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Biomedical subjects

S S Hans

Publications and source records attributed to S S Hans.

17 recordsLinked to original sources
PubMed1992

Endarterectomy with arterial dilators: surgical technique.

A simplified technique of semi-closed endarterectomy with arterial dilators that insures complete removal of intimal fragments was used by the authors. Complications, such as arterial wall penetration and residual intimal fragments, are reduced. This technique has proven useful in aortoiliac and short-segment femoral artery endarterectomy. It is also helpful for proximal anastomosis of femoral/popliteal/tibial in situ bypass where termination of saphenous vein cannot reach femoral artery.

Arterial Occlusive Diseases↗
PubMed1992

The role of renin and catecholamine production in postcarotid endarterectomy hypertension.

Correlation between increased cranial and peripheral norepinephrines and increased cranial to systemic renin ratio has been observed in a small number of patients with postcarotid endarterectomy hypertension. In an effort to confirm these findings, we studied cranial and peripheral levels of catecholamines and peripheral renin activity in 120 consecutive carotid endarterectomies. Samples were taken before carotid clamping (Sample I) and just after clamp release (Sample II). Norepinephrine, epinephrine and dopamine values did not correlate with postcarotid endarterectomy hypertension. There was no association between peripheral renin values and postcarotid endarterectomy hypertension.

Aged↗
PubMed1991

Late follow-up of carotid endarterectomy with venous patch angioplasty.

Ninety carotid endarterectomies with venous patch angioplasty were performed in 83 patients between July 1980 and December 1985. The primary indication for patching was a small-caliber internal carotid artery (ICA) with a diameter less than 3.0 mm in 54 arteriotomies (60%). Patency of the endarterectomy was evaluated by completion arteriography in all instances. Follow-up was conducted after an intermediate postoperative period of 21 +/- 12.5 months in 69 sides by arteriography. A late follow-up was conducted at 55.4 +/- 11.2 months either by arteriography (in 45 sides) or by carotid duplex scanning (in 11 sides). Twenty-one patients with 23 endarterectomies died, only 1 of a cerebral event. Seven patients moved or refused study and five were lost to follow-up. Three recurrent stenoses and five carotid occlusions developed by the time of the intermediate follow-up. By the time of late follow-up, three additional patients developed recurrent stenoses. Our results suggest that recurrent stenosis continues to develop with a longer period of follow-up in patients undergoing venous patch angioplasty with carotid endarterectomy.

Aged↗
PubMed1990

Renal functional response to dopamine during and after arteriography in patients with chronic renal insufficiency.

The potential renal vasodilatory effect of dopamine in improving renal function after arteriography was studied. Sixty patients with preexisting renal insufficiency were prospectively randomized into two groups. Patients in the treated group (n = 30) received an infusion of dopamine for 12 hours starting at the beginning of arteriography. Patients who received placebo infusion with arteriography (n = 30) served as controls. The study was conducted in two different time intervals. In the first interval, serum creatinine levels and 12-hour creatinine clearance values were obtained before and immediately after arteriography in 12 patients in the dopamine group and 13 patients in the control group. In the second interval, the same variables were measured before arteriography and for 3 consecutive days after arteriography in 18 patients in the dopamine group and 17 patients in the control group. Serum creatinine levels became significantly elevated in the control group on the 1st day and remained so on the 3rd day after arteriography, whereas the dopamine group did not show significant elevation of these levels. Creatinine clearance decreased in the control group on the 1st day, but this deterioration was not sustained on the 3rd day. In the dopamine group, there was no deterioration in creatinine clearance on either day, and mean effective renal plasma flow during and after arteriography was greater.

Aged↗
PubMed1990

Increased blood loss with in situ bypass.

This study uses perioperative hematocrit determinations to quantitatively evaluate blood loss in patients undergoing either in situ (n = 37) or reverse vein technique (n = 44) for femorodistal popliteal or proximal tibial/peroneal reconstruction. The median drop in hematocrit was significantly greater on the fourth postoperative day in the in situ group as compared with the reverse vein group. The median drop in hematocrit was 8.8 +/- 4.2 per cent in the in situ group as compared with 4.8 +/- 4.1 per cent in the reverse vein group (P less than 0.0005). Blood transfusions were required in 11 of 37 patients (30%) in the in situ group as compared with five of 44 patients (11%) in the reverse vein group (P less than 0.05). Despite limitations of a retrospective study, our data indicate that there is greater blood loss with in situ technique as compared with reverse vein technique for femoropopliteal and crural reconstruction.

