The Poet and the Prince: John Keats and Astley Cooper.

John Keats was one of the great Romantic poets. For 17 months, he was also a medical student at Guy's Hospital before deciding to devote all of his time to poetry. His most influential teacher was Astley Cooper, one of the greatest surgeons of the 19th century.

Credit where due.

The history of medicine is filled with stories of tireless researchers who failed to get credit for their hard work. Examples of this include Rosalind Franklin, who helped to elucidate the structure of DNA; Frederick Banting, who helped to discover insulin; and Jay McLean, who discovered heparin. The founding of the field of vascular surgery provides one of the most vivid examples of uncredited work.

Laser Science and Limb Salvage.

Harnessing light energy in the form of lasers became possible after the discovery of electricity. Scientists found various uses for lasers beginning in the 1960s. Creating large amounts of pulsed UV light with any device, including a laser, remained difficult until excimer lasers were invented in the following decade.

Hypogastric preservation with Viabahn stent graft during endovascular aneurysm repair.

The presence of bilateral iliac aneurysms extending to the iliac bifurcations, in conjunction with an abdominal aortic aneurysm, complicates endovascular repair because of the difficulty of preserving one or both hypogastric arteries. Several open techniques have been suggested for hypogastric preservation, but they usually involve some type of anatomic or extra-anatomic bypass. Endovascular techniques for hypogastric preservation include branch iliac grafts, chimney grafts, and bellbottom limbs.

Standardizing vascular surgery residency: merger of two programs to create one model.

The practice of vascular surgery has been transformed in the last decade. It is now necessary to change the way we train vascular surgeons, to keep pace with this rapidly evolving specialty.

Neural inhibition of inflammation: the cholinergic anti-inflammatory pathway.

The innate immune system is activated by infection and injury to release pro-inflammatory cytokines, which activate macrophages and neutrophils and modulate specific cellular responses. The magnitude of the cytokine response is critical, because a deficient response may result in secondary infections, while an excessive response may be more injurious than the original insult. We recently described a neural pathway, termed the "cholinergic anti-inflammatory pathway", that reflexively monitors and adjusts the inflammatory response by inhibiting pro-inflammatory cytokine synthesis.

The cholinergic anti-inflammatory pathway: a missing link in neuroimmunomodulation.

This review outlines the mechanisms underlying the interaction between the nervous and immune systems of the host in response to an immune challenge. The main focus is the cholinergic anti-inflammatory pathway, which we recently described as a novel function of the efferent vagus nerve. This pathway plays a critical role in controlling the inflammatory response through interaction with peripheral a7 subunit-containing nicotinic acetylcholine receptors expressed on macrophages.

Clinical application of eversion carotid endarterectomy.

The results of 250 eversion carotid endarterectomies (ECEAs) in 227 consecutive patients in 1 institution were evaluated. The outcomes of 250 consecutive ECEAs at North Shore University Hospital by a single surgeon, between January 1998 and August 2001, were recorded prospectively. In the single series of 250 ECEAs the 30-day operative mortality was 0.

Use of a local fasciocutaneous flap for treatment of exposed vascular grafts to the dorsalis pedis artery.

Exposed or infected peripheral vascular grafts pose a significant challenge to the vascular surgeon. Although graft removal and extraanatomic bypass is feasible in selected circumstances, this procedure is generally not applicable for bypass to the pedal vessels. Preservation of patent grafts is almost always required for limb salvage.

The gesture life of high mobility group box 1.

Purpose Of Review: Products of infection, ischemia, and injury stimulate the innate immune system to release proinflammatory cytokines, which act locally to activate specific cellular immune responses and initiate recovery. In pathological cases, however, cytokines are released systemically, resulting in progressive tissue injury, hypotension, organ dysfunction, or death. Observations that animals frequently succumb to systemic inflammation long after the peak activity of tumor necrosis factor and interleukin-1beta suggest that later-acting, downstream inflammatory factors can mediate the pathological sequelae of lethal systemic inflammation.

Combined off-pump coronary artery bypass and abdominal aortic surgery is associated with low morbidity and mortality.

Patients with abdominal aortic aneurysms (AAAs) often have concomitant coronary artery disease. In patients with large or symptomatic AAAs and symptomatic coronary artery disease, it may be necessary to address both problems simultaneously. We report a case series of five patients undergoing simultaneous off-pump coronary artery bypass and abdominal aortic reconstruction.

Pseudoaneurysm of the subclavian-vertebral artery junction--case report and review of the literature.

Pseudoaneurysm of the subclavian-vertebral artery junction (SVJ) is a rare complication of internal jugular vein catheter placement. Because of its retroclavicular location, arterial injury at the SVJ poses a significant therapeutic challenge. A case report and review of the literature are presented.

Cholinergic antiinflammatory pathway inhibition of tumor necrosis factor during ischemia reperfusion.

Objective: Ischemia-reperfusion injury is a pathologic event characterized by tissue damage. It is mediated by tumor necrosis factor (TNF) and other cytokines that activate complement and proteases and stimulate fibrinolysis, degranulation of white blood cells, and free radical production. We recently reported that vagus nerve stimulation (VNS) suppresses endotoxin-induced cytokine synthesis through alpha bungarotoxin-sensitive cholinergic receptors.

Lower extremity compartment syndrome after coronary artery bypass.

Compartment syndrome is a rare and dangerous complication of coronary artery bypass. All reported cases involved the vein donor limb. Once recognized, immediate fasciotomy is necessary to prevent irreversible ischemia and limb loss.

Leg revascularization in patients with calciphylaxis.

Calciphylaxis is a rare complication in patients undergoing hemodialysis. The pathogenesis and risk factors for this disease are poorly understood, although an association with secondary hyperparathyroidism has been suggested. Only two cases of lower-extremity revascularization of patients with calciphylaxis appear in the literature; this report adds two more.

Pedal branch arterial bypass for limb salvage.

In patients with critical lower extremity ischemia and occlusion of the distal tibial and pedal arteries bypasses to pedal artery branches may offer the only alternative to primary amputation. The results of 22 pedal branch arterial bypasses are reported, and a review of the literature is offered. The charts of 22 patients undergoing pedal branch arterial bypass during a 12-year period were retrospectively reviewed.