The late results after axillo-femoral bypass grafts in patients with leg ischaemia

The late results--up to six years--after axillo-femoral bypass reconstruction are reported for 85 patients with leg ischaemia who were regarded as poor-risk patients for aortic bypass surgery, or who had aortic graft infection. Velour-Dacron grafts and expanded polytetrafluoroethylene (PTFE, Gore-Tex)--grafts have been used. The cumulative patency rate (life table) six years after graft implantation was 64% (PTFE-grafts) and 58% (Velour-Dacron grafts). The corresponding cumulative limb salvage rate six years after graft implantation was 88% when PTFE grafts were used and 77% when Velour-Dacron grafts were used. Our results demonstrate that axillo-femoral reconstruction is a useful procedure with a good patency rate 6 years after implantation. This procedure should be considered when dealing with poor risk patients with severe leg ischaemia.     

Effect of acupuncture on respiratory mechanisms in patients with bronchial asthma

Simultaneous recording of the spirogram, pneumotachogram and transpulmonary pressure as well as total plethysmography were applied in 30 patients with bronchial asthma to study the respiratory ventilation and mechanism before and after single procedures of acupuncture. The bronchodilatory action of acupuncture has been proved, related, in particular, with a significant decrease of non-elastic resistance of the lungs. At the same time pronounced changes in the elastic resistance were noted. However, they appeared to be of different directions. The improvement of ventilatory function was determined not only by a decrease in the intrapulmonary resistance but also by shifts in respiratory regulation and in the activity of the respiratory musculature, confirmed by an analysis of the curves of the respiratory work obtained before and after acupuncture. The curative action of acupuncture in bronchial asthma cannot be adequately explained by the placebo effect.     

Diagnosis of Ewing sarcoma of the thoracic spine--differential diagnostic difficulties

Spinal Ewing's sarcomas are rare and cause problems in differential diagnosis. The radiologic, nuclear medicine and CT findings in two children with histologically proven Ewing's sarcoma are presented and problems in differential diagnosis discussed. Biopsy should be done early.     

Histology of port wine stains after copper vapour laser treatment

We report histological changes in four patients with port wine stains treated with 578 nm yellow light from a high power copper vapour laser. Histology showed that selective damage occurred to the ectatic blood-vessels in the dermis, without haemorrhage and damage to non-vascular structures, and without scarring. The initial damage to the overlying epidermis was not permanent, and the damaged ectatic vessels returned to normal size or were completely necrosed and replaced by collagen.     

The place of colectomy with ileo-rectal anastomosis in inflammatory bowel disease

The present status of total colectomy with ileorectal anastomosis in the surgical treatment of inflammatory bowel disease is examined. Special reference is made to the different indications for the use of the operation in Crohn's disease and in ulcerative colitis. The late results are illustrated by the outcome in the 59 patients in a personal series, and other published results.