Aged↗
PubMed1989

Carotid endarterectomy for high plaques.

Seventeen instances of high plaque (plaque extending up to the level of the second cervical vertebra) were encountered out of a total of 454 carotid endarterectomies (3.7 percent). With careful dissection and knowledge of anatomy superior to hypoglossal nerve, carotid endarterectomy was accomplished without resorting to mandibular subluxation or dislocation. There was no operative mortality or perioperative strokes. One patient had perioperative myocardial infarction and another sustained temporary glossopharyngeal nerve dysfunction. High carotid plaques were more common in male patients with bilateral stenoses or contralateral internal carotid occlusion and could be suspected by findings of preoperative carotid arteriography in some instances. In the majority of cases, extension of high plaque in a tongue-shaped manner on the posterior wall of the internal carotid artery was an unexpected finding at the time of carotid endarterectomy.

Aged↗
PubMed1989

Use of EEA stapler in reconstruction after gastric resection.

Herein is described our technique and experience with the EEA stapler in performing the Billroth I and II gastrectomies and Roux-en-Y reconstructive procedures. We did not perform a gastrotomy or an enterotomy to achieve the desired end to end or end to side anastomosis, thus avoiding another site to be closed later. In its single application, the EEA stapler gives a double layer of staggered staples, which results in a uniform and satisfactory healing. The removal of a ring of tissue with a central core, with examination for its completeness, assures a satisfactory anastomosis. The completed anastomosis can be examined under vision for any bleeding. As a final step, a TA 90 stapler is used at the desired line of transection of the stomach. This method of intestinal anastomosis shortens the operative time and creates a better anastomosis. We have performed these procedures upon 33 patients with good results.

Anastomosis, Roux-en-Y↗
PubMed1989

Pancreatitis and duodenal obstruction after aortic surgery.

Three patients developed pancreatitis and duodenal obstruction after aortic surgery, contributing significantly to stormy postoperative courses. Serum amylase and lipase levels should be obtained in any patient who has duodenal obstruction and/or persistent ileus after aortic surgery. If these enzyme levels are elevated, computerized tomography of the abdomen should be performed to implicate or exclude pancreatitis as a possible cause.

Aged↗
PubMed1988

Angiodysplasia in transposed colon.

A 40-year-old man with a history of colonic transposition for lye stricture at 10 years of age presented with upper gastrointestinal tract bleeding due to angiodysplasia in a transposed right colon.

Adult↗
PubMed1978

Uncommon presentations of venous disease.

Venous disease can manifest itself in unusual ways; three uncommon venous disease states are described, together with discussions of their treatment. The cases include an iliac compression syndrome, incipient venous gangrene of an upper limb associated with polycythemia and congestive cardiac failure, and venous edema of a lower limb as a sequel to previous radical pelvic surgery.

Adolescent↗
PubMed1977

Eosinophilic granulomas of the gastrointestinal tract.

Three patients with eosinophilic infiltration of the stomach and one with eosinophilic granulomatous polyp of the ileum are described. We believe that eosinophilic granulomatous lesions of the gastrointestinal tract comprise a distinct clinical and pathologic entity which should be considered in the differential diagnosis of obstructing or ulcerating lesions.

Adult↗
PubMed1976

Carcinoma arising in thyroglossal duct remnants.

Papillary adenocarcinoma arising in a thyroglossal cyst is described in a 38-year-old man to make a total of 83 cases in the literature. Most cases appear to be benign thyroglossal duct cysts. The malignant nature of the lesion was recognized only after the permanent pathology sections were reviewed. Paillary carcinoma was the most common type of carcinoma arising in thyroglossal duct remnants. Local resection by the Sistrunk method is the standard treatment when the malignancy has not extended beyond the confines of the cyst. The differentiation between a carcinoma arising in a thyroglossal duct remnant and a metastatic papillary carcinoma from an occult primary in the main thyroid gland is discussed.

Adenocarcinoma, Papillary↗
PubMed1976

Post-thyroidectomy hypoparathyroidism.

The incidence of hypoparathyroidism following thyroid surgery in the series reported was 7.8 per cent. Temporary hypoparathyroidism was present in 15 patients (4.6%) and permanent hypoparathyroidism in 10 (3.2%). Persistently low levels of serum calcium and high levels of serum phosphorus at six to 10 weeks after thyroid operation in patients with temporary hypoparathyroidism, with no tendency toward normalization, suggests permanent hypoparathyroidism. Serum calcium below 5 mg per cent suggests permanent hypoparathyroidism.

Calcium↗