bluuebunny/crossref_metadata_2025_split huggingface dataset:
Basic Vascular Access for Hemodialysis
Authors: Strate Richard G. 
Published: November 2007

Vascular access for acute or chronic hemodialysis can be relatively simple or present a significant surgical challenge. The patient about to undergo acute dialysis is frequently suffering from multi-system disease and renal failure is just one component of his illness. Hemodialysis may need to be initiated on an emergent basis because of life threatening chemical abnormalities, drug intoxication, or fluid overload. Semi-emergent dialysis may be required when a rising serum creatinine indi cates that renal function is deteriorating at a rapid rate. The acute dialysis patient not uncommonly becomes a candidate for chronic dialysis and consid eration must be given to establishing some form of permanent access. The need for chronic dialysis, however, may often be anticipated and access created many weeks before the first dialysis is actually required allowing sufficient time for maturation of an arterio-venous fistula.
Frequency of Thrombus on Non-Pathologic and Atherosclerotic Intima of Human Aorta — Thrombosis as a Pathogenesis of Atherosclerosis
Authors: Tanimura Akira , Hayashi Itsuro , Nakashima Teruyuki 
Published: November 2007

Forty-four aortas dissected from human subjects were sliced into 30-50 se rial sections and studied morphologically for the presence of thrombi. A total of 569 thrombi were found histologically in 1,400 sections. The frequency of thrombosis was 7% for subjects under 30 years-old. However, with increasing age, the frequency rose to 8% in the third decade, 9% in the fourth decade, 13.5% in the fifth decade, 10.5% in sixth decade, 25.5% in the seventh decade and 33.5% for subjects over 80 years-old. Thrombi were morphologically classified into three types: (1) microthrombi (2) membranous thrombi, and (3) large massive thrombi. The latter were rarely found on the intima, and no sclerotic lesions were observed. The frequency of thrombosis on non-pathologic areas was 11 %, and almost all of them were microthrombi. The thrombi on the areas of cloudy thickening was 47% with 6% of them being classified as membranous thrombi or large massive thrombi. The thrombi on atherosclerotic lesions was 42%, unusually high compared with the other categories and 32 % of them were membranous or large massive thrombi. In each region of thoracic and abdominal aorta, thrombi were apt to be more on abdominal aorta than that on thoracic aorta.
Aortic Aneurysm and Ureteral Obstruction Associated with Retroperitoneal Fibrosis and Arteritis. A Case Report and Literature Survey
Authors: Harjula A.L.J. , Harjola P.-T. , Heikkilä L. , Somer T. , Nordling S. 
Published: November 2007

Idiopathic retroperitoneal fibrosis (IRF) is a rare disease of unknown etiol ogy. The disease is related to some therapeutic agents. Previously only in two cases methylopa has been associated with IRF. 4,5 The reported patient, a 56- year-old woman had suffered from arterial hypertension for 20 years and the only medication used was methyldopa for two years. A low back pain and a feeling of heaviness in her lower abdomen resulted in clinical examinations and an abdominal aortic aneurysm with moderate hydronephrosis on the right-hand side was found. IRF was revealed at operation. A ureterolysis and an aorto-iliac reconstruction were made using prosthesis. Postoperative recovery was un eventful. An inflammatory reaction in the outer part of the media and in the adventi tia of the aortic wall was found. The inflammatory cells were mostly lympho cytes and plasmacells but also some areas with heavy eosinophilic infiltrates were present. Vasculitis was seen in small vessels. Eleven cases of IRF associated with arteries from the previous literature are described.
Doppler Ultrasound, Ophthalmic Arteries and Temporal Giant Cell Arteritis: A Report of 31 Cases
Authors: Dany François , Liozon Frederic , Adenis Jean Paul , Hammel Jean 
Published: November 2007

