Abstract:
BACKGROUND:The relationship between preoperative stenosis and the effect of carotid endarterectomy (CEA) upon internal carotid blood flow (ICF) is not well understood. With the intention of better characterizing this, we compared intraoperative measurements of internal carotid blood with the maximum single diameter stenosis found in preoperative angiograms. METHODS:Fifty-two patients undergoing 64 carotid endarterectomies (12 bilateral) had transit-time ultrasound perivascular probes used to measure ICF before and after CEA, and the percent change in ICF (% delta ICF) achieved was calculated. Maximum single-diameter stenosis was determined by comparing the least diameter in the flow path from the common carotid to the normal-appearing internal carotid just distal to bifurcation disease. RESULTS:The entire group had a mean of 53 +/- 21% stenosis found on preoperative angiograms, and % delta ICF averaged 64 +/- 92%. When divided into subgroups based on degree of stenosis, patients with 0% to 40% stenosis (n = 17) had % delta ICF of 32 +/- 46%, patients with 41% to 70% stenosis (n = 30) had % delta ICF of 72 +/- 105%, and patients with more than 70% stenosis had % delta ICF of 168 +/- 160%. The differences in % delta IC were significant for the > 70% group compared with the other groups (analysis of variance, P < 0.005), and marginally significant (P = 0.056) between the 0% to 40% and the 41% to 70% groups. The scatter plot of % delta ICF versus stenosis showed a significant second order direct correlation (r = 0.428, P < 0.001) and disproportionate increases in ICF above 60% stenosis. CONCLUSION:A curvilinear relationship between stenosis and immediate increase in ICF after CEA was demonstrated in agreement with theory, and in those patients with more than approximately 60% single-diameter stenosis, large disproportionate increases in blood flow were more frequently observed.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Gordon IL,Stemmer EA,Williams RA,Arafi M,Wilson SEdoi
10.1016/s0002-9610(94)80051-0subject
Has Abstractpub_date
1994-08-01 00:00:00pages
127-30issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(94)80051-0journal_volume
168pub_type
杂志文章abstract::An eighteen month study of the incidence of nosocomial infections was conducted at a 436 bed general army hospital. The overall rate of nosocomial infection was 1.48 per cent, with a monthly range of 0.42 to 2.30 per cent. Gynecology had the highest rate of 5.8 per cent. Escherichia coli, klebsiella, and Staphylococcu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90410-x
更新日期:1977-09-01 00:00:00
abstract:PURPOSE:Vascular smooth muscle cell (VSMC) proliferation is an early event in the pathogenesis of atherosclerosis. Insulin and glucose are known to stimulate the growth of VSMC. Cell membrane receptors play an important role in the proliferation of VSMC in response to growth factors. Insulin and insulin-like growth fac...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00150-6
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:The multimodality addition of preoperative gabapentin, acetaminophen, and celecoxib (GAC) and postoperative TENS has been recommended to diminish narcotics. We predict that GAC-TENS implementation will reduce recovery room time, improve pain control, reduce narcotic refills, and demonstrate usefulness of TEN...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.01.070
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:In women undergoing breast conserving surgery (BCS), up to 60% can require re-excision. Our objective is to develop an optically based technology which can differentiate benign from malignant breast tissues intraoperatively through differences in tissue composition factors. METHODS:A prospective study of op...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjsurg.2009.06.018
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Response evaluation criteria in solid tumors (RECIST) is the accepted method for determining tumor progression. However, RECIST may not estimate disease burden accurately because the axial plane often does not produce the actual longest diameter. Volumetric measurements may be an alternative to better determ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.07.007
更新日期:2012-11-01 00:00:00
abstract::The records of 123 patients with squamous cell cancer of the lip presenting to the Vancouver Clinic of the British Columbia Cancer Agency from 1984 and 1988 were reviewed, and 4 were excluded from the study for various reasons. Initial treatment was surgery in 40, radiotherapy in 61, and combined in 18 patients. The p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90389-9
更新日期:1992-05-01 00:00:00
