PubMed Health⌕ Search

Biomedical subjects

A Lossing

Publications and source records attributed to A Lossing.

12 recordsLinked to original sources
PubMed1993

Nonanastomotic pseudoaneurysm of expanded polytetrafluoroethylene axillofemoral bypass graft.

A case of nonanastomotic pseudoaneurysm of a unilateral axillofemoral bypass graft is reported. The graft material used in this particular instance was an 8 mm, reinforced, thin-walled, fluorinated ethylene-propylene-ringed, expanded polytetrafluoroethylene (ePTFE). The pseudoaneurysm occurred 1 year after insertion of the graft and was not associated with any direct trauma. It manifested with a painful tender mass at the top of the body of the axillofemoral bypass graft at the level of the nipple line. There were no symptoms of localized or diffuse sepsis. Immediate surgical exploration confirmed the diagnosis of a pseudoaneurysm of the ePTFE graft. Successful repair of the disrupted segment was accomplished by use of an interposition, nonringed, reinforced, thin-walled, 8 mm ePTFE graft. To our knowledge this is the first case of a nonanastomotic pseudoaneurysm of a ringed, ePTFE, axillofemoral bypass graft not associated with direct trauma.

Adult↗
PubMed1992

A prospective controlled trial of teaching basic surgical skills with 4th year medical students.

Scrubbing, gowning, gloving and aseptic technique are currently the only formal teaching 4th year medical students receive at the beginning of an 8-week surgery rotation. Teaching is often delegated to junior house staff and early bad habits are difficult to unlearn in post-graduate training. A study population of 4th year medical students from three hospitals were examined. At the beginning of an 8-week surgery rotation technical skills were tested with a simulation appendectomy model at the beginning and end of the surgery rotation. On day one, after a pre-test, a teaching intervention was alternated between two hospitals. A control group received only a post-test. The outcome measure was a cumulative score of the students' performance in technical stations in the simulation model. A comparison was made of the mean post-test scores in the teaching, non-teaching and control groups. An analysis of variance of all post-test scores rejected the null hypothesis at the 0.05 level. Duncan's multiple range test demonstrated a significant difference between the teaching and non-teaching group. Feedback from 25 students indicated the teaching model was practical and relevant. A formal teaching intervention of basic technical skills with 4th year medical students improved their performance on a simulated appendectomy model.

Clinical Competence↗
PubMed1992

Intermittent claudication caused by compression of tibial vessels as a result of calf muscle hypertrophy: case report.

We present a case with findings suggestive of popliteal artery entrapment in a patient with intermittent claudication and localized muscle hypertrophy in the calf muscles after removal of a herniated disk. Angiography failed to demonstrate popliteal artery entrapment but instead revealed compression of the tibial vessels caused by calf muscle hypertrophy. The concept of muscle hypertrophy caused by denervation is also discussed.

Humans↗
PubMed1984

Morphologic studies of intestinal allograft rejection. Immunosuppression with cyclosporine.

The usefulness of isolated intestinal pouches of an intestinal allograft for monitoring mucosal histology during rejection episodes was studied in a canine model. Total small intestinal autotransplantation was performed in four dogs, and allotransplantation in 18 dogs. Isolated pouches from the proximal and distal ends of the allografts were brought to the skin as stomas. Serial biopsies were obtained from these pouches. Nine allotransplants were treated with a suboptimal dose of cyclosporine. Nine allografted dogs were not immunosuppressed. Biopsies from all animals were normal the first two days postoperatively, and remained so in the autotransplants. Mononuclear cell infiltration in the lamina propria and submucosa was seen up to five days before death from rejection of the allograft in dogs on cyclosporine. At autopsy, all dogs had histologic findings in the transplanted bowel similar to those of simultaneously obtained pouch biopsies. The results show that histologic changes in isolated pouches from intestinal allotransplants reflect changes in the incontinuity segment of the graft and, therefore, such pouches can be used for histologic monitoring of the graft.

Administration, Oral↗
PubMed1984

Results and hemodynamic changes after interposition mesocaval shunt.

Forty-seven patients have been treated by interposition mesocaval shunting for portal hypertension and variceal bleeding between December 1973 and March 1980. The average age was 55 years. The underlying diseases were alcoholic cirrhosis in 26 patients (56%), macronodular cirrhosis in 11 patients (23%), and other causes in 10 patients (21%). Thirty-five operations (75%) were performed on an emergency basis for patients who continued to bleed after failure of conservative management. In these patients, the early mortality rate was 43%. Overall survival, rebleeding, and postshunt encephalopathy rates are correlated with the preoperative Child's classification. These figures are similar to those reported for end-to-side portocaval shunts. The improvement in postshunt encephalopathy rates as reported by Drapanas is not borne out by our results. Postshunt angiography was performed in 31 patients and shunt patency was confirmed in 28 (90%). In 26 patients, selective studies to determine portal flow patterns were carried out, and in only three patients was there any evidence of hepatopedal flow. In each of these patients, some kinking of the shunt was noted. Mesocaval shunting is a reasonable alternative to end-to-side portocaval shunts and is associated with similar rates of patency, rebleeding, mortality, and late postoperative encephalopathy. A well-constructed, patent mesocaval shunt totally diverts portal flow.

Adult↗
PubMed1983

Gastroduodenal Crohn's disease: diagnosis and selection of treatment.

Crohn's disease of the stomach and duodenum is uncommon and difficult to diagnose. This study reviews 23 patients with this condition seen at the Toronto General Hospital between 1970 and 1981. In 12 patients the major symptoms were due to coexisting lower intestinal Crohn's disease (primarily distal disease). Diarrhea and crampy abdominal pain were the primary presenting complaints. None had obstructive symptoms. Nine of the 12 were treated medically, 7 with success; 1 required surgical intervention and 1 continued to have pain but no evidence of ulceration. In the remaining 11 patients, the major symptoms were due to their gastroduodenal Crohn's disease (primarily proximal disease) even though 10 had coexisting disease of the intestine. Their symptoms included postprandial vomiting, upper intestinal bloating, hematemesis and epigastric pain. Only one patient was successfully treated medically; the others required surgical intervention. At the time of writing, 9 of the 11 patients had no symptoms. The authors conclude that response to medical therapy occurs only in patients whose gastroduodenal disease is relatively mild and whose symptoms come from distal intestinal disease. In contrast, patients whose main symptoms are from gastroduodenal involvement usually require surgical treatment. Vagotomy with gastroenterostomy is the procedure of choice.

Adolescent↗