bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carotid Plaque Characterization Using Digital Image Processing and its Potential in Future Studies of Carotid Endarterectomy and Angioplasty
Authors: Biasi Giorgio M. , Mingazzini Paolo M. , Baronio Lucia , Piglionica Maria Rosa , Ferrari Stefano A. , Elatrozy Tarek S. , Nicolaides Andrew N. 
Published: March 2015

Purpose: To corroborate the validity of a computerized methodology for evaluating carotid lesions at risk for stroke based on plaque echogenicity. Methods: The records of 96 carotid endarterectomy patients (59 men; median age 69.5 years, range 52 to 83) with stenoses > 50% were studied retrospectively. Forty-one patients (43%) had been symptomatic preoperatively. All patients had undergone computed tomography (CT) to detect infarction in the carotid territory and a duplex scan to measure carotid stenosis. Plaque echogenicity was analyzed by computer, expressing the echodensity in terms of the gray scale median (GSM). The incidence of CT-documented cerebral infarction was analyzed in relation to symptomatology, percent stenosis, and echodensity. Results: Symptoms correlated well with CT evidence of brain infarction: 32% of symptomatic patients had a positive CT scan versus 16% for asymptomatic plaques (p = 0.076). The mean GSM value was 56 ± 14 for plaques associated with negative CT scans and 38 ± 13 for plaques from patients with positive scans (p < 0.0001). However, there was no difference in the GSM value between plaques with > or < 70% stenosis. Furthermore, the incidence of CT infarction was 40% in the cerebral territory of carotid plaques with a GSM value < 50 and only 9% in those with a GSM > 50 (p < 0.001). Conclusions: Computerized analysis of plaque echogenicity appears to provide clinically useful data that correlates with the incidence of cerebral infarction and symptoms. This method of analyzing plaque echolucency could be used as a screening tool for carotid stent studies to identify high-risk lesions better suited to conventional surgical treatment.
Combined Surgical and Endovascular Removal of Thrombus Entirely Occluding a Bifurcated Aortic Stent-Graft
Authors: Rückert Ralph I. , Romaniuk Paul , Rogalla Patrik , Thieme Torsten , Umscheid Thomas , Stelter Wolf J. , Müller Joachim M. 
Published: March 2015

Purpose: To explore a method combining interventional, endovascular, and conventional surgical techniques for treating a completely occluded bifurcated stent-graft after endovascular aortic aneurysm repair. Methods and Results: A 60-year-old patient underwent endovascular repair of an abdominal aortic aneurysm (AAA) with a Talent bifurcated stent-graft. Five months later, after chronic thrombotic occlusion of the right iliac limb, he presented with acute occlusion of the entire stent-graft. Local intra-arterial infiltration thrombolysis successfully reconstituted flow through the main aortic segment and left iliac limb. With a combination of conventional surgical and intraoperative endovascular procedures, thrombectomy and recanalization of the right iliac limb was completed by stenting a severe stenosis of the proximal iliac limb. Conclusions: A combination of techniques may be essential for successful management of thrombotic complications after endovascular AAA repair.
Laparoscopic Aortic Aneurysm Resection
Authors: Edoga John K. , James Kevin V. , Resnikoff Michael , Asgarian Kourosh , Singh Deepak , Romanelli John 
Published: March 2015

Purpose: To describe a laparoscopic technique for resection of infrarenal abdominal aortic aneurysms (AAAs). Methods: The operation is based on the principle of retroperitoneal reinforced staple exclusion of the aneurysm sac with aortobifemoral or aortoiliac bypass using gas and gasless laparoscopic techniques. Patients were eligible for this procedure if their infrarenal AAAs (with or without iliac artery involvement) were considered appropriate for surgical resection; however, renal or other visceral arterial stenoses, aneurysmal disease requiring surgical treatment, and/or aneurysms of the hypogastric arteries excluded patients from laparoscopic AAA resection. Results: Of 31 candidates for this procedure, 9 were excluded owing to high surgical risk. Twenty-two patients (16 males; age range 62 to 88 years) were deemed appropriate for the laparoscopic procedure. Maximum aneurysm diameter ranged from 4.0 to 8.0 cm. The operation was completed successfully in 20 (91%) patients. Two (9%) deaths in high-risk patients admitted early to the study occurred within 30 days of surgery. The only major complication was an injured ureter, for which a nephrectomy was performed. Comparison to a historical cohort of conventionally treated patients showed that the study group needed less ventilator support, had shorter intensive care and hospital stays, and resumed diet earlier despite relatively prolonged anesthesia and aortic clamping times. Conclusions: The laparoscopic approach to infrarenal AAAs appears feasible, with several potential advantages in low- and moderate-risk patients. Once the technique is optimized, randomized prospective studies will be needed to verify the apparent benefits demonstrated by these initial patients.
Subfascial Perforator Vein Ablation: Comparison of Open versus Endoscopic Techniques
Authors: Sato Dean T. , Goff Charles D. , Gregory Roger T. , Walter Barry F. , Gayle Robert G. , Parent F. Noel , DeMasi Richard J. , Meier George H. , Wheeler Jock R. 
Published: March 2015

