Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Introduction: Reconstruction of craniofacial defects can be carried out with autogenous tissue (calvarium, rib, iliac crest), allogeneic implants (AAA-bone, lyophilized cartilage) or alloplastic material (methacrylate, hydroxyapatite, titanium implants and mesh systems). Selection of the implant material used for reconstruction is still controversial. Material and Methods: At the Department of Oral and Maxillofacial Surgery, Kantonsspital Luzern, 20 patients with defects in the craniofacial and/or orbito-ethmoidal region have been treated using titanium micro-mesh between 1991 and 1998. Two different mesh systems, micro-titanium augmentation mesh and dynamic mesh, have been used for bony reconstruction in non load-bearing areas. The defects were caused by acute trauma, osteomyelitis of the frontal bone and previous operations. The titanium micro-mesh was used with the following indications: (1) immediate reconstruction in the primary treatment of comminuted fractures with bone loss in non load-bearing areas, (2) treatment of contour irregularities (possibly in combination with bone or cartilage grafts). All patients were followed up clinically and radiographically at quarterly intervals for a year. Results: No wound infections, exposures or loss of the mesh have been observed. Long-term stability of the reconstructions was excellent. When walls of the paranasal sinuses were reconstructed complete repneumatisation took place. Conclusions: Advantages of this reconstructive technique are: (1) universal applicability (craniofacial, orbital, sinus defects, comminuted fractures); (2) stable 3-D reconstruction of complex anatomic structures were easily performed; (3) immediate availability with no donor site morbidity as bone or cartilage grafts were not necessary; (4) combination with bone or cartilage grafts is possible; and (5) very low susceptibility to infection. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.
...
PMID:Long-term results following reconstruction of craniofacial defects with titanium micro-mesh systems. 1130 83

The case of an 86-year-old man with an infected abdominal aortic aneurysm (AAA) that developed suddenly over 3 weeks is presented here. Previous reports on the diagnosis of infected AAA have focused mainly on the findings of single computed tomography (CT). These include the presence of a saccular aneurysm with an irregular lumen, perianeurysmal fluid, gas and/or hematoma, osteomyelitis in adjacent vertebral bodies, disruption of intimal calcification, and obscuring of the aortic wall. Our case report presents a useful diagnostic technique for the diagnosis of infected AAA, emphasizing the importance of serial CT for suspected cases, even if the initial scan does not demonstrate the findings listed above.
 ...
PMID:Infected abdominal aortic aneurysm presenting with sudden appearance: diagnostic importance of serial computed tomography. 1166 47

We describe a case of a 63-year-old man with chronic-contained rupture of an abdominal aortic aneurysm at the site of prior graft repair of the aneurysm. Initially misinterpreted as osteomyelitis on the basis of CT findings, this chronic-contained rupture of the abdominal aorta eroding the vertebrae was preoperatively diagnosed at MR imaging and confirmed at surgery. A conventional angiogram failed to show the pseudoaneurysm. Owing to a major difference in the management of a contained aortic aneurysm rupture versus that for osteomyelitis, MR imaging with CT or MR angiography is recommended before any operative or invasive procedure.
 ...
PMID:Vertebral mass resulting from a chronic-contained rupture of an abdominal aortic aneurysm repair graft. 1167 78

A 73-year-old male patient presented with a pulsating abdominal mass and intractable low back pain for several days. Magnetic resonance imaging revealed an infected abdominal aortic aneurysm invading the second, third, and fourth lumbar vertebrae. He underwent radical debridement of the infected aneurysm with reconstruction using vascular bypass, partial corpectomy of the L2 to L4 vertebrae, anterior reconstruction with autogenous fibular shaft, and posterior instrumentation with posterolateral fusion. Culture of the necrotic tissues grew oxacillin-resistant Staphylococcus aureus. He received intravenous vancomycin infusion for 4 weeks and oral ciprofloxacin for 6 months postoperatively. After a 15-month follow-up, no apparent signs of further infection were noted. C-reactive protein and erythrocyte sedimentation rate returned to normal during follow-up. No neurologic symptoms other than mild low back soreness were noted. The stability of the lumbar spine was maintained using long segment reconstruction with autogenous fibula shaft and posterior instrumentation along with posterolateral fusion. Infected aortic aneurysm with vertebral osteomyelitis is a rare clinical entity. Prompt diagnosis and adequate treatment are essential.
 ...
PMID:Osteomyelitis of multiple lumbar vertebrae associated with infected aortic aneurysm: a case report. 1460 25

