bluuebunny/crossref_metadata_2025_split huggingface dataset:
Viability of microorganisms in novel antineoplastic and antiviral drug solutions
Authors: Krämer Irene 
Published: November 2007

Introduction. In determining the expiration-dates of ready-to-use antineoplastic and antiviral drug solu tions, microbiological aspects must be considered. This is especially true because many antineoplastic drugs introduced into the market are already known to lack antimicrobial activity. The purpose of this study is to evaluate the growth of four different microorganisms in ready-to-use solutions of 14 differ ent novel antineoplastic and antiviral drugs. Methods. The lowest concentrations of 14 dif ferent antineoplastic and antiviral drugs prescribed in our hospital were prepared in polyvinyl chloride bags or a polyethylene container (paclitaxel) containing 0.9% sodium chloride or 5% dextrose solution. Inoc ulations were performed by adding 9 mL of a freshly prepared drug solution to a 1 mL suspension of bacteria or fungi (Staphylococcus aureus, Enterococ cus faecium, Pseudomonas aeruginosa, Candida albicans). Resulting concentrations were about 104 microorganisms per milliliter. Pure 0.9% sodium chlo ride and 5% dextrose solutions served as positive controls. Inoculated solutions were stored at elevated temperatures (22°C or 37°C). Samples of each test solution were withdrawn at 0, 15, 30, and 60 minutes and at 2, 3, 4, 24, 48, and 120 hours after inoculation, transferred to tryptic soy agar, and incubated at 37°C. After 24 hours, colony-forming units were counted. Results. In the concentrations tested, no antimi crobial activity was registered with most of the drugs tested. There were only two cases of significant antibacterial activity, involving treosulfan and oxali platin against P. aeruginosa, respectively. Moderate antifungal activity was seen with foscarnet, ganciclo vir, pentostatin, and treosulfan. Conclusions. The lack of antimicrobial proper ties should be considered when assigning extended expiration dates to ready-to-use antineoplastic and antiviral drug solutions. Solutions should be kept under refrigeration whenever possible to minimize the growth of any contaminating microorganism. With the exception of treosulfan, end-product steril ity testing may be performed without further dilution or inactivation.
Stability of three cytotoxic drug infusions in the Graseby 9000 ambulatory infusion pump
Authors: Priston Melanie J , Sewell Graham J 
Published: November 2007

Objective. The purpose of this study was to deter mine the stability of three cytotoxic infusions in the Graseby 9000 ambulatory pump (Graseby Medical, Watford, UK) under both refrigerated storage and in-use conditions. The infusions studied were: (a) doxorubicin (2 mg/mL) plus vincristine (0.2 mg/mL) and (b) ifosfamide (20 mg/mL) plus mesna (20 mg/ mL) and etoposide (0.5 mg/mL). In each case, the diluent was water for injection. Methods. Graseby 9000 medication cassettes, each containing one of three infusions studied, were incubated at either 8°C or 37°C to represent refriger ated storage or 'in-use' temperatures, respectively. Samples were withdrawn for chemical and physical analysis at various intervals. Chemical stability was determined using validated, stability-indicating high performance liquid chromatography methods. The assessment of physical stability included pH, appear ance, moisture loss from cassettes, subvisual particu late counts, and leaching of diethylhexylphthalate (DEHP) plasticiser from the medication cassettes. Results. Both the doxorubicin plus vincristine and the ifosfamide plus mesna infusions were physi cally and chemically stable in Graseby 9000 medica tion cassettes for 14 days at 8°C and for 7 days at 37°C. The etoposide infusion caused significant leach ing of DEHP plasticiser from the Graseby cassette; in addition, one of the infusion cassettes stored at 8°C exhibited precipitation of etoposide by day 10. Conclusion. Infusions of doxorubicin (2 mg/ mL) plus vincristine (0.2 mg/mL) and ifosfamide (20 mg/mL) plus mesna (20 mg/mL) demonstrated ac ceptable stability in the Graseby 9000 device under refrigerated storage and ambulatory infusion condi tions. Precipitation under refrigerated storage and significant leaching of DEHP would preclude the combination of etoposide infusion (0.5 mg/mL) and the Graseby 9000 pump for ambulatory administra tion.
Symptomatic Aneurysm of the Abdominal Aorta
Authors: Bangash Mahmud 
Published: November 2007

