bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Surgical Anatomy of the Colorectal Intramural Blood Supply
Authors: Al-Fallouji M.A.R. 
Published: November 2007

An experimental angiology study of 12 surgical colorectal specimens resected from 12 patients with colorectal malignancies in a prefixed state (panoramic view) and after fixation (cross-sectional views taken at 5 different segmental levels) was conducted in Newmarket General Hospital over a 6 month period. The angiology films were analysed quantitatively in order to study the surgical anatomy of the intramural blood supply with the aim of determining whether the arteriolar anastomotic pattern was variable, possibly making one part more suitable for anastomosis than others. The results revealed no difference in intramural vasculature at different lev els and the selection of any segment for colorectal anastomosis should be gov erned, so far as the blood supply is concerned, by the adequacy of the extramural circulation.
The Recurrence of Varicose Veins After Surgery
Authors: Kutz Charles M. 
Published: November 2007

After having performed at least two thousand varicose vein operations, I have come to the conclusion that despite careful preoperative diagnosis and meticulous surgery, there are some patients who develop recurrences. Barlow in 1948 1 stated that varicose veins is a progressive degenerative dis ease. Surgical treatment is directed at eliminating all discernable varicosities. However, since the disease is naturally progressive, some degree of recurrence is inevitable. Therefore, all patients should be followed ad infinitum.
Arterial Abnormalities of the Lower Extremities: The Embryological Link
Authors: Kim Maurice , Dany François , Hammel Jean , Brutus Paul 
Published: November 2007

This study is a review of the main aspects of arterial pathology of the lower extremities. It appears that some coincidences can be correlated with abnormal ities of embryonic development. Many diseases of lower arteries, such as per sistent sciatic artery, trapped popliteal artery, Leriche Fontaine aneurysmal dystrophy and hypoplasia of the tibial vessels, can be explained by an embyrolo gic link. These possible mechanisms, rare in the upper arteries, can also be found in anomalies of the renovascular system. It seems necessary to take into account this problem, first to avoid associated lesions of the same type on the contraolateral limb and in order to obtain a better surgical correction.
Sack-Barabas Syndrome (Ehlers-Danlos IV Type) (Clinic and Histopathologic Ultrastructural Correlations)
Authors: Stella A. , Gessaroli M. , Cifiello B.I. , Mirelli M. , Loperfido V. , Riva R. , Guizzardi S. 
Published: November 2007

The patient that led the authors to make some physiopathological reflections on the Ehlers-Danlos syndrome (EDS) was a young 30 year old suffering from a poly-aneurismatic syndrome, identifiable as EDS type IV. After a surgical treatment on the abdominal aortic aneurysm and an aorto bis-iliac by-pass, a specimen of the aortic wall was the subject of an ultrastruc tural study. In particular, correlations between the histopathological alterations were sought. Particular reference was made to the collagen and the clinical vascular mani festations found not only in this patient but also repeatedly in other patients suffering from this type of EDS.
Popliteal Artery Entrapment. Analysis of the Literature and Report of Personal Experience
Authors: Cavallaro Antonino , Di Marzo Luca , Gallo Pietro , Cisternino Silvestro , Mingoli Andrea 
Published: November 2007

A review has been made of 210 cases of popliteal artery entrapment syn drome, submitted to direct surgical therapy, from 1959 (first case reported by Hamming) through 1983. A personal experience of 14 operative procedures on 14 limbs of 11 patients is reported. Eighteen anatomical variants producing entrapment have been identified; however, in more than 80% of the cases, the medial gastrocnemius was involved. About two-thirds of the patients were operated on with an already occluded popliteal artery, and this implied the need for some kind of reconstructive pro cedure. No reliable data on the true incidence of the disease are yet available; however, it is certainly higher than previously suspected, as witnessed by the growing number of reported cases. Extensive screening procedures could allow identification of probable cases, but a reliable diagnosis cannot be made without angiography. Surgery should be performed as a preventive measure or in case of embolic lesions such as stenosis or aneurysm. If the artery is already oc cluded, an efficient collateral network may develop and surgery should be lim ited to patients not improving with time or at risk of limb loss.
Healing and Long-Term Viability of Grafts in the Venae Cavae Reconstruction
Authors: Motta G. , Ratto G.B. , Sacco A. , Ogata T. , Masuda H. , Kikuchi K. , Takagi K. , Tanaka S. , Yoshizu H. , Senoo A. 
Published: November 2007