Staphylococci can cause a wide spectrum of infections, including endocarditis, osteomyelitis, and sepsis, which is reflected by the numerous virulence factors they produce, among them a recently identified new class of adhesins, namely, the multifunctional autolysins/adhesins. Here we report the identification and molecular characterization of Aaa, a novel autolysin/adhesin from Staphylococcus aureus. The gene encoding Aaa was cloned from the clinical isolate Staphylococcus aureus 4074. DNA sequence analysis revealed that aaa encodes a deduced protein of 334 amino acids with a predicted molecular mass of 35.8 kDa. Aaa contains three N-terminal repetitive sequences that comprise features of a peptidoglycan-binding domain, the LysM domain. The expression of aaa by Escherichia coli and its subsequent characterization revealed that Aaa possesses bacteriolytic activity as well as adhesive properties, such as binding to extracellular matrix proteins. Real-time biomolecular interaction analysis demonstrated that the interaction of Aaa with fibrinogen, fibronectin, and vitronectin is dose dependent and saturable and occurs with a high affinity. Furthermore, we demonstrate that Aaa binds to the Aalpha and Bbeta chains of fragment D of fibrinogen. Immunofluorescence microscopy revealed that Aaa is located at the cell surface. Finally, an aaa knockout mutant showed reduced adherence to surface-adsorbed fibrinogen and fibronectin, strongly suggesting a role for Aaa in the colonization of host factor-coated polymer surfaces and/or host tissue.
 ...
PMID:The multifunctional Staphylococcus aureus autolysin aaa mediates adherence to immobilized fibrinogen and fibronectin. 1604 Sep 92

Most adults in the United States will experience an episode of back pain at some point during their lifetime. Most will present to their primary care physician for evaluation and treatment. Many patients have non-life-threatening etiologies and recover within 4 to 6 weeks. A small percentage, however, have back pain due to a potentially life-threatening emergency. AD,rupturing AAA, SEM, cauda equina syndrome, vertebral osteomyelitis,and SEA are just some of the medical emergencies that can present with back pain. Clinical suspicion for these diagnoses begins with a thorough history and physical examination. It is imperative that the office-based physician search for and accurately identify any red flag within the history or physical examination. Appropriate laboratory studies and diagnostic imaging are obtained based on the suspected etiology.
 ...
PMID:Back pain emergencies. 1647 2

Infected aortic aneurysm is an uncommon life-threatening disease. A 68-year-old man had a history of type 2 diabetes mellitus and repeated urinary tract infections. He presented with fever, chills, low back pain, leukocytosis, and Salmonella group B bacteremia. For evaluation of suspected lumbar vertebral osteomyelitis, a 3-phase bone scan and a gallium-67 scan were performed. An abdominal aortic aneurysm was noted incidentally on the blood flow and blood pool phase images. Gallium-67 scan demonstrated increased radioactivity within the soft tissues surrounding the aneurysm, which was suggestive of an infected abdominal aortic aneurysm. The previously unsuspected infected abdominal aortic aneurysm was confirmed by computed tomography.
 ...
PMID:Detection of an infected abdominal aortic aneurysm with three-phase bone scan and gallium-67 scan. 1835 80

