No abstract available.
Pneumothorax* ; Thorax*

Open heart surgery under cardiopulmonary bypass which is combined with moderate hypothermia and 5% dextrose priming offers several advantages over the conventional methods; i.e., simplification of the machine, economy in operation, elimination of the need for a large amount of heparinized blood, avoidance of hemaological complications and utilization of the unit as a standby method. The results of open heart operations with this method in our initial 10 cases were comparable to other methods. None of the complications and the mortality were directly attributable to the oxygenator itself.

A hypothermic, low flow perfusion, using 5% dextrose in water as the priming fluid in the pump-oxygenator, was carried out to observe oxygen consumption, blood pH changes, and CO2 tension during the bypass period. A low oxygen consumption which was approximately one third of the preperfusion value, was observed during the total by-pass period. This is believed to be due to the effect of low flow rates employed, hypothermia and low CO2 tension observed in these animals. The pH of the arterial blood and the partition of the total CO2 remained within a fairly normal range. There was a marked reduction in CO2 tension during the bypass period. Its harmful effect on the oxyhemoglobin dissociation curve and cerebral circulation was discussed. The hemodilution attendant to the use of 5% dextrose in water as the priming fluid is considered insignificant.
Animals ; Dogs ; Glucose/*adverse effects ; *Heart-Lung Machine ; *Hypothermia, Induced ; Plasma Substitutes/*adverse effects

Treatment of the olecranon fractures by prolonged immobilization often results in limited elbow motion. With the use of tension band wiring, anatomical reduction was obtainable, and only a short period of immobilization was needed. We reviewed the cases of 17 patients who underwent surgical treatment of the olecranon fracture. All patients were treated by tension band wiring. In the overall series, we were able to obtain 53 percent excellent, 30 percent good, and 18 percent fair results.
Elbow ; Humans ; Immobilization ; Olecranon Process*

With respect to the histogenesis of the neurofibroma, there are many controversies, since von Recklinghausen postulated that neurofibromas are mainly fibrous tumors arising from the connective tissue of the nerve sheaths. According to the recent studies through the electron microscope, the neoplastic perineurial cells are regarded as the main components of the tumor. So, the neurofibroma enucleated from the median nerve at the level of proximal arm without resulting neurologic sequale was examine through the light-and electron microscope. Ultrastructurally, this tumor is composed of the perineurial cells, fibroblasts, and collagen fibers. The predominant perineurial cells show distinct basal lamina, and contain abundant microfilaments.
Actin Cytoskeleton ; Arm ; Basement Membrane ; Collagen ; Connective Tissue ; Fibroblasts ; Median Nerve* ; Neurofibroma*

No abstract available.
Adult* ; Esophageal Atresia* ; Fistula* ; Humans

Differential independent lung ventilation is gaining growing attention for management of patients with unilateral pulmonary pathology. This case presents the method for the intraoperative anesthetic management of a patient with empyema and bronchopleural fistula of the left lung which could be controlled by the use of dual-mode asynchronous lung ventilation. The healthy right lung was ventilated by a conventional mechanical ventilator and disessde left lung by a high frequency jet ventilator. The use of endotracheal anesthesia and high frequency ventilation were necessary to prevent drainage of infected secretions into the right side healthy lung and to achieve good gas exchange in the presence of a bronchoplsural fistula. The method used by us, high frequency ventilation for the diseased lung a conventional mechanical ventilation for the other, demonstrated that differential independent lung ventilation using double lumen tube as in this case was suited for handling the problem of a bronchopleural fistula and empyema, further extending the indication for a giant lung bulls, lung cyst, major tracheobronchial disruption and one lung contaminating the other lung with either infected material or blood.
Anesthesia ; Drainage ; Empyema ; Fistula ; High-Frequency Ventilation ; Humans ; Lung* ; Pathology ; Respiration, Artificial ; Ventilation* ; Ventilators, Mechanical

In spite of large volume of reports, surprisingly little information is avail-able about the function of the foot in standing and there are still many controversies about the exact proportion of the weight distributed in discrete areas of the foot. The purpose of this study is to evaluate about the exact proportion of the weight distribution in discrete areas of the foot through the photoelastic technique. In the results of this study according to the 10 regional division method, 4.4% of the total load of one foot was loaded on the toes(1 st toe, 2.2% ;2nd toe, 0.8%; lateral toes, 1.4%), 27.4% on the metatarsal area(lst metatarsal, 6.6%; 2nd metatarsal 8.7% ; lateral metatarsals, 12.5%), 8.6% on the midfoot(medial midfoot, 1.4%; lateral midfoot, 7.3%) and 59.2% on the heel(medial heel, 31.9%; lateral heel, 27.%), respectively. As in other reports, the toes played little role in weight bearing and the midfoot suggested the presence of the longitudinal arch. The metatarsal area received considerable amount of weight but the priority of the first metatarsal area was not demonstrable, rendering the presence of the transverse metatarsal arch doubtful. The heel received more than half of total weight given in one foot(p < 0.005). No significant difference was demonstrable between the dominant side and the nondominant side other than in midfoot.
Foot ; Heel ; Metatarsal Bones ; Methods ; Toes ; Weight-Bearing

A persistent left superior vena cava is the most common anomaly of the superior caval system. Usually the persistent left superior vena cava is connected with the right atrium via the coronary sinus, resulting in no physiologic derangement : however in 7 to 8 percents of the patietns with a persistent left superior vena cava, the anomalous vessel communicates with the left atrim. In the absence of obstruction to the flow from the left atrium to the left ventricle. this anatomic situation usually results in right to left shunting of varying degress. We recently experienced a case of persistent left superior vena cava in a 52-year-old female who complained of chest discomfort, epigastric pain and dyspnea(NYHA functional class II). Cine-angiography showed that the contrast passed from the left SVC through the dilated coronary sinus into right atrium. And right sided SVC was not seen. The patient was treated with conservative measures and discharged with improved condition.
Coronary Sinus ; Female ; Heart Atria ; Heart Ventricles ; Humans ; Middle Aged ; Thorax ; Tricuspid Valve Insufficiency* ; Vena Cava, Superior

OBJECTIVE: To find most effective pressure relief method in wheelchair seated spinal cord injured patients and to evaluate effectiveness of trunk lateral bending, trunk pulling and trunk forward flexion methods in practical environment METHOD: Twenty spinal cord injury patients were included in this study. After 5 cm air-filled cushion (ROHO(R)) was placed on wheelchair seat, patients were seated on wheelchair with neurtal position and interface pressure of buttock was measured by X-sensor 4.0 system. Patients took a posture lateral bending, trunk pulling, forward flexion methods. Mean and maximal pressure of buttock were measured at each pressure relief methods. RESULTS: Mean and maximal pressure of buttock were reduced by 90degrees trunk forward flexion (p<0.05). In trunk lateral bending method, pressure was reduced in non-weight bearing side of buttock, but pressure was highly elevated in weight bearing side. In trunk pulling method, pressure was elevated in both weigth bearing and non-weight bearing side. CONCLUSION: 90degrees trunk forward flexion method can be recommended to wheelchiar seated spinal cord injured patients for pressure relief of buttock.
Buttocks ; Humans ; Posture ; Spinal Cord Injuries ; Spinal Cord* ; Weight-Bearing ; Wheelchairs*