Three cases of symptomatic aneurysm of the abdominal aorta are pre sented. One patient age 96, described with this condition, is perhaps the oldest patient in the literature. In another patient the aneurysm measured two feet in length, extending from the diaphragm to the pelvic outlet. This was perhaps the biggest aneurysm yet recorded. All three patients presented dif ficult medical problems, withstood the operation, and were discharged from the hospitals with successful results. Aneurysm of the abdominal aorta is a serious condition. It is commonly found in patients in their seventh decade. The condition carries a high mor tality with advancing age, especially when associated with other diseases. In symptomatic aneurysms where expansion, dissection or frank hemorrhage is suspected, emergency resection and replacement with dacron graft is carried out. We are reporting three cases, two aged 96 and 91, perhaps the oldest pa tients in the world literature operated upon for expanding aneurysms of the abdominal aorta with beginning dissection. The third patient had an aneurysm measuring two feet in length, perhaps the biggest aneurysm reported. All patients survived the operation and are living.
Electrocardiographic Changes in Coronary Care Unit Patients During Defecation
Authors: Singman Henry , Kinsella Eileen , Goldberg Emanuel 
Published: November 2007

Fifty-one consecutive patients admitted to a coronary care unit were mon itored for ECG changes while having a total of 63 bowel movements (BM's). Twenty-three patients had proven myocardial infarction while 28 had no acute cardiac disease. ECG changes in patients using either commode or bedpan facilities were compared during defecation. Patients using the commode were found to have a greater increase in heart rate and other nonspecific ECG abnormalities compared to those using the bedpan. Electrocardiographic changes and occasional deaths have been reported during defecation 1 and instrumentation 2,3 of the rectum.4 The sudden increase in intrathoracic pressure while straining is thought to initiate the cardiovascular changes that lead to these events. The alterations in cardiovas cular dynamics which follow a "strain" are similar to those occurring during a Valsalva maneuver. 5 The published studies in this area present observations of subjects performing the Valsalva maneuver under controlled conditions, or in individuals without heart disease.6 With this in mind, patients with known or suspected acute myocardial infarction admitted to a coronary care unit were studied for electrocardiographic and heart rate changes during defecation. In addition an effort was made to compare changes occurring while using the bedpan to those observed while sitting on a commode.
Valve Replacement and Coronary Revascularization: Combined Surgical Approach
Authors: Janke Walter H. , Cafoncelli Antonio 
Published: November 2007

Report is presented of sixteen patients who had coronary bypass procedures performed in combination with valvular surgery. There was a hospital mortality of two patients or 12.5%. Significant improvement occurred in the remaining fourteen patients or 87.5%. Of these fourteen patients, one patient required re-operation for mitral valve replacement following an open mitral commissurotomy two years previously. Coronary arteriosclerosis complicating the outcome of patients undergoing valvular surgery is well recognized (1). Hall and associates (2) reported the results of seventy-two patients undergoing combined procedures with seven teen operative deaths, an operative mortality rate of 23.6%. Merin's group (3) reported on a series of fifty patients from the Mayo Clinic with an operative mortality rate of 14%. Loop and coworkers (4) reported an operative mortality rate of 8% in fifty patients undergoing combined procedures. Crouch and associates (5) reported on thirty-six patients with four hospital deaths, an operative mortality of 11%. At the Heart Institute of Michigan, five hundred fifty-six patients under went coronary bypass surgery from December, 1969 to September, 1974. This is an all inclusive, consecutive experience. Overall mortality in this group was nine patients or 1.6%. Of five hundred forty patients who did not have associated valvular surgery, the mortality was seven patients or 1.3%. The purpose of this presentation is to elaborate on the sixteen patients who had coronary surgery combined with valvular surgery. Mortality in this group was two patients or 12.5%.
The Effect of Postural Changes Upon the Ankle Arterial Perfusion Pressure
Authors: Pollak Erich W. , Chavis Patrick , Wolfman Earl F. 
Published: November 2007

