Case report: Liver PEComa after kidney transplantation in recipient with tuberous sclerosis complex.

Introduction: Perivascular epithelioid cell tumors (PEComa) are rare tumors of mesenchymal origin that exhibit perivascular epithelioid cell phenotype. One of its most common localizations is uterus, whereas only a few studies reported PEComa localization as liver. There is a correlation between the presence of PEComa and tuberous sclerosis complex (TSC).

Combined Liver-Pancreas Transplantation as Novel Treatment for Patient With Cystic Fibrosis: A Case Report.

Background: A 21-year-old woman diagnosed with cystic fibrosis developed cirrhosis, exocrine pancreatic insufficiency, and insulin-dependent diabetes mellitus. The patient qualified for double organ liver-pancreas transplantation beyond typical indications. The respiratory symptoms of cystic fibrosis were moderate and well-treated.

Thioredoxin regulates the redox state and the activity of the human tRNA ligase complex.

The mammalian tRNA ligase complex (tRNA-LC) catalyzes the splicing of intron-containing pre-tRNAs in the nucleus and the splicing of mRNA during the unfolded protein response (UPR) in the cytoplasm. We recently reported that the tRNA-LC coevolved with PYROXD1, an essential oxidoreductase that protects the catalytic cysteine of RTCB, the catalytic subunit of the tRNA-LC, against aerobic oxidation. In this study, we show that the oxidoreductase Thioredoxin (TRX) preserves the enzymatic activity of RTCB under otherwise inhibiting concentrations of oxidants.

The effect of electron correlation on the conformational space of melatonin.

The pineal gland hormone melatonin regulates several physiological processes including circadian rhythm and also alleviates oxidative stress-induced degenerative diseases. In spite of its important biological roles, no high level ab initio conformational study has been conducted to reveal its structural features. In this work, the conformational flexibility of melatonin was investigated using correlated ab initio calculations.

Free-floating thrombus of the carotid artery: literature review and case reports.

Background: Free-floating thrombus (FFT) of the carotid artery is an uncommon entity that usually presents as an acute emergency. Management is based on case reports and series because the natural history and optimal treatment are unknown. This study was conducted to systematically review the world literature in an attempt to better understand FFT, its presentation, distribution, management, and outcome.

Infrainguinal endovascular procedures should be reserved for patients who do not have good open surgical options.

This article is the result of a debate. The motion proposed was "Infrainguinal endovascular procedures should be reserved for patients who do not have good open surgical options.'' Arguments in favor of the motion were offered by Daniel J.

Neovascularization in acute venous thrombosis.

Objective: The aim of this study was to describe the phenomenon of arteriovenous fistula (AVF) formation in venous thrombus.

Methods: Patients referred to the vascular laboratory for evaluation for deep venous thrombosis were included. Duplex ultrasound scanning was used to detect flow within the thrombus.

Arteriovenous access: managing common problems.

The creation and maintenance of hemoaccess occupies a significant portion of most vascular and general surgery practices. In this article, the methods used to detect hemoaccess at risk for failure and the endovascular and surgical techniques used to prolong or restore their patency are reviewed. Also, the management of hemoaccess infection, aneurysmal degeneration, false aneurysm formation, and symptomatic arterial steal syndrome are described.

The vascular surgeon's role in risk factor modification: results of a survey.

Purpose: Comprehensive care of vascular patients includes attention to atherosclerotic risk factor management. We surveyed members of the Midwestern Vascular Surgical Society (MVSS) with the following objectives: (1) to determine the usual practice pattern with respect to risk factor inquiry, screening, and intervention, (2) to determine which risk factors vascular surgeons believe are important for patients with peripheral arterial disease, and (3) to determine the vascular surgeon's confidence for management of each risk factor.

Methods: A survey was mailed to all MVSS members and two additional notifications were sent for initial nonresponders.

Neovascularization after great saphenous vein ablation.

Objective: To determine the prevalence, distribution, and flow characteristics of intraluminal neovascularization in patients undergoing great saphenous vein (GSV) endovenous laser (EVLT) or radiofrequency ablation (RFA).

Methods: Duplex ultrasound (DU) was performed in patients undergoing EVLT or RFA before, during, and after their procedures. Follow-up included assessment for deep venous thrombosis and obliteration.

Are your arteries older than your age?

Purpose: To determine the effect of age and atherosclerotic risk factors on the carotid intima-media layer thickness and morphology characteristics.

Patients And Methods: Three groups of subjects were included in the study: Individuals with atherosclerotic risk factors including a family history of CHD, hypertension, hyperlipidemia, diabetes, and/or smoking (group A, n=180), age- and sex-matched healthy subjects without risk factors (group B, n=60) and a group of significantly younger volunteers (group C, n=25). The carotid artery was imaged longitudinally with B-mode ultrasound.

To what extent has endovascular aneurysm repair influenced abdominal aortic aneurysm management in the state of Illinois?

Purpose: This study was performed using population-based data to determine the changing trends in the techniques for abdominal aortic aneurysm (AAA) repair in the state of Illinois during the past 9 years and to examine the extent to which endovascular aneurysm repair (EVAR) has influenced overall AAA management.

