Autologous fashioned graft for aneurysm repair in a contaminated field.

Background: In situ synthetic grafts are not routinely used for aortoiliac reconstruction in the presence of active or potential infection, while the use of a venous autologous graft in these circumstances is limited by the size and length of the venous conduit that is required, the superficial femoral vein being most frequently used.

Methods: We describe a new technique in which an autologous venous conduit was constructed with side-to-side anastomosed segments of a longitudinally opened greater saphenous vein. Thus the diameter of the new conduit was increased.

Economy class stroke syndrome: case report and review of the literature.

Objectives: Venous thromboembolism associated with travelling, or economy class syndrome, is increasingly recognised as a sequence of long haul flights and so paradoxical cerebral embolism through a patent foramen ovale. Materials and methods. We present a new case of economy class stroke syndrome and review of the literature using MEDLINE search.

The Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) study. Aims and results of quality control.

Aim: The results of the Asymptomatic Carotid Atherosclerosis Study (ACAS) study have provided the first scientific evidence that in patients with asymptomatic carotid stenosis greater than 60% carotid endarterectomy reduces the risk of stroke from 2% to 1% per year. The implications are that approximately 20 operations need to be performed in order to prevent 1 stroke in 5 years. The aims of the Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) study are to identify a subgroup or subgroups at a risk for stroke higher than 4% and a group at a risk for stroke less than 1% per year using systemic and local risk factors (plaque characterization) in addition to the degree of stenosis.

Ultrasound plaque characterisation, genetic markers and risks.

The arterial wall changes detected by ultrasound are the end result of all risk factors (exogenous, endogenous and genetic) known and unknown and are better predictors of risk than any combination of conventional risk factors. However, ultrasound cannot be used in people younger than 45 because characteristic changes occur after this age. Nevertheless, it can be used in individuals over 45 to identify the genetic risk factors associated with atherosclerosis.

Validation of the new venous severity scoring system in varicose vein surgery.

Objectives: We performed this observational study to validate the three components of a new venous severity scoring (VSS) system, ie, venous clinical severity score (VCSS), venous segmental disease score (VSDS), and venous disability score (VDS), and to evaluate VCSS, VDS, and CEAP clinical class and score in quantifying outcome of varicose vein surgery. Patients and methods The study included 45 patients who underwent superficial venous surgery in 48 legs with primary varicose veins. Venous color duplex scanning, clinical examination, and a questionnaire were used preoperatively and at 6 weeks and 6 months postoperatively to assign VSS and CEAP clinical class and score.

Increased mast cell infiltration in familial varicose veins: pathogenetic implications?

Aim: Increased infiltration of activated mast cells has been recently implicated in the pathophysiology of varicose veins. The aim of the present study was to investigate a possible association between mast cell infiltration of primary varicose veins and clinical features, which could clarify further varicose vein pathophysiology.

Methods: Seventeen patients, operated on for primary varicose veins and greater saphenous vein incompetence, participated in the study.

S-18886 Servier.

S-18886, the active isomer of S-18204, is a thromboxane A2 receptor antagonist with a long duration of action. The compound is under development by Servier for the potential treatment of cardiovascular diseases [269611]. By 2000, a clinical trial had been carried out in patients with coronary artery disease [389458]; advanced clinical trials were ongoing in August 2001 [420310].

Ambulatory venous pressure measurements: new parameters derived from a mathematic hemodynamic model.

Purpose: The mechanism of venous pressure decrease during exercise still remains unclear. To explore the components involved with the regulation of ambulatory venous pressure, we reinvestigated the pattern of pressure decrease during tiptoe exercise with a newly developed mathematic model.

Methods: Seventeen healthy limbs of 16 volunteers (normal group) and 35 limbs of 33 patients with signs and symptoms of chronic venous insufficiency were studied.

Improved hemodynamic effectiveness and associated clinical correlations of a new intermittent pneumatic compression system in patients with chronic venous insufficiency.

Purpose: A new intermittent pneumatic compression device (SCD Response System) has recently been shown in healthy volunteers to have the ability to detect the postcompression refilling of the calf veins and to respond by initiating the subsequent cycle when these veins are full. This has proven to be more effective in expelling blood proximally than the conventional intermittent pneumatic compression device (SCD Sequel System). The aim of this study was to test the influence of venous disease on the postcompression refill time detected by means of the SCD Response and the effectiveness of the new system in expelling blood in patients who have venous reflux caused by post-thrombotic syndrome or varicose veins.

Carotid plaque echogenicity and types of silent CT-brain infarcts. Is there an association in patients with asymptomatic carotid stenosis?

Background: The aim of this study was to identify the differences in echogenicity and the degree of stenosis of asymptomatic carotid plaques associated with different types of ipsilateral silent CT-brain infarcts.

