Surgical treatment of thoracoabdominal aortic aneurysms]

Between February, 1981, and April, 1989, 20 patients underwent surgical treatment of thoracoabdominal aortic aneurysms. Most of the patients were operated under temporary external bypass. For Group I and III aneurysms without reconstruction of renal arteries, a modified Crawford's graft inclusion technique was employed to shorten abdominal visceral ischemic time. This modification consists of (1) using adjuncts to perfuse the distal aorta during aortic clamp, (2) starting the first anasistomosis from the distal end of the graft, and (3) shifting the distal aortic clamp on the graft after completing the anastomosis in order to restore abdominal visceral circulation as soon as possible. For Group III and IV aneurysms with reconstruction of renal arteries as well as celiac and superior mesenteric arteries, a modified DeBakey's procedure was employed. This modification consists of (1) using the spiral opening method, (2) doing end-to-end anastomosis at the proximal aortic site, and (3) maintaining the circulation of abdominal organs and spinal cord by using adjuncts during the anastomosis of the proximal end. There were one operative death and two hospital deaths. Paraplegia developed in two cases, one of which was a ruptured case. Renal dysfunction was not found in any case. The survivors were followed from 5 to 103 months, and there was no late death. The results suggest that our modified procedures for thoracoabdominal aortic aneurysms are useful and reliable ones.     

Doctoral Programs in Psychology, 1957-1958.

Each fall the APA Education and Training Board sends to every graduate department with an approved program in clinical or in counseling psychology a detailed questionnaire. This questionnaire asks for information about the number of faculty members in the graduate training program, the number of full-time and part-time graduate students, the number of persons admitted to candidacy for the PhD, the number of PhDs granted the preceding year, and the number of graduate students admitted. This article presents a summary of the data obtained via these questionnaires. The authors suggest that for more precise information, a more complete questionnaire with carefully defined categories of training areas or subject matter would need to be answered by graduate departments, including both those with approved programs and those without them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Annual report of the executive secretary: 1958.

Discusses the American Psychological Association's various activities over the past year. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Technical advances in the surgical management of thoracoabdominal aortic aneurysms]

Thoracoabdominal aortic aneurysmectomy ranks among the major cardiovascular surgical procedures. During the last two decades perioperative results have improved to the point that surgery should be discussed in the vast majority of patients seen with a thoracoabdominal aortic aneurysm. This progress is largely attributable to a variety of technical improvements including: aortic reconstruction using the graft inclusion technique, usually with direct reattachment of aortic branches to the prosthetic graft; distal aortic perfusion; selective use of deep hypothermic circulatory arrest in anatomically complex situations; preoperative visualization of arterial blood supply to the spinal cord using selective arteriography of intercostal and lumbar arteries. Current perioperative mortality is around 10% whereas the spinal cord complication rate is between 5% and 20% according to clinical and anatomical conditions. Future efforts should concentrate on the prevention of spinal cord complications.     

Government support of psychological research: Fiscal year 1958.

"In fiscal year 1958 (ending June 30, 1958), approximately $23,900,000 were obligated by some 12 departments and subdivisions of the federal government for the conduct of research in psychology and closely related areas. This is an increase of about $8,000,000 over the support reported for fiscal year 1957, and about $13,000,000 over that for fiscal year 1956." 4 tables indicate: (a) expenditure by agency, (b) research areas in psychology supported, (c) expenditure by geographic region, (d) obligations of federal government for research by scientific fields. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visceral aneurysms. Two case reports

The authors report two case stories of visceral aneurysm: a 54 year-old man presenting recurrent gastrointestinal bleeding caused by a splenic artery aneurysm, and a 57 year-old man presenting with acute abdomen due to rupture of a hepatic artery aneurysm. Visceral aneurysms often present with classical gastrointestinal symptoms. They are connected with considerable mortality. Rupture requires instant surgery. In the elective phase the literature recommends embolization or resection.     

Report of the Policy and Planning Board: 1958.

The Policy and Planning Board provides this report to the members of the American Psychological Association (APA) on its activities in 1957. The board met twice, in Chicago: November 8, 1957 and April 2-3, 1958. This year the board put aside any major questions about the organization of the APA--a matter that has occupied much of our time in the past two years. The board turned its attention, rather, to the kind of a role the APA ought to play in the public and professional life of our time. In addition, we acted on a number of limited issues which are summarized in this report. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Committee on Relations with Psychiatry: 1958 annual report.

The Committee on Relations with Psychiatry first presents its recommendations for the American Psychological Association in condensed form; these are followed where necessary by suggestions for implementing them. Finally, the Committee presents some of the special considerations and the rationale leading to our recommendations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Retrograde memory after rupture of aneurysms of the anterior communicating artery]

The aim of this study was to investigate deficits of retrograde memory, semantic, autobiographical, and for famous events, associated with prefrontal, cingulate and subcortical lesions resulting from anterior communicating artery rupture. Analyses were performed during the secondary phase post-stroke in 16 patients, and performances were compared to those of an equivalent number of matched control subjects. Semantic investigations revealed a significant deficit in each task using evocation, more especially categorical and literal evocations, and the verbal subtests of the WAIS-R: vocabulary, information, comprehension, and similarities. Furthermore, the capacity to categories was preserved. The Crovitz paradigm, which evaluated the autobiographical memory showed a severe deficit in the evocation of events associated with a precise context in place and moreover in time, with a clear tendency to produce semantic responses, but without significant increase in confabulations. The questionnaire on famous events (1936-1985) did not document deficit in recognition and recall. Furthermore, the patients disorder was more severe in learning new information. Memory disorders were best explained by the severity of lesions in the medio-basal frontal and cingulate cortices, but also by the subcortical injury. Significant correlations were observed between the retrograde memory performance and "frontal" tasks, more especially the WCST; however, similar relations were also documented between learning new information and "frontal" performance. These data suggest that retrograde amnesia results from a selective impairment in accessing old memory representations, and that cognitive processes more specifically altered have tight relations with the capacity to organize the search and to shift.     

