bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective randomized trial comparing postoperative pain and return to physical activity after transabdominal preperitoneal, total preperitoneal or Shouldice technique for inguinal hernia repair
Authors: Schrenk P , Woisetschläger R , Rieger R , Wayand W 
Published: February 2007

Abstract
In a prospective randomized study postoperative pain, analgesic consumption, return to physical activity and work, cosmetic result and experience with the type of operation were assessed in 86 patients undergoing inguinal hernia repair by means of either the Shouldice technique (n = 34), the laparoscopic transabdominal preperitoneal (TAPP) (n = 28) or total preperitoneal (TPP) (n = 24) repair. Patients having TAPP repair had decreased visual analogue scale scores for pain on the day of operation compared with those undergoing TPP and Shouldice repair (4·8 versus 6·5 and 6·2 respectively, P = 0·02) and on the first postoperative day compared with TPP (4·0 versus 6·0, P = 0·01). There was no difference between the three groups for days 2, 3, 4, 5 and 30 after operation. Patient satisfaction with the operation, analgesic consumption, return to physical activity such as walking, driving, climbing stairs, running, bicycling and sexual intercourse, as well as return to work, was comparable in the three groups. There was a better cosmetic result after TAPP and TPP repair. This study failed to demonstrate significant benefits from laparoscopic hernia repair over the Shouldice technique.
Prognostic value of negative intraoperative ultrasonography in primary colorectal cancer
Authors: Paul M A , Blomjous J G M , Cuesta M A , Meijer S 
Published: February 2007

Abstract
The risk of developing recurrent tumour was assessed in a group of 85 patients with primary colorectal cancer who had a negative intraoperative ultrasonographic examination at the time of primary tumour resection. At a median follow-up of 40 months liver metastases had developed in 14 patients (16 per cent). Dukes classification of the primary tumours was stage A, B and C in one, three and ten patients respectively. The interval between primary tumour resection and detection of metastases varied from 6 to 24 months but all became evident within 2years. Sixteen patients (19 per cent) presented with extrahepatic recurrence, one of whom also developed liver metastases. A negative intraoperative ultrasonographic examination did not prove to be a favourable prognostic factor which allowed exclusion from follow-up or adjuvant chemotherapy.
Effect of blood transfusion on outcome after pancreaticoduodenectomy for exocrine tumour of the pancreas
Authors: Yeh J J , Gonen M , Tomlinson J S , Idrees K , Brennan M F , Fong Y 
Published: February 2007

AbstractBackgroundBlood transfusion is thought to have an immunosuppressive effect. The aims of this study were to examine survival in patients with pancreatic cancer receiving blood transfusion in association with pancreaticoduodenectomy, and to define preoperative risk factors for subsequent transfusion.MethodsA retrospective review was performed of a prospective database of patients with exocrine tumours of the head of the pancreas who had undergone pancreaticoduodenectomy between 1998 and 2003. Clinical data, transfusion records and preoperative laboratory values were recorded.ResultsA total of 294 patients underwent pancreaticoduodenectomy for exocrine tumours in the pancreatic head. Of these, 140 (47·6 per cent) received a blood transfusion. Their median survival was 18 months, compared with 24 months for those who did not have a transfusion (P = 0·036). Postoperative transfusion, margin status and node stage were independent predictors of survival. Age and preoperative total bilirubin and haemoglobin levels were the only preoperative factors that correlated with transfusion.ConclusionIn patients with exocrine tumours of the pancreas, blood transfusion should be avoided when possible. Preoperative risk factors can identify patients who are likely to require transfusion and would therefore benefit most from blood conservation methods.
Comparison of Indices of Muscle and Pump Performance in Patients with Coronary Artery Disease
Authors: Rogers William J. , Russell Richard O. , Moraski Roger E. , Coghlan H. Cecil , Zisserman Dimitry , Rackley Charles E. 
Published: February 2007

