Subject(s)
Ureter/anatomy & histology , Fiber Optic Technology , Humans , Intraoperative Period , Light , Urinary CatheterizationABSTRACT
Arterial blood flow was measured in dogs simultaneously with electromagnetic flow probes and with ultrasonic "flow probes." The ultrasonic probes were used to determine transcutaneously the mean velocity of arterial flow and the cross-sectional area of the blood vessel. A 10 MHz probe was used for blood vessels 1 cm deep or less, while a 5 MHz probe was used for vessels between 1.0 and 2.5 cm deep. The correlation coefficient between the flow calculated with the ultrasound method and the flow measured with the electromagnetic flow probes was 0.966, p less than 0.01. Blood flow was also measured intraoperatively in five patients. There was a correlation coefficient of 0.999, p less than 0.01, between the flow obtained with the ultrasound method and that determined simultaneously by the electromagnetic flow probes. The coefficient of determination for the regression of electromagnetic-determined flow on ultrasound-determined flow was 0.99. Thus, accurate transcutaneous determination of blood flow is possible with slightly modified ultrasound equipment.
Subject(s)
Arteries/physiology , Blood Flow Velocity , Ultrasonography , Animals , Auscultation , Dogs , Humans , Mathematics , RheologyABSTRACT
Isolated arteriosclerotic aneurysms of the internal iliac artery are uncommon, with an incidence approaching 0.4%. Although the symptoms invariably involve the genitourinary or gastrointestinal systems, the aneurysms may be found during abdominal, rectal, or vaginal examinations. The 75% mortality associated with the rupture of an internal iliac aneurysm mandates for early surgery for these aneurysms. Operation may consist of ligation of the internal iliac artery, excision of the aneurysm, or an obliterative endoaneurysmorrhaphy. While the operative mortality has average 33.3%, there were no operative deaths in this series.
Subject(s)
Aneurysm/surgery , Arteriosclerosis/surgery , Iliac Artery/surgery , Aged , Aneurysm/diagnosis , Aneurysm/diagnostic imaging , Arteriosclerosis/diagnosis , Arteriosclerosis/diagnostic imaging , Humans , Iliac Artery/diagnostic imaging , Male , Middle Aged , RadiographyABSTRACT
A retrospective review of the deaths in 2877 consecutive operations for biliary calculus disorders was directed at defining the high-risk factors in operations for stone disease. A correctable factor in biliary operative mortality relates to errors in differential diagnosis and iatrogenic technical errors that result in hemorrhage, anastomotic leaks, duodenal injuries, and the tardy recognition and treatment of postoperative intraabdominal sepsis. A less manageable problem is the patient over 70 with advanced heart disease and/or diabetes, who presents with acute biliary sepsis. The combination of circumstances puts the individual at great risk, albeit there is no present alternative to surgery.
Subject(s)
Cholelithiasis/surgery , Postoperative Complications/mortality , Adult , Age Factors , Aged , Biliary Tract Diseases/diagnosis , Cholelithiasis/diagnosis , Diagnosis, Differential , Female , Humans , Iatrogenic Disease , Male , Middle Aged , New York , RiskABSTRACT
Complete infrarenal aortic occlusion was found in 20 of 325 patients who underwent bypass for atherosclerosis of the distal aorta. Eleven had normal distal arteries as demonstrated by arteriography; the remaining patients had multilevel areas of stenosis and occlusion below the inguinal ligament. The two groups were significantly different in age, blood pressure levels, and duration of symptoms. The bypass relieved symptoms and restored flow in all the patients with normal distal vessels. There were four acute graft failures, two of which resulted in death, in the group with distally diseased vessels, and only two of these nine patients were symptomatically improved by the bypass. These data indicate that there are at least two distinct patient populations with the Leriche syndrome. Anatomic changes at the aortic bifurcation may be responsible for the clinical differences.
Subject(s)
Arteriosclerosis/complications , Ischemia/etiology , Leg/blood supply , Leriche Syndrome/pathology , Aged , Arteriosclerosis/pathology , Female , Humans , Ischemia/surgery , Male , Middle AgedABSTRACT
Three patients had primary enteric tuberculosis. Therapy included antituberculous chemotherapy and resection of the involved segment of bowel with primary anastomosis in each case. The symptomatology, roentgenographic findings, histopathology, and treatment of enteric tuberculosis are reviewed. The surgeon must be aware of the fact that primary enteric tuberculosis continues to exist in the United States. Though no pathognomonic symptoms or syndrome occur in enteric tuberculosis, this disease should be included in the differential diagnosis of patients with vague abdominal complaints, weight loss, and anorexia.