The usefulness of intraoperative high-frequency doppler flowmetry in surgeries for intracranial aneurysms]

The semi-automatic method for the determination of the bisphosphonate pamidronate in serum and citrate plasma involves a manual protein precipitation with trichloroacetic acid and a manual coprecipitation of the bisphosphonate with calcium phosphate, followed by an automated solid-phase extraction on anion-exchange columns. After off-line evaporation of the extract under nitrogen and reconstitution in water, the automatic procedure is continued by automatic derivatization with 1-naphthylisothiocyanate, ion-pair liquid-liquid extraction and a treatment with hydrogen peroxide, prior to analysis by ion-pair HPLC and fluorescence detection at 285/390 nm. The intra- and inter-day precisions are 1.3 and 7%, respectively, for a standard of 100 ng ml(-1) pamidronate in serum; the average accuracy for this standard is 107%. The lower limit of quantification is 20 ng ml(-1) pamidronate in 1 ml of human serum.     

Traumatic intracranial aneurysms after removal of tuberculum sellae meningioma: case report]

Two cases of traumatic aneurysms (TA) of the internal carotid artery (IC) due to removal of tuberculum sellae meningioma (TSM) are presented, and ideal treatment of those aneurysms is discussed. The tumor, compressing the IC laterally, was removed out without arterial injury in case 1. Though the patient's postoperative course was uneventful, frontal and intraventricular hemorrhage developed 2 months after the operation, and an IC dorsal aneurysm was detected. Preoperative angiograms showed no aneurysm, so it was considered to be a traumatic aneurysm due to the surgical procedure. The aneurysm was clipped at once, but postoperative angiograms showed recurrence of the aneurysm. IC balloon occlusion was carried out as the Matas test was negative. In case 2, a small tear in the IC was inadvertently made during recurrent TSM removal, which was wrapped with muscle using fibrin glue. 2 weeks after the operation, frontal hemorrhage developed. Angiograms revealed a small aneurysm of the IC, which was considered to be a traumatic aneurysm. IC balloon occlusion was performed as the Matas test was negative. These 2 patients have had no episodes of rerupture after the IC balloon occlusion. Tumors and main arteries are frequently adhesive, so arteries are easily injured during removal of meningiomas. Muscle wrapping was not enough to prevent TA formation. Neck clipping was not appropriate for treatment of TA, but IC balloon occlusion was an effective and excellent therapy for TA of IC.     

American Board of Examiners in Professional Psychology: 1958 annual report.

The American Board of Examiners in Professional Psychology (ABEPP) has now completed its eleventh year of service to American psychology. This article is its eleventh Annual Report to the American Psychological Association and to the membership of the Canadian Psychological Association. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hypogastric arterial aneurysms associated with abdominal aortic aneurysms

The purpose of this study was to compare the physiological responses of professional and elite road cyclists during an incremental cycle ergometer test. Twenty-five elite cyclists (EC; 23+/-1 yr) and 25 professional cyclists (PC; 25+/-2yr) performed a ramp protocol (increases of 25 W x min(-1)) during which the following parameters were measured: oxygen consumption (VO2), pulmonary ventilation (VE), ventilatory equivalents for oxygen and carbon dioxide (VE x VO2(-1) and VE x VCO2(-1), respectively), respiratory exchange ratio (RER), ventilatory thresholds 1 and 2 (VT1 and VT2, respectively), blood lactate, and electromyographic activity (EMG) of the vastus lateralis. Significant differences existed between the two groups mainly at submaximal intensities, since both VT1 and VT2 occurred at a higher exercise intensity (p<0.001) in PC than in EC (VT2: 80.4+/-6.6 vs 87.0+/- 5.9% VO2max in EC and PC, respectively). Lactate levels showed a similar response in both groups at low-to-moderate intensities (< 300 W), and thereafter blood lactate was significantly higher in EC. Finally, the "electromyographic threshold" (EMGT) occurred at a significantly higher intensity (p < 0.05) in PC when compared to EC (64.7+/-14.2 vs 56.0+/-14.9% VO2max, respectively). It was concluded that, in comparison with EC, PC exhibit some remarkable physiological characteristics such as a high VT2, an important reliance on fat metabolism even at high power outputs, and several neuromuscular adaptations.     

Unusual aneurysms

Cerebral aneurysms can present in a variety of special circumstances. Aneurysmal subarachnoid hemorrhage (SAH) can complicate systemic or neoplastic disease, head injuries, arterial dissection, and other cerebrovascular conditions. Aneurysms associated with non-saccular configuration or giant size can make surgical or endovascular intervention difficult if not impossible. This article will review these uncommon aneurysms and their management.