AbstractDuring diagnostic cardiac catheterization of 20 patients, 19 of whom had coronary artery disease (CAD), left ventricular (LV) performance was assessed by both muscle function indices and pump function indices. Muscle function indices included max dP/dt, Vpm, Vce5, and Vmax, the latter derived from both total pressure (TP) and developed pressure (DP) using catheter‐tip manometry. Pump function indices included LV ejection fraction (EF) and percent abnormally contracting segment (ACS), determined from biplane LV angiography. Muscle and pump function indices were also compared to the presence of the S3 (ventricular diastolic) gallop. Correlations existed between EF and Vmax (TP), EF and Vpm, percent‐ACS and Vmax(TP), and percent‐ACS and Vpm, with r values of 0.760, 0.777, −0.884, and −0.841, respectively. Vmax(TP) and Vpm also correlated quantitatively with the presence of the S3 gallop (p < 0.0005). Total pressure‐derived muscle function indices appear to adequately describe mean LV performance in patients with CAD and ACS, but these muscle function indices are probably highly dependent upon the size of the myocardial scar.
Cardiac Catheterization and Selective Angiography in Infants with a New Flow‐Directed Catheter
Authors: Schwartz David C. , Kaplan Samuel 
Published: February 2007

AbstractPreliminary experience with a new flow‐directed pediatric anglography catheter in 35 infants indicates that catheterization of all cardiac chambers and both great vessels can be accomplished without risk of perforation or major arrhythmia. Antegrade access to the aorta from the left ventricle via the foramen ovale reduced the need for retrograde arterial catheterization. The maneuverability of this balloon‐tipped catheter coupled with the ability to perform safely selective anglography at any site entered establishes a unique advantage over standard cardiac catheters now in use. The success with this catheter in performing right and left heart studies and the safety in its use promise to significantly reduce the risk of mechanical and angiographic accidents during the intracardiac investigation of critically ill Infants with congenital heart disease.
Thromboembolism Associated with Pigtail Catheters
Authors: Rashid Ahmad , Hildner Frank J. , Fester Arieh , Javier Roger P. , Samet Philip 
Published: February 2007

AbstractThree incidents of asymptomatic arterial thromboembolism associated with polyurethane pigtail catheters occurred during 1,417 cases of left ventricular angiocardiography. No similar incident occurred with polyethylene pigtail or (dacron) Eppendorf and Gensini (style) catheters. In vitro comparison of hydraulic characteristics of polyurethane (Cordis) and polyethylene (Cook) pigtail catheters showed higher flow‐pressure transmission through the tip of the Cordis polyurethane catheter favoring dislodgment of any existing clot. The problem of thrombogencity of polyethylene compared with polyurethane remains unsettled. Our experience with polyurethane pigtail catheters has resulted in limitation of their use in our laboratory.
A New Atrial Septostomy Technique
Authors: Park Sang C. , Zuberbuhler J. R. , Neches William H. , Lenox Cora C. , Zoltun Richard A. 
Published: February 2007

AbstractBalloon atrial septostomy is usually ineffective if the atrial septum is thickened. A technique for incising the atrial septum is described. A no. 6 French catheter was modified to enclose a tiny surgical blade. The distal end of the blade was pivoted to the catheter tip, and the proximal end was attached to a guide wire in the catheter lumen. Advancing the guide wire protruded the blade through a slit in the long axis of the tip of the catheter. Atrial septostomy was performed in five newborn lambs in vivo and in adult dog hearts and human hearts in vitro by advancing the catheter tip across the atrial septum with the blade retracted and withdrawing it to the right atrium with the blade extended. Eight to 12 mm lacerations of the atrial septum were produced and could be extended by subsequent balloon septostomy. The technique may be useful when balloon septostomy has been ineffective.
Dosimetry of Portable Image Intensifiers in Pacemaker Insertions
Authors: Hayt David B. , Malsky Stanley J. , Blatt Charles J. , Greenberg Elliott I. , Pochaczevsky Rubem , Simon Donald F. , Perez Louis A. 
Published: February 2007

AbstractWith the increased utilization of portable image intensifiers for pacemaker insertions, an investigation of the radiation hazards to operative personnel was undertaken. The personnel were tested first utilizing a Rando phantom and later during actual pacemaker insertions. Studies of medical personnel show the critical organs to be the thyroid (approximately 15mR per procedure) and the lens of the eye (approximately 13mR per procedure). While the MPD/week was not exceeded, the radiation dosage was substantial and could increase under operating conditions other than those measured. Recommendations to insure safer operation of this equipment are presented.
Experience with Preformed Catheters for Coronary Angiography by the Brachial Approach
Authors: Zir Leonard M. , Dinsmore Robert E. , Goss Cynthia , Harthorne J. Warren 
Published: February 2007

