A cumulative analysis of an individual surgeon's early experience with elective open abdominal aortic aneurysm repair.

Background: Several studies have reviewed the role of hospital and surgeon case volumes in determining early mortality after elective open abdominal aortic aneurysm (AAA) repair. Few, however, have analyzed this relationship at the individual surgeon level. The purpose of this study was to display the usefulness of a unique statistical tool as a form of an ongoing practice audit.

Risk-adjusted analysis of outcomes following elective open abdominal aortic aneurysm repair.

The purpose of this study was to describe a method to analyze outcomes following open abdominal aortic aneurysm (AAA) repair while considering the variability in patients' preoperative risk. Consecutive patients undergoing elective open infrarenal AAA repair during a 4-year period (2000-2003) were reviewed. Thirty-day or in-hospital mortality was the major outcome variable.

The use of 3D epiaortic scanning to enhance evaluation of atherosclerotic plaque in the ascending aorta: a case series.

Transesophageal echocardiography (TEE) is becoming the standard of practice for cardiopulmonary bypass (CPB) surgery. Unfortunately, large sections of the ascending aorta are not visible on TEE, and epiaortic scanning has proven superior to TEE and aortic palpation in determining the extent of plaque in the ascending aorta. The recently introduced x4 3-dimensional (3D) ultrasound probe allows both real time 3D imaging and gated acquisition sequences.

Human central nervous system tissue culture: a historical review and examination of recent advances.

Tissue culture has been and continues to be widely used in medical research. Since the beginning of central nervous system (CNS) tissue culture nearly 100 years ago, the scientific community has contributed innumerable protocols and materials leading to the current wide variety of culture systems. While nonhuman cultures have traditionally been more widely used, interest in human CNS tissue culture techniques has accelerated since the middle of the last century.

Is more frequent hemodialysis beneficial and what is the evidence?

Purpose Of Review: The HEMO study results have shown that increasing dialysis dose in conventional thrice weekly hemodialysis does not improve patient outcomes. Interest has therefore turned to more frequent (daily) hemodialysis treatments. This review covers the rationale for such an approach together with a current review of the published study data.

Family cancer histories predictive of a high risk of hereditary non-polyposis colorectal cancer associate significantly with a genomic rearrangement in hMSH2 or hMLH1.

Hereditary non-polyposis colorectal cancer (HNPCC) results from inactivating germline mutations in a set of DNA-mismatch-repair genes, of which the most clinically relevant are hMSH2 and hMLH1. Computer-assisted pedigree risk assessment tools are available to assist in the calculation of an individual's likelihood of bearing such a deleterious mutation. One such tool, cancergene version 3.

Simplified intensity-modulated arc therapy for dose escalated prostate cancer radiotherapy.

Simplified intensity-modulated arc therapy (SIMAT) employs forward planned, conformal, and avoidance arc combinations with dynamic multileaf collimation (MLC) as a simpler alternative to other forms of intensity-modulated radiotherapy (IMRT). In this work, we compare SIMAT with 4-field (4F) and 6-field (6F) 3D conformal radiation therapy (CRT) for prostate cancer treatment. Prostate, seminal vesicle, bladder, and rectum were contoured on the CT images of 10 patients being planned for radiotherapy.

Orthostatic hypotension occurs frequently in the first hour after anesthesia.

Unlabelled: Symptoms of orthostatic intolerance are common after general anesthesia and are associated with an increased risk of postoperative morbidity. The contribution of orthostatic hypotension (OH) has not been well defined. We conducted a head-up tilt test on patients after general anesthesia for minor surgery to assess the incidence of and risk factors for OH after general anesthesia.

Nocturnal but not short hours quotidian hemodialysis requires an elevated dialysate calcium concentration.

Interest in quotidian (daily) hemodialysis (HD) is growing. Some advocate short-hours high-efficiency daily HD (SDH) and others long-hours slow-flow nocturnal HD (NH) while the patient is asleep, both being used 5 to 7 d/week. The London Daily/Nocturnal Hemodialysis Study was the first attempt to obtain data of SDH and NH that may be compared with conventional thrice weekly HD (CH).

Effects of thrombolysis for acute stroke in patients with pre-existing disability.

Background: Thrombolysis for acute stroke is beneficial in selected patients. Because clinical trials generally exclude patients with pre-existing disability, this subgroup of patients has not been studied. We examined the outcomes after thrombolysis of patients with and without disability before their stroke.

Hemodynamic and volume changes during hemodialysis.

