Navigating Identity: The Intersection of Social and Biological Identity from the World War II Battle of Tarawa.

The 1943 Battle of Tarawa resulted in the loss of approximately 1,000 US service members on or around Betio Island, Tarawa Atoll, Republic of Kiribati. Nearly half these casualties were accounted for after the battle. The Defense POW/MIA Accounting Agency (DPAA) has worked to identify the remaining ∼510 unaccounted-for service members and has successfully identified ∼160 service members to date.

Flow characteristics of peripherally inserted central catheters.

Purpose: Clinical applications of peripherally inserted central catheters (PICCs) are limited by the relatively small lumina and long lengths of these devices. Quantitative analysis of the flow capabilities of a variety of PICCs was performed to aid in deciding which patients should have a PICC and in selecting the appropriate catheter.

Materials And Methods: Sixteen different PICCs from six manufacturers were infused at flow rates of 25-270 mL/h.

Percutaneous transluminal angioplasty of visceral arterial stenoses: results and long-term clinical follow-up.

Purpose: To determine the efficacy and safety of percutaneous transluminal angioplasty (PTA) of the visceral arteries.

Patients And Methods: We retrospectively evaluated the results of PTA performed in 20 visceral arteries in 19 patients (10 men, nine women; mean age, 63 years). Eleven patients had symptoms characteristic of mesenteric ischemia, four had atypical abdominal pain, and four were undergoing prophylactic dilation before undergoing another procedure involving the abdominal aorta.

Contemporary diagnostic approaches to acute pulmonary emboli.

Because of its availability and familiarity, the V/Q scan remains the most frequently used noninvasive screening study for the diagnosis of acute PE. Fast CT and MR imaging techniques probably will have more significant roles in the future in the diagnosis and management of PE, but limited availability and familiarity with these imaging modalities make it impractical to currently recommend them as primary screening tools for acute PE. Although the cost and time benefits appear to place fast CT ahead of MR imaging, more clinical experience and a greater understanding of the imaging nuances and pitfalls of interpretation for both fast CT and MR imaging are needed.

Recent development of rigors during infusion of urokinase: is it related to an endotoxin?

Purpose: This study was undertaken to determine the prevalence of rigors associated with the use of urokinase (UK) and to assay for the presence of an endotoxin in the UK solution.

Patients And Methods: Records of 75 patients who underwent 86 UK infusions between January 1988 and July 1992 were reviewed to evaluate for the development of UK-associated rigors. A modified chromogenic limulus amebocyte lysate (LAL) test was performed to determine the presence of endotoxin in four samples of UK from lots associated with rigors, one sample of UK not associated with rigors, sterile water, nonionic contrast medium, and ionic contrast medium.

Reducing the discomfort of lidocaine administration through pH buffering.

Purpose: A prospective, double-blind study was undertaken to evaluate the effect of using a buffered lidocaine solution on the perception of pain experienced by a patient during its intradermal injection.

Patients And Methods: One hundred fifty patients undergoing diagnostic angiographic and interventional procedures at the authors' institution were randomly assigned to receive a 1-mL aliquot of one of three lidocaine solutions: plain 1% lidocaine, 1% lidocaine diluted with normal saline in a 10:1 ratio, and 1% lidocaine diluted with 8.4% sodium bicarbonate in a 10:1 ratio.

Peripheral angioplasty balloon technology.

Changes in balloon and catheter technology have led to the development of smaller, more flexible, and less traumatic balloon dilatation systems. The physical principles that govern balloon angioplasty and the current status of balloon materials and catheter designs will be reviewed. A compilation of various angioplasty catheters is also summarized.

Balloon angioplasty above the aortic arch: immediate and long-term results.

Objective: Angioplasty above the level of the aortic arch is becoming more common, and the indications for it are increasing. We report our experience with this procedure, including life-table analysis of the long-term results.

Materials And Methods: We dilated 32 lesions in 29 patients.

Thromboembolectomy with the transluminal extraction catheter (TEC) as an adjunct to thrombolysis.

Multiple surgical and percutaneous interventional radiologic techniques have been used to restore blood flow in an acutely ischemic extremity. The transluminal extraction catheter (TEC) system was used as a mechanical thromboembolectomy device to supplement pharmacologic thrombolysis in one patient. In this case, 40 hours of direct intraarterial infusion of urokinase into the occluded vascular segments of a threatened lower extremity resulted in incomplete thrombolysis.