AbstractExperience with a simplified technique for selective coronary angiography by the brachial cutdown approach using preformed coronary catheters in over 500 cases is described. This technique has facilitated selective catheterization of the coronary arteries in patients where use of the Sones catheter has proven difficult or impossible. Particularly, coronary arteries in patients with a dilated aortic root, high‐rising left coronary artery or tortuous subclavian artery are easily catheterized with the preformed catheters described in this report. Shortened procedure time, an acceptable morbidity (1.4%) and mortality (0.2%), and improved coronary opacification by virtue of the ease in selectively entering the coronary ostia make these preformed catheters a useful modification to coronary angiography by the transbrachial approach.
Preoperative Coronary Angiographic Prediction of Bypass Flow and Short‐Term Patency
Authors: Mehta Jawahar , Hamby Robert I. , Aintablian Agop , Hoffman Irwin , Hartstein Marvin L. , Wisoff B. George , Smedresman P. 
Published: February 2007

AbstractA quantitative preoperative coronary angiographic index was defined in 148 patients undergoing coronary revascularization. Each diseased vessel was scored 0–3, for both diameter and quality of run‐off. The sum of the scores for diameter and run‐off constituted the numerical index for the diseased vessel. Correlations between the index and graft flow measured by electromagnetic flow meter at surgery were established in 259 bypassed vessels. The highest scores (5–6) were associated with higher flows, and the lower scores (0–4) with the lower flows (P < 0.005). Repeat angiography performed 2 wk postoperatively in 110 patients demonstrated 174 graft patencies and 15 graft closures. Mean flow in open grafts was 82 ± 41 ml/min vs. 60 ± 23 ml/min in closed grafts (P < 0.005). It is concluded that graft flow is predictable from preoperative Coronary Angiographic Index and that higher flow and index scores are more likely to be associated with graft patency than low flows and index scores.
105 mm Photofluorography: An Adjunct to the Study of Coronary Arterial and Vascular Disease
Authors: Grollman J. H. , Gray Robert K. , Po Jonathan , Macalpin Rex N. , Eber Leslie M. 
Published: February 2007

AbstractObtaining high resolution static films through an image intensifier has been made possible by recent developments in radiographic equipment. Serial photofluorography 105 mm spot filming has been used successfully to complement cine coronary arteriography in approximately 700 patients. Many patients with coronary heart disease have diffuse peripheral atheromatous changes which are also suitable to study by serial 105 mm photofluorography. Aortic arch, abdominal aortography, and peripheral studies are easily and quickly performed in conjunction with coronary arteriography.Satisfactory results still depend upon skillful application by the angiographer of this imaging mode and proper processing of the film. Advantages of photofluorographic filming over conventional large film techniques include lower radiation exposure, reduction of costs, and easier film handling and storage. Most important is the facilitation of the performance of angiographic studies since constant television monitoring of the catheter and the contrast injections is possible. Disadvantages include restricted area of coverage and slight decrease in resolution. Our experience indicates that photofluorography may be relied upon in the study of vascular disease eliminating the need for large film changers in a laboratory used primarily for cardiac diagnosis.
Angiographic assessment of right ventricular volumes and ejection fraction
Authors: Ferlinz Jack 
Published: February 2007

AbstractSince the advent of cardiovascular angiography only a few decades ago (1), a massive number of data related to the ventricular function have been accumulated. Specifically, left ventricular (LV) geometry, volumes, and patterns of contractility have been extensively investigated (2–7), especially in patients with coronary artery disease (8–11). In contrast, much less attention has been given to the characteristics of the right ventricle (RV). This has been due partially to the fact that the LV was always considered to be the more important chamber of the heart. The relative neglect of RV performance has been further compounded by difficulties in analyzing the geometry of the RV chamber: while the LV configuration approximately resembles an ellipsoid of revolution (and therefore lends itself to relatively simple mathematical analysis), the RV has always been considered a somewhat amorphous structure that does not yield to simple geometric manipulation.In this review, recent approaches to the angiographic measurements of RV volumes and ejection fraction are examined.
Percutaneous catheter emboli: Sources and prevention
Authors: Page Harry L. 
Published: February 2007

