bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical care in octogenarians
Authors: Bufalari A , Ferri M , Cao P , Cirocchi R , Bisacci R , Moggi L 
Published: February 2007

Abstract
The general surgical profile of octogenarians compared with that of younger patients, and risk factors predictive of operative mortality and morbidity, were determined retrospectively using a computer database for all patients admitted between 1989 and 1993. There were 934 admissions of octogenarians and surgery was performed in 447 cases (47.9 per cent). The admission rate of patients over 80 years of age increased during the 5-year period from 4.6 to 9.0 per cent, and was significantly higher than that of geriatric patients aged 65.79 years (P&lt;0.01). Emergency admissions (63.6 per cent) and operations (42.3 per cent) were more frequent in patients aged over 80 years (P&lt;0.01); emergency operations increased during the 5 years from 38 to 59 per cent. Altogether, 83 deaths and 171 complications were recorded. The mortality rate of octogenarians was greater than that of younger patients (P&lt;0.01). Postoperative mortality and morbidity rates were 10.1 and 32.2 per cent respectively. After multiple logistic regression analysis with stepwise backward elimination, an American Society of Anesthesiologists score of II-V (P&lt;0.01), the presence of two associated diseases (P&lt;0.01) and laparotomy procedures (P&lt;0.03) appeared to be independent risk factors for postoperative mortality and morbidity.
Histological identification of fascial structures posterolateral to the rectum
Authors: Kinugasa Y , Murakami G , Suzuki D , Sugihara K 
Published: February 2007

Abstract

Background
A comprehensive understanding of fascial structures around the rectum is important for surgeons. Multilaminar fascial structures have provided different interpretations of reliable surgical planes in rectal surgery.

Methods
Pelvic visceral materials for histological assessment were obtained from 12 male cadavers. Large specimens covering wide areas around the mesorectum were embedded in paraffin, followed by preparation of semiserial horizontal sections and sagittal sections for histological examination.

Results
Histological examination demonstrated a prehypogastric nerve fascia and parietal presacral fascia in the retrorectal multilaminar structure. The parietal presacral fascia seemed to divide into several lateral continuations. The prehypogastric nerve fascia appeared to join the most medial continuation of the parietal presacral fascia, which continued ventrally and communicated with Denonvilliers' fascia. Any fascial structure connecting directly between the fascia propria of the rectum and the parietal presacral fascia (that is, the rectosacral fascia) was not found in sagittal sections.

Conclusion
In the retrorectal multilaminar structure, prehypogastric nerve fascia is evident between the fascia propria of the rectum and the parietal presacral fascia. Sharp dissection in front of the prehypogastric nerve fascia according to the histological configuration of the posterolateral fasciae seems reliable.
Inotropic Action of Tolbutamide on Human Myocardium
Authors: Hildner Frank J. , Yeh Billy K. , Javier Roger P. , Fester Arieh , Samet Philip 
Published: February 2007

AbstractThe inotropic action of tolbutamide previously demonstrated in vitro was evaluated in 15 nondiabetic subjects during diagnostic cardiac catheterization. Following bolus injection of 250 mg of tolbutamide intravenously, a rise of serum insulin and a slight fall of serum potassium were observed. Inotropic response was determined from significant fall in PEP/LVET ratio, significant fall of left ventricular end‐diastolic pressure, shift to an augmented function curve in work‐pressure relationships, and prominent rise of dP/dt values at comparable heart rates. The inotropic effect was greatest at 5–15 min with return to near control values at 30 min. An unusually marked inotropic response was observed in one subject. While the measurable net hemodynamic effect of tolbutamide in the human heart is small, its effect on ischemic and normal areas within the heart of a diabetic patient with atherosclerosis may be different. Thus, its ultimate effect on the diseased heart may be significant.
Prolapse of the Tricuspid Leaflets in the Systolic Murmer‐Click Syndrome
Authors: Maranhao Viadir , Gooch Alden S. , Yang Sing S. , Sumathisena D. R. , Goldberg Harry H. 
Published: February 2007