The normal arterial blood pressure at the ankle, (AP), right brachial arterial pressure (RBP) and pressure index (PI) were investigated in 50 healthy young volunteers under basal conditions and during certain positions of the legs, utilizing Doppler ultrasound flow determination and standard size blood pressure cuff. The mean AP was 10 mm Hg higher than the mean RBP in 76 instances but AP was smaller than RBP in 24 out of 100 investigated lower extremities. Mean PI was 1.069 ± 0.158. There was no statistically significant difference between PI of heavier and leaner patients although increased weight was associated with a significantly higher brachial and ankle arterial pressure. Departure of the lower extremity from the horizontal position resulted in AP changes explained by gravitational effects. If the new posture was maintained, the new AP persisted, thus indicating an absence of significant corrective circulatory adaptation to the posture changes. Extreme flexion of hip and knee joints resulted in a marked decrease of AP and PI, suggesting arterial kinking. This change was not affected by the weight:height ratio of the subject. It is concluded, therefore, that the presence of a greater amount of periarterial soft tissues does not significantly prevent arterial kinking. These tensional shifts indicate changes of flow pattern occurring in normal subjects during extreme flexion. Even more marked shifts can be anticipated in arteriosclerotic patients under similar circumstances.
Abdominal Aortic Aneurysms Mimicking Acute Intraperitoneal Inflammation
Authors: Bass A. , Rosenman Y. , Adar R. 
Published: November 2007

Four cases of abdominal aortic aneurysm misdiagnosed as acute intraperitoneal in flammation secondary to cholecystitis or di verticulitis are presented. Three were rup tured, and in the fourth there was impending rupture. The presentation of ruptured ab dominal aortic aneurysm as intraperitoneal inflammation with fever has been described, but it is rare and scarcely reported. This mis diagnosis tends to delay diagnosis and treat ment and compounds the poor prognosis of these patients. Angiography led to the correct diagnosis in all cases but was done only 5 days after presentation in 2 of the patients. One patient (Case 4) died from complication of a septic graft, and 2 of the other 3 had markedly pro longed hospitalizations and stormy post operative courses. Physician awareness of this possibility may help prevent this misdi agnosis or reduce its future occurrence.
Diagnosis of Ureteral Injury after Aortic Bypass Surgery
Authors: Taheri Syde A. , Elias Steven M. 
Published: November 2007

One of the most severe, life-threatening post-operative complications of abdominal aortic surgery is infection. Symptoms may occur weeks or years later and include back pain, fever, and lethargy. Since symptoms presented by the patient may be linked to graft or ureteral infection or may be due to obstruction or injury to the ureter, it is essential than an accurate, prompt diagnosis be made. If the patient has at some time undergone abdominal aortic surgery, computerized tomography of the retroperitoneum combined with retrograde urography can be helpful in a differential diagnosis. In one such case, diagnosis of ureteral injury accompanied by infection was made using the computerized tomography with retrograde urography. We believe that computerized tomography of the retroperitoneum should be used to help delineate causes of post-operative symptoms in patients who have undergone aortic bypass surgery.
Management of Draining Wounds in Vascular Surgery
Authors: Schaberg Frank J. , Wong Richard , Phillips Martin R. , Healey Eugene H. , Healey Paul J.M. 
Published: November 2007

Drainage from a wound overlying a prosthetic vascular graft is a source of major concern in vascular surgery, often heralding serious complications in cluding hemorrhage, thrombosis or infection. Despite improvement in graft design and surgical technique, healing problems are reported to occur in about 2 % of cases.1 Perigraft fluid collections may be secondary to infection, ac cumulation of lymph or serum, to failure of the graft material or to allergy to graft material or some foreign substance adherent to its surface.1-6 The management of draining wounds remains controversial. Early experi ence with infected grafts treated locally was uniformly unsuccessful, and resulted in significant morbidity and mortality.1 This led to the classic teaching that grafts underlying infected wounds must be removed and replaced through extra anatomic pathways. Recently local treatment has received renewed interest in an attempt to salvage an otherwise functioning graft.2,3 We have utilized an early aggressive local approach to draining wounds with salvage of grafts that would otherwise have been removed and a considerable decrease in morbidity.
The Below- Knee Transposition of a Vein Bypass— A New Therapeutic Principle
Authors: Rendl Karl-Hans , Prenner Konrad 
Published: November 2007

