Surgical management of severe acute lower extremity ischemia.

Seventy-four patients (70 men [95%], 4 women [5%], mean age, 63 years) with severe, acute lower limb ischemia (acute clinical deterioration and absent pedal Doppler signals) caused by either arterial thrombosis (n = 68) or embolism (n = 6) underwent urgent surgical management consisting of operative revascularization with or without amputation in 67 patients (91%) and primary amputation alone in 7 patients (9%). Sixty-one patients (82%) had severely threatened limb viability, and 13 (18%) had major irreversible ischemic limb changes at presentation. Eighty-six percent of patients were initially anticoagulated with heparin.

Limb salvage vs amputation for critical ischemia. The role of vascular surgery.

Since 1980, 498 patients with 627 critically ischemic legs (rest pain, gangrene, ischemic ulcer, and ankle-brachial pressure index less than 0.40) were treated with revascularization regardless of operative risk or anticipated operative difficulty. Primary amputation was performed only when no graftable distal vessels were present (14 primary amputations [2.

Prognostic factors for survival after pancreaticoduodenectomy for malignant disease.

Forty patients underwent pancreaticoduodenectomy for malignant disease in a 25-year review of 6 Portland-area hospitals. After resection, 10 patients survived for greater than 5 years. Characteristics of survivors included a short prodrome of symptoms, minimal weight loss, tumor in the periampullary region, and female sex.

Virologic studies of acute respiratory disease in young adults. V. Coronavirus 229E infections during six years of surveillance.

Hamre, D. and M. Beem (DepL Pediatrics, Univ.