recurrence was further deep venous thrombosis or remaining incompetent perforating veins. All patients with a recurrence of their ulcer had a further operation and incompetent perforating veins were ligated and divided with good clinical results.