The need for superior vena cava (SVC) or inferior vena cava (IVC) recon struction is not uncommon: lung cancer, mediastinal tumors, or retroperitoneal neoplasms are the most frequent indications for caval replacement. Since auto genous veins, which represent the most satisfactory venous substitute, have not been applicable to caval replacement, because of the lack of suitable length and caliber, many types of materials have been tested in the venous system. The present study was planned to compare the potential of expanded polytetrafluoroethylene (e-PTFE) and glutaraldehyde-tanned human umbilical vein (HUV) grafts as caval substitutes. Patch (4 x 5 cm) reconstruction of the SVC was carried out in 10 dogs, tubu lar (3 x 10 mm) reconstruction of the SVC in 5 dogs, and patch (1 x 2 cm) recon struction of the IVC in 8 dogs. In the patch reconstruction groups, HUV grafts were used in half of the cases and 30 μm pore sizes e-PTFE grafts in the other half, while in the tubular SVC replacement group, only e-PTFE grafts were employed. The grafts were removed fifteen to thirty days after IVC patch re construction, thirty to two hundred seventy days after SVC patch reconstruc tion, and thirty-three to forty-one months after SVC tubular replacement. In every instance, specimens were obtained for light microscopy (LM) and scan ning electron microscopy (SEM). HUV patches implanted in the SVC showed hemorrhagic foci at their central portion and marked constriction at the anastomotic regions. On the contrary, the inner surface of e-PTFE patch grafts was covered with a uniform and glis tening neointima. By LM, e-PTFE patches showed a smooth and regular lumi nal surface, while the inner surface of HUV patches was irregular, with hemorrhagic areas in the underlying layers. By SEM, e-PTFE patches revealed a more rapid and orderly endothelialization of their inner surface than HUV patches did. Tubular SVC reconstruction showed the good long-term viability of the e-PTFE neointima (as long as forty-one months after grafting). Only spotty areas revealed neointima alterations, such as fibrinoid degeneration, fo cal necrosis, or minor thrombotic foci. In the IVC patch reconstruction model, HUV grafts showed an exuberant fibrin deposition on their inner surface and delayed endothelialization patterns, as compared with e-PTFE grafts. Since rapid healing with rapid endothelialization is accepted as the most important factor providing the graft luminal surface with the best antithrombotic proper ties, the present study demonstrated that e-PTFE is a more suitable material than HUV for SVC and IVC reconstruction.
Surgical Techniques from Intraoperative Angiographic and Velocimetric Controls in 43 Consecutive Carotid Bifurcation Endarterectomies
Authors: Tiberio Giorgio , Giulini Stefano Maria , Floriani Marco , Bonardelli Stefano , Portolani Nazario 
Published: November 2007

From January to November, 1985, 43 carotid bifurcation endarterectomies (CE) were performed with intraoperative functional (Doppler spectrum analy sis) and morphologic (angiography) controls. In the first 20 cases, after thromboendarterectomy and direct suture, Dop pler showed absence of or no significant variations of frequency in 17 cases, a frequency increase corresponding to a less than 45% diameter reduction steno sis at the apex of the suture in 2 cases, and no flow in the internal carotid artery (ICA) in 1 case. Angiography confirmed the thrombosis in the above mentioned case and showed 3 less than 50% stenoses at the distal end of the arteriotomy: 2 already recognized by Doppler in small-size ICAs and 1 in a medium-size ICA without significant changes of flow. The reason for thrombosis was a distal intimal flap, which was successfully removed; the 2 stenoses in which Doppler and angiography agreed were corrected by patch angioplasty. In the last 23 cases, patch angioplasty was performed routinely in small-size ICAs (6 cases); in 1 case, first treated by a direct suture, Doppler and angiography showed a medium-grade stenosis, immediately corrected; in 1 case both techniques showed a 50% stenosis in a common carotid artery, immediately corrected. The execution of intraoperative angiography in this group of patients al lowed the authors to define the indication for the use of patch angioplasty, never previously employed. Nevertheless, the authors state that, on account of loss of time, costs, and exposure to radiations, intraoperative angiography must be reserved for those cases selected by Doppler spectrum analysis. This method seems to be highly sensitive in recognizing significant technical defects that could lead to an immediate or late failure.
Transient Division of the Left Renal Vein as Adjunct to Perirenal Aortic Surgery
Authors: Esato Kensuke , Takenaka Hiroaki , Fujioka Kentaro , Akimoto Fumikazu , Nakamura Takashi , Ohhara Masaki 
Published: November 2007