A prospective study of continuous-wave Doppler ultrasound was performed on 31 patients with histologically confirmed temporal arteritis (TA). Patients were divided into three groups according to ophthalmoscopy: group A: no ophthalmic anomalies, 20 cases group B: nonspecific symptoms, 15 cases group C: ocular specific lesions of TA, 6 cases (amauroses with optic neuropathy) Doppler ultrasound showed normal velocity curves in patients of groups A and B. No major morphologic anomalies were obtained. Mean amplitude of systolic peaks was 7.93 mm in group A and 10.30 mm in group B (p/NS), with no significant difference from a reference population of 22 patients with no TA. Group C had very significant anomalies: no perception of ocular arteries in 1 case, very low blood flow in 4 cases, and disturbances in 1 case. Mean amplitude of systolic peaks was very low: 1.81 mm. A significant increase in blood velocities was observed after steroid therapy with a normalization of curves in most cases, including patients of group C. This paper suggests that Doppler ultrasound is the single reliable technique for the evaluation of ophthalmic consequences of TA. It allows discrimination between high-risk patients with anomalies of blood flow in the optic vessels and low-risk patients with normal Doppler curves. High-risk cases have to be treated vigorously and quickly with high doses of steroids and need regular ultrasonic studies during the first weeks.
Prophylaxis of Pulmonary Embolism with Partial Interruption of the Inferior Vena Cava: Indications and Results
Authors: Alemany J. , Teubner K. , Marsal T. 
Published: November 2007

From 1970 to 1985, the authors performed 440 partial interruptions of the inferior vena cava for prophylaxis of embolisms. An extraluminal clip was im planted in 248 patients, an intraluminal filter in 138 patients, and an intra luminal umbrella in 54 patients. Long-term clinical, phlebographic, and hemodynamic results are described. Situations indicating, and situations contraindicating, this prophylactic sur gical procedure are listed. The extraluminal clip and the intraluminal filter were associated with less than 1% postoperative mortality, whereas a mortality rate of 7% was associated with the extraluminal umbrella. The permeability of the inferior vena cava and the hemodynamic status were not much compromised over a five- to fifteen-year period with the extraluminal clip or the intraluminal filter.
In Vivo Study of Collagen-Impregnated Double Velour Prosthesis
Authors: di Marzo Luca , Hunter William J. , Schultz Richard D. , Risavy Joseph 
Published: November 2007

Cross-linked bovine collagen treatment of double velour prosthesis has re cently been introduced to help the graft ingrowth and neointima development in high-porosity graft without any need of preclotting. The authors have im planted (end-to-end) a total of 18 double velour 6-mm grafts (length 6 cm) in the infrarenal aorta of 18 dogs (15-25 kg). Nine prostheses were treated with colla gen (DVC) and 9 were untreated (DV). Animals with both kinds of prosthesis were sacrificed 3, 7, 10, 14, 21, 30, 60, 120, and 360 days after the implant. Preclotting was required only in DV grafts even though both grafts had some porosity (1,900 cc/min/cm2). Organization of the neointima of both grafts was studied and compared by light and scanning electron microscopy. DVC grafts showed an earlier (3-10 days) deposition of neoendothelial cells and a signifi cantly thicker neointima development within the first week from graft implant (p < 0.02). No statistical differences were noted in later neoendothelialization. Both grafts had a multifocal neoendothelial surface development around the neovasa vasorum in longer survival (days 21-360) whereas the ingrowth started from anastomoses in the early survival (days 3-14). In conclusion, DVC grafts, owing to the collagen treatment, do not require any preclotting despite their high porosity (equal to DV) and successfully accel erate short-term neointima development (> DV).
Cardiovascular and Metabolic Adequacy and Survival After Aorto-Aortic Bypass
Authors: Borzone A. , Giovannini I. , Iannace C. , Vulpio C. , Chiarla C. , D'Andrea G. , Salgarello G. , Sbarra G. Morelli , Castagneto M. , Castiglioni G.C. 
Published: November 2007

Hemodynamic, metabolic, and respiratory parameters were measured be fore aortic cross-clamping and after declamping in 14 pigs undergoing experi mental aorto-aortic bypass procedures. The changes observed at declamping provided cumulative evidences of a loss of myocardial competence and of peculiar metabolic alterations, which were more pronounced in the cases with a lethal outcome. These findings emphasize the need for perioperative support of physiologic functions and for the use of protective measures during aortic cross-clamping and ischemia. They also imply the possibility of using new parameters as indica tors of the severity of the alterations induced by ischemia and as prognostic indicators.
Experimental Study of Ascending Aortic Dissection: Hemodynamics and Pathologic Aspects
Authors: Senoo Masaaki , Teramoto Shigeru , Uchida Hatsuzo 
Published: November 2007