AbstractPercutaneous coronary arteriography has been associated with numerous reports of embolic complications. Efforts to minimize such complications have focused upon normal hemostatic functions and the possible preventative role of systemic heparin. In considering the source and prevention of catheter emboli it is useful to review the mechanisms by which particulate matter may be introduced into the aortic root and to recognize that foreign material unaffected by anticoagulation may constitute a significant source of emboli. A simple technical protocol described in this communication has been followed during 3,500 percutaneous transfemoral coronary arteriograms using the Judkins approach. During this experience no embolic complications have been observed.
Aortic stenosis, angina pectoris, coronary artery disease
Authors: Moraski Roger E. , Russell Richard O. , Mantle John A. , Rackley Charles E. 
Published: February 2007

AbstractThe data from 88 patients (pts) with aortic stenosis (AS) were reviewed to determine relationships between angina pectoris (AP) and coronary artery disease (CAD). Results of surgery performed in 81 of these pts was analyzed. All pts had coronary arterlograms, and lesions ≥ 50% were considered significant. Fifty‐nine pts had an aortic valve gradient measured at catheterization ≥ 40 mmHg, and in 29 pts, AS was confirmed at operation.Sixty‐eight pts (77%) experienced AP, and 32 had coexisting CAD (47%); 9 of 20 pts without AP had CAD (45%). There were no significant differences in the incidence of AP in pts divided into subgroups by the aortic valve gradient (40–50, 51–100, 101–200 mmHg) or age (40–59, 60–81 years. Also, no significant differences were found in the incidence or extent of CAD between the two age groups; the extent of CAD was similar regardless of the presence or absence of AP. In pts with AP (1) CAD was more likely in pts ≥ 60 years of age; (2) CAD was less likely when the aortic valve gradient was > 100 mmHg, suggesting that AP in these pts was due to hemodynamically severe AS. All pts with 3‐vessel CAD experienced AP, and the aortic valve gradient was less in these pts than in those with no CAD or less extensive CAD. In 19 pts with combined AS and CAD who had both the aortic valve replaced and a revascularization operation only 1 of pts died in the hospital, while 3 of 19 pts with combined AS and CAD who had aortic valve replacement alone died.In this study a significant number of pts with AS experienced AP, and the presence or absence of AP did not predict coexisting CAD. Coronary arteriography is recommended in the evaluation of pts ≥ 40 years of age with AS. The operative mortality appears to be decreased in pts with AS and CAD who have combined surgery.
Ejection time — Heart rate relationship during exercise
Authors: Lance Veronica Q. , Spodick David H. 
Published: February 2007

AbstractThe slope of the regression equation for left ventricular ejection time (LVET) vs heart rate (HR) is the appropriate factor for correcting LVET for HR. Because the regression relationship varies under different conditions, we determined the LVET‐HR equations for subjects (1) seated at rest on a bicycle ergometer, and (2) during uninterrupted bicycle exercise. In 18 normally active male volunteers, ages 22 − 37, HR and LVET were measured under the two conditions and the regression relationship for LVET on HR determined for each. Regression equations are as follows: (1) LVET = 379 − 1.8 HR ± 11.0 for subjects seated at rest on a bicycle ergometer, and (2) LVET = 371 − 1.2 HR ± 13.9 for subjects performing upright bicycle exercise. The slope factors (1.8 and 1.2) differed significantly (p<0.01). The data indicate that considerable error can result from arbitrarily applying to exercising or resting subjects a correction factor which does not fit the conditions of the data to be corrected.
A semiautomated technique for the rapid evaluation of left ventricular regional wall motion
Authors: Cole James S. , Holland Patricia A. , Glaeser Donald H. 
Published: February 2007