Methods: Some 273 asymptomatic carotid plaques (218 patients) causing 50 to 99% stenosis were studied with high-resolution ultrasound. B-mode images were digitised and normalised by assigning certain grey values to blood and adventitia.

Fatty liver in obesity: relation to Doppler perfusion index measurement of the liver.

Background: The correlation of clinical and laboratory findings with various imaging techniques in obese patients is difficult. Colour duplex Doppler is of particularly limited value in fat individuals. The Doppler Perfusion Index (DPI) measures the ratio of hepatic arterial to total liver blood flow and seems to be more accurate in the study of hepatic hemodynamics.

The efficacy of the new SCD response compression system in the prevention of venous stasis.

Objective: The current commercially available sequential intermittent pneumatic compression device used for the prevention of deep venous thrombosis has a constant cycle of 11 seconds' compression and 60 seconds' deflation. This deflation period ensures that the veins are filled before the subsequent cycle begins. It has been suggested that in some positions (eg, semirecumbent or sitting) and with different patients (eg, those with venous reflux), refilling of the veins may occur much earlier than 60 seconds, and thus a more frequent cycle may be more effective in expelling blood proximally.

Relative risk of cancer in sonographically detected thyroid nodules with calcifications.

Purpose: The aim of this prospective study was to evaluate the significance of sonographically detected thyroid calcifications in the diagnosis of thyroid cancer.

Methods: One hundred eighty-eight patients with thyroid disease, including 37 with thyroid cancer, were included in the study. Each patient underwent preoperative, high-resolution sonography to evaluate the thyroid gland for the presence of calcifications.

Surgical treatment of non-parasitic hepatic cysts: report of 12 cases.

Objective: To present our experience of non-parasitic hepatic cysts.

Design: Retrospective study.

Setting: University Hospital, Greece.

Treatment of patients with severe acute necrotizing pancreatitis based on prospective evaluation.

Background/aims: To examine the impact of a prospectively applied diagnostic and treatment protocol in patients with severe acute necrotizing pancreatitis.

Methodology: During a 4-year period (1993-1996), 26 patients were treated for necrotizing pancreatitis, as documented by contrast-enhanced computed tomography (CE-CT). All patients were prospectively treated by medical means.

Popliteal venous aneurysm mimicking a soft tissue tumour. A case report.

A case of a giant, thrombosed popliteal venous aneurysm without pulmonary embolism in a 53-year-old woman is reported. Despite thorough preoperative investigation including ultrasound and magnetic resonance imaging, this was misdiagnosed as a benign soft tissue tumour. During the operation the thrombosed venous aneurysm was resected and a vein graft from the contralateral saphenous vein was interposed.

Intra-arterial versus systemic chemotherapy for non-operable hepatocellular carcinoma.

Background/aims: To compare intra-arterial (regional) hepatic chemotherapy with doxorubicin, to the systemic (intravenous) one in patients with non-resectable (Stage IVA) hepatocellular carcinoma.

Methodology: Seventy-two patients with inoperable hepatocellular carcinoma were randomized to receive doxorubicin 50 mg/m2 as a bolus infusion either via an implantable intra-arterial catheter (Group A) or as systemic chemotherapy (Group B) every 21-28 days.

Results: Patients of Group A had a higher rate of objective and subjective remissions and Karnofsky performance status improvement in comparison to Group B.

Aortocaval fistula in ruptured aneurysms.

Objectives: to study incidence, clinical presentation and problems in management of aortocaval fistula in our series.

Design: retrospective study.

Materials: during a seven-year period, 112 patients operated on for abdominal aortic aneurysm, including four patients with aortocaval fistula.

Ductectatic mucinous cystadenocarcinoma of the pancreas: a rare variant.

A rare case of the ductectatic variant of mucinous pancreatic cystadenocarcinoma in a 64 year-old man, presenting with painless obstructive jaundice, is reported. CT scan revealed a multicystic lesion of the pancreatic head, which caused biliary obstruction. Endoscopic retrograde pancreatography (ERP) revealed the characteristic grapelike cluster pattern of pancreatic ductectatic neoplasms.

Seasonal variation of the abdominal aortic aneurysm rupture in southwestern Greece.

Objective: To examine the hypothesis of seasonal variation in the rupture of abdominal aortic aneurysm in our region.

Design: Retrospective open study.

Setting: University Hospital, Greece.

Nonabsorbable antibiotics reduce bacterial and endotoxin translocation in hepatectomised rats.

There is increasing evidence that septic complications, occurring after major hepatectomies, may be caused by gram negative bacteria, translocating from the gut. We investigated in rats, the effect of extended hepatectomy on the structure and morphology of the intestinal mucosa as well as on the translocation of intestinal bacteria and endotoxins. We also examined the effect of nonabsorbable antibiotics on reducing the intestinal flora and consequently the phenomenon of translocation by administering neomycin sulphate and cefazoline.