AbstractRight ventriculography was used to assess the tricuspid valve in 61 patients with systolic murmur‐click syndrome. Systolic murmurs were present in 47 cases, and 32 had clicks. Mitral valve prolapse was present in 52 patients. Late systolic prolapse of the tricuspid valve was demonstrated in 32 patients (52.4%). In 9 cases, prolapse involved the tricuspid valve alone. In the systolic murmur‐click syndrome, prolapse may involve either or both of the atrioventricular valves.
Optimizing Cinefilm
Authors: Kato Warren , Wong Maylene 
Published: February 2007

AbstractA system for improving the quality of cinefilm and for maintaining quality control is described. Objective criteria for contrast, resolution, and grain structure were established to measure the effects of varying X‐ray dose, f‐stop, development temperature, and selection of film and developer. We found that all variables must be adjusted to maximize the viewing quality and that similar density curves can be achieved, independently of the choice of film and developer.
An Additional Angiographic Sign for Determining Coronary Artery Dominance in Obstructive Coronary Artery Disease
Authors: Cohn Peter F. , Markis John E. , Gorlin Richard 
Published: February 2007

AbstractAn additional angiographic sign for determining coronary artery dominance is proposed. This sign is based on the anatomic pattern of the infraventricular branches in the left anterior oblique view. It is especially helpful in patients in whom the right coronary and/or left circumflex coronary arteries are completely occluded and distal vessels are filled via collaterals.
Measurement of Ejection Fraction in Man by Videodensitometry
Authors: Schuette William H. , Grauer Leonard E. , Whitehouse Willard C. , Itscoitz Samuel B. , Redwood David R. 
Published: February 2007

AbstractThis report describes a new method based on roentgen videodensitometry for the measurement of left ventricular ejection fraction in man. The net forward ejection fraction (NFEF) is calculated directly from the formula NFEF = 1‐exp (−.693/N), where N is the number of cardiac cycles necessary for half of the injected contrast material to be washed out of the left ventricle. The derivation of this formula is presented, and the technique is validated by comparison with washout curves from a Lucite model of the heart and with simultaneous angiographically determined left ventricular ejection fractions in man. The videodensitometry technique offers the following advantages over the conventional volume technique: (1) only a small amount of contrast material is required; (2) ectopic beats are uncommon during the washout phase when measurements are made; (3) the ejection fraction measured is an average of several cardiac cycles; and (4) dependence upon operator interpretation is minimized. Furthermore, given adequate mixing within the chamber, NFEF should be independent of ventricular geometry. Thus, NFEF of the unusually shaped left ventricle can be readily determined.
Percutaneous Cannulation of the Internal Jugular Vein for Temporary Endocardial Pacing
Authors: Widmann Warren D. , Mangiola Stelio , Thomas Lucille , Venezia Janet 
Published: February 2007

AbstractIn 148 cases the right internal jugular vein was used as the initial approach for percutaneous insertion of temporary endocardial pacemaker electrodes. Complications were few and none were serious. The technique of percutaneous cannulation of this vein for temporary endocardial pacing is described in detail.
Radiation Exposure to Angiographer During Coronary Arteriography Using the U arm Image Amplifier
Authors: Begg Frank R. , Hans Lawrence F. 
Published: February 2007

AbstractRadiation exposure to the angiographer was measured using thermoluminescent dosimeters (TLD), commercial film badges, and appropriate ionization survey meters.Data were collected during 47 coronary artery examinations with the lead overleaf. During a single coronary examination, the angiographer receives 0.9 mR to the lens and 2.8 mR to the hand. The calculated yearly exposure to the angiographer performing 10 examinations per week is 450 mR to the lens, 9% of the maximum permissible dose (MPD), and 1400 mR to the hand, 2% of the MPD.Exposure rates for the left anterior oblique (LAO) and right anterior oblique (RAO) projections during cine and fluoroscopy were taken at the position occupied by the angiographer. Scatter radiation is 5‐10 times greater in the LAO projection.The second trial was monitored during 18 coronary artery examinations minus the lead overleaf. A significant decrease in radiation exposure was accomplished through the use of the lead overleaf.
Coronary Arteriography: Prevention of Thromboembolic Complications Using a Pressure‐Drip Flushing Technique
Authors: Rashid Ahmad , Hildner Frank J. , Fester Arieh , Javier Roger P. , Narula Onkar S. , Samet Philip 
Published: February 2007

