Saphenous vein graft modification to Scribner shunt.
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Biomedical subjects
Publications and source records attributed to A Aszodi.
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External biliary drainage is often required to relieve bile duct obstruction. Most often this is a temporary situation and internal drainage is soon established by means of surgery or by transhepatic biliary stents placed through the obstruction into the duodenum. When internal drainage cannot be established and external biliary losses are prolonged, malabsorption, dehydration, and electrolyte imbalance may ensue. In this report we present two such cases in which an external biliary-gastric fistula was created by connecting the biliary drainage catheter to a percutaneous endoscopic gastrostomy. In both cases internal diversion was effectively achieved. We believe this technique warrants consideration in those patients otherwise committed to prolonged external biliary drainage.
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This study compared thallium stress testing and exercise changes in QRS duration using a computerized 'optic scanner' in three groups. Group 1 consisted of 108 subjects with positive exercise ECG tests by ST-T segment criteria and with proven coronary artery disease. Group 2 included 19 subjects with nondiagnostic exercise ECG ST-T changes and with proven coronary artery disease. Group 3 was formed by 38 healthy controls. Group 1: Mean increase in exercise QRS width of 12.4 +/- 14 ms. Group 3: Mean decrease in exercise QRS width of 4.9 +/- 9.3 ms (p < 0.0001). Group 2: Mean QRS prolongation of 7.8 +/- 9.2 ms, which was significantly different from the controls (p < 0.0001) but not from group 1. When compared to thallium stress testing, exercise QRS prolongation had a sensitivity of 93%, specificity of 71%, relative risk of 5, and positive predictive value of 86%. QRS duration measurement can improve the diagnostic accuracy of the exercise ECG stress test.
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