In perirenal aortic surgery, a transient division of the left renal vein may be necessary in order to expose the perirenal aorta. Perirenal aortic surgery was performed on 4 patients with infrarenal abdominal aortic aneurysms and 1 pa tient with Leriche's syndrome by transection and reanastomosis of the left renal vein. All but 1 of the cases had uneventful postoperative recovery. One of the patients died of septicemia and disseminated intravascular coagulation (DIC) on the fifty-first postoperative day; however, septicemia and DIC were not attrib uted to transient division of the left renal vein. In all of these cases, the renal function stabilized, and no permanent kidney damage relating to the transient division of the left renal vein could be found. Although there have been several reports that ligation and division of the left renal vein are a reasonably safe and acceptable procedure for perirenal aortic surgery, the resuturing of the divided left renal vein is recommended. Although this maneuver is simple, it is impossible to determine the adequacy of collateral venous circulation of the left kidney without extensive dissection.
Long-Term Evaluation of Human Umbilical Vein as Small-Caliber Arterial Substitute
Authors: Motta G. , Ratto G.B. , Sacco A. 
Published: November 2007

Since 1977, 61 arterial reconstruc tions using glutaraldehyde-tanned human umbilical vein (HUV) grafts were carried out in 56 patients (51 males, 5 females) with unsuitable au togenous saphenous vein. Their mean age was 69 ± 14 years. Limb salvage was the primary indication for sur gery. HUV grafts were used to perform 44 femoropopliteal, 4 composite aor topopliteal (with a direct end-to-end anastomosis between an aortofe moral Dacron graft and a femoropo pliteal HUV graft), 5 femorotibial, and 6 axillofemoral bypasses, and 1 femorofemoral and 1 iliopopliteal by pass. Ten-year cumulative patency rates were 31 % for all HUV recon structions, 36% for femoropopliteal bypasses, and 32% for femoropopli teal bypasses carried out for limb sal vage only. Four of the 5 femorotibial reconstructions failed during the first month following surgery. Two of the 6 axillofemoral and 3 of the 4 com posite aortopopliteal bypasses throm bosed within one and three years after surgery respectively. In conclu sion, the study evidenced long-term durability of HUV grafts, supporting their use for femorodistal reconstruc tions in patients with limb-threaten ing ischemia and inadequate autoge nous saphenous vein.
How to Select and Operate on Patients with Deep Venous Insufficiency of the Lower Limb
Authors: Psathakis Dimitrios N. , Psathakis Nikolaos D. 
Published: November 2007

Investigation of the deep venous system of the lower limb must mainly aim to elucidate its capabilities. Be cause deep venous incompetence is necessarily connected with a popliteal reflux accounted for by valvular in competence of the popliteal vein, its presence must be clarified. Only pa tients with popliteal reflux detected by Doppler ultrasound require a fur ther examination by venous pressure measurements and by phlebography. An operation in the deep veins is ad missible only when a popliteal reflux more than 40%, an ambulatory ve nous pressure more than 60 mmHg, a refilling time less than fifteen sec onds, a venous insufficiency more than 20%, and a patency or recanali zation of the deep veins more than 70% have been confirmed. The substitute "valve" operation by Technique II designed to overcome reflux in the popliteal vein was per formed on 170 patients (190 limbs) with deep venous incompetence of the lower limbs, primary or postthrom botic. Results were assessed clini cally, by Doppler ultrasound, by venous pressure measurements, and partially by phlebography. Clinical improvement in 181 of 190 limbs was associated with reduction of ambula tory venous pressure and prolonga tion of refilling time with interrup tion of the popliteal reflux by Dop pler (168 limbs) and with phlebographic evidence of a valve- like effect of the silastic tendon.
Abnormal Response of Ankle Pressure After Exercise in Seemingly Normal Subjects Living in Blackfoot Disease-Hyperendemic Villages in Taiwan
Authors: Tseng Chin-Hsiao , Chen Chien-Jen , Lin Boniface J. , Tai Tong-Yuan 
Published: November 2007