AbstractAll selective coronary arteriographic examinations (1,833) performed in the authors' laboratory during a five‐year period (1/1/70 to 12/31/74) were analyzed for mortality and total morbidity according to method used. During the first two years, the control period, the classic brachial artery cutdown (Sones) and percutaneous femoral artery puncture (Judkins) techniques were utilized. Mortality rate for the total 589 patients was 1.01%. This included a mortality of 0.26% (1/386) for the brachial arteriotomy method, and 2.5% (5/203) for the percutaneous femoral puncture approach.After introduction of the pressure‐drip flushing technique, the subsequent three‐year mortality rate for a total of 1,244 patients was 0.16%. This included an incidence of 0.17% (1/585) for brachial arteriotomy and 0.15% (1/659) for modified percutaneous puncture techniques.The morbidity incidence during the initial two‐year period was 3.0% (18/589). This included an incidence of 2.0% for brachial arteriotomy and 5.0% for percutaneous puncture techniques. After institution of the new pressure‐drip flushing technique the total incidence fell to 1.2% equally divided between arteriotomy and percutaneous techniques.Modification of the classic percutaneous femoral artery puncture technique has resulted in major reduction of mortality and morbidity complications which are chiefly thromboembolic in nature. It has not significantly influenced local thrombotic complications of arteriotomy.
Tricuspid Whoop
Authors: Edelstein Josef , Kerin Nicholas Z. , Louridas George 
Published: February 2007

AbstractThe present report describes a patient with a whooping murmur secondary to tricuspid insufficiency. The main features of this tricuspid whoop were as follows: variable in time, moving from mid to late systole; unpredictably associated with normal respiratory phases; after deep inspiratory apnea was almost constantly present.
Quantitative Evaluation of Coronary Perfusion in Man
Authors: Klocke Francis J. 
Published: February 2007

AbstractThe usefulness and limitations of currently available techniques for quantitating coronary flow in ischemic heart disease are summarized. There are appreciable difficulties in assessing coronary flow solely from an arteriographic evaluation of the epicardial arteries. There is a considerable reserve mechanism for vasodilation at the arteriolar level, and a proximal occlusive lesion produces a reduction in flow only after this distal reserve has been exhausted. In addition, small increments in the severity of established lesions sometimes cause profound reductions in flow. The development of clinically useful flow measurements has been impeded by methodological problems related to nonuniformity of flow within the left ventricle in coronary artery disease. Validation of specific techniques for abnormal situations is difficult but possible and should probably be a prerequisite to the clinical application of any technique. When a methodologically appropriate technique is employed, average left ventricular flow per unit weight is found to be reduced systematically at rest in patients with double‐ and triple‐vessel disease. This reduction is a group difference, however, and is not always evident in individual patients. Accordingly, more recent measurements have concentrated on the assessment of regional perfusion, and two general approaches, selective venous sampling and selective precordial sampling are illustrated. While only preliminary measurements of regional flow are available, it is clear that these measurements offer a more sensitive tool for detecting abnormalities of flow in individual patients and thereby for contributing to the management of specific clinical problems. Measurements of regional flow need to be performed during stress as well as at rest. For the future, there is also need for techniques which can assess transmural variations of flow in man and relate measurements of regional flow to regional oxygen demand. Because of the complexity of current techniques which are methodologically adequate, measurements of coronary flow will, for the immediate future, probably remain confined to clinical centers which have a special interest in them. The effort in these centers will hopefully include significant emphasis on the refinement of existing techniques so that they are more widely applicable.
Treadmill Exercise Testing in the Presence of Digitalis Therapy or Nonspecific ST‐T Changes: Correlation with Coronary Angiography
Authors: Nasrallah Antoine T. , Garcia Efrain , Benrey Jaime , Hall Robert J. 
Published: February 2007

