The American surgeon
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Physicians and other advanced medical personnel commonly perform subclavian vein cannulation. Success depends on adequate knowledge of the anatomy. With this knowledge subclavian vein cannulation can be performed with low complication rates. The manuscript reviews the anatomy and the literature of subclavian vein cannulation.
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The American surgeon · Jul 2004
Review Case ReportsPinch-off syndrome: case report and collective review of the literature.
Pinch-off syndrome (POS) occurs when a long-term central venous catheter is compressed between the clavicle and the first rib. The compression can cause transient obstruction of the catheter and may result in a tear or even complete transsection and embolization of the catheter. POS may be preceded by a finding of "pinch-off sign" on chest X-ray (CXR) films in which the catheter is indented as it passes beneath the clavicle. ⋯ Treatment of POS is removal of the catheter. If the tip of the catheter has embolized, it can usually be retrieved percutaneously with a transvenous snare. POS can be prevented by using the internal jugular vein for access rather than the subclavian vein.
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The American surgeon · May 2004
ReviewSkin-sparing and nipple-sparing mastectomy: preoperative, intraoperative, and postoperative considerations.
The last several decades have witnessed significant advances in the surgical management of breast cancer. Although many have embraced breast conservation as the procedure of choice, some patients will still opt for mastectomy for a variety of reasons. ⋯ However, this surgical approach must be considered within a multidisciplinary context, and there are a number of perioperative issues that need to be considered. In addition, newer techniques, which spare the nipple and/or areola, warrant further examination.
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The American surgeon · Jan 2003
ReviewA targeted approach for antiangiogenic therapy of metastatic human colon cancer.
The realization that the growth and spread of tumors are dependent on angiogenesis has created new avenues of research designed to help us to better understand cancer biology and to facilitate the development of new therapeutic strategies. However, the process of angiogenesis consists of multiple sequential and interdependent steps with a myriad of positive and negative regulators of angiogenesis being involved. ⋯ In addition, specific integrins such as alphavbeta3 and alpha5beta1 mediate endothelial cell survival and have been shown to be overexpressed on the endothelium of colon cancer. These angiogenic mediators thus serve as targets for therapy of metastatic colon cancer and have shown promise in preclinical trials.
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The American surgeon · Oct 2002
Review Case ReportsMalignant hyperthermia in an adult trauma patient.