Purpose: To compare the outcomes and complications of open (OSPS) versus endoscopic subfascial perforator surgery (SEPS) for treatment of chronic venous insufficiency. Methods: Data were retrospectively collected on 25 patients who underwent 27 SEPSs from February 1996 to August 1997 and from 22 patients who underwent 29 OSPSs between March 1978 and May 1993. Outcomes were evaluated for postoperative complications, ulcer healing, recurrence, and venous dysfunction scores on the last follow-up for the SEPS group and at 1-year follow-up for the OSPS group. Results: The 2 groups were similar in age, sex, history of previous venous surgery, healed or active ulcers, etiology, deep venous incompetency, pathophysiology, and venous refill times. Eighteen (90%) of 20 active ulcers in the SEPS group healed with recurrences in 5 (28%) limbs at 7.5 ± 5.4-month follow-up. All 19 ulcers in the OSPS group healed, with recurrences in 13 (68%) limbs at 35 ± 35-month follow-up. Clinical venous dysfunction scores showed significant improvement following SEPS (10.0 ± 3.6 to 5.4 ± 4.1, p < 0.001) and OSPS (10.0 ± 3.2 to 6.7 ± 3.6, p < 0.001) with no significant difference between groups. Both groups also had significant improvement in anatomical and disability scores. There was no postoperative mortality in either group. The OSPS group had significantly more wound complications (45%) than the SEPS group (7%) (p < 0.005). The hospital stay and readmission rate for wound problems were also higher in the OSPS group. Conclusions: The early outcome showed equal improvement in clinical venous dysfunction scores in the 2 groups, but with significantly fewer complications in the SEPS group. Although the long-term durability of the endoscopic approach has not been determined, the short-term results would favor SEPS for treatment of severe venous insufficiency when perforator incompetence is a significant component.
Percutaneous Stenting of the Internal Carotid Artery: The European CAST I Study
Authors: Bergeron Patrice , Becquemin Jean-Pierre , Jausseran Jean-Michel , Biasi Giorgio , Cardon Jean-Marie , Castellani Lucien , Martinez Robert , Fiorani Paolo , Kniemeyer Peter 
Published: March 2015

Purpose: To report the results of a multicenter safety trial of percutaneous carotid stenting performed by vascular surgeons. Methods: Symptomatic or asymptomatic patients ≥ 65 years of age with internal carotid artery (ICA) stenoses ≥ 70% and ≤ 2-cm long were eligible for enrollment. The procedures were performed in an operating room with the choice of anesthesia and the percutaneous access site at the discretion of the surgeon. Only Palmaz stents were used. Results: From January 1, 1996 to December 31, 1997, 99 patients (74 men, mean age 70 years, range 51 to 94) were enrolled in the study. More than half (57 of 99 patients) were asymptomatic. The direct cervical approach was used predominantly (97%). Three (3%) cases were converted to surgery for inability to access the artery or deploy the stent (technical success 97%). No perioperative death or myocardial infarction was reported. Six (6%) procedural complications included 1 reversible arterial spasm, 2 dissections, 1 cervical hematoma, and 2 residual stenoses. One neurological event reversed within 7 days(1% minor stroke rate) and 4 (4%) transient ischemic attacks resolved within 24 hours. One (1%) asymptomatic early occlusion occurred 2 days postoperatively. No neurological event was observed in the 1- to 24-month follow-up (mean 13 months). Two (2%) patients died of nonprocedurally related causes. No stent compression was seen, but 1 asymptomatic occlusion and 3 asymptomatic, non-flow-limiting restenoses (2 < 40%, 1 at 60%) were found within 1 year (3% restenosis rate on an intention-to-treat basis). Patency was 98% at 1 year. Conclusions: The results of this trial support the contention that carotid stenting of short ICA lesions can be performed with a low neurological complication rate.
Endoluminal Repair of Aneurysms Containing Ostia of Essential Branch Arteries: An Experimental Model
Authors: Wisselink Willem , Abruzzo Frederick M. , Shin Chung K. , Ramirez Jose R. , Rodino William , Kirwin Jon D. , Panetta Thomas F. 
Published: March 2015