Arsenic-related peripheral vascular disease has been reported in many countries, including Taiwan, where the disease was called blackfoot disease (BFD) after the dry gangrene at its terminal stages. Because the induction period of BFD is twenty to thirty years, the authors speculated that subclinical arterial insufficiency might be present. The purpose of this study was to detect possible minor arterial insufficiency in the seemingly normal subjects who had consumed the high-arsenic well water for more than thirty years. Twenty-three seemingly normal men living in BFD-hyperendemic villages and 28 age-sex-BMI-matched men from a nearby nonendemic area were recruited. All of them were not obese, had neither diabetes mellitus nor hypertension, did not smoke, and had normal Doppler ultrasound examination findings at rest. Brachial pressures on both arms and ankle pressures on both right and left dorsal pedal and posterior tibial arteries were measured before and after treadmill exercise (1.2 mph, 10% grade, ten minutes). Before exercise, brachial pressures, ankle pressures, ankle-brachial index, and ankle- brachial gradients were similar in BFD area and nonBFD area groups. After exercise, ankle pressure increased in correspondence to increased brachial pressure in the nonBFD area group, maintaining ankle-brachial index and ankle-brachial gradient within normal limits. However, in the BFD area group, a paradoxical drop of ankle pressures led to a significant fall of ankle-brachial index and ankle-brachial gradient. Only 3 (10.7%) cases ( continued on next page) ( Abstract continued) with 4 (7.1%) limbs from the nonBFD area showed negative values of ankle-brachial gradients (-3 mmHg to -10 mmHg). However, there were 13 (56.5%) cases with 20 (43.5%) limbs showing negative gradients (-1 mmHg to -33 mmHg) in the BFD area group. The odds ratios of having minor arterial occlusive disease was about 10 times higher in the seemingly normal subjects living in BFD-hyperendemic villages with ankle- brachial gradients after exercise either < 0 mmHg or < -9 mmHg as a cutoff point. The authors conclude that subclinical arterial insufficiency could be demonstrated in a high percentage of the seemingly normal subjects who had been chronically exposed to arsenic. For early detection of arterial disease and early intervention to prevent future amputation, they advocate the exercise test as a screening and monitoring method.
The Current Role of Profundaplasty in Complex Arterial Reconstruction
Authors: Jacobs Donald L. , Seabrook Gary R. , Freischlag Julie A. , Towne Jonathan B. 
Published: November 2007

By use of direct surgical procedures, including endarterectomy and patch angioplasty, the reconstructed profunda femoris artery has been employed to treat symptoms of claudication from femoral-popliteal occlusive disease and to facilitate healing of ampu tations that spare the knee joint. As the techniques of distal arterial bypass have become more sophisticated with improved long-term patency, the role of profun daplasty has changed. Sixty-eight reconstructions of the profunda femoris artery were reviewed for 51 patients with limb-threatening ischemia (69%), claudication (28%), or infected pros thetic vascular grafts (3%). Thirty-three (49%) of the limbs had undergone 73 prior arterial reconstructions. Forty-nine patients had inflow procedures performed at the time of the profundaplasty, and 13 had concomitant reconstruction of arterial outflow. In only 6 cases was the procedure an isolated profundaplasty. Successful profun daplasty was defined as primary patency of the vascular reconstruction. By life table analysis, revascularizations utilizing profundaplasty had a primary patency of 81% at one year, 64% at two years, and 54% at four years. The series achieved a limb salvage rate of 96% at four years. Isolated profundaplasty is seldom utilized to treat critical ischemia of the lower extremity. The current role of profundaplasty places the procedure as an important adjunct to achieve long-term limb salvage and patency of complex vascular reconstructions.
Management of External Hemorrhage from Varicose Veins
Authors: Bergan John J. 
Published: November 2007

In the thirty-six-month period after October 1, 1992, 20 patients were seen who experi enced profuse external hemorrhage from subcutaneous varicose veins or intracutaneous telangiectasias. These were, for the most part, elderly, the 11 women averaging 68.9 years of age, and the 8 men (exclusive of a fourteen-year-old boy) averaging 58.6 years of age. None of the episodes of bleeding occurred in patients with venous ulcer, and trauma was not a factor in producing bleeding. The bleeding was characterized by high-pressure jet effect, which caused a fountain-like hemorrhage to occur. Hemorrhage was stopped by local pressure, and definitive treatment was by sclerotherapy, surgical removal of sources of venous hypertension, or combinations of these. Continuous-wave Doppler evaluation assisted in selecting patients for surgery, and duplex ultrasound provided information that guided the surgical events. A complete review of previously reported cases suggests this is a dangerous and not trivial complication of venous hypertension and varicosities. Suggested management is outlined.
Simplified Screening of Lower Extremity Arterial Bypasses
Authors: Sawchuk Alan P. 
Published: November 2007