abstract::By means of intragastric instillation of meat extract, two groups of duodenal ulcer patients were identified--antral responders and antral nonresponders. Antral response was abolished ater vagotomy and drainage or vagotomy-antrectomy. The differentiation would allow for selective surgery for duodenal ulcer patients. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90355-5
更新日期:1977-08-01 00:00:00
abstract::The determination of intestinal viability intraoperatively remains difficult. Intestinal blood flow can be demonstrated in the serosa and mesentery-bowel junction by use of the Doppler ultrasound flow detector. The presence of flow in these areas after an ischemic episode correlates well with ultimate viability of the...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90337-2
更新日期:1975-06-01 00:00:00
abstract::The survival of 103 patients operated on for advanced carcinoma of the stomach other than the cardia was assessed. The median duration of survival for patients subjected to palliative partial gastrectomy, total gastrectomy, gastrojejunostomy, and biopsy only was 24, 22, 11, and 10 weeks, respectively. All of these pat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90051-4
更新日期:1982-06-01 00:00:00
abstract:BACKGROUND:Although increasingly administered to patients with pancreatic ductal adenocarcinoma, the role of preoperative therapy for patients with distal cholangiocarcinoma is undefined. METHODS:All patients with distal cholangiocarcinoma who underwent pancreatoduodenectomy between 1999 and 2014 were retrospectively ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.08.024
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Multivisceral resection is often required in the treatment of locally advanced rectal cancers. Such resections are relatively rare and oncologic outcomes, especially when sphincter preservation is performed, are not fully demonstrated. METHODS:A retrospective review was conducted of patients who underwent m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.10.014
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Predicting length of stay (LOS) is difficult for trauma and emergency general surgery (TEGS) patients. Our aim was to determine the accuracy of LOS predictions by TEGS team members and the NSQIP Risk Calculator and the patient factors associated with inaccurate predictions. METHODS:LOS for 200 TEGS patients...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.01.055
更新日期:2020-09-01 00:00:00
abstract::We attempted to determine the incidence and significance of cytomegalovirus infection and the effect of immunoglobulin G infusions on specific cytomegalovirus titers in burn patients. On admission, 48 percent of a group of 120 patients (mean burn size 28.5 percent of the total body surface area) were seronegative, inc...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(88)80718-9
更新日期:1988-02-01 00:00:00
abstract:BACKGROUND:Necrotizing pancreatitis is a common condition with high mortality; the acute care surgeon is frequently consulted for management recommendations. Furthermore, there has been substantial change in the timing, approach, and frequency of surgical intervention for this group of patients. METHODS:In this articl...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2020.08.027
更新日期:2020-08-26 00:00:00
abstract::Maximal anal pressures have been measured after proctoscopy in 145 patients with hemorrhoids, 48 patients with anal fissure, and 78 asymptomatic control subjects. Anal pressures in patients with hemorrhoids (106 +/- 40 cm H2O) and anal fissure (130 +/- 43 cm H2O) were very significantly higher than those of controls (...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90445-7
更新日期:1977-11-01 00:00:00
abstract:BACKGROUND:Little is known about postgastrectomy syndrome and quality of life (QOL after laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG). The aim of this study was to assess postgastrectomy syndrome and QOL after LAPPG as compared with laparoscopy-assisted distal gastrectomy with Billroth-I reconstruction (...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.09.041
更新日期:2017-04-01 00:00:00
abstract::A seven day old dehydrated male infant was found to have acute ischemia of the leg due to acute thrombotic occlusion of an external iliac, common and superficial femoral, and popliteal arteries. Early thrombectomy and arterioplasty resulted in complete remission of ischemia. Our success with direct vascular surgery pr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90254-8
更新日期:1975-03-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to examine the outcomes of checklist-driven preoperative briefings and postoperative debriefings during the Veterans Health Administration (VHA) medical team training program. METHODS:A briefing score (1, never started; 2, started then discontinued; 3, maintained on original ta...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.07.011
更新日期:2010-11-01 00:00:00