The purpose of this study is to clarify the predisposing factors and the mechanism of progression of aor tic dissection and the pathologic changes of the dissected lumen. An experimental model of acute and chronic ascending aortic dissection was prepared in 49 mongrel dogs (weighing from 7 to 30 kg, mean 15.0 kg). They were divided into two groups: the acute group (n=25) and the chronic group (n=24). After the progression of dissection the period of observation was from three days to one year. Medial dissection of the as cending aorta was surgically initiated by using the modification of Blan ton's method. Dissection progressed in 39 dogs (15 dogs in the acute and 24 in the chronic group) with intravenous mi crodrip administration of noradrena line and adrenaline. In the acute group, the %DS (the length of dissec tion divided by distance from the ori gin to the celiac artery) was definitely correlated with aortic systolic and aortic diastolic and left ventricular systolic pressures (r=0.73, p < 0.01; r=0.73, p<0.01; r=0.81, p < 0.001, respectively; n =14). The location of the intimal tear and the width, length, and dissected layer of the surgical pocket were ret rospectively examined. The dissected layer of the pocket was not important as a factor influencing the progres sion of dissection, but the width was important. Histologically the dis sected aortic wall revealed ischemic changes in three days and the false lumen was covered with pseudoin tima constituted by collagen and elas tic fibers in about two weeks. The authors concluded that the effective control of acute aortic dissection re quires the reduction of systolic and diastolic pressure, and it takes about two weeks for the organization of the aortic wall after dissection.
Predictive Model for Colonic Ischemia Following Abdominal Aortic Aneurysm Repair
Authors: Gerhart Clark D. , Nicholas Gary G. , Reed James F. 
Published: November 2007

Colonic ischemia is a complication of abdominal aortic aneurysm (AAA) repair that results in significant morbidity and mortality. Numerous causes of colonic ischemia have been reported, but no attempt has been made to identify factors that predict its development. This study identifies those factors that increase risk for colonic ischemia following AAA repair and develops a predictive model for identification of patients who need more aggressive intervention. The records of 12 patients who underwent AAA repair at the authors' institution from 1987 to 1991 and developed colonic ischemia after surgery were reviewed along with a control group of 67 randomly chosen patients who also underwent AAA repair. Clinical factors in the following categories: vascular disease risk factors, medical history, presentation of aortic aneurysm, operative procedure, and postoperative course were examined. Fifteen factors, found to be significantly associated with the development of colonic ischemia (p<0.01), were used for the logistic analysis. Three factors: aneurysm rupture as indication for repair, coagulopathy, and intraoperative hypotension were identified as independent predictors. The presence of one of these factors gave an approximate probability of 10%, two factors 50%, and three factors 90% for development of colonic ischemia.
Screening for Carotid Artery Stenosis with the Continuous Wave Doppler Listening Examination
Authors: Huber Thomas S. , Harward Timothy R. S. , Read Cindy D. , Werts Stephen G. , Flynn Timothy C. , Seeger James M. 
Published: November 2007

The Asymptomatic Carotid Atherosclerosis Study (ACAS) demonstrated that carotid endarterectomy was beneficial for selected asymptomatic patients with carotid artery stenoses greater than 60%. However, the optimal technique for identifying these asymp tomatic lesions remains undefined. Carotid duplex is the current standard, but cost limits its use for screening large populations. This study prospectively examines the audible interpretation of the continuous wave (CW) Doppler signal as a screening tool for carotid artery stenoses. Carotid artery listening examinations were performed using CW Doppler immedi ately before standard carotid duplex examinations in 207 patients (414 examinations) by two certified vascular technologists. Stenosis in the extracranial internal carotid artery was classified as <50°/a or ≥50% based on the listening examination alone, and the results were correlated with the duplex findings (duplex ≥50% stenosis—peak systolic frequency [PSF] ≥5 KHz). The results were analyzed in two groups to determine whether accuracy improved with experience (phase I: 107 patients; phase II: 100 patients). The overall sensitivity (95% confidence interval), specificity, positive predictive value, and negative predictive value of the CW Doppler listening examination compared with carotid duplex was 76% (67.4-83.8), 97% (94.4-98.6), 91% (83.0-95.6), and 92% (87.9-94.3), respectively, for the 414 examinations. The sensitivity (phase I: 68% vs phase II: 85%, P<0.05) increased during the second phase of the study although no significant change was noted in the specificity (phase I: 98% vs phase II: 96%, P=0.44), positive predictive value (phase I: 93% vs phase II: 89%, P=0.71), or negative predictive value (phase I: 89% vs phase II: 95%, P=0.11). Twenty-one of the 27 false-negative listening examinations (CW Doppler <50%, duplex ≥50%) occurred in arteries with stenoses between 50% and 69% (PSF 5-<7 KHz) on duplex. There were only six false- negative examinations among 80 lesions ≥70% on duplex (PSF ≥7 KHz). The time (2.1 ±1.0 vs 12.6 ±9.6 min, P<0.05, Student's t test) and cost ($22.95 vs $166.47) of the listening examination were both less than those of duplex. The CW Doppler carotid listening examination is an accurate, cost-effective alterna tive to the carotid duplex examination for screening asymptomatic patients for significant carotid artery stenoses.
Reendothelialization and Platelet-Derived Growth Factor Activity Associated with Intra-arterial Stented Grafts
Authors: Ombrellaro Mark P. , Stevens Scott L. , Freeman Michael B. , Goldman Mitchell H. 
Published: November 2007

