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Biomedical subjects

C H McCollum

Publications and source records attributed to C H McCollum.

At least 19 recordsLinked to original sources
PubMed1997

Impact of a problem-based learning conference on surgery residents' in training exam (ABSITE) scores. American Board of Surgery in Training Exam.

The impact of problem-based learning on surgery residents' education is unknown. In this study we measured the impact of a weekly structured problem-based learning conference on surgery residents' ABSITE scores and compared it to traditional clinical conferences and self-studying. A questionnaire was designed to determine the perceived quality of the basic (PQCB), and the clinical (PQCC) conferences as well as self-studying (PQCS). The Pearson correlation between PQCB, PQCC, PQCS, and attendance at the basic science conference and each of the ABSITE total score (ABSITE), basic science (BS) and clinical science (CS) component scores were calculated. PQCS (4.2) was significantly higher than PQCB (2.9) and PQCC (2.5) (P = 0.0002). PQCS and PQCB correlated highly with each of ABSITE, CS, and BS while PQCc did not show any correlation. A high correlation was also observed between attendance at basic science and each of ABSITE, CS, and BS but narrowly missed significance. It was also observed that BS scores highly correlated to the CS scores at all postgraduate levels (P = 0.0001). We conclude that performance on all components of the ABSITE is mostly dependent on individual residents. This individual factor is boosted by self-studying which can be motivated by instituting a problem-based learning technique within the program. Traditional conferences even if popular among residents have no impact on measurement tests.

Educational Measurement↗
PubMed1987

High levels of cytomegalovirus antibody in patients requiring vascular surgery for atherosclerosis.

157 caucasian male patients undergoing vascular surgery for atherosclerosis and a matched control group of patients with high cholesterol levels were screened for antibodies to cytomegalovirus (CMV) and herpes simplex virus type 1 (HSV1) and type 2 (HSV2), indicative of persistent infection. The prevalence of CMV antibodies was higher in the surgical group than in the control group (90% and 74%, respectively), and a significantly greater percentage (p less than 0.001) of surgical cases than controls had high titres of CMV antibodies (57% and 26%, respectively). Small but not significant differences in antibodies to HSV1 were observed, and there were no differences in HSV2 antibody titres. For each virus there was no correlation between antibody titre and blood levels of total cholesterol or triglycerides. It is suggested that periodically activated virus may have a role in the pathogenesis of atherosclerosis.

Adult↗
PubMed1986

Experience with tracheal resection for traumatic tracheal stenosis.

Ten patients with traumatic tracheal stenosis--unresponsive to conservative therapy--underwent tracheal resection. Two of the stenoses resulted from gunshot injuries, three were due to prolonged intubation, and five developed after tracheotomy. Eight of the operations were completely successful. There was one death, and one patient has had recurrent granulation tissue at the anastomotic site. The pathogenesis of tracheal stenosis, as well as its treatment--including the technical details of tracheal resection--are discussed.

Adult↗
PubMed1986

Brachial artery injury after cardiac catheterization.

During a 3-year period, 12,158 cardiac catheterizations were performed via the brachial artery. During this same period, 106 patients were operated on for complications of brachial artery injury and/or thrombosis, an incidence of 0.9%. The indication for the cardiac catheterization was coronary artery disease in almost 92% of the patients. Early (less than 4 days) brachial artery repair was done in 90% of the patients. The operative findings were thrombosis (91%), intimal injury (54%), stenosis (13%), laceration and/or perforation (11%), and atherosclerotic plaque (6%). Because of vessel injury, localized resection was done in two thirds of the patients. Vascular continuity was obtained with axial reanastomosis in 45 patients and interposition vein graft in 26 patients. Primary lateral repair was performed in 23 patients (22%). Ninety-five percent (101 patients) had initial excellent results. Of the five patients who required reoperation, flow was restored in four patients. Thus, 99% of patients had restoration of a patent brachial artery. Contributing factors for brachial artery complications are "redo" catheterization, prolonged catheterization time, catheter change, brachial artery atherosclerosis, improper arteriotomy closure, experience of cardiologist, female patient, and failure to use heparin. Because of the unpredictability of ischemic symptoms occurring after brachial artery thrombosis, the need for bypass graft surgery when delayed, and the good results with early surgical intervention, early exploration of brachial artery complications after cardiac catheterization and appropriate repair are recommended.

Adult↗
PubMed1983

Cytomegalovirus antigen within human arterial smooth muscle cells.

