ABSTRACT
We reviewed 112 patients with amaurosis fugax to refine our indications for carotid angiography. Eighty patients had a carotid endarterectomy. Thiry-four patients with ipsilateral hemispheric transient ischemic attacks plus amaurosis fugax all had an operable carotid lesion. The presence or absence of a carotid bruit, a normal or abnormal ophthalmologic examination, or a normal or abnormal cerebrovascular Doppler examination did not predict which patients would or would not have an operable carotid lesion. All patients with amaurosis fugax being evaluated for an operable carotid stenosis require angiography.
Subject(s)
Blindness/etiology , Carotid Artery Diseases/complications , Angiography , Arterial Occlusive Diseases/surgery , Carotid Artery Diseases/surgery , Cerebrovascular Disorders/etiology , Doppler Effect , Endarterectomy , Hematoma/surgery , Humans , Hypoglossal Nerve , Ischemic Attack, Transient/etiology , Paralysis/etiology , Regional Blood Flow , Retinal Artery , Ulcer/surgery , Vocal Cord Paralysis/etiologyABSTRACT
A simple and safe method of medical treatment for control of massive acute gastric mucosal hemorrhage is described. The procedure was developed from the observation that gastric HCl played a central role in peretuating the syndrome. The treatment consists in neutralization of the gastric acid with antacid to pH of 7.0. In preliminary observations of consecutive admissions, 19 of 20 (95 per cent) patients treated with this techinique stopped bleeding. The one remaining patient required surgery. There were no deaths. In contrast, 10 of 15 (66 per cent) patients stopped bleeding with conventional medical therapy. Four of the remaining patients required surgery to control the bleeding. One patient did not stop on medical management. All five (33 per cent) patients died.
Subject(s)
Antacids/therapeutic use , Gastrointestinal Hemorrhage/drug therapy , Gastric Acidity Determination , Gastric Juice , Gastric Mucosa/metabolism , Gastrointestinal Hemorrhage/etiology , Humans , Hydrogen-Ion Concentration , MethodsABSTRACT
Four cases of desmiod tumors of the anterior abdominal wall recently treated at the University of Chicago Hospitals and Clinics are presented. From our experience we conclude: 1. Inadequate excision of desmoid tumors results in local recurrence. 2. Adequate excision of desmoid tumors ot the abdominal wall sometimes necessitates creation of an abdominal wall defect too large for primary closure. 3. Marlex mesh has been used successfully in reconstruction of the abdominal wall following adequate excision of desmoid tumors. 4. One patient (Case 4) with an abdominal wall desmoid tumor associated with familial polypisis and mesenteric fibromatosis has benefited greatly following wide excision of abdominal wall and reconstriction using Marlex mesh, despite the fact that the mesenteric fibrous tumor was unresectable.