Acute low back pain is one of the most frequent reason for an emergency or primary care physician visit. Up to 90% of all adults will experience an episode of back pain at some point during their lifetime. Although the majority of patients have uncomplicated benign presentation and 80-90% recover within 4 to 6 weeks, there is a small subset who has an underlying potential life-threatening etiology. Among them are aortic dissection, ruptured abdominal aortic aneurysm, vertebral osteomyelitis, spinal epidural abscess and the cauda equina syndrome (CES). The latter entails a compression of the nerve roots of the cauda equina. These patients usually present post-traumatically with the clinical triad of saddle anesthesia, bowel or bladder dysfunction and muscular weakness of the lower extremeties. A delayed diagnosis can result in a significantly increased morbidity. Therefore, early diagnosis and the initiation of the appropriate therapeutic steps are essential. A thourough anamnesis and physical examination are leading to the suspected diagosis. Below, clinical presentation, diagnosis and relevant treatment of the CES are discussed.
 ...
PMID:[Emergency scenario: cauda equina syndrome--assessment and management]. 1854 37

Despite immediate open surgery, aortoenteric fistula (AEF) remains a highly lethal condition. Endovascular management is widely employed, although there is no agreement on its role as a definite treatment or, because of a high incidence of recurrent bleeding and sepsis, as a bridge to open repair. Two cases of secondary AEFs after distant elective abdominal aortic aneurysm repair are presented. The first patient was a 76-year-old man and the second one a 70-year-old man. Both patients presented with hematemesis, had no signs of sepsis and were successfully managed with endovascular surgery, using aortic cuff extenders. Postoperative course was uneventful for both patients who were discharged on long-term antibiotics. However, during follow-up the first patient was readmitted four times; twice due to infection (at 2 and 6 months, respectively) and twice due to recurrent bleeding (at 5 and 9 months, respectively). The last episode of bleeding was managed with axillobifemoral bypass grafting, removal of the prostheses and closure of the aortic stump and the duodenal defect, but the patient died on the 5th postoperative day from multiple organ failure. The second patient remained asymptomatic until the 16th postoperative month when he developed lumbar spine osteomyelitis as a direct extension of graft infection and was deemed inoperable due to multiple comorbidities. Endovascular management of AEF can achieve satisfactory short-term results. Due to the high rate of recurrent bleeding and sepsis it should be used as a temporary measure and a bridge to open repair, whenever this is feasible.
 ...
PMID:Endovascular management of aortoenteric fistulas with aortic cuff extenders: report of two cases. 2161 14

Aortoenteric fistulas (AEFs) are a rare complication of infrarenal abdominal aortic aneurysm repair. They occur in <1% of aortic grafting procedures, result from graft defects, foreign bodies, and trauma, and are associated with a high mortality rate. We report a complex AEF associated with vertebral body osteomyelitis, likely secondary to tuberculous infection. A 78-year-old man presented with a 2-week history of abdominal pain, fever, and anemia. Past surgical history is significant for open repair of infrarenal abdominal aortic aneurysm followed later by an endovascular repair of a proximal para-anastomotic aneurysm. Computed tomography angiography revealed air in the aneurysm sac, without evidence of endoleak. The posterior aspect of the aneurysm was noted to be in continuity with a destructive osteomyelitis of the second lumbar vertebral body and an adjacent psoas abscess. Percutaneous drainage revealed purulent fluid containing mixed enteric flora. With fluoroscopic guidance, injection of contrast in the aortic sac drainage catheter demonstrated complex fistulous communications from the aortic sac to the overlying small intestine. After a course of drainage, antibiotic therapy, and parenteral nutrition, the patient underwent a transperitoneal repair of the AEF with duodeno-duodenectomy and wide debridement of the aortic sac and Dacron graft. Pathology revealed giant cell granulomas, highly suggestive of tuberculosis.
 ...
PMID:Aortic endograft infection with aortoduodenal fistula associated with adjacent vertebral body mycobacterial osteomyelitis (Pott's disease). 2230 65


1 2 Next >>