The autologous femoro-popliteal vein bypass is a proven treatment concept for the correction of the chronical, and more seldom, of the acute arterial occlusion with good long-term results. 1,2 Recurrent operations show a clearly worse prognosis than the first opera tion. The reasons are the technical difficulties of the revision, the absence of an autologous vessel graft and the less favourable prognosis of the lengthy desob literation, which is recommanded by certain authors as second operation.3,4 The pseudo-recurrent occlusion represents a rather rare indication for a new opertion. Because of an obliteration of the outflow artery, it is considered clinically and oscillographically as a recurrent occlusion. Only the direct Doppler-ultrasound-sonography or the angiography show the patency of the primary bypass, which can flow through small collateral vessels or backward over the distal anastomosis. This paper is meant to be a contribution to the operative treatment of this occlusion kind in case of missing autologous graft after a short femoro-popliteal vein bypass.
Prophylaxis Against Thromboembolism in Vascular Surgery
Authors: Urbanyi B. , Spillner G. , Schleinzer P. , Freidank H. , Schlosser V. 
Published: November 2007

Thrombosis prophylaxis is indicated in vascular surgical patients for two general considerations: to prevent thromboembolism from the venous system and occlusion of reconstructed arterial vessels. The purpose of this randomized, prospective study was to compare the effectiveness of low-dose heparin, heparin in combination with dihyder gotamine, and dextran-60 in the prevention of postoperative venous throm bosis and pulmonary embolism after vascular operations. In addition, any adverse effects of each medication on patency after arterial reconstruction was to be determined.
Surgical Treatment of Post Phlebitic Syndrome
Authors: Taheri Syde A. , Lazar Louis , Elias Steven M. 
Published: November 2007

Sequelae of deep vein thrombophlebitis, such as post phlebitic syndrome with or without ulceration, can be treated by direct surgery on the valve. Present surgical treatment of stasis ulcer includes removal of the incompetent communicating veins with excision of the ulcer and skin graft. This procedure is usually associated with a high incidence of leg ulcer among the patients with an incompetent deep venous system. Experimental studies to restore venous valve function, such as autogenous vein valve transplant, valvoplasty, homologous vein transplant and synthetic valve procedures, have been tried. It has been shown that the patency rate with autogenous vein graft is higher than with other procedures. The authors have operated on ten patients utilizing autogenous vein valve from the upper extremities to restore a normal functioning venous system of the distal leg. Data on pre- and post-operative, non-invasive, and ascending and descending venography with the results of surgery will be presented and discussed.
Controlled Preoperative Occlusion of an Infected Vascular Graft: A Rational Approach to Treatment
Authors: Aukland A. , McCollum C.N. , Slaney G. 
Published: November 2007

The presence of infection in a vascular prosthesis usually necessitates its removal. When the graft is still patent collaterals have no time to develop and limb perfusion following its removal cannot be predicted. We present a case in which an infected axillo-femoral graft was gradually occluded over a period of six days using a Silastic loop snare with Doppler control. Peripheral perfusion was satisfactory following graft thrombosis and it was subsequently removed without revascularisation.
Orthotopic Heart Transplant in Dogs After a Short-Term Storage with Cardioplegia
Authors: Morishita Yasuo , Taira Akira , Poirier Robert A. 
Published: November 2007

The purpose of this study was to assess potassium-induced cold cardio plegia as the modality for myocardial protection of canine hearts during an ischemic interval (2½ hours) through orthotopic transplantation. The hearts were preserved for one hour by two coronary infusions (at 0 and 45 minutes) both in Group I (5 animals) with cold lactated Ringer's solution and Group II (8 animals) with cold cardioplegia. In Group III (8 animals) hearts were treated similarly to Group II, but an additional infusion of cold cardioplegia was given during implantation. The grafts in all groups supported the recipient circulation after transplantation for a minimum of a 2-hour observation period. Group III exhibited approximately 85-90% recovery of ventricular function from the pretransplant baseline level. This study indicates that potassium-induced cold cardioplegia and hypothermia is effective for myocardial protection of the heart during ischemia through orthotopic transplantation.
A Case of latrogenic Fistula Between the Left Internal Mammary Artery and the Pulmonary Vessels
Authors: Di Giacomo V. , Carmenini G. , Vastano M. , Rossi P. 
Published: November 2007