This study assessed a new technique comparing the width of the distal Doppler signal with that of the proximal Doppler signal in order to detect intervening bypass graft or anastomotic stenoses. The width of the Doppler signal was defined as the time from the initial Doppler signal upstroke until the time the signal returned to within 10% of its baseline. The width of the distal Doppler signal was compared with the width of the proximal Doppler signal for 11 normal bypasses and for 11 bypasses with a significant intervening stenosis. The distal Doppler signal was at least 10% wider than the proximal Doppler signal in all bypasses with a significant intervening stenosis, unlike most bypasses without an intervening stenosis (P<0.001). This technique detected all the significant bypass graft stenoses while eliminating the need to do complete bypass graft duplex ultrasound studies on most normal bypasses.
Prophylactic Strategy against Calf Vein Thrombosis Through an Intraoperative Lithotomic Position
Authors: Matsumoto Kenji , Shirasugi Nozomu , Nakagawa Motohito , Arisawa Yoshito , Aiura Koichi , Ishii Seiichiro , Noga Katsuhiko 
Published: November 2007

The aim of this retrospective and prospective study was to evaluate the efficacy of the authors' newly devised lithotomic position (NDLP) for use during surgery to prevent intraoperative calf vein thrombosis (CVT). From their concern about development of CVT during rectal cancer surgery, they reviewed 84 patients who were operated on in a traditional lithotomic position (TLP) retrospectively and examined prospectively 102 patients operated on in an NDLP. In the TLP group, 8 patients (9.5%) developed CVT; however, none of the NDLP group suffered from CVT, the difference being significant (P<0.01). From this study, the effectiveness and usefulness of the NDLP are strongly empha sized to prevent intraoperative CVT during rectal cancer surgery.
Computing Heritability and Selection Response From Unbalanced Plant Breeding Trials
Authors: Piepho Hans-Peter , Möhring Jens 
Published: November 2007

AbstractHeritability is often used by plant breeders and geneticists as a measure of precision of a trial or a series of trials. Its main use is for computing the response to selection. Most formulas proposed for calculating heritability implicitly assume balanced data and independent genotypic effects. Both of these assumptions are often violated in plant breeding trials. This article proposes a simulation-based approach to tackle the problem. The key idea is to directly simulate the quantity of interest, e.g., response to selection, rather than trying to approximate it using some ad hoc measure of heritability. The approach is illustrated by three examples.
Drosophila G9a Is a Nonessential Gene
Authors: Seum Carole , Bontron Séverine , Reo Emanuela , Delattre Marion , Spierer Pierre 
Published: November 2007

Abstract
Mammalian G9a is a euchromatic histone H3 lysine 9 (H3K9) methyltransferase essential for development. Here, we characterize the Drosophila homolog of G9a, dG9a. We generated a dG9a deletion allele by homologous recombination. Analysis of this allele revealed that, in contrast to recent findings, dG9a is not required for fly viability.
Food Preferences and Meal Satisfactionof Meals on Wheels Recipients
Authors: Lirette Theresa , Podovennikoff Jennifer , Wismer Wendy , Tondu Liz , Klatt Linda 
Published: November 2007

Purpose: To investigate Edmonton Meals on Wheels (MOW) recipients’ food preferences and meal satisfaction.Methods: A preliminary study of 13 lunch club participants divided into two focus groups was conducted to determine overall themes in clients’ menu preferences and suggestions. A questionnaire was developed, based on previous MOW client comments, and delivered to all clients (n=271) receiving hot meal service from the Edmonton MOW program; 140 surveys (52% response rate) were returned.Results: The majority (72% to 88%) of hot meal clients were satisfied with the taste, texture, value, variety, and portion size of their meals. Popular menu items were barbecued chicken, perogies, and desserts. Up to 25% of participants indicated that meats were too tough and vegetables were too firm. Vegetables such as broccoli and Brussels sprouts were the most commonly disliked items.Conclusions: Overall, clients find the Edmonton MOW menu foods appealing and enjoyable. MOW programs should advertise the availability of texture-modified foods and offer a variety of vegetables. Meal services for the elderly must continue to monitor meal acceptance as client needs change with our aging population.