bluuebunny/crossref_metadata_2025_split huggingface dataset:
Generation of Free Radicals During Cold Injury and Rewarming
Authors: Iyengar Jaisimha , George Anna , Russell John C. , Das Dipak K. 
Published: August 2008

Cold injury is often associated with irreversible cell damage. At present, however, the pathophysiology of cold injury is not known. This study examines the mechanism of such injury. New Zealand white rabbits were anesthetized and their femoral artery and vein were exposed. After baseline measurements one hind limb was cooled with a freezing mixture to 0°C, followed by rewarming. The other hind limb served as control. During the experiment blood samples were withdrawn from the femoral artery and vein for the subsequent analysis of creatine kinase (CK), lactate dehydrogenase (LDH), and malonaldehyde (MDA). At the end salicylate was injected through the femoral vein to trap any hydroxyl radical (OH°) formed. Rabbits were immediately sacrificed, and biop sies were withdrawn and frozen at liquid nitrogen temperature for analysis of OH° and high-energy phosphate compounds. The results indicate that local blood flow in the cold-exposed hind limb was reduced significantly, suggesting that cold injury was associated with ischemic insult. CK and LDH increased after cold exposure and increased further during rewarming. MDA formation followed a similar pattern. OH° generated after cooling increased significantly upon rewarming. These results indicate that re warming is associated with an episode of ischemia/reperfusion with simultane ous generation of free radicals, which, at least in part, may be responsible for cellular injury associated with rewarming.
Aneurysm Formation After Laser-Assisted Microvascular Anastomosis: Etiology, Growth Rate, and Prevention
Authors: Wang Su , Basu Samir , Thomsen Sharon , Marini Corrado , Tachmes Lenny , Jacobowitz Israel J. , Cunningham Joseph N. 
Published: August 2008

Aneurysm formation has been a major complication in laser-assisted micro vascular anastomosis (LAMA). The authors investigated the effect of increased laser energy on the formation and growth rate of aneurysms. In addition, possi ble methods of prevention were reviewed. End-to-end anastomoses were per formed on 89 rat femoral arteries with the placement of three stay sutures (120 degrees apart) followed by application of CO2 laser irradiation (power = 80 mW, pulse mode = 0.2 s, spot size = 0.275 m). In Group I (N=55), anasto moses were performed with 45 laser pulses, and in Group II (N = 34) 135 laser pulses were used. Each disruption of an anastomosis was repaired by use of 15 additional laser pulses. Six of 18 aneurysms in Group I were reevaluated at weeks 1, 3, and 8 to assess growth rate. All vessels were examined at week 3 for patency and aneurysm formation. Overall aneurysm rates in the two groups were similar, despite the increased laser energy used in Group II (p > 0.05). There was a higher incidence of aneu rysm formation in disrupted vessels in both groups when compared with non- disrupted vessels (p < 0.05 in Groups I and II). The aneurysm rates did not differ between the two groups when vessels with no disruption or with 1 disrup tion were compared (p > 0.05). Mean aneurysm size increased 0.4 mm/week during the first week, 0.25 mm/week during the second and third weeks, and less than 0.1 mm/week during the remaining five weeks. In conclusion, the authors have shown that aneurysm formation is not re lated to the total amount of laser energy applied and that disrupted anastomoses have higher aneurysm rates independent of laser energy. Aneurysm growth rate is maximal during the first week.
Vibration Syndrome: Legal Aspects and Staging
Authors: Laroche Gilles P. 
Published: August 2008

Although vibration syndrome (VS) is now a well-known clinical entity and a legally described disease, many clinical and legal aspects aspects remain confused. Furthermore, complete reliance by the physician on the patient's own history of white finger and related symptoms in the absence of reliable and repeatable objective test for impairment determination has explained the reluctance to accept this professional disease . The purpose of this paper, based on a review of 405 cases of Raynaud's phenomennon, of which 210 were vibration syndrome, is to help medical officers in assessing VS. It reviews some clinical facts essential to an adquate diagnosis and some factors of severity and reversibility. A simple staging is the harbinger of a proper assessment for legal estimation of impairment.
Arterial Flow Enhancement by Impulse Compression
Authors: Morgan R.H. , Carolan G. , Psaila J.V. , Gardner A.M.N. , Fox R.H. , Woodcock J.P. 
Published: August 2008

