Showing papers by "Ochsner Medical Center published in 1991"
TL;DR: High resolution percutaneous coronary angioscopy can be performed safely in conjunction with balloon angioplasty and excellent visualization of the target lesion was achieved in 16 of the last 17 patients.
133 citations
Journal Article•
TL;DR: It was concluded that silastic silo repair and primary fascial closure are both acceptable alternatives for neonates with gastroschisis or omphalocele and primary closure is attractive whenever possible to avoid additional operations.
Abstract: Optimal surgical management of neonates with gastroschisis and omphalocele remains controversial. Suggested benefits of primary fascial closure include earlier return of gastrointestinal function, decreased hospital stay, less sepsis, less risk of postoperative intestinal obstruction and fistulae, and lower mortality. Between 1978 and 1989, 40 neonates with gastroschisis or omphalocele underwent repair. Primary fascial repair was performed in 30 children, 18 of whom had a gastroschisis and 12 of whom had an omphalocele. Ten children had staged repair with the use of a silastic silo; seven of these had a gastroschisis and three an omphalocele. Comparison between the groups was made regarding birth weight, days on the ventilator before and after surgery, days to first feeding, days in the hospital after surgery, postoperative complications, and survival. There was no significant difference in birth weight, days on the ventilator, days to first feeding, and postoperative days in the hospital. There were nine complications in nine patients (30%) with primary repair and four complications in two patients (20%) with staged repair. Two infants died after primary repair (6.7%), and one (10%) died after staged closure. It was concluded that silastic silo repair and primary fascial closure are both acceptable alternatives. Primary closure is attractive whenever possible to avoid additional operations.
29 citations
TL;DR: Results suggest that the sensitivity of mammography in detecting breast cancer is decreased when implants are present, and the effects of prostheses on mammographic findings are needed.
Abstract: We performed a retrospective study to determine the sensitivity of mammography in detecting breast cancer arising in women with augmented breasts. Of eight women with breast implants in whom breast cancer developed, six had mammograms before biopsy. Only two of the six cancers were identified mammographically (sensitivity = 33%), and one of these two was seen only in retrospect. In both cases, the mammographic findings suggested a benign rather than a malignant process. All eight women had a palpable mass and early disease, and all are clinically disease-free at present. The sensitivity of mammography in detecting palpable cancers in a control group of women without implants was 92% (118 of 128). For tumors of 2 cm or less, the sensitivity was 88% (58 of 66). These results suggest that the sensitivity of mammography in detecting breast cancer is decreased when implants are present. Further investigations are needed to determine the effects of prostheses on mammographic evaluations.
16 citations
TL;DR: It is concluded that this lensed fiber coupled with a holmium:YAG laser is a safe and effective method for crossing total occlusions in the relatively straight iliac arteries of this animal model.
Abstract: Laser recanalization of totally occluded swine iliac arteries was performed to assess the safety and efficacy of a lensed fiber laser angioplasty system with a holmium:YAG (2.1 μm) laser. Silica lenses of 1.0 mm, 1.3 mm, and 1.5 mm in diameter attached to the distal end of a 300-μm diameter silica fiber delivered fluences of 79.5 J/cm2, 31.4 J/cm2, and 25.5 J/cm2, respectively. The pulse duration of the laser was 250 μsec and the repetition rate was 4 Hz. The mean length of the total occlusions was 5.3 ± 2.0 cm (range 0.5 cm to 8.0 cm). Successful recanalization was obtained in 16/16 lesions without angiographic vessel perforation. Angiographically significant residual stenoses (>50%)remained in every case following successful laser recanalization. Histologically there was minimal evidence of thermal or acoustic tissue injury; however, in 4 of 16 arteries there was evidence of deep arterial dissection following laser recanalization. We conclude that this lensed fiber coupled with a holmium:YAG laser is a safe and effective method for crossing total occlusions in the relatively straight iliac arteries of this animal model.
16 citations
TL;DR: Although coronary angiography remains the "gold standard" for diagnosis of CAD, much of the data obtained from risk factor assessment, medical history, and various noninvasive tests provides information that may be even more important than cardiac catheterization data alone for defining prognosis and directing management.
Abstract: PreviewEver since Heberden's classic description of angina pectoris almost 200 years ago, most clinicians have devoted a major part of their practice to the assessment and management of patients either known to have coronary artery disease (CAD) or at high risk for its development. In this article, Dr Lavie and his colleagues discuss the importance of reducing risks for CAD and the factors to consider when deciding which screening tests to use in assessing patients with known or suspected CAD.
6 citations