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Selected commercially designated temporary clips (Acland, Biemer, Kleinert-Kutz, Variangle, and Yasargil) were applied for 1 hour to rat common carotid arteries. Scanning electron and light microscopic studies revealed varying degrees of endothelial damage. The authors believe that further improvements are needed in the design of temporary clips.
In carefully selected cases of arterial aneurysms and deep-seated arteriovenous malformations (AVM), when direct attack may be dangerous or impossible, the authors advocate stereotaxic clipping. A special device and technique for its application are described. The instrument is introduced through a trephine opening and clipping is monitored by angiography. Successful results have been obtained in 10 operations performed on eight patients, three of whom had arterial aneurysms (two internal carotid and one anterior cerebral-anterior communicating) and five with AVM's.
The authors report a case of digestive hemorrhage due to rupture of oesophageal varices, for which treatment by means of a Prioton oesophageal clip was effective but followed by two rare complications: pyloric stenosis by migration of the balloon of the gastrostomy catheter and retention of the clip which required its removal by oesophagotomy. Analysis of the mechanism of these complications rarely encountered in the literature suggests a method of prevention.
Details of the menstrual cycles in 504 women were recorded before laparoscopic sterilization with a spring-loaded clip and at six months and one year after the procedure. The operation did not affect the length of the menstrual cycle or duration of menstrual flow, nor the patient's assessment of the amount of blood losss or the incidence of dysmenorrhoea. The previous method of contraception was significantly related to subsequent menstrual patterns.
The iris-clip (four-loop) lens of Binkhorst has been and continues to be the best intraocular lens on the market. It is recommended for primary or secondary implantation in an eye with a suitable iris sphincter and anterior chamber. Complications may occur, but these can be minimized by appropriate treatment and, particularly, by case selection.
The platinum clip (Platina) intraocular lens is reserved for the patient with an active mobile pupil when some type of fixation device is necessary to avoid the complication of dislocation. A surgical technique is described in which the surgeon fixates the lens with the cataract wound closed (closed-eye system), thereby allowing the procedure to be carried out safely.
Patients in a randomised controlled trial were chosen either to have iris clip lens implantation after intracapsular cataract extraction or intracapsular extraction only. They were assessed in terms of corneal thickness, postoperative epithelial oedema, and endothelial cell counts. All patients had 1 eye submitted to operation, which was carried out by the same surgeon. There was significantly greater increase in corneal thickness (P less than 0.05) on the 5th postoperative day in eyes which had lens implants (23 patients with intracapsular extraction and 19 with implant), but the difference between the 2 groups became insignificant at 1 month (17 patients in each group). Daily corneal thickness measurements and observations of epithelial oedema in a subgroup (20 patients divided equally into 2 groups) showed that postoperatively there was greater and more widespread corneal oedema after implant surgery. When the operated eye was compared with the unoperated eye, endothelial cell loss was significantly greater in those with implants (P less than 0.01) than in those with simple intracapsular extraction.
Spironolactone at 10 mg per kilogram per day was given to control and 'one-kidney-one-clip' hypertensive dogs for 6--7 weeks. Compared with untreated animals the treated animals had a lower arterial water content, a higher arterial, myocardial, and skeletal muscle sodium content, and variable changes in tissue potassium concentrations.
The displacement of surgically placed metallic clips by fibrosis and scarring can simulate a recurring or enlarging tumor. A careful correlation with the clinical findings is indicated when this radiographic change is noted.
Computerized Language Information Processing (CLIP) is a system of radiologic reporting in which the user interacts with a computer keyboard and cathode-ray tube terminal to generate coded reports. The hierarchical medical classification on which the code is based permits rapid on-line compilation of reports of any degree of complexity. The system provides organized sets of pre-assembled statements that are rapidly accessed and modified for each examination. Although the reports are printed in English, they are held in the computer as a succinct code that is eminently suited for permanent storage and rapid retrieval.
The exact marking of certain regional landmarks of the anatomy permits the determination of the co-ordinates of these points by stereoscopic diagnostic radiology. The mid-point of the upper margin of the symphysis is selected as the origin of the co-ordinates. The markings of the uterus are placed through the laparoscope with silver clips. The markings in the urinary bladder are placed close to the ureteral orifices through the cytoscope. The doses of radiation generated by the sources of radiation (tubes, colpostat, vaginal cylinder, cervical plate) can with this new marking technique not only be measured experimentally in anatomically well-defined points in the body but the dosage (the energy) can be calculated by the computer. In as many points in the body as desired. The maximal permissable dosage in the tumor can be determined with special consideration for the avoidance of radiation lesions to marked adjacent points such as the ureteral orifices.
Findings are reported of a study conducted to evaluate and compare the safety and effectiveness of the spring-loaded clip and the electrocoagulation techniques of tubal occlusion via laparoscopy. The study was conducted from June, 1974 to June, 1975 on 300 cases in a Bangkok, Thailand hospital. Only patients who requested sterilization to limit family size were included in the study, and study patients were required to return for 6- and 12-month follow-up visits. To minimize possible patient and physician biases, all sterilization procedures were performed by one author (S. K.). and data were analyzed by the other author (S. P.). The specific operative technique was randomly assigned to the patient immediately prior to surgery, and the patient was unaware of the particular technique used. The findings showed no potentially serious complications for either technique. Neither complication rates nor incidence of pain were significantly different for the two procedures. The presence of adhesions was the most frequent cause of surgical difficulty in both techniques. No mechanical difficulties were reported. No pregnancies were reported within one year of sterilization.
Lens implantation as a form of replacement surgery has some clear advantages over other forms of aphakic correction. The most feared complication of this type of operation is bullous keratopathy. A short-term study was carried out in two comparable groups of patients to assess corneal oedema and endothelial cell loss after simple cataract extraction and after iris-clip lens implantation following intracapsular extraction as a primary procedure. All patients were randomly chosen to have one or other procedure. The results indicate that lens implantation causes greater postoperative corneal oedema and greater endothelial cell loss. It is therefore important for implant surgeons to bear in mind the possible harm they may be inflicting and the need both for stringent criteria of selection and for the adoption of techniques which will minimize endothelial trauma.
Indications and methods of inferior vena cava interruption in the management of recurrent pulmonary embolism are discussed. The results of a collected series are analyzed with special regard to the partial interruption technique using the Adams and de Weese clip. Five of our own cases, followed up 1 year postoperatively, are presented.
An aneurysm in a branch of the renal artery within the hilus of a 44 year old woman was successfully obliterated without affecting the circulation in the parenchyma. The surgical treatment consisted of applying Scoville clips designed for intracranial aneurysms to the neck of the sac of the aneurysm. Postoperatively the patient has remained free of her previous hypertension for over four years.
A simple, easily readable system for permanent individual identification of rodents was accomplished by clipping off selected toes according to a code. Up to 10,000 animals could be consecutively numbered using this system.
The authors, having had a case of deep pelvic phlebitis occurring in a young primiparous woman who was treated prophylactically against the occurrence of a pulmonary embolus by placing a clip on the inferior vena cava discuss: the etiology of the condition: the difficulties of the diagnosis. They point out the value of phlebo-cavography which is an essential investigation in which no more than 4 films are taken, because it is on this that the indication for surgery rests. They point out the value of anticoagulant treatment, especially that using Calciparine which permits the patient to lead a more or less normal life at home. As far as the surgical procedure is concerned, a median approach seems to them the best way to carry out the operation.
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