bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laser-Assisted Anastomoses of the Trachea and Carotid Artery in Dogs
Authors: Moosdorf Rainer , Scheld Hans H. , Stertmann W.A. , Fitz Hartmut , Borner Ulf , Hehrlein Friedrich W. 
Published: November 2007

Anastomoses or reconstructions at the trachea are known to be related to a high risk of complications. Simi larly, anastomoses at smaller vessels have often occasioned discussion con cerning new techniques and different suturing materials. Low-dose laser energy seems to offer a new chance of tissue welding in these areas. In 10 Beagle dogs tracheal anastomoses were performed with an argon laser system, stabilized only by three single sutures for readaptation of the stumps. In 5 dogs even these three su tures were removed immediately af ter the tissue welding was finished. The anastomoses were monitored by bronchoscopy after an interval of six weeks and were removed after twelve weeks for pathologic investigations. In another 5 dogs carotid arteries were transected and reanastomosed with a similar technique. Readapta tion was achieved by four single su tures at equal distance, which were left in situ. Patency was monitored by Doppler ultrasound and by angiogra phy, and again after an interval of four to six weeks the anastomotic seg ments were resected and examined pathologically. All animals showed an uneventful postoperative course. None of the tracheal anastomoses showed any signs of functional impairment, air leakage, or infection. Bronchoscopy revealed no significant luminal nar rowing. These findings were con firmed after resection. Histology showed regular wound healing and especially normal reconstruction of the ciliated endothelium of the tra chea. Similarly all carotid anasto moses were patent in Doppler ultrasound and angiographic con trols. Neither angiography nor direct inspection after resection revealed signs of aneurysm formation. Micro scopic investigations showed a smooth endothelial passage between the two anastomosed segments and regular wound healing of the arterial wall. There were no signs of excessive scar formation or intimal hyperpla sia. The results underline the applica bility of laser energy for the perform ance of anastomoses at the tracheobronchial tree, as well as at smaller vessels. Clinical application has to be preceded by further investi gations and some technical improve ments, but still the technique shall prove to be an alternative to conven tional suturing techniques for se lected cases in the near future.
Predictive Value of Transcutaneous Oxygen Tension Measurement in the Indication for Spinal Cord Stimulation in Patients with Peripheral Vascular Disease: Preliminary Results
Authors: Sciacca Vincenzo , Mingoli Andrea , di Marzo Luca , Maggiore Claudia , Fiume Dario , Cavallaro Antonino 
Published: November 2007

Thirteen patients (12 males, 1 fe male, mean age 60.5 years) affected by peripheral vascular disease (21 lower limbs: 9 with intermittent clau dication and 12 with rest pain and/or necrosis smaller than 3 cm2) have been studied by means of transcuta neous oxygen tension (TcpO2) mea surements. They had been submitted to spinal cord stimulation (SCS) de vice implant from one day to twenty- two months previously. In 8 patients (15 limbs) implanted from one day to twenty-two months, the TcpO2 index was calculated to evaluate the neuro- stimulator effect on peripheral blood circulation. In 5 patients (6 limbs) studied before definitive implanta tion, preoperative and postoperative TcpO2 measurements were able to predict the SCS efficacy during the temporary trial period: when TcpO2 did not increase immediately (4 limbs), no result was achieved (am putation) ; a TcpO2 increase corre sponded to relief of symptoms (2 limbs). On the basis of this preliminary report, TcpO2 measurement could be useful for predicting SCS efficacy in vascular patients; the possibility of dividing the patients into responders and nonresponders to SCS by TcpO2 measurement represents an impor tant achievement in determining the indication for SCS implant.
Angiographic and Duplex Scanning Assessment of Biografts in Femorodistal Reconstructions
Authors: Huk I. , Gritzmann N. , Karnel F. , Jantsch H. , Kretschmer G. , Polterauer P. , Wagner O. 
Published: November 2007