Preliminary observations of rapid relief of ischemic rest pain following appli cation of a foot impulse compression device prompted this study to quantify its immediate effects. Blood flow was calculated by means of a duplex ultrasound imager interfaced with a Doppler spectrum analyzer. Twelve normal subjects and 10 patients with peripheral vascular disease (mean Doppler ankle/brachial systolic pressure index = 0.62 (range 0.33-0.74) were studied. Mean resting blood flow ( SD) was not significantly different in the two groups: 55.6 24.0 in normal subjects and 48.3 29.8 in the arteriopaths (p = > 0.1). During five minutes of pump application in a 45-degree foot-down position, mean popliteal blood flow increased by 93% in normal subjects (p < 0.0001) and 84 % in peripheral vascular patients (p < 0.03); there was no change in the opposite limb. In 5 normal subjects a "placebo" device produced no significant change in flow (p >0.1). In 4 patients with vascular disease lying supine, impulse pumping produced no significant increase in popliteal blood flow. It is suggested that the hyperemic effect may be explained by the liberation of endothelial-derived relaxing factor (EDRF), a powerful relaxant of vascular smooth muscle, produced in response to sudden pressure changes (hemodynamic shear-stress) within the venous system.
Cryopreserved Venous Allografts Pretreated with Cyclosporine Revisited
Authors: Donovan Thomas J. , Ruby Steven T. , Brockbank Kelvin G. M. 
Published: August 2008

In 1983 Bandlien et al reported that pretreatment of cryopreserved jugular allografts with cyclosporine (CsA) reduced immunogenicity and increased the patency of these grafts in the canine carotid artery. The purpose of this study was to determine whether CsA pretreatment of nonreversed cephalic venous allografts modifies the histologic events or increases patency in the canine femoral artery. The authors also wished to document the histologic events in the nonreversed cryopreserved cephalic autograft and allograft over a five-month period. Thirty-six nonreserved cephalic grafts were interposed in the canine femoral artery. Right venoarterial grafts were cryopreserved with CsA and the left grafts were cryopreserved without CsA. There were 28 allografts and 8 autografts so treated. Cryopreserved autograft endothelial cells (ECs) were quite well pre served on preoperative biopsies and rapidly repopulated the intima in one to three weeks like fresh autografts. All autografts remained patent. In contrast, allograft ECs disappeared early and were very slowly replaced with host ECs in the midgraft after five months. The allograft patency was more than 70 % in weighted analysis for the early periods studied without significant difference between CsA and control groups. Pretreatment with CsA did not appear to spare endothelium or influence the immune process significantly.
Acute Arterial Embolus
Authors: Solak Hasan , Yeniterzi Mehmet , Yiiksek Tahir , Ozpinar Cevat , Ceran Sami 
Published: August 2008

Between December, 1983, and December, 1988, 100 patients (54 men, 46 women) with acute arterial embolus, ranging in age from twenty-three to eighty- three years, were treated in our clinics. The main symptom of the patients was pain (94 % ), followed by coldness (72%), pallor (64%), sensory defect (42%), motor disorder (37%), muscular rigidity (10%), and tissue necrosis (7%). We have determined the etiology to be atrial fibrillation in 53 cases, 36 of which arose from mitral stenosis: acute myocardial infarction (MI) in 14 cases; thromboembolus based on arteriosclerosis obliterans (ASO) in 27 cases; and tumor embolus in 2 cases; 4 cases could not be explained etiologically. The most common site of embolism was the femoral artery (33%). Arterial exploration was done under local anesthesia in the 76 patients who did not have distal localization of the embolus. Embolectomy was performed in 49 of these cases and embolectomy plus localized tromboendarterectomy in 27. Owing to developing necrosis, amputation was necessary in 6 cases—4 above the knee and 2 above the elbow. Motor and sensory defect persisted to various degrees in 27 cases. The death rate was 4%.
Bacteremic Infectability of Vascular Grafts: An Experimental Study
Authors: Cavallaro Antonino , Sciacca Vincenzo , Cisternino Silvestro , di Marzo Luca , Mingoli Andrea , Farina Carlo , Gallo Piero , Bernucci Paola , Bordi Eugenio , De Mori Patrizia , Orefice Gabriella 
Published: August 2008