Purpose: To examine experimentally the feasibility of transfemoral endoluminal repair of aneurysms containing the ostia of essential branch arteries. Methods: In a canine model (n = 4), suprarenal aortic aneurysms were created by suturing an artificial patch onto an anterior arteriotomy. Following a 2-week recovery period, the dogs underwent endovascular exclusion of their aneurysms using an aortic stent-graft with separate renal artery branch grafts. Outcome was evaluated using angiography, intravascular ultrasound (IVUS), Doppler flow, invasive pressure monitoring, and autopsy, respectively. Results: Successful creation and subsequent endovascular exclusion of the aneurysm using aortic stent-grafts and separate bilateral renal artery stent-grafts was achieved in all trials. Angiographically, all aneurysms were excluded from aortic flow and all renal arteries were patent at completion of the procedure. With IVUS, good graft apposition and absence of perigraft flow were demonstrated in all animals. Mean pressure in the aneurysmal sac at completion of the procedure was 40 ± 7 mmHg, compared to a mean systemic blood pressure of 105 ± 8 mmHg (p < 0.05). At autopsy, no gross intimal damage was seen in the aorta or the renal arteries, and intact aortic grafts and branch grafts without twisting, coiling, or kinking were found in all trials. Conclusions: In an acute animal model, suprarenal aortic aneurysms can be excluded from the circulation with preservation of renal flow using an endoluminally placed aortic stent-graft with separate branch grafts.
Carotid Stenting with Cerebral Protection: First Clinical Experience Using the PercuSurge GuardWire System
Authors: Henry Michel , Amor Max , Henry Isabelle , Klonaris Christos , Chati Zukaï , Masson Isabelle , Kownator Serge , Luizy François , Hugel Michèle 
Published: March 2015

Purpose: To study the feasibility and safety of carotid angioplasty and stenting using a new cerebral protection device that temporarily occludes the distal internal carotid artery (ICA). Methods: Forty-eight high-risk patients (39 men, mean age 69.1 ± 8 years, range 54 to 86) with 53 ICA stenoses underwent percutaneous angioplasty and stenting via the femoral approach under cerebral protection afforded by a 0.014-inch GuardWire balloon occlusion device. Mean stenosis was 82.1% ± 9.65% (range 70 to 96) and mean lesion length was 16.0 ± 7.5 mm (range 6 to 50). Thirty-three (62%) lesions were calcified, and 38 (72%) were ulcerated. Thirty-two (60%) of the lesions were asymptomatic. With the occlusion balloon inflated in the distal ICA, the lesion was dilated and stented. The area was cleaned by aspiration and flushed via an aspiration catheter advanced over the wire. Blood samples were collected from the external carotid artery (ECA) and analyzed to measure the size and number of particles collected. Computed tomography and neurological examinations were performed the day after the procedure. Results: Immediate technical success was achieved in all patients with the implantation of 38 Palmaz stents, 8 Expander stents, and 11 Wallstents. Carotid occlusion was well tolerated in all patients but 1 who had multiple, severe carotid lesions and poor collateralization. Mean cerebral flow occlusion time was 346 ± 153 seconds during predilation and 303 ± 143 seconds during stent placement. Total mean flow occlusion time was 542 ± 243 seconds. One immediate neurological complication (transient amaurosis) occurred in a patient who had an anastomosis between the external carotid (EC) and ICA territories. Debris was removed in all patients with a mean 0.8-mm diameter catheter. Conclusion: Cerebral protection with the GuardWire device is easy, safe, and effective in protecting the brain from cerebral embolism. Larger studies are warranted.
Relocation of the Iliac Artery Bifurcation to Facilitate Endoluminal Treatment of Abdominal Aortic Aneurysms
Authors: Parodi Juan C. , Ferreira Mariano 
Published: March 2015