Morphologic and hemodynamic changes in 32 long-standing human umbilical vein (HUV) grafts due to biodegradation (segmental dilatation, aneurysmal degeneration, and peri prosthetic tissue reaction) were inves tigated by use of duplex sonography (DS) and intravenous digital subtrac tion angiogaphy (DSA) techniques. The follow-up time ranged from nineteen to eighty-four months with a median of fifty months. Patients were divided into three groups, namely, with biografts patent for less than two years, for three to four years, and for five years or longer. Maxi mum diameter was measured for each group and yielded the following median values: 5.9, 8.9, and 11.2 mm respectively. Sonographic measure ments of internal diameter in HUV grafts showed an increase in 85% of all cases; in the last two groups a biodegradation of the grafts' inner surface was commonly observed. Three true aneurysms were seen in the third group. Segmental dilatation and wrinkling effect occurred in both the second and third groups, but no degeneration was seen in the first group. In 1 case a seroma was de tected as a sign of late periprosthetic tissue reaction. Despite the high incidence of late morphologic changes of the biograft an acceptable patency rate was achieved, although late aneurysmal degeneration of the HUV grafts seems to be a limiting factor in a younger group of patients. With ei ther technique, morphologic changes of the biografts could be observed.
Cyclooxygenase Activity in the Thoracoabdominal Aorta After 24 Hours of Intraaortic Balloon Counterpulsation: An Assessment of the Effects of Localized Mechanical Trauma
Authors: Hoover Eddie L. , Kharma Bassam , Ross Margery , Webb Hueldine , Fani Kazam , DiMaio Frank , Ketosugbo Anukware , Hsu Hwei-Kang 
Published: November 2007

Using a canine model, the authors evaluated the effects of twenty-four hours of intraaortic balloon counterpulsation (IABCP) on the morphology of the thoracoabdominal aorta and its spontaneous and arachidonate stimulated pro duction of prostacyclin (PGI2). The treated group was counter-pulsed at a 1:1 ratio with a 40 cc balloon. The control group had the balloon inserted and left deflated across the thoracoabdominal aorta. There were no differences between the IABCP or sham groups in prostanoid production either in the thoracic or abdominal aorta. Baseline PGI2 production in the control versus treated group of thoracic aortas was 1880 ± 1140 pg/cm2/ min vs 1992 ± 1125. The stimulated response in the control group, 9180 ± 1198, was statistically different from baseline (P < .001). The stimulated in crease in the IABCP group, 6269 ± 5240, relative to baseline was also signifi cant (P < .01). There were no significant differences, either between or within groups in the abdominal aortas. Poststimulation values (30 min) were signifi cantly below baseline in each group in each section of the aorta (P < .05). Light microscopy showed a statistically significant difference in endothelial preserva tion between the control and the balloon group, 66 ± 25% vs 19 ± 17% (P < 0.05) . The authors conclude that IABCP results in severe endothelial destruction but that spontaneous and stimulated PGI2 production is unimpaired. It remains to be determined whether the aorta may sustain long-term damage due to the repair process after IABCP.
Degenerative Dacron Graft Changes: Is There A Biological Component in This Textile Defect ? — A Case Report
Authors: Cardia Giuseppe , Regina Guido 
Published: November 2007

A false aneurysm occurring six years after insertion of a woven femoropopli teal dacron graft into a patient is discussed. The lesion clearly appeared during an anticoagulation overdosage. The authors propose, therefore, that an excess of anticoagulants may have an effect on the repair of a simple, accidental, da cron fiber rupture and thus contribute to the appearance and enlargement of an initially microscopic hole. This suggests that, at least in some of the degenerative dacron graft changes, the interreaction between the host and plastic material may play a determinant role.
Coronary Artery Bypass Surgery in Chinese Septuagenarians
Authors: Chen Thay-Hsiung 
Published: November 2007

Arteriosclerosis has been well known to be intimately connected with the human aging process, and thus the prevalence of coronary artery disease in creases with the advance of age. On the other hand, senility seems to cause extra surgical risk when a patient undergoes a major operation such as coronary artery revascularization. In the past, physicians, and perhaps patients too, took a conservative attitude toward coronary artery bypass surgery for aged patients. But in the author's experience with 38 patients aged seventy years or more, there were 3 deaths (7.9%), a mortality rate not significantly different from that (4.9%) of another group of 264 patients aged less than seventy years. Thus, the author concludes that cur rently coronary artery bypass surgery can be safely performed upon Chinese septuagenarians with limited surgical risks and satisfactory consequences.
Postoperative Morbidity Following Red Cell Deformability Changes During Cardiopulmonary Bypass Using Bubble and Membrane Oxygenators
Authors: Belboul Ali , Khaja Najib Al , Bergman Per , Roberts Donald , William-Olsson Göran 
Published: November 2007