In 1977 Angiology published a paper of Edmiston et al.1 entitled "Angiographic demonstration of an acquired internal mammary-to-pulmonary artery fistula." These authors described a case of a 25 year old man in whom a spontaneous left pneumothorax was treated with a chest tube placed anteriorly at the level of the second intercostal space. Twenty months later, a continuous murmur was appreciated at the level of the third intercostal space, 2 cm medial to the midclavicular line. A selective catheterization of the left internal mammary artery revealed a network of vessels connected with the pulmonary artery. A relationship between the previous placement of the tube and the development of the fistula was hypothesized, whereas this malformation is thought to be usually congenital. In the present report we describe another case of fistula between the left internal mammary artery and the pulmonary vessels, following to a spontaneous pneumothorax. Also in this case it may be hypothesized as an iatrogenic origin.
Composite Saphenous Vein Grafts in Portacaval Shunting Evolution, Technique, Experience
Authors: Byer Arnold , Moss Charles M. , Keys Roger C. 
Published: November 2007

Nine patients with portal hypertension and bleeding esophageal varices un derwent composite saphenous vein graft (CSVG) portacaval shunts. CSVG por tacaval shunts incorporate the widely accepted and practiced principles of "H" grafting, as well as the known benefits of autogenous vein grafting in the venous system. The evolution and validity of these principles is outlined. The technique of CSVG portacaval shunts is described in detail and illustrated. Clinical experience with these shunts during a 13 year period has yielded satisfactory results. Other applications of this technique are suggested.
Surgical Repair of True Femoral Aneurysms
Authors: Huard G. Stedman , Hardin Creighton A. 
Published: November 2007

True aneurysms are rare. All patients were white Caucasian males. The most common physical sign was an expanding pulsatile mass. Femoral aneu rysms should be exercised with graft replacement. The complication of distal arterial emboli or rupture will be obviated. When the superior femoral artery is completely occluded in the presence of a femoral aneurysm femoral-popliteal bypass also should be done. The occurrence of both abdominal or iliac aneu rysms and femoral aneurysm can call for staging or complete repair. This judg ment depends on the patient's condition and the surgeon's experience. A retrospective study revealed that 23 patients had 31 arteriosclerotic true femoral aneurysms. Twenty-three of 27 patients had a complete recovery with aneurysmectomy and prosthetic grafts. Preprosthetic endoaneurysmorrhaphy resulted in two early and late below-knee amputations. No improvement in claudication was present in two patients.
Intrahepatic Arteriovenous Fistula Secondary to Penetrating Trauma: Report of Case and Selected Review of the Literature
Authors: Obeid Farouck N. , Sharma Rajinder , Meyers Eugene , Obeid Farouck N. 
Published: November 2007

A traumatic arteriovenous fistula developed following penetrating liver trauma due to a gunshot wound. The initial liver injury was managed by over sewing the hepatic laceration and draining the area of injury. Post-operatively the patient developed the clinical triad of jaundice, gastrointestinal bleeding and abdominal pain consistent with hemobilia. Selective hepatic arteriography was utilized to confirm the diagnosis and to demonstrate an hepatic artery to portal vein fistula. The fistula was successfully occluded by transcatheter embo lization of the right hepatic artery. This case and a review of the literature illustrates two points. First, although traumatic hemobilia is relatively uncommon, and traumatic intrahepatic arteri ovenous fistulae are rare sequelae of trauma, the diagnosis should be considered when the triad of pain, jaundice and gastronintestinal bleeding occur following hepatic injury. Second, transcatheter embolization may be a useful alternative to operative intervention in management of the intrahepatic source of bleeding.
The Use of Hemorheological and Microcirculatory Parameters in Evaluating the Effect of Treatment in Raynaud's Phenomenon
Authors: Jacobs M.J.H.M. , Slaaf D.W. , Lemmens H.A.J. , Reneman R.S. 
Published: November 2007

Hemorheological and microcirculatory techniques were used to explore whether these methods could be used to make objective the possibly subjective changes induced by therapeutic intervention. In this study a vasoactive drug, ketanserin, was used in the treatment of patients with primary and secondary Raynaud's phenomenon. The subjective clinical improvement in the acute situation could be con firmed by an increase in red blood cell velocity in the nailfold capillaries before and after cold provocation. Dynamic capillary microscopy even allowed dis crimination between patients who did and those who did not respond to longer lasting treatment with ketanserin. The hemorheological parameters did not dis tinguish respondents from nonrespondents. In conclusion, dynamic capillary microscopy can be used to evaluate subjec tive changes of treatment and to distinguish respondents from nonrespondents to treatment.