Background: Volume overload is a factor in the hypertension of hemodialysis (HD) patients. Fluid removal is therefore integral to the hemodialysis treatment. Fluid removal by hemodialysis ultrafiltration (UF) may cause intradialytic hypotension and leg cramps.

Management of bacillus Calmette-Guerin (BCG) refractory superficial bladder cancer: results with intravesical BCG and Interferon combination therapy.

Introduction And Objective: BCG is the most efficacious intravesical treatment for superficial bladder cancer. However, 30%-40% of tumors are refractory. BCG failure is an indication for cystectomy but several salvage intravesical (IVe) strategies have been proposed.

WBC reduction reduces storage-associated RBC adhesion to human vascular endothelial cells under conditions of continuous flow in vitro.

Background: The effects of storage duration, WBC reduction, and irradiation on RBC adherence to vascular endothelia are unknown and are investigated under conditions of continuous flow.

Study Design And Methods: Thirty-two RBC units were collected and divided into three groups, non-WBC-reduced (NWR), WBC-reduced (WR), and irradiated-WBC-reduced. Aliquots of RBCs were removed on Days 1, 15, and 28 of storage for analysis.

Central, peripheral, and other blood volume changes during hemodialysis.

Volume overload is a factor in development of hypertension in hemodialysis patients. Fluid removal by hemodialysis (HD), however, may cause intradialytic hypotension and associated symptoms. A better understanding of the relationships between blood pressure volume status and the pathophysiology of fluid removal during HD are, therefore, necessary to control blood pressure and to eliminate intradialytic hypotension.

Are hemodialysis access flow measurements by ultrasound dilution the standard of care for access surveillance?

Maintenance of vascular access function is vital to the delivery of adequate hemodialysis therapy. Failure of function is associated with significant morbidity and cost. Thus, access surveillance programs are suggested.

Reduced requirement for erythropoietin with quotidian hemodialysis therapy.

Quotidian (daily) hemodialysis has many potential advantages over conventional three times weekly hemodialysis, including improved control of anemia. However, previous reports do not consistently describe beneficial effects regarding anemia and erythropoietin requirements. We sought to determine whether erythropoietin dose is altered in this form of therapy, and elucidate the potential contributing factors.

Detection of submicroscopic aberrations in patients with unexplained mental retardation by fluorescence in situ hybridization using multiple subtelomeric probes.

Purpose: To further assess the frequency of subtelomeric aberrations in a selected population and to examine the feasibility of a clinical testing.

Methods: Patients were selected based on the following criteria: (1) mental retardation (IQ < 70) or developmental delay with dysmorphic features; (2) a normal karyotype at the level of resolution of 450 to 500 bands; and (3) exclusion of other possible etiologies by a full genetic assessment and relevant tests. Fluorescence in situ hybridization (FISH) was performed using multiple subtelomeric probes.

Nestin expression in cortical dysplasia.

Object: It is recognized that cortical dysplasia (CD) is associated with an increased incidence of glioneuronal neoplasms. Among hypothetical considerations, there is the possibility that CD and other neuronal migration abnormalities harbor dysmature cells with the potential to give rise to glioneuronal neoplasms. Such cells, if present, would be reasonably expected to display immature features.

Red wine-cisapride interaction: comparison with grapefruit juice.

Objectives: Our objective was to compare the interactions of red wine and grapefruit juice with cisapride.

Methods: The oral pharmacokinetics of cisapride, its norcisapride metabolite, and electrocardiographic QTc interval were determined over a 24-hour period after administration of cisapride 10 mg with 250 mL grapefruit juice, red wine (cabernet sauvignon), or water in a randomized 3-way crossover study in 12 healthy men.

Results: The cisapride area under the concentration-time curve (AUC) and the maximum plasma drug concentration after single-dose administration (C(max)) with grapefruit juice were 151% (P <.

Vascular smooth muscle cells of recipient origin mediate intimal expansion after aortic allotransplantation in mice.

Intimal expansion by vascular smooth muscle cells (SMCs) is a characteristic feature of graft vascular disease. Whether graft intimal SMCs arise from donor or recipient tissue is not well established but has important pathogenetic implications. We examined for the presence of male cells in the expanded intima of sex-mismatched mouse aortic allografts (C57BL/6-to-BALB/c) at 30 or 60 days after transplant by in situ hybridization using a Y-chromosome probe.

GEWF solution.

Background: Lymph node status is an important prognostic factor in the staging of colorectal carcinoma. Several adjunctive solutions have been used to increase the yield of pericolic lymph nodes from colorectal cancer resection specimens.

Methods: During 1998 at the Grey Bruce Regional Health Centre (Owen Sound, Ontario), 67 colonic resections were performed for colorectal cancer.