The present study was undertaken with the aim of defining the differences, if any, in bacteremic infectability of some currently available arterial grafts. The following prostheses were investigated: • two kinds of expanded polytetrafluoroethylene (PTFE) • Dacron knitted double velour • Dacron knitted pretreated with gelatin Forty beagle dogs were used . In each animal the infrarenal aorta was resected and replaced by means of ϕ.6 mm segment of: • PTFE type I 10 dogs • PTFE type II 10 dogs • Dacron knitted double velour 10 dogs • Dacron knitted pretreated with gelatin 10 dogs At the end of the operation, each animal was administered IV with 100 mL of normal saline containing a suspension of Staphylococcus aureus coagulase-posi tive phage type 5504. The bacterial load was 105in 5 animals of each group, 107in the remaining 5. The graft was retrieved after forty-five days and studied in the microbiology laboratory (study of graft homogenate) and in the pathology laboratory (study by conventional microscopy of graft healing). When culture yielded a strain of Staph. aureus, this was retyped for phage 5504 specificity. All grafts were patent at the end of the experiment: partial thrombosis was, however, observed, coupled with a frank perigraft inflammation in: • 3 PTFE type 1 (2 Staph. 105, 1 Staph. 107) • 1 PTFE type 2 (Staph . 105) • 1 Dacron knitted double velour (Staph . 107 ) Baterial colonies within the graft tissue were evident at microscopy in 4 PTFE grafts and in 1 gelatin-pretreated graft. Culture was positive and specific in all the gelatin-treated Dacron grafts and in 60% of the nonpretreated Dacron and PTFE grafts. An optimal result (good healing, no inflammation, no infection) was observed only in 3 PTFE and in 2 "conventional" Dacron grafts. The possibility is suggested that bacteria may be harbored in graft tissue without any clinically evident effect; moreover, some late graft infection could be attributable to an early bacteremic contamination.
Long-Term Results of 102 Abdominal Aortic Aneurysms
Authors: O-hara Masaki , Zempo Nobuya , Nakamura Takashi , Fujioka Kentaroh , Takenaka Hiroaki , Esato Kensuke 
Published: August 2008

One hundred and two abdominal aortic aneurysmectomy were performed during 1973 to 1988. 87 patients underwent elective surgery (non-ruptured group). Comparatively, emergency surgery was carried out for 15 patients with ruptured aneurysms (Ruptured group). Bifurcation prostheses were used for the aortic reconstruction following aneurysmectomy in all patients. (Cooley Double Velour Graft) Postoperative morbidity occurred in 22 % (19/87) of the nonruptured group and in 47 % (7/15) of the ruptured group. Mortality occurred in 4.7% (4/87) of the nonruptured group and in 33% (5/15) of the ruptured group. In late stage after aneurysmectomy there were two patients with anastomotic aneurysms. There were, however, no deaths related to aneurysmectomy and no graft occlusion. The cumulative 3-year and 5-year survival rate in the non-rup tured group was 80 % and 74 % respectively, whereas, in the ruptured group 73%. The long-term results following the operative repair of an abdominal aneu rysm were satisfactory, despite the fact that the early operative results for patient having a ruptured aneurysm were poor. The abdominal aortic aneurysmectomy should be performed before ruptured to obtain the highest survival rate.
Psoas Abscess Caused by an Infected Aortic Graft—A Case Report
Authors: Lundgren Eric , Ricci Michael A. , Deshmukh Narayen 
Published: August 2008

The aorta is rarely a cause of pyogenic abscess of the psoas despite their close proximity. The authors report a case of an infected aortic graft, Documented by paraprosthetic gas on computed tomography, that progressed to frank pyogenic psoas abscess. The patient was successfuly treated by graft excision, abscess drainage, and extra-anatomic bypass. Although rarely reported, clearly an infected aortic graft may be the cause of psoas abscess. Signs and symptoms of psoas abscess may dominate the clinical picture.
Laser Doppler Flowmetry and Transcutaneous Oxygen Tension in Patients with Severe Arterial Insufficiency Treated by Epidural Spinal Cord Electrical Stimulation
Authors: Sciacca Vincenzo , Mingoli Andrea , Maggiore Claudia , Fiume Dario , di Marzo Luca , Tamorri Marco , Cavallaro Antonino 
Published: August 2008