The preoperative blood cell trauma and postoperative morbidity were com pared in a prospective randomized study in two groups of patients undergoing cardiac surgery with extracorporeal circulation (ECC). One group was oxygen ated during ECC with a membrane oxygenator (MO) and the other with a bub ble oxygenator (BO). Red cell trauma was ascertained by a standard microfiltration technique that expressed the rheologic properties of standard ized red cell suspensions. The filtrability of the cell suspension was significantly reduced during ECC for both membrane (MO) and bubble (BO) oxygenators. However, the bubble type proved to be more traumatic, and the difference was statistically signifi cant after thirty minutes of ECC. The filtrability was reduced by 20% in the MO group and by 35% in the BO group at the end of ECC (p < 0.01). A significantly higher frequency of postoperative bleeding (p < 0.05), blood transfusion (p < 0.05), and arrhythmias was found in the BO group (p < 0.01). This study demonstrates that the microrheology of red blood cells is better preserved with the membrane oxygenator, which is associated with a smoother postoperative course, owing probably to a better preserved microcirculation. The membrane oxygenator can be recommended even for short perfusions and routine procedures requiring cardiopulmonary bypass (CPB) and should be used whenever possible.
Experimental Study of Effects of the Ultrasonic Surgical Aspirator on the Vascular System
Authors: Akiyama Kazuya , Watanabe Sunao , Amano Shigeo , Sawatani Osamu , Nishida Hiroshi , Endo Masahiro , Koyanagi Hitoshi 
Published: November 2007

The effects of an ultrasonic surgical aspirator on the vascular system was evaluated in 12 mongrel dogs. The pathologic effects of the device were investi gated in femoral vessels by light and electron scanning microscopies and the physiologic effects by measuring the internal mammary arterial and femoral venous blood flow. Changes in the intimal surface of arteries (platelet aggregation and fibrin network formation) were more frequent at higher vibration amplitudes, while such changes were less common in the vein. Disintegration and loss of the vascu lar wall did not extend beyond the adventitia. There was no obvious change in the blood flow pattern or flow rate after administration of ultrasonic vibrations. The results showed that by keeping the output below 110 microns and using the aspirator together with other conventional surgical devices for dissection, damages to the vascular wall may be held to a minimum. This device can be a very useful supplementary tool in cardiovascular surgery.
Peripheral Vascular Reconstruction in Werner's Syndrome—A Case Report
Authors: Kimura Tadahiro , Yoshizaki Satoshi , Sano Makoto , Hanai Gento , Banno Tetsuya , Matsumoto Sumio , Horibe Yoshimune 
Published: November 2007

A fifty-one-year-old Japanese man with Werner's syndrome underwent suc cessful reconstruction of peripheral arteries. His chief complaints were rest pain and intermittent claudication in the left lower extremity. Clinical manifestations included short stature, low body weight, stocky trunk with thin limbs, graying hair, peripheral muscular atrophy, a high-pitched voice, bilateral cataracts, typical facies, atrophic skin, and diabetes mellitus. Angiograms showed multi ple and severe calcified stenoses of the left femoropopliteal artery. The operative method used was semiclosed thromboendarterectomy. To the authors' knowledge, this case is the first surgical correction of a pe ripheral vascular lesion in a patient with Werner's syndrome.
Bilateral Carotid Endarterectomy: Impact of Staging on Early Results
Authors: Karlson Karl J. , Najafi Hassan , Javid Hushang , Monson David O. , Fannanapazir Khazeh 
Published: November 2007

