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S Bowald

Publications and source records attributed to S Bowald.

At least 37 records · Page 2Linked to original sources
PubMed1990

A new method of angiographic runoff evaluation in femorodistal reconstructions. Significant correlation with early graft patency.

In 62 patients undergoing femorodistal bypass surgery, the foot vessel runoff was analyzed with a new grading system based on intraoperative postreconstruction serial angiography. The patients were divided into two groups according to the level of the distal anastomosis (proximal or low). Good runoff was defined as integrity of the anterior and/or posterior foot arch in proximal femorodistal grafts and integrity of both arches in low bypasses. In the proximal group, runoff was classified as poor when the arches were deficient or occluded, and in the low group, when only one arch was intact. The patency rate after 6 months was 81% in the good runoff group, whereas all grafts in patients with poor runoff were occluded. The new method allowed better prediction of the early outcome than does the primary and secondary pedal arch integrity concept.

Aged↗
PubMed1990

Angiographic criteria for prediction of early graft failure of secondary infrainguinal bypass surgery.

Complete intraoperative postreconstruction angiograms were obtained during 93 reoperations after failed femoropopliteal and femorodistal bypass grafts to evaluate the predictive value of a new method of angiographic runoff assessment. Good runoff was defined as patency of two or three lower leg arteries to the foot, or one patent vessel continuous with an intact anterior or posterior foot arch in femoropopliteal and proximal femorodistal bypasses, and integrity of both arches in low femorodistal bypasses. All other outflow patterns were considered poor. The cumulative 1-year patency rate was 61% with a 79% limb salvage rate after reoperations performed in limbs with good runoff. In reoperations with poor runoff, the patency rate was only 5% with a 22% limb salvage rate. In reoperations with good runoff, and 85% patency rate of vein grafts compared to 43% of prosthetic grafts clearly demonstrated the importance of graft material on early outcome. The improved prediction of early outcome with this new method of angiographic runoff evaluation might allow more rational management of patients with failed infrainguinal grafts.

Adult↗
PubMed1989

Arterial lesions of the foot vessels in diabetic and non-diabetic patients undergoing lower limb revascularisation.

This study was undertaken to compare the atherosclerotic involvement of the foot arteries in diabetic and non-diabetic patients with leg ischaemia. Ninety-four non-diabetic and 57 diabetic patients were investigated with intraoperative postreconstruction serial angiography during femoro-popliteal and femoro-distal bypass surgery. The foot vessels were evaluated with regard to the anterior and posterior foot arches which were classified as intact, deficient or occluded. Integrity of the pedal circulation was defined as patency of both the anterior and posterior foot arches. Severe involvement of the foot arches was rarely seen in limbs with 3- or 2-lower leg vessel run-off to the foot. The posterior foot arch was more often spared than the anterior foot arch, especially in the non-diabetic group (P less than 0.001). The integrity of the pedal circulation was similar in diabetic and non-diabetic patients (intact in about 20%). Patients with claudication showed a significantly lower occlusion rate of leg and foot arteries than patients with rest pain or gangrene. The results of this study showed that the foot vessels were similarly affected in diabetics and non-diabetics undergoing lower limb revascularization. The same aggressive diagnostic and therapeutic approach should be applied for limb salvage in both groups.

Aged↗
PubMed1989

Postoperative predictive value of a new method of intraoperative angiographic assessment of runoff in femoropopliteal bypass grafting.

In 96 consecutive patients undergoing primary femoropopliteal bypass grafting, the runoff was evaluated with a new grading system, based on findings at intraoperative postreconstruction serial angiography. This concept, which takes foot vessel involvement into account in patients with only one patent crural artery, is a modification of the traditional method of runoff assessment. Good runoff was defined as patency of two or three lower leg arteries to the foot or one patent, vessel continuous with intact anterior or posterior foot arch. In limbs with no patent vessel or one patent vessel with deficient or occluded foot arches, the runoff was classified as poor. The cumulative primary patency rates at 12 months in groups with good and poor runoff were 81% and 37%, respectively. The predictive value of the new method was superior to that of other comparable methods (traditional method, Society for Vascular Surgery and International Society for Cardiovascular Surgery criteria, and modified Society for Vascular Surgery and International Society for Cardiovascular Surgery criteria). This improved prediction can be ascribed to the optimal angiographic technique for visualizing distal vessels, selective evaluation of foot vessel runoff with a new concept, and the criteria used to define good and poor runoff.

Adult↗
PubMed1989

Angiographic runoff patterns in patients undergoing lower limb revascularization.