The purpose of this study was to determine whether intraluminal placement affects reen dothelialization rate and platelet-derived growth factor (PDGF) secretion in polytetra fluoroethylene (PTFE) grafts. Thirty dogs underwent infrarenal abdominal aorta PTFE interposition (12) or intra luminal stented (18) grafting. Grafts were explanted at four and eight weeks and rates of endothelial ingrowth calculated. Cell-specific immunohistochemical stains were used to quantitate perianastomotic endothelial (CD 31 +), proliferating (PCNA+), and PDGF secreting cell content. Mean endothelial cell resurfacing rates were 1.1 ±0.2, 3.9 ±0.2, 1.4 ±0.2, and 2.4 ±0.2 mm/week for the four-week control (6), stented (7), eight-week control (6), and eight-week stented (8) grafts at the proximal anastomosis, and 1.2 ±0.2, 3.8 ±0.2, 1.2 ±0.2, and 2.6 ±0.2 mm/week, respectively, at the distal anastomosis. Reendothel ialization was greatest with intra-arterial stented grafts at both four and eight weeks (P<0.01). Between four and eight weeks, the decline in resurfacing rates among stented grafts was attributed to the complete reendothelialization observed in eight-week specimens. PDGF+ cell content was similar among four-week control and stented grafts, and greatest in eight-week controls (P<0.05). An inverse correlation was noted between PDGF+ and endothelial (CD 31 +) cell content at both anastomotic sites ( r=-0.34, P<0.01). Trends between increasing reendothelialization rates with decreasing PDGF+ cell content did not achieve statistical significance (P=0.08). Intra-arterial graft placement accelerates reendothelialization of PTFE grafts. PDGF secretion decreases with progressive endothelial cell coverage.
Endovascular Treatment of Chronic Superior Vena Cava Syndrome Associated with Hemodialysis Access
Authors: Laronga Christine , Ciocca Rocco , Warner Sloan , Nosher John , Graham Alan M. 
Published: November 2007

Superior vena cava (SVC) syndrome was first described in 1757 by William Hunter as a complication of a syphilitic aneurysm. With the advent of antibiotics, 74% to 93% of reported cases are now secondary to a malignant process. Benign causes include goiter, mediastinal fibrosis, pericardial constriction, Behçet's disease, polyarteritis nodosa, and thrombosis secondary to catheter placement, most notably pacing wires. This case report describes a patient who was diagnosed with chronic SVC syndrome after multiple hemodialysis access procedures were performed over a short span of time. The patient is a fifty-five-year-old man with hypertension and end-stage renal disease, etiology unknown, who presented with left upper limb swelling one week after placement of an arteriovenous (AV) graft in his left forearm. One month prior he had had an AV fistula created in the left distal forearm. Owing to difficulty in accessing the fistula, a Shiley catheter was placed in the left internal jugular vein for temporary dialysis. The AV graft was placed later that week. He presented the following week with progressive left upper limb edema associated with limitation of hand movement and pain/numbness of the fingers. The pain was relieved with upper limb elevation. An outpatient fistulogram showed a patent AV graft and AV fistula, a small amount of thrombosis around the Shiley catheter tip, and occlusion of the SVC. Collaterals were noted involving the right innominate vein, SVC, and the left innominate vein. A catheter and guidewire were then passed through the venous limb of the AV graft into the SVC. Urokinase was delivered as a bolus and then as a continuous infusion into the left innom inate vein and SVC to dissolve any clots that might be in the SVC or around the Shiley catheter. A computed tomography scan of the chest failed to reveal any pathology around the SVC. Systemic heparin therapy was also started. Twenty-four hours later the patient underwent repeat venography, which demon strated some clot lysis and a patent but severely narrowed SVC. Three self-expanding Wallstents were then placed. The stents were dilated to 14 mm. Completion venography revealed adequate patency of the SVC. After the procedure the patient did well with prompt resolution of his left upper limb swelling and pain. The Shiley catheter was removed during this hospitalization and his dialysis was initiated via the AV graft. Endovascular treatment of chronic SVC syndrome manifesting after hemodialysis access procedures is a viable option that is associated with excellent short-term patency.
Plication for Correction of Excessive Carotid Artery Kinking, Unacceptable Torn End Point, and Perforation from Plaque Erosion: Techniques and Results
Authors: Sottiurai V.S. , Gonzales J. , Omlie W. , Cooper M. , Lyon R. , Ross C. , McNeil J. , Hatter D. 
Published: November 2007