Treatment of hemodialysis fistula pseudoaneurysms with detachable balloons: technique and preliminary results.

Pseudoaneurysm formation is commonly encountered during the life of a dialysis fistula. When these become excessively large or numerous, surgical revision of the graft has been the only treatment option. The authors have treated seven patients by using percutaneous placement of a detachable balloon to occlude a pseudoaneurysm of an upper extremity graft.

Normal venous anatomy and collateral pathways in upper extremity venous thrombosis.

Collateral pathways are well known in superior vena cava occlusion but not in axillary or subclavian vein occlusion, even though these occlusions are becoming more common. In a series of 127 arm venograms obtained for suspected venous thrombosis, the authors found 32 instances of subclavian or axillary vein occlusion. The authors reviewed the cases for site of occlusion and definition of collateral pathways.

Circumferential rupture of an angioplasty balloon with detachment from the shaft: case report.

Rapidly evolving angioplasty balloon techniques need continual evaluation for the type or frequency of balloon-related complications. We recently encountered a case where a new narrow shaft polyethylene terephthalate balloon completely separated from the catheter following circumferential rupture. The balloon was successfully retrieved using grasping forceps and a basket.

Real-time ultrasound for the detection of deep venous thrombosis.

Purpose: Accurate diagnosis of deep venous thrombosis (DVT) is a clinical problem in emergency practice. A prospective trial was conducted comparing real-time ultrasound with contrast venography in the diagnosis of proximal DVT.

Methods: Seventy patients whose clinical presentations mandated diagnostic evaluation for DVT had real-time ultrasound of the involved leg followed by contrast venography.

Results and complications of angioplasty in aortoiliac disease.

Percutaneous transluminal angioplasty was used to treat 340 aortoiliac lesions in 200 patients who were followed for as long as 90 months (mean, 28.7 months; median, 23 months). The initial success rate was 94.

Results and complications of angioplasty in fibromuscular disease.

Percutaneous transluminal angioplasty (PTA) was used to treat 66 patients with 85 renal artery stenoses due to fibromuscular dysplasia. The hypertension was refractory to medical management in 46 patients, and the initial success rate was 100%. Clinical follow-up has been obtained in all patients, who were followed for as long as 121 months.

New balloon-through-balloon angioplasty technique for the treatment of segmental lesions.

A new balloon catheter on a wire that can be passed through standard 5- and 7-F angioplasty catheters recently became available. This capability allowed the authors to dilate segmental arterial lesions in which different balloon sizes were required without multiple catheter exchanges. Six patients were successfully treated with this technique, without complications.

Vascular injury following foreign body perforation of the esophagus. Review of the literature and report of a case.

Esophageal perforation resulting from foreign body ingestion is a rare occurrence. Most of the complications associated with this event, such as retroesophageal abscess, mediastinitis, pericarditis, pneumothorax, and pneumomediastinum, are widely recognized. However, little attention has been directed to the possibility of vascular injury caused by the perforating object.

Experience with new retrieval forceps for foreign body removal in the vascular, urinary, and biliary systems.

A new type of foreign body retrieval forceps recently has become available. It consists of single- or multiple-tooth forceps mounted on a flexible stainless steel 0.038-inch shaft.

Inferior vena caval invasion by renal cell carcinoma: false positive diagnosis by venacavography.

We reviewed the records of 22 renal cell carcinoma patients who were referred to this hospital to determine inferior vena caval extension of tumor. Preoperative radiological studies from referring hospitals and this institution were compared to the operative findings. Four cases of false positive inferior vena caval involvement on preoperative venacavograms performed and interpreted elsewhere were identified.

In situ lithotripsy of ureteral calculi: review of 261 cases.

The authors report 261 cases of single ureteral calculi treated with in situ lithotripsy after retrograde manipulations had failed. Previous reports have indicated that extracorporeal lithotripsy of impacted ureteral calculi has not been highly successful. Two hundred five of the calculi were located in the proximal ureter, above the sacroiliac joint; 27 were in the presacral ureter, overlying the bony pelvis; and 29 were in the juxtavesicular ureter, below the inferior border of the sacroiliac joint.