AbstractTreadmill exercise test results were studied in 93 patients with chest pain who had received digitalis therapy or had nonspecific ST‐T changes in the resting electrocardiogram. Results of the treadmill test were correlated with the findings of coronary angiography. A positive treadmill result was defined as horizontal or down‐sloping ST segment depression greater than or equal to 1.0 mm. Of the 40 patients with no or insignificant coronary artery disease, 15 had taken digitalls; 4 of the 15 demonstrated a positive response on the treadmill test. Of the 53 patients with coronary artery disease, 21 had taken digitalis; 15 of the 21 displayed a positive response. Among the remaining 32 not on digitalis, 20 had a positive response. The specificity of the treadmill exercise test was 96% in patients with coronary artery disease not on digitalis and whose resting electrocardiogram showed nonspecific ST changes. The specificity of the treadmill test in patients who had received digitalis was 73%. Sensitivity was 63% and 71%, respectively. By utilizing more stringent criteria in the interpretation of the treadmill exercise test (greater than or equal to 1.5 mm ST depression), among the patients on digitalis only 6.7% (1/15) with normal coronary arteries and 48% (10/21) with coronary artery disease had a positive response. With the use of the latter criterion the test was specific in 93% (14/15) of the patients and is usually indicative of coronary artery disease.
Left Ventricular Pressure Responses in Post‐Angiographic Angina
Authors: Boudoulas Harisios , Leighton Richard F. 
Published: February 2007

AbstractAlterations in left ventricular end‐diastolic pressure and in dp/dt observed in ten patients with coronary heart disease who developed angina pectoris following left ventricular cineangiography were compared with those of six other patients who developed angina spontaneously and with patients who underwent left ventricular cineangiography without experiencing angina. In the patients with post‐angiographic angina there was a greater increase in end‐diastolic pressure than that seen in the other patients, but there was no significant change in dp/dt. Changes in left ventricular pressure associated with post‐angiographic angina would appear to reflect the combined effects of increased preload provided by the contrast material and of ventricular dysfunction including diminished compliance associated with angina. A rise in end‐diastolic pressure greater than 20 mmHg following left ventricular cineangiography should alert the physician that the patient may be having myocardial ischemia.
Post Infarction Left Ventricular Pseudoaneurysm Properly Diagnosed Clinically and Angiographically and Successfully Treated Surgically
Authors: Scanlon Patrick J. , Moran John M. , Nemickas Vidas , Johnson Sarah A. , Pfister Charles , Gunnar Rolf M. 
Published: February 2007

AbstractA case of pseudoaneurysm of the left ventricle following acute myocardial infarction is reported. The condition was accurately diagnosed by left ventricular angiography and successfully treated by surgical resection of a massive false aneurysm.
Serial Coronary Arteriography with 105mm Photofluorography: 24‐Month Experience, 2,200 Patients
Authors: Schoonmaker Fred W. , Vijay N. K. , Rich Jerry 
Published: February 2007

AbstractA 105 mm camera has been used for over 24 mo in evaluation of the coronary circulation for the most part and occasionally the proximal peripheral arteries in 2,200 patients. This photofluorographic technique provides sufficient diagnostic image detail with improved operating convenience and reduced radiation exposure compared to the large film changer.105 mm serialography is a good adjunct to cine arteriography as a complementary film recording system, and in many cases may supplement large film serialography.
The external field intravascular electromagnetic flowmeter system as applied to standard arteriographic catheters and conscious humans
Authors: Macalpin Rex N. , Kolin Alexander , Stein Justin J. 
Published: February 2007

AbstractNew methodology, utilizing electromagnetic principles, has been developed for the measurement of regional vascular blood flow in intact animals and man. The flow sensor consists of a fine, insulated wire loop which has a small electrode on each side of the loop. This loop‐probe, which is inserted like a guidewire through standard cardiac or angiographic catheters, springs open upon emerging from the catheter, and the electrodes are automatically applied to diametrically opposite sides of the inner vascular wall. This miniaturization of the flow sensor has been achieved by imposing the magnetic field which pervades the artery from a coil located outside the body. As blood flows through the vessel across the magnetic field, the induced voltage across the blood column detected between the electrodes is proportional to the volume rate of blood flow. The loop‐probe can be used simultaneously as an arterial diameter gauge. Means are described for achievement of a reliable, nonocclusive zero‐flow baseline and flow calibration.
Treadmill exercise testing in mass screening for coronary risk factors
Authors: Allen William H. , Aronow Wilbert S. , De Cristofaro Dominic 
Published: February 2007