AbstractA semiautomated system for the rapid evaluation of left ventricular regional wall motion is described. The system includes direct projection of the cineangiogram film on an X‐Y digitizer which is interfaced with a PDP‐9 computer. The ventricular model used to evaluate regional wall motion and the methods of data analysis are described. Validation of the accuracy of the technique and specific clinical applications are presented. It is concluded that this technique provides a rapid means of evaluating left ventricular regional wall motion and that the accuracy of the technique is acceptable for clinical application.
Congenital obstructive lesions involving the major pulmonary veins, left atrium, or mitral valve: A clinical, laboratory, and morphologic survey
Authors: Luke Glancy D. , Roberts William C. 
Published: February 2007

AbstractThe clinical, laboratory, and morphologic features of congenitally obstructive lesions causing pulmonary venous hypertension are reviewed. These lesions are responsible for considerable infant mortality and morbidity, especially in the first weeks of life, are not infrequently encountered in older children, and are occasionally seen in adults. The presence of a malformation causing pulmonary venous hypertension often can be detected clinically, but precise anatomical and physiological diagnoses, usually necessary for optimal patient management, often can be made only by detailed laboratory study. Cardiac catheterization and angiocardiography remain the prime modes of accurate diagnosis in such patients, many of whom have other significant cardiovascular malformations, and echocardiography is an extremely useful adjunct, especially in patients with mitral valvular stenosis, hypoplasia, or atresia. The only definitive treatment in any of these patients is operative relief of the obstruction, and the chances of success depend not only on the skill of the surgeon, but also on the nature of the obstructing lesion, the types of associated malformations, and the precision with which these are defined preoperatively.
Pulmonary arteriography in congenital heart disease
Authors: Freedom Robert M. , Olley Peter M. 
Published: February 2007

AbstractPulmonary outflow tract obstruction may occur at subvalve, valve, or pulmonary artery level. Selective ventriculography will usually define the intracardiac obstruction (whether valve, subvalve, or both) and may define pulmonary arterial abnormalities. Increasing experience in the surgical management of patients with tetralogy of Fallot and other conotruncal abnormalities characterized by significant pulmonary outflow tract obstruction suggests that preoperative recognition of pulmonary arterial stenosis is essential to the successful operative management of these patients (1‐4).
Coronary artery spasm: The effect of cardiovascular laboratory premedication practice
Authors: Bennett Kenneth R. 
Published: February 2007

AbstractEighty‐four university cardiovascular laboratories responded to a questionnaire concerning premedication practice and observation of noncatheter‐induced coronary artery spasm during routine coronary angiography. Half of the laboratories stated that they had not observed the phenomenon. The data suggest that premedication practice may account in part for the relative rarity of this phenomenon.
The significance of early changes of positive and negative dp/dt following contrast ventriculography
Authors: Crelinsten Gordon , Fallen Ernest , Fenton Richard , Marpole Derek , Sniderman Allan 
Published: February 2007

AbstractThe contrast agents used for cardiac angiography have pharmacologic effects on the myocardium and on peripheral and coronary circulations. These effects are a stress to the left ventricle. We have studied the sequential changes in heart rate, LVEDP, positive and negative dP/dt in 34 patients following left ventriculography. These patients were divided into three groups: nine normal patients, 14 patients with valvular or coronary artery disease and abnormal left ventricular function at rest, and 11 patients with significant coronary artery stenosis but normal left ventricular function at rest. Changes in dP/dt most clearly defined the normal and abnormal response. In the normal group the mean positive dP/dt rose abruptly at 30 sec after the ventriculogram, whereas the abnormal group showed a mean decrease. The extent of change varied, however, for patients within each group. Negative dP/dt decreased in both groups but more so in the abnormal group. As did the other groups, patients with coronary artery disease but with normal ventricular function showed individual variation in response. Their mean changes in positive and negative dP/dt were intermediate. Positive dP/dt decreased at 30 sec (similar to, but less than, the group with abnormal ventricular function) and negative dP/dt also diminished at 30 sec with a mean value between the normal and abnormal groups. The results of this study support the concept that left ventricular dysfunction may be elicited by the stress of contrast injection. More importantly, such dysfunction seen both with abnormal and normal left ventricles at rest, may be reflected by the relatively simple measurement of positive dP/dt after ventriculography.