Purpose: To report a surgical technique to preserve the internal iliac arteries (IIAs) and facilitate endovascular repair of abdominal aortic aneurysms (AAAs) with extensive iliac artery involvement. Technique: A new iliac artery bifurcation is created surgically through an 8-cm lower left abdominal incision by implanting the IIA onto the distal external iliac artery either directly or by using a tube graft interposition. Careful technique is required to avoid embolic complications, but after relocating the bifurcation, aortic endografting can be performed, either simultaneously or staged, depending upon patient characteristics. Conclusions: Relocation of the iliac artery bifurcation appears to be a good alternative to preserve pelvic arterial flow in selected candidates for endoluminal AAA repair.
Endovascular Repair of Abdominal Aortic Aneurysm Using a Pararenal Fenestrated Stent-Graft
Authors: Faruqi Rishad M. , Chuter Timothy A. M. , Reilly Linda M. , Sawhney Rajiv , Wall Susan , Canto Catherine , Messina Louis M. 
Published: March 2015

Purpose: To report an unusual case of endovascular abdominal aortic aneurysm (AAA) exclusion in which a fenestrated stent-graft was used to seal a proximal Type I endoleak. Methods and Results: An 84-year-old man with a 6.0-cm AAA underwent an aortomonoiliac aneurysm exclusion procedure that was complicated by a proximal endoleak. Because the patient had no right kidney, an additional stent-graft was designed to cover the right renal artery stump while preserving left renal perfusion through a fenestration in the graft material. This approach was successful in obliterating the endoleak around the proximal attachment site, but flow through the lumbar arteries remained. Conclusions: The use of a fenestrated stent-graft is feasible, but the type of fenestration in this case has limited applicability owing to the rarity of patients with suitable anatomy.
Verbal Memory and Brain Aging
Authors: Libon David J. , Preis Sarah R. , Beiser Alexa S. , Devine Sherral , Seshadri Sudha , Wolf Philip A. , DeCarli Charles , Au Rhoda 
Published: March 2015

Objective: Analysis sought to determine whether Wechsler Memory Scale-Logical Memory (LM)-correct responses and errors were related to magnetic resonance imaging (MRI) brain volume measurements. Methods: The LM immediate (LM-I) and LM delay (LM-D) free recall correct responses and related and unrelated errors were scored. Principal components analysis yielded a 3-factor solution: LM-I and LM-D correct responses, LM-I and LM-D-unrelated errors, and LM-I/-D-related errors. The MRI total cerebral brain volume, frontal brain volume, temporal horn volume (THV), and white matter hyperintensities volume (WMHIV) were obtained. Results: Increasing THV (suggesting greater regional atrophy) was associated with lower scores on the LM-correct responses factor. Extensive WMHIV was associated with higher scores on the LM-related errors factor. Conclusion: These results suggest that LM-correct responses could relate to emerging brain alterations. Longitudinal research might enhance the sensitivity of this test to identify preclinical impairment and persons at risk of mild cognitive impairment and dementia.
N-acetylcysteine infusion in preventing hepatotoxicity secondary to intravenous injection of household bleach
Authors: Eidan Anthony H , Sira James , Bellamy Mark 
Published: March 2015

We present a case of non-accidental injection of 40 ml of domestic bleach through a long-term central venous catheter (CVC) with subsequent AKI, and for the first time in the literature severe coagulopathy and acute liver injury. We detail the clinical course of events and our management plan which adds to the body of evidence for prognosis and treatment in these unusual cases.
Monitoring the Progression of Spontaneous Articular Cartilage Healing with Infrared Spectroscopy
Authors: O’Brien Megan P. , Penmatsa Madhuri , Palukuru Uday , West Paul , Yang Xu , Bostrom Mathias P. G. , Freeman Theresa , Pleshko Nancy 
Published: March 2015

