The exhausted ability of cerebral autoregulation is an important factor differentiating between symptomatic and asymptomatic patients with severe carotid stenosis. Successful surgery provides good recovery of cerebral hemodynamics in both symptomatic and asymptomatic patients.
Low CVR and increased asymmetry of MCA velocities were found in patients who subsequently required shunting during carotid endarterectomy. The relatively low accuracy of the MCA asymmetry should prevent the use of this criterion as a reliable preoperative predictor for shunting during carotid surgery, whereas CVR was more accurate and may prove useful in this setting.
Adenocarcinoma of the prostate constitutes 18 % of all cancers in men, and is a major cause of neoplastic death second only to carcinoma of lungs and large bowel. In spite of the high incidence of the disease, there is still disagreement as to the right treatment. In our study we reviewed 101 patients in stages T0b, T1 + T2, T3 (N₀M₀) who were treated by nonradical prostatectomy and no other treatment. The follow-up of these patients was 58 months. The actuarial 5- and 10-year survival according to stage was respectively: 91.30 and 64.62% in stage T0b; 60.61 and 34.11 % in stage T1 + T2, and 41.67% in stage T3. Survival rates resembled those quoted in the literature. Our results justify a less aggressive approch to carcinoma of the prostate.
Theoretically thrombolysis provides an attractive option in the therapy of the acutely ischemic limb. This is particularly so since thrombosis on the background of arteriosclerotic disease has become the common presenting cause, whereas previously the main cause was embolic disease. This consideration also applies to the acutely occluded peripheral vascular graft. Eighty-four patients who were treated with urokinase during a 24-month period were studied retrospectively. Thrombosis was the cause of occlusion in 68 patients (80.9%), and embolus was the cause in 16 (19.0%). In 17 patients (20.2%) there was occlusion of a bypass graft, and in 67 patients (79.7%) there was occlusion of the native artery. We also studied the effect of thrombolysis with acute occlusion in 25 patients who were diabetic. The time from onset of symptoms to beginning of treatment was also considered. We believe that thrombolysis should have a place in the treatment of the acutely occluded limb, but the physician should be aware of the potential complications of thrombolytics, particularly hemorrhage. Furthermore, an adequate infrastructure should be in place consisting of properly trained nursing staff and an angiography facility providing service on a 24-hour basis.
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