Successive bilateral carotid endarterectomies were performed in 323 pa tients ; 193 (60%) had both sides operated on within fourteen days during the same hospitalization (Group I), and 130 (40%) were discharged after the first operation and readmitted for contralateral carotid endarterectomy more than two weeks later (Group II). High-risk patients who were older and sicker com prised the majority in Group II. Otherwise no attempt had been made to be selective based on preconceived criteria. There were 4 deaths (2.1 %) in Group I, and 1 death (0.7%) in Group II. Permanent neurologic complications occurred in 10 (5.2%) Group I patients and 8 (6.1%) Group II patients. Transient neuro logic complications were found in 8 (4.1%) of patients in Group I and 14 (10.8%) in Group II. No patients in Group II suffered any neurologic compro mise because of the waiting period between operations. A history of hyperten sion or previous cerebral infarction was found to place patients at increased risk for the development of permanent neurologic complications. Postoperative hy pertension after the second endarterectomy was greater in Group I than in Group II patients. Observations from this retrospective review support the concept that staging of bilateral carotid endarterectomies in two hospitalizations allows elderly, sicker patients to be operated on as safely as younger, otherwise healthy individ uals. The indications for staging bilateral carotid endarterectomies in separate hospitalizations should be liberalized in order to minimize complications.
Automatic Implantable Cardioverter Defibrillators: Surgical Approaches for Optimal Function
Authors: Yee Edward S. 
Published: November 2007

The automatic implantable car dioverter defibrillator (AICD) has significantly enhanced the treatment of malignant tachyarrhythmia but has complex requirements for contin uous function. Forty-nine patients (pts, ages nine to seventy-nine) from 377 pts studied for life-threatening tachyarrhythmias (13%) underwent AICD hardware placement during the first forty-eight months of clinical investigation. Access was dictated by (1) prior operative procedures (17 pts), (2) adequate sensing thresholds (12 pts), and (3) low thresholds (ie, s 15 watts) for successful defibrilla tion configuration (21 pts). Late com plications and morbidity (26 pts, 53%) have been the rule, the most common due to: (A) generator fail ures (15 pts), (B) patches or lead mal positions (4 pts), (C) inappropriate sensing from lead failures (3 pts), and (D) required explanations (leads only for 2 pts and units for 2 pts). There has been only 1 operative death among the 49 pts and none for the 21 revisions and generator changes (overall 1/70 procedures, 1.4%). However, survivals at one, two, and three years were 82%, 56%, and 40% respectively with the majority of late deaths attributed to congestive heart failure (CHF). In summary, (1) AICD morbidity remains frequent but can be mini mized. Incidental placement should be avoided owing to associated mor bidity (explantation). (2) Optimal configurations usually require (a) ep icardial access, (b) patches directed at the ventricular focus for lower de fibrillation thresholds, (c) generator implantation adjusted for habitus, growth in children, and frequent generator failure. (3) Long-term sur vival has been poor in patients with associated CHF.
Inhibition of Endothelium-Dependent Relaxation by Free Hemoglobin in the Human Internal Thoracic Artery
Authors: Spyt Thomas J. , Blake Karen L. , Watt Pamela A. C. , Thurston Herbert 
Published: November 2007

Hemolysis and postoperative hypertension are well recognized complications of cardiopulmonary bypass (CPB). The rise in the concentration of total and free hemo globin is directly related to the duration of CPB. It is well established that free hemoglobin binds and inactivates endothelium-derived relaxing factor, and the authors have studied the effects of low concentrations of free hemoglobin on the endothelium-dependent and endothelium-independent relaxation of the human internal thoracic artery (ITA). In the presence of free hemoglobin the endothelium-dependent relaxation induced by acetylcholine was reduced by 80% with 0.5 μM free hemoglobin (P< 0.01) and by 52% with 0.1 μM free hemoglobin (P<0.05). Sodium nitroprusside, endothelium indepen dent, produced relaxation of almost 100%. These results indicate that relatively low concentrations of free hemoglobin significantly inhibit endothelium-dependent but not endothelium-independent relaxation. This may influence blood flow in the ITA and may be a contributory factor in postoperative hypertension.
Long-Term Survival after Reconstructive Operation in Patients with Arteriosclerosis Obliterans
Authors: Ota Toshiaki , Okada Masayoshi , Yoshida Masato , Tsukube Takuro , Matsuda Hitoshi 
Published: November 2007