Six patients (3 men, 3 women, mean age 74.2 years) affected by severe arterial insufficiency with rest pain and/or necrosis (smaller than 3 cm2) have been studied simultaneously by means of transcutaneous oxygen tension (Tcp02) and laser Doppler flowmetry (LDF) measurements. They had been submitted to epidural spinal cord electrical stimulation (ESES) device implant from one week to thirteen months previously. Tcp02 vasodilation index and LDF flow and LDF volume increased in 5 patients in whom the ESES was effective in pain relief and ulcer healing. In 1 diabetic patient the clinical result was poor and neither Tcp02 nor LDF showed any improvement. The LDF flow and LDF volume increase, coupled with the simultaneous Tcp02 vasodilation index increase, testify to the amelioration of the cutaneous microcir culation, related to a diminished vasomotor tone (sympathetic activity), induced by ESES . In diabetic patients with neuropathy (autonomic sympathectomy) a high vasodilation index contraindicates ESES implant.
Comparison of Aortography, Computed Tomography, and Magnetic Resonance in Abdominal Aortic Aneurysm
Authors: Rosenthal David , Seagraves M. Annette , Bisese John H. , Clark Michael D. , Lamis Pano A. 
Published: August 2008

During a three-year period 51 patients with abdominal aortic aneurysm (AAA) underwent magnetic resonance imaging (MRI) computed tomography (CT) and aortography to evaluate the diagnostic accuracy and role of each study. Ct and MRI were 100% accurate in establishing the diagnosis of AAA, whereas aortography did not visualize the AAA in 3 patients nor the associated iliac aneurysms in 3 other patients. MRI and aortography were superior to CT in evaluating the celiac, superior mesenteric, and renal arteries. CT should be the screening method of choice to identify AAA, and when operation is contemplated, aortography will best demonstrate the mesenteric and renal anatomy. If aortography is deemed too hazardous, MRI will yield the most information and should then be the noninvasive test of choice.
Echogenic Types of Venous Thrombi in the Common Femoral Vein by Ultrasonic B-Mode Imaging
Authors: Ohgi Shigetsugu , Ito Katsuaki , Tanaka Kohichi , Hara Hiroshi , Mori Tohru 
Published: August 2008

In order to more precisely evaluate deep venous thrombosis (DVT), venous thrombi in the common femoral vein (CFV) were classified according to size of clots and their echogenicity by means of ultrasonic B-mode imaging, and the echogenic types were correlated with the clinical course and presentation of DVT in 106 lower extremities of 81 patients with DVT. They underwent venous Doppler study, venous outflow measurement, and ultrasonic B-mode imaging. Seven clots in the CFV were removed for histologic examination. Of 106 lower extremities 71 had clots in the CFV. These were classified into three types (A, B, C) and eight subtypes (A1, A2, B1, B2, B3, C1, C2, C3). Type A was thick and homogeneous (41 %), type B was thick and heterogeneous (35%), and type C was thin (24%). Types A (83%) and B (88%) were more frequently noted within one month from the onset than type C (12%) (p<0.01, p<0.001, respectively): 88 % of type C was identified after more than one month. Types A and B were correlated with the acute symptoms of DVT (pain, swelling, discoloration), but type C was correlated with the chronic symptoms (pigmentation, stasis ulcer). The echogenic classification of venous thrombi by ultrasonic B-mode imaging is useful for precise evaluation of DVT.
Patterns of Fluorescence Distribution on the Foot Sole After Intravenous Injection of Fluorescein in Patients with Peripheral Arterial Disease
Authors: Wallin Lena , Westling HÅkan 
Published: August 2008

Fluorescein angiography (FA) was performed in 119 patients with peripheral arterial disease. In total 226 lower extremities were examined. The pattern of initial fluorescence distribution on the foot soles was classified, the vascular anatomy of the foot being borne in mind. The distribution patterns were related to peripheral arterial pressures. At ankle pressure > 100 mm Hg and/or toe pressure >40 mm Hg the first fluorescence on the foot sole appeared equally often at all sites of the foot. At lower pressures the first fluorescence appeared less often at the distal part of the foot. Delayed fluorescence on the medial part of the foot corresponding to the distribution area of the medial plantar artery ("lateral pattern") was found in 24%, and delayed fluorescence corresponding to the distribution area of the lateral plantar artery ("medial pattern") was found in 10%. The frequency of medial or lateral distribution patterns was the same in feet with different levels of ankle pressure. In 26 % of the feet, delayed fluorescence was found in the area where the perforating artery from the dorsal pedal artery joins the plantar arcade between the medial and lateral plantar arteries, and 6 % had early fluorescence at this site with delayed fluorescence in the surrounding area. In 1 foot the pattern of initial fluorescence distribution was compared with the result of contrast angiography. Good correspondence was found between areas with delayed fluorescence in the FA pictures and areas where no contrast appeared in the main foot arteries on the angiogram.
A Reappraisal of Exclusion Angiography in Gunshot Wounds of the Extremities
Authors: Luks Francois I. , Picard Daniel L. , Pizzi Walter F. , Battaglia Steven A. , LaMaute Henry R. 
Published: August 2008