Methods: All records of patients who underwent AAA repair (1995 to 2003 inclusive) were retrieved from the Illinois Hospital Association COMPdata database. The outcome as determined by in-hospital mortality was analyzed according to intervention type (open vs EVAR) and indication (elective repair vs ruptured AAA).

Inferior vena cava endograft to control surgically inaccessible hemorrhage.

Open surgical repair of retrohepatic inferior vena cava (IVC) injuries can be technically difficult, usually requiring extensive hepatic mobilization and associated with significant morbidity. We report a case of uncontrolled hemorrhage from the retrohepatic inferior vena cava (IVC), which occurred during attempted resection of a large retroperitoneal leiomyosarcoma, and was successfully managed using an endoluminal stent-graft. This case demonstrates that endoluminal grafts can be successfully applied to control life-threatening hemorrhage arising from lesions in the retrohepatic IVC that are otherwise extremely difficult or inaccessible to direct surgical repair.

What are the long-term results of conventional open surgical repair of abdominal aortic aneurysms?

Purpose: To determine the long-term results of conventional open surgical repair of abdominal aortic aneurysms (AAAs) and the prevalence of late arterial abnormalities.

Methods: CT scan follow-up was obtained between 8 and 9 years after elective AAA repair on a cohort of patients enrolled in the Canadian Aneurysm Study, a registry that originally consisted of 680 patients. A request for CT follow-up was sent to the responsible surgeon in 1994 when 251 patients were alive and available.

Aortic and iliac reconstruction after kidney transplantation: experience with an algorithm for renal protection.

Advances in renal transplantation have allowed for improved survival and an increased age of recipients. This has resulted in more aortoiliac lesions requiring intervention. The optimal approach for renal protection during aortoiliac surgery remains unknown.

How do vascular surgeons perceive atherosclerotic risk factor management?

The specific objectives of this report were to determine (1) the usual practice of vascular surgeons with respect to risk factor inquiry and intervention, (2) which risk factors are endorsed by vascular surgeons as being very important in the management of patients with PAD, and, finally, (3) which risk factors vascular surgeons are confident in managing.

Long-term follow-up of management of failing in situ saphenous vein bypass grafts using endovascular intervention techniques.

Purpose: To report the long-term follow-up of previously reported cases of salvaging failing or failed in situ bypass grafts using endovascular techniques, to include previously unreported cases, and to include the results of thrombolysis for the salvage of occluded in situ venous bypass grafts.

Materials And Methods: Between 1985 and 1995, 352 patients underwent distal bypass via the in situ saphenous vein. Seventy-three of these patients underwent endovascular interventions for (i) graft stenoses (65 lesions in 40 patients) treated by balloon angioplasty (PTA), (ii) AV residual fistulas to veins (AVF) (23 patients) occluded by coil embolotherapy, (iii) graft occlusion (21 occluded grafts in 19 patients) treated by catheter-directed high-dose thrombolytic infusion and PTA or surgical revision of uncovered stenoses, and (iv) retained valve leaflets causing stenoses (five patients) treated by valvectomy and/or PTA.

Thoracofemoral bypass: proximal exposure and tunneling.

Although axillobifemoral bypass is the usual alternative to the standard aortobifemoral bypass (ABF) when the latter is contraindicated because of comorbid operative risk or when the transabdominal approach is considered hazardous, a more proximal aortic inflow source is desirable in selected low-risk patients. The results with these more proximal aortic procedures are more durable than with axillobifemoral bypass and approach those that can be achieved with an ABF. This article reviews some of the specific technical details of descending thoracofemoral bypass, specifically, the techniques for proximal exposure and tunneling.

Saccular aortic aneurysms.

Most vascular surgeons believe that saccular aortic aneurysms have a more ominous natural history than the typical fusiform aneurysm, although this is not documented in the literature. Expeditious repair is indicated for symptomatic saccular aneurysms, and intervention is usually advocated even when they are asymptomatic because of the general belief that their unique shape predisposes them to rupture. The objective of this report is to review the presentation and surgical management of this uncommon pathology.

A practical approach to vascular access for hemodialysis and predictors of success.

Purpose: The long-term results and predictors of success for vascular access at The Toronto Hospital were studied. This report describes the access program and emphasizes the role of the vascular access coordinator.

Methods: A total of 384 consecutive patients underwent 466 vascular access procedures.

The value of late computed tomographic scanning in identification of vascular abnormalities after abdominal aortic aneurysm repair.

Purpose: The purpose of this study was to determine the prevalence of late arterial abnormalities after aortic aneurysm repair and thus to suggest a routine for postoperative radiologic follow-up examination and to establish reference criteria for endovascular repair.

Methods: Computed tomographic (CT) scan follow-up examination was obtained at 8 to 9 years after abdominal aortic aneurysm (AAA) repair on a cohort of patients enrolled in the Canadian Aneurysm Study. The original registry consisted of 680 patients who underwent repair of nonruptured AAA.