The purpose of this study was to introduce carotid plication as a simpler alternative approach to internal carotid resection, reimplantation, graft replacement in the management of symptomatic carotid kink, carotid perforation, and unacceptable end point. Fifty-two carotid plications (internal carotid = 49, common carotid = three) were performed on 50 patients (29 men, 21 women) and followed up for 8-129 months (mean 67). Carotid plications were performed for kink (n: 43), carotid perforation from plaque erosion (n: three), and unacceptable end point of endarterectomy (n: six). The operation was performed with 100% shunting and vein patch angioplasty. There was no death, stroke, aneurysm, pseudoaneurysm, rupture, or stenosis in the 52 carotid plications. Symptomatic relief was successful in amaurosis fugax, transient ischemic attack, global ischemia, and vertebral-basilar symptoms. Only partial relief was achieved in carotid throbbing. Carotid plication is a simple, dependable, and durable procedure for symptomatic carotid kink, carotid perforation due to plaque erosion not amendable to lateral repair, and unacceptable distal end point in carotid endarterectomy.
A Proline-based Macrocyclic Amide with S4 Symmetry
Authors: Ahn Hee Choon , Yun Sun-mi , Choi Kihang 
Published: November 2007

Abstract
A new square-shaped macrocyclic amide was prepared from N-(4-amino-2-nitrophenyl)proline (ANPP). The two enantiomers of ANPP were connected in an alternating sequence and then cyclized to the corresponding macrocyclic tetramer with S4 symmetry. In this design, there is a central cavity approximately 7 Å in diameter and rigid aromatic rings and intramolecular hydrogen bonding help to reduce the conformational flexibility of the molecule.
Approaches to the Study of Social Policy Making
Authors: Ham Chris 
Published: November 2007

The aim of this paper is to suggest possible future approaches to the study of social policy making. The paper’s main argument is that students of social policy who are interested in policy making could usefully draw on concepts and theories from the developing field of policy analysis. Social policy and policy analysis have so far developed separately as fields of study, yet they share some common concerns. In particular, both are concerned with the processes of policy making and policy implementation, and it is on this common ground that students of social policy may gain insights from policy analysis.
The paper is divided into three parts. In the first part a typology of traditions in the study of social policy is put forward. This is followed by a review of approaches to the study of social policy making, which examines critically the work of a number of writers who have contributed to this area of work. Then, in the third part of the paper, some suggestions are made for the closer linking of policy analysis and social policy.
The Politics of Pay Beds: Labour Party Policy and Legislation
Authors: Butcher Tony , Randall Ed 
Published: November 2007

In 1976 the Labour Government introduced a Bill into the House of Commons which proposed the separation from National Health Service hospitals of accommodation and facilities used for the private practice of medicine. When this measure received the Royal Assent in the same year it marked the culmination of a two year struggle over an issue which had been effectively contained for more than 20 years. Despite the fact that the continued existence of private practice within the framework of the National Health Service (NHS) had been a source of controversy within the Labour Party since the inception of the NHS, it was not until the mid-1970s that it came to the forefront of political debate and the phasing out of pay beds in NHS hospitals was unequivocally accepted by the Labour Party as a priority for government action.
It is the purpose of this article to provide an account of the pay beds issue since 1946 and, arising from this, to explain why the introduction of legislation to provide for the withdrawal of private practice from NHS hospitals was accorded priority by the Labour Government in the mid-1970s.
Pay beds have a long history in Britain.