abstract::Diabetic neuropathic ulcers are thought to arise from repetitive injury during normal walking in areas of high plantar pressures. It has been suggested that metatarsal head (MTH) resection alleviates elevated pressures at the site of the ulcer and, thus, expedites healing and prevents recurrence. We investigated the e...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90203-8
更新日期:1994-03-01 00:00:00
abstract::The p53 tumor suppressor gene has been implicated in human esophageal tumorigenesis, and mutations are reported in primary esophageal adenocarcinomas and associated Barrett's epithelium. To evaluate the potential clinical significance of this molecular genetic marker in the progression of Barrett's epithelium to invas...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90053-1
更新日期:1994-01-01 00:00:00
abstract::The relative merits of the anterior and posterior approaches to the adrenal gland were assessed in a series of 103 patients with bilateral cortical hyperplasia or unilateral cortical adenoma (less than 25 g). In none of the patients was additional concomitant surgery planned. Sixty-four patients were operated on throu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90010-1
更新日期:1982-09-01 00:00:00
abstract::Seroma is a frequent sequelae of neck dissection involving cervical lymphadenectomy. The incidence is correlated with flap elevation, lymphovascular interruption, and tissue removal. Current methods of resolving seroma, such as vacuum drainage, are not risk free. A novel approach to this problem was the use of intraop...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80301-5
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:The objective of this study was to investigate whether the preoperative hematologic markers, the platelet-lymphocyte ratio (PLR), or the neutrophil-lymphocyte ratio (NLR) ratio are significant prognostic indicators in resected pancreatic ductal adenocarcinoma. METHODS:A total of 84 patients undergoing pancr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.08.041
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Surgeons who have demonstrated excellence through extensive publication in the medical education literature can provide valuable guidance for new surgeons interested in educational research. METHODS:National databases identified members of the Association for Surgical Education (ASE) who have accumulated th...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00301-9
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Leakage from esophageal anastomoses is higher than that for other gastrointestinal anastomoses. An intrathoracic anastomotic leak is a potentially catastrophic event. METHODS:Patients with and without thoracic anastomotic leakage were compared for predisposing factors. Leak-related mortality was analyzed. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00559-1
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Splenectomy is generally a second-line therapy in patients with immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AHA) refractory to medical therapy. Our objective was to evaluate outcomes after splenectomy for these disorders. METHODS:A retrospective review of the medical records of pa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.05.030
更新日期:2012-12-01 00:00:00
abstract::Following its introduction in 1993, the LAP-BAND (INAMED Health, Santa Barbara, CA) has been used extensively across the world for the treatment of obesity, and data on safety and effectiveness are now available. This review draws on the literature and our own clinical patient base to provide an overview of the early ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(02)01179-0
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:This study analyzed presentation and management of hemorrhage after pancreaticoduodenectomy (PD) to determine the respective role of surgery and embolization. METHODS:From January 1992 to March 2005, 411 patients underwent PD and were analyzed with regard to postoperative hemorrhage. RESULTS:Hemorrhage occ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.08.088
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:We propose a simple algorithm for management of patients with challenging abdominal fascial defects. METHODS:The medical records of 64 patients with complicated abdominal wall defects representing a consecutive series by a single surgeon over a 4-year period were reviewed. Group I patients presented with ma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00566-3
更新日期:2001-02-01 00:00:00
abstract:PURPOSE:Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for full-thickness excision of benign and malignant rectal neoplasms located 4 to 24 cm above the anal verge. Entrance into the peritoneal cavity during TEM has been regarded as a complication that mandates conversion to open laparotomy f...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.01.004
更新日期:2004-05-01 00:00:00