AIM: The aim of this study was to evaluate the results following surgery for carotid artery stenosis in a single institution during a 20-year period. METHODS: In a retrospective study, 556 operations were performed in 496 patients during the period 1983-2002. Comorbidities, mortality, stroke and other surgical and general complications were recorded. Follow-up was performed and data retrieved from medical records, questionnaires, and visits to local hospitals. Data on late mortality were retrieved from the Norwegian Registrar's Office of birth and deaths. RESULTS: The mean age was 66.9 years (range 43-84 years), and 60% were men; 84% had symptomatic carotid artery stenosis. General anesthesia was applied in 95.5%. A shunt was used in 61.3%, and patch angioplasty in 95.1%. Autologous vein patch was used in almost all cases and there were no cases of patch rupture. Postoperative myocardial infarction occurred in 16 (2.9%) of the patients, and 5 were fatal. All types of stroke within 30 days of surgery occurred in 23 (4.1%) including 1 fatal stroke, and 7 patients died of other causes. The total stroke/mortality rate was 5.4%. Patients with previous coronary artery bypass had a favorable outcome regarding long-time survival. In contrast, increasing age, diabetes, renal failure and intermittent claudication predicted reduced long-term survival. No operations were performed for recurrent stenosis. CONCLUSIONS: We have used fairly the same policy regarding operative technique during the 20-year period and the results are in agreement with those presented in large international trials. The long-term results were favorable, and improved over time, probably due to better preoperative evaluation of the patients, better timing of surgery and treatment of comorbidities.
Autosomal recessive congenital ichthyosis (ARCI) is a group of keratinisation disorders that includes the ichthyosis prematurity syndrome (IPS). IPS is rare and almost exclusively present in a restricted region in the middle of Norway and Sweden, which indicates a founder effect for the disorder. We recently reported linkage of IPS to chromosome 9q34, and we present here the subsequent fine-mapping of this region with known and novel microsatellite markers as well as single nucleotide polymorphisms (SNPs). Allelic association, evaluated with Fisher's exact test and P (excess), was used to refine the IPS haplotype to approximately 1.6 Mb. On the basis of the average length of the haplotype in IPS patients, we calculated the age of a founder mutation to approximately 1,900 years. The IPS haplotype contains a core region of 76 kb consisting of four marker alleles shared by 97.7% of the chromosomes associated with IPS. This region spans four known genes, all of which are expressed in mature epidermal cells. We present the results from the analysis of these four genes and their corresponding transcripts in normal and patient-derived samples.
AIM: The aim of this study was to describe the number and severity of carotid artery stenosis in an unselected stroke population in hospital. METHODS: The carotid arteries were investigated consecutively with color-coded duplex scanning in patients suspected of having stroke and admitted to a stroke unit during a 6-month period. Percent internal carotid artery stenosis by diameter reduction was described. RESULTS: A total of 144 patients were included in the investigation and the mean age was 75 years. The final diagnosis was stroke in 126 patients, while 18 had transient ischemic attacks. On the side, relevant to the neurologic deficit, a stenosis of >70% diameter reduction was observed in 4 patients and occlusion in 3. Severe stenosis and occlusion was found to have almost the same incidence on the contralateral side. Altogether 46 stenoses >30% (16.3%) were observed in 282 arteries investigated. The distribution was equal between the two sides. CONCLUSION: These findings indicate that few patients are eligible for surgery. However, routine duplex ultrasound examination in stroke patients gives information whether there are carotid arterial lesions, which could be a source of emboli. Such information can also be a guide for further medical treatment and lifestyle modification.