AbstractThe prevalence of an abnormal maximal treadmill stress test (MTST) was correlated with coronary risk factors in 1,077 asymptomatic adults (709 men and 368 women) in Long Beach, California. Of 1,077 adults, 113 (10.5%) had a positive MTST. A positive MTST was correlated with sex (p < 0.001), age (p < 0.001), a serum cholesterol ≥ 200 mg% (p < 0.02), hypertriglyceridemia (p < 0.05), cigarette smoking (p < 0.025), and with the number of coronary risk factors (p < 0.005) but not with hypertension, cigar or pipe smoking, obesity, or blood sugar.
Effects of intravenous glucose during pacing‐induced angina pectoris in patients with coronary artery disease
Authors: Zir Leonard M. , Nocero Michael M. , Rose Malcolm , Weisinger Barbara , Krauss Kenneth , Glassman Ephraim 
Published: February 2007

AbstractThe effects of hypertonic glucose infusion on the anginal threshold determined by atrial pacing was studied in 14 patients with significant coronary artery disease. After glucose, angina occurred at a significantly lower heart rate and double product (systolic arterial pressure × heart rate), suggesting a decreased tolerance to ischemic stress. No stoichiometric relationship was noted between glucose uptake and lactate production, and there was no evidence that hypertonic glucose infusion resulted in enhanced anaerobic glycolysis in the ischemic myocardium. Acute elevation of plasma glucose levels may not be beneficial to patients with coronary artery disease.
Prolapsing mitral valve leaflet syndrome. A spectrum that includes cleft posterior mitral valve
Authors: Kerin Nicholas Z. , Edelstein Josef , Louridas George 
Published: February 2007

AbstractTwo patients with a prolapse and cleft posterior mitral leaflet were studied. The first case had an associated ostium secundum type atrial septal defect. In both cases, the pansystolic regurgitation of contrast material during angiography corresponded to the pansystolic configuration of the murmur. In each instance, the systolic murmurs displayed a late systolic accentuation during the maximal prolapse of the mitral valve. The echocardiographic studies demonstrated only a late systolic prolapse which in both patients corresponded angiocardiographically to the maximum buckling of the pansystolic prolapse. Echocardiographic and angiocardiographic features of cleft posterior mitral valve leaflet are discussed.
Aneurysm of the subclavian artery: A complication of retrograde brachial artery catheterization
Authors: Chiavacci Wayne E. , Bucciarelli Richard L. , Victorica Benjamin E. 
Published: February 2007

AbstractA case of an aneurysm of an anomalous right subclavian artery following retrograde catheterization of the right brachial artery is described. This complication was not recognized until the patient presented with symptoms related to a superior mediastinal mass. After appropriate studies were performed operative intervention was successful in establishing a patent subclavian artery.
The wolff‐Parkinson‐White syndrome: The value of the HIS bundle electrogram
Authors: Haft Jacob I. , Gomes Joseph Anthony C. 
Published: February 2007

AbstractThe HIS bundle electrogram has led to the aquisition of additional information on the physiology of the WPW syndrome and has become a useful technique for its diagnosis. The findings on the HBE and their interpretation in WPW are reviewed.
Cine angiographic diagnosis of patent foramen ovale in paradoxical embolism
Authors: Tracy Gerald P. , Smulyan Harold , Potts James L. , Eich Robert H. , Johnson Lewis W. 
Published: February 2007

AbstractA case of paradoxical embolism is presented in which the antemortem diagnosis was facilitated by a new simple angiographic technique that demonstrated a patent foramen ovale. An additional 14 patients were studied by this technique, and one had a patent foramen ovale. The mechanism of reversal of the normal intraatrial pressure gradient and subsequent right to left shunt through a patent foramen ovale is discussed. This angiographic technique may be readily applied in any diagnostic catheterization laboratory and complements existing methods for detecting patency of the foramen ovale in patients with suspected paradoxical embolism.
The evaluation of routine selective arteriography in the investigation of renovascular hypertension
Authors: Staab Edward V. , Smith Clyde W. , Burko Henry 
Published: February 2007

AbstractA comparison of lesions discovered by selective renal arteriograms with abnormalities observed on abdominal aortograms was made in 100 consecutive hypertensive patients. Twenty‐one lesions not seen on aortograms were found by selection. Eight patients with a normal aortogram had lesions. An abnormality was discovered in at least one study in 58 patients. The increased rate of lesion detection by selective studies outweighs the slight risk of complications.