The routine use of exclusion angiography in trauma to the extremities has resulted in varying percentages of negative studies, mostly because of a great variability in location and type of injury. The authors reviewed 117 low-velocity gunshot wounds to the extremities. Twenty-six cases presented with hard signs of vascular injury and underwent immediate exploration. Ninety-one exclusion angiograms were performed (11 for soft signs and 80 for proximity only), 89 (98%) were considered negative. Two cases (2 % ) that presented without hard signs required vascular repair. Physical examination alone was 93 % sensitive and 99 % specific for recognition of vascular injuries. Routine angiography did not substantially improve the diagnostic accuracy and had a positive predictive value of only 2%. The authors conclude that angiography may be safely omitted in low-velocity gunshot wounds to the extremities if the absence of signs or symptoms of vascular injury can be firmly established.
Biological Grafts for Vascular Access in Patients with End-Stage Renal Failure
Authors: Bitker M.O. , Barrou B. , Mouquet C. , Jacobs Cl. , Chatelain Ch. 
Published: August 2008

From 1981 until 1987, 52 vascular accesses were created in patients with end stage renal failure; 392 could be studied retrospectively. Of these, 112 were created by using a biological graft: 88 homologous saphenous vein grafts and 24 bovine heterografts. The overall permeability rate was 94% postoperatively, 62% at 1 year, 45% at 2 and 3 years. There was no statistical difference in the permeability between human saphenous vein grafts and bovine heterografts or between grafts implanted as first access or after failure of an anterior fistula. The main complication observed during the followup was secondary throm bosis, which occurred after an average duration of 8 months. Aneurysms, infec tions, and high flow were very rare. Compared with the results observed with fistulas using the native veins, biological grafts results are poor. Compared with those of other authors 1/m especially for homologous saphenous vein grafts 1/m the authors' results are poor at 1 year and quite good at 2 and 3 years, These data should lead to detection of early stenosis before the end of the first year, especially stenosis of venovenous anastomoses, which are probably responsible for late thrombosis in most cases.
Nine Years' Experience with the Valvular Substitution by Technique II in Deep Venous Insufficiency of the Lower Limb
Authors: Psathakis Dimitrios N. , Psathakis Nikolaos D. 
Published: August 2008

Venous incompetence of the lower limb is necessarily connected with a popliteal reflux on account of a valvular incompetence of the popliteal vein; the presence of the reflux must be clarified, with initial investigation by Doppler ultrasound. Only patients with popliteal reflux of more than 40% can be fur ther examined by venous pressure measurements and by phlebography, if these are required. An operation in the deep veins is admissible only when a popliteal reflux of more than 40%, an ambulatory venous pressure of more than 60 mmHg, a refilling time of less than fifteen seconds, a venous insufficiency of more than 20%, and a patency or recanalization of the deep veins of more than 70% have been confirmed. In a series of 52 patients (68 limbs) operated on over the last two years the selection for operation was made successfully by Doppler ultrasound only. The substitute "valve" operation by Technique II designed to overcome reflux in the popliteal vein was performed on 197 patients (228 limbs) with deep venous incompetence of the lower limbs, primary or postthrombotic. Results were as sessed clinically, by Doppler ultrasound, by venous pressure measurements, and partially by phlebography. In the first-mentioned series of 52 patients (68 limbs) the results were assessed only by Doppler ultrasound and correlated with the clinical condition, consist ing of abolition or minimizing of the popliteal reflux. Clinical improvement in 216 of 228 limbs was associated with reduction of ambulatory venous pressure and prolongation of refilling time with interruption of the popliteal reflux (Dop pler ultrasound) and with phlebographic evidence of the valve-like effect of the silastic tendon on the popliteal vein.