Postoperative long-term survival for arteriosclerosis obliterans (ASO) of lower extremities was examined in 218 patients who underwent reconstructive surgery from 1973 to 1992. The causes of late deaths and their relation to the arteriosclerosis of various organs were also examined. Patients were divided into three groups according to the type of operation: aortoiliac/femoral (AIF), axillo/femorofemoral (AxF), and femoropopliteal bypass (FP) and were then divided into two subgroups according to the times of operation: "former decade" (subgroup F, 1973-1982, AIF 43, AxF 31, FP 10) and "latter decade" (subgroup L, 1983-1992, AIF 58, AxF 40, FP 36). The mean ages at operation for AIF-F/L were sixty/sixty-three years, and these were significantly younger than sixty-nine/seventy for AxF-F/L and sixty-five/sixty-seven for FP-F/L. There were 74 late-death patients, and of them, 57 (77%) died of arteriosclerosis-related diseases of various organs such as ischemic heart disease. Among these 57 patients, 39 (68%) experienced organ failure as a preop erative complication, whereas in the remaining 18, such failure was not clinically evident prior to operation. The survival rates at five/ten years after operation were 84%/61% in AIF-F, 88%/76% in AIF-L, 49%/20% in AXF-F, 75%/52% in AXF-L, and 73%/73% in FRL. The survival rate at ten years for subgroup L was 66% and was higher as compared with 42% for subgroup F owing in large part to the significant improvement in AXE In conclusion, for patients with ASO, postoperative life expectancy improved recently, but arteriosclerosis of various organs was still the main cause of late deaths. Lifelong critical care for systemic organs was necessary even in patients in whom such lesions were not yet clinically evident at the time of operation.
Hemodialysis Vascular Access and Complications
Authors: Al-Wakeel Jamal , Huraib Sameer , Mitwalli Ahmed , Abu-Aisha Hassan , Al Mofti Adnan , Faqih Saad , Al Salman Mosaad , Ali Memon Nawas 
Published: November 2007

From January, 1985, to July, 1991, 105 uremic patients had 148 vascular accesses for chronic hemodialysis. Thirty-three (31.4%) patients received more than one access. Of 148 accesses, 131 (88.5%) were arteriovenous (AV) fistulae and 17 (11.5%) were AV grafts. The mean hospital stay for patients with AV fistula was twenty-four days and for those with polytetraflouroethylene (PTFE) graft was thirty-five days. The maturation period for fistulae and grafts was six to eighty-one days and two to forty-five days respectively Early postoperative complications included death in 1 patient, major bleeding in 6 (4.6%) fistulae and primary failure in 28 (21.4%) fistulae and 2 (11.8%) grafts. Deep vein thrombosis occurred in the upper limb of 1 patient with AV graft, and ischemic manomelic neuropathy developed in 1 patient with AV graft. Late complications included bleeding in 6 (4.6%) fistulae and 4 (23.5%) grafts, ischemia in 2 (0.15%) fistulae and late failure due to thrombosis in 19 (14.5%) fistulae and 7 (41.2%) grafts. Infection of the access occurred in 18 (13.7%) fistulae and 14 (82.3%) grafts and led to death in 1 patient. AV fistulae patency rate was 80% after one year and 67% after five years. The patency rate for AV grafts was 67% after one year and 48% after five years.
Effect of Intensive Walking Exercise on Skeletal Muscle Blood Flow in Intermittent Claudication
Authors: Weiss Th. , Fujita Y. , Kreimeier U. , Messmer K. 
Published: November 2007

Walking exercise is generally accepted as a valid therapeutic regimen in the treatment of peripheral arterial occlusive disease (PAOD) of Fontaine stage II. In order to quantify the effect of walking exercise and/or drug therapy on regional muscular blood flow, PAOD Fontaine stage II was induced by multiple ligations of the femoral artery and of all side branches in one hindlimb of mongrel dogs; the contralateral extremity served as control. The animals underwent walking exercise with increasing intensities on a tread mill five days per week over one year; one group received 600 mg buflomedil (BF) per day orally in addition. At the end of the training period, the regional blood flow in all skeletal muscles of both hindlimbs was quantified by means of 15 μm radioactively labeled microspheres at resting conditions, after treadmill exercise (ten minutes) with or without preinjection of BF (3 mg/kg body weight) into the abdominal aorta. At resting condition and at the end of treadmill exercise the regional muscular blood flow did not differ significantly between the diseased and control extremity Supplementary oral treatment with BF over one year had no significant effect; the increase in muscular blood flow during treadmill exercise was not enhanced after intra- aortic injection of BE Consequently walking exercise has the potential to increase the functional capacity of collaterals in intermittent claudication and to restore blood supply to skeletal muscle.