Intraoperative postreconstruction serial angiography was performed in 194 patients undergoing lower-limb revascularization (206 limbs), in order to analyze the atherosclerotic involvement of the lower leg and foot arteries. Occlusion of two or three leg vessels was found in 71% of the diabetic patients, and in 52% of the non-diabetics. The peroneal artery was less frequently affected than the other leg arteries. Severe involvement of the foot arteries was commonly observed in patients with only one or no patent leg vessel. The posterior foot arch was less commonly affected than the anterior. Complete visualization of the lower leg and foot arteries is suggested to be important for adequate evaluation of the distal vascular runoff. Pedal runoff may have prognostic significance in femoropopliteal as well as femorodistal bypass surgery.

Adult↗
PubMed1987

The vitreous after C3F8 gas instillation: long-term histologic findings after spontaneous reabsorption of the gas in rabbit eyes.

Perfluoropropane gas (C3F8) was injected intravitreally into rabbit eyes to displace the vitreous. Histologic examination by light and scanning electron microscopy revealed the vitreous material slowly expanded up to a nearly normal configuration during a follow-up of 6 months. Neither posterior vitreous detachment nor liquefaction of the vitreous could be observed.

Animals↗
PubMed1987

Peritoneal reaction to liquid silicone: an experimental study.

Silicone oils (polymethylsiloxanes) with different viscosities (200, 1000 and 5000 cSt) and a fluorinated silicone oil (5000 cSt) were injected into the peritoneum of CBA mice. Three weeks after the injection, peritoneal exudates were obtained and investigated using light and electron microscopy. For each silicone-oil type, light-microscopic examination revealed the presence of abundant extracellular lipid-like droplets and a dense cellular infiltrate composed of macrophages, lymphocytes and multinucleated giant cells. Lipid-like inclusions were observed in macrophages and multinucleated giant cells. These intracellular inclusions were revealed to be membrane bound by transmission electron microscopy. We observed no differences with respect to the amount of phagocytotic activity for the different silicone-oil types tested. Purified silicone oils of lower viscosity (OP 200 and OP 1000) resulted in the mildest chronic inflammatory reaction. Our results suggest that emulsification, phagocytosis and granulomatous inflammation are associated with intraocular silicone-oil implantation. The question of which properties would make a silicone oil most suitable for clinical use requires further investigation.

Animals↗
PubMed1986

Small bowel necrosis after aorto-iliac reconstruction.

Small bowel ischaemia causing necrosis is a rare complication after aorto-iliac reconstructive surgery. During a 14-year-period we have seen 6 cases out of 1343 reconstructions, making a frequency of 0.4 per cent. Diagnosis was difficult, causing a delay until re-exploration. Thrombocytopenia was a constant finding, and should raise suspicion. Pathogenesis was multifactorial. In two of our cases diagnosis was made at autopsy and in four at operation. Two patients survived extensive bowel resection but had a long stormy postoperative course.

Adult↗
PubMed1986

[Silicone oil in epiretinal membranes 3-4 months following implantation: microscopic findings in 2 cases].

After vitrectomy and silicone oil instillation, several oil inclusions were found on histologic examination of recurrent epiretinal membranes 3-4 months after oil instillation. The authors discuss how far an early emulsification of silicone oil stimulates macrophages as well as other proliferating cells and thus leads to impregnation and reproliferation of epiretinal membranes. If highly refined oil is used, impregnation and its complications will perhaps become less significant.

Adult↗
PubMed1985

Microproliferations in proliferative diabetic retinopathy and their relationship to the vitreous: corresponding light and electron microscopic studies.

Using a special embedding method, autopsied eyes with proliferative diabetic retinopathy were studied. In areas with no posterior vitreous detachment, small proliferations may arise multifocally and grow within the vitreous cortex. The fibrous material of the vitreous cortex is densely interconnected with and obviously incorporated into the newly formed proliferated tissue, a process which causes coarse traction lines on the vitreous cortex lamellae. The clinical consequences of these findings are discussed.

Adult↗
PubMed1983

Combined macroscopic, light microscopic, scanning, and transmission electron microscopic investigation of the vitreous body. 3. The structure of the anterior border layer of the vitreous.

The anterior vitreous border layer consists of multiple net-like densely compacted individual lamellae as shown by combined macroscopic, light microscopic, scanning, and transmission electron microscopic investigations. Each lamella displays a polygonal two-dimensional meshwork formed by vitreous fibrils. This multilamellar border layer is reinforced by zonula fibres which merge with anterior lamellae. Probably this special architecture corresponds to the membrane-like function as mentioned by Balazs.

Adult↗
PubMed1983

Spontaneous rupture of the splenic vein secondary to hepatic cirrhosis.

Spontaneous rupture of the splenic vein secondary to hepatic cirrhosis is a rare condition with a high mortality rate. Two case histories are presented with a review of the two other cases in the literature. Survival following rupture depends upon early recognition and immediate operation.

Adult↗