Objective Evaluation of early compositional changes in healing articular cartilage is critical for understanding tissue repair and for therapeutic decision-making. Fourier transform infrared imaging spectroscopy (FT-IRIS) can be used to assess the molecular composition of harvested repair tissue. Furthermore, use of an infrared fiber-optic probe (IFOP) has the potential for translation to a clinical setting to provide molecular information in situ. In the current study, we determined the feasibility of IFOP assessment of cartilage repair tissue in a rabbit model, and assessed correlations with gold-standard histology. Design Bilateral osteochondral defects were generated in mature white New Zealand rabbits, and IFOP data obtained from defect and adjacent regions at 2, 4, 6, 8, 12, and 16 weeks postsurgery. Tissues were assessed histologically using the modified O’Driscoll score, by FT-IRIS, and by partial least squares (PLS) modeling of IFOP spectra. Results The FT-IRIS parameters of collagen content, proteoglycan content, and collagen index correlated significantly with modified O’Driscoll score ( P = 0.05, 0.002, and 0.02, respectively), indicative of their sensitivity to tissue healing. Repair tissue IFOP spectra were distinguished from normal tissue IFOP spectra in all samples by PLS analysis. However, the PLS model for prediction of histological score had a high prediction error, which was attributed to the spectral information being acquired from the tissue surface only. Conclusion The strong correlations between FT-IRIS data and histological score support further development of the IFOP technique for clinical applications, although further studies to optimize data collection from the full sample depths are required.
NKG2D expression by CD8+ T cells contributes to GVHD and GVT effects in a murine model of allogeneic HSCT
Authors: Karimi Mobin A. , Bryson Jerrod L. , Richman Lee P. , Fesnak Andrew D. , Leichner Theresa M. , Satake Atsushi , Vonderheide Robert H. , Raulet David H. , Reshef Ran , Kambayashi Taku 
Published: March 2015

Key PointsNKG2D enhances cytotoxicity and survival of CD8+ T cells, which contributes to GVHD and GVT effects after allogeneic HSCT. The temporally distinct expression pattern of NKG2D ligands may allow separation of GVHD and GVT effects by transient NKG2D blockade.
Functional outcomes in ICU – what should we be using? - an observational study
Authors: Parry Selina M , Denehy Linda , Beach Lisa J , Berney Sue , Williamson Hannah C , Granger Catherine L 
Published: March 2015

Abstract
Introduction
With growing awareness of the importance of rehabilitation, new measures are being developed specifically for use in the intensive care unit (ICU). There are currently 26 measures reported to assess function in ICU survivors. The Physical Function in Intensive care Test scored (PFIT-s) has established clinimetric properties. It is unknown how other functional measures perform in comparison to the PFIT-s or which functional measure may be the most clinically applicable for use within the ICU. The aims of this study were to determine (1) the criterion validity of the Functional Status Score for the ICU (FSS-ICU), ICU Mobility Scale (IMS) and Short Physical Performance Battery (SPPB) against the PFIT-s; (2) the construct validity of these tests against muscle strength; (3) predictive utility of these tests to predict discharge to home; and (4) the clinical applicability. This was a nested study within an ongoing controlled study and an observational study.

Methods
Sixty-six individuals were assessed at awakening and ICU discharge. Measures included: PFIT-s, FSS-ICU, IMS and SPPB. Bivariate relationships (Spearman’s rank correlation coefficient) and predictive validity (logistic regression) were determined. Responsiveness (effect sizes); floor and ceiling effects; and minimal important differences were calculated.

Results
Mean ± SD PFIT-s at awakening was 4.7 ± 2.3 out of 10. On awakening a large positive relationship existed between PFIT-s and the other functional measures: FSS-ICU (rho = 0.87, p < 0.005), IMS (rho = 0.81, p < 0.005) and SPPB (rho = 0.70, p < 0.005). The PFIT-s had excellent construct validity (rho = 0.8, p < 0.005) and FSS-ICU (rho = 0.69, p < 0.005) and IMS (rho = 0.57, p < 0.005) had moderate construct validity with muscle strength. The PFIT-s and FSS-ICU had small floor/ceiling effects <11% at awakening and ICU discharge. The SPPB had a large floor effect at awakening (78%) and ICU discharge (56%). All tests demonstrated responsiveness; however highest effect size was seen in the PFIT-s (Cohen’s d = 0.71).

Conclusions
There is high criterion validity for other functional measures against the PFIT-s. The PFIT-s and FSS-ICU are promising functional measures and are recommended to measure function within the ICU.

Trial registration
Clinicaltrials.gov NCT02214823. Registered 7 August 2014).