Arterial tissues from carotid artery plaques or from punch-biopsy samples of uninvolved areas of the aorta were removed from 132 patients with atherosclerosis during blood-vessel surgery. Cells morphologically identical to smooth muscle cells were cultured from 26 to 126 plaque samples and from 6 of 6 punch-biopsy samples. Immunofluorescence tests of these cells showed that more than 25% of the cell cultures from both types of sample contained antigens of human cytomegalovirus (CMV) but not of herpes simplex virus type 1 or type 2. Replicating CMV was not detected by electron microscopy in the antigen-positive cells, suggesting that the artery walls may be a site of CMV latency.

Antigens, Viral↗
PubMed1981

Polytetrafluoroethylene (PTFE) grafts for haemodialysis in chronic renal failure: assessment of durability and function at three years.

The utilization of 162 PTFE grafts for angio access in 131 patients over a three year period is reported. One hundred and three new PTFE arterio-venous fistulae were constructed in addition to 59 patch and tube incorporations into pre-existing graft fistulae. At three years, the cumulative patency of newly constructed grafts was 85%. Seventy four per cent of the grafts have had no thrombosis and are functioning up to 38 months following insertion. An aggressive approach was adopted towards the 15% of grafts that had at least one episode of thrombosis prior to flow being successfully restored. Graft occlusion which occurred up to 18 months following insertion, represented 11% of the group in this series. PTFE has provided an important advance in angio access for chronic renal failure with high patency and excellent durability after three years.

Blood Vessel Prosthesis↗
PubMed1980

Aneurysms of the splanchnic arteries.

Experience with 19 surgically resected aneurysms of the splanchnic artery is reviewed. In contrast to early series and cases reported, all patients but one were operated on electively. The only death occurred in a patient with a ruptured celiac artery aneurysm. Long-term follow-up has revealed continuing good results, and the subsequent formation of a visceral artery aneurysm in another location in one patient.

Abdomen↗
PubMed1980

Extensive arterial aneurysm formation proximal to ligated arteriovenous fistula.

As a result of abnormal flow patterns and hyperdynamic flow in arteries proximal to an arteriovenous fistula a particular susceptibility to atherosclerotic changes and aneurysmal deterioration develops. In the following report two patients are presented in which chronic arteriovenous fistulas existed for 15 and 33 years prior to correction. Each patient developed extensive and progressive aneurysmal dilation of the proximal arterial tree and subsequently required surgical resection and graft replacement.

Adolescent↗
PubMed1979

Aneurysms of the extracranial carotid artery. Twenty-one years' experience.

Aneurysms of the extracranial carotid artery are an uncommon but potentially serious problem, usually due to rupture or thromboembolic events. Thirty-seven aneurysms of the extracranial carotid artery were seen in thirty-four patients from 1956 to 1977. The ages ranged from twenty-nine to ninety-two years, with an average of fifty-nine years. There were twenty-three males and eleven females. Nineteen (51 per cent) were false aneurysms, sixteen (44 per cent) atherosclerotic aneurysms, and two (5 per cent) posttraumatic aneurysms. All patients presented with evidence of a mass in the neck, and only five (15 per cent) had neurological symptoms related to the aneurysm. Surgery was performed on twenty-eight carotid aneurysms. Resection and patch angioplasty was employed for eighteen aneurysms, resection with graft replacement for six, and resection and ligation of the internal carotid artery for four. Postoperative neurologic deficits developed in three patients (11 per cent), and one of these died. There was one other operative death due to acute myocardial infarction (operative mortality, 7 per cent). Nonoperative treatment was employed when the patient had other associated high risk disease or a small asymptomatic aneurysm.

Adult↗
PubMed1979

Chronic traumatic aneurysms of the thoracic aorta: an analysis of 50 patients.

The records of 50 patients having thoracic aortic aneurysms and a remote history of severe chest trauma were reviewed. Time intervals between thoracic trauma and operation varied from 3 months to 32 years (average, 11.9 years). In 25 patients (50%) this interval was greater than 10 years and in six (12%) greater than 20 years. Surgical correction was accomplished with low mortality and morbidity. Detection and diagnosis of chronic traumatic thoracic aortic injuries may not become clinically evident in some cases for many years. This diagnosis should be considered in all patients with a history of severe thoracic trauma, no matter how remote.

Aorta, Thoracic↗
PubMed1977

Myocardial revascularization prior to subsequent major surgery in patients with coronary artery disease.

Of our series of patients undergoing direct myocardial revascularization, we selected 60 patients who had subsequent major surgical and cardiovascular operative procedures. Thirteen of these patients had a second subsequent operative procedure, and four of the original 60 patients had a third subsequent operation. None of the patients died during the subsequent operation and none sustained a myocardial infarction. During the 77 subsequent procedures, there were eight different episodes of cardiac complications: seven patients had supraventricular arrhythmias and one patient had acute pulmonary edema. All patients responded to medical therapy. These results are suggestive that myocardial revascularization should be performed prior to other major indicated operative procedures in patients with documented coronary artery disease.

Adult↗