摘要:

&NA;Penetrating injuries of the internal carotid artery at the base of the skull often require permanent or transient occlusion of the injured vessel during repair. Extracranial‐intracranial bypass (EC‐IC) was employed in five patients to insure adequate cerebral perfusion during cervical exploration. Preoperative neurologic deficits were noted in three patients; two demonstrated complete reversal following EC‐IC. This experience suggests that EC‐IC can maintain adequate cerebral perfusion during repair of internal carotid injuries and allow selective revascularization of patients with neurologic deficit and carotid occlusion.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;A 9‐year experience at the University of New Mexico affiliated hospitals involving 18 patients with self‐inflicted gunshot wounds to the face is reviewed. Almost all were young males, averaging 27.9 years of age. Fourteen patients were Native American, six from the same pueblo. Four shootings were ‘accidental’ and the rest suicidal. Sixteen patients were intoxicated at the time of injury.Interpersonal conflict with an important female and acculturation difficulties were thought to play major roles. Rifles were most commonly used, and injuries tended to be severe. High muzzle velocity (≥2,000 ft/sec), high muzzle energy (≥2,000 ft‐lbs) weapons tended to be the most injurious, and low muzzle energy (≤1,000 ft‐lbs) guns were related to a lesser extent of injury regardless of muzzle velocity. Patient compliance during reconstruction has been excellent, and functional return to society with gainful employment and a stable marriage has been the rule. Subsequent suicide attempts have been uncommon.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;A case of traumatic arteriovenous fistula of the superior mesenteric vessels is added to a collective review of 16 previous cases. Nausea, vomiting, cramping abdominal pain, diarrhea, abdominal thrill and bruit were usually present. Arteriography was diagnostic. Four patients operated upon immediately or within 11 hours after penetrating abdominal trauma had superior mesenteric arteriovenous injuries repaired; the remainder had a mesenteric vascular injury missed at initial laparotomy. The location of the fistula determined the method of repair. Spontaneous obliteration occurred in one patient. In two of the three deaths, portal hypertension was present and a fistula was discovered at autopsy; the other occurred 3 months after massive bowel resection. Thorough exploration of hematomas and lacerations of the mesentery will minimize or eliminate subsequent formation of an arteriovenous fistula.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;A prospective and retrospective evaluation of 75 patients with hand wounds contaminated by human saliva (35) or animal saliva (40) demonstrates that a program of outpatient management can be sufficient for optimal care in many patients. This series challenges the proposition that hospitalization, radiographs, and surgical debridement are necessary for most such wounds. Sixty‐seven per cent did not have surgical intervention and no complications resulted. Ninety‐two per cent received antibiotics. Radiographs were obtained only when bony injury or entry into a joint was suspected. Delay in seeking treatment until obvious signs of infection or pain are present is common. Literature review details the anatomic factors important in the natural history and control of these infections, and the changes with respect to modes of treatment for these potentially dangerous wounds. The injury is caused by bites with the hand extended or, in fight‐bite wounds, with the metacarpal‐phalangeal and interphalangeal joints flexed, allowing deeper penetration and then sealing of the wound when the first is opened.StaphylococcusandStreptococcusare the organisms most frequently found in human bites, and in animal bites;Pasteurella multocidashould be considered in dog and cat bites.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;A review of 245 patients requiring replantation surgery from 1970 to 1978 revealed a 70% survival rate for complete amputation. In this group, there were 347 replanted parts, including the lower extremity. Upper‐extremity survival rates alone (>90%) are higher than for lower extremity replantation. Meaningful assessment of replantation must include not only survival data but functional criteria as well. While functional data are incomplete on several early cases, our assessment criteria are reviewed. Criteria should include two‐point discrimination sensibility ratings, grip strength, range of motion, absence of cold intolerance, and return to employment. Evaluation of candidates for replantation is critical, and the importance of teams with microsurgical skills working in special centers is emphasized.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;Nine cases of bilateral femoral shaft fractures were seen in a series of 126 patients treated from 1973‐1977. Patients were multitrauma cases from automobile accidents. Treatment by traction followed by cast‐bracing resulted in a high percentage of unsatisfactory results, lengthy recoveries, and the necessity of secondary surgical procedures to improve the results.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;The effects of 3‐methyl‐5‐isoxazole carboxylic acid (MIC) on postburn plasma volume loss have been studied in the anesthetized dog, and the results demonstrated that, when administered before thermal trauma, MIC significantly reduces the plasma volume loss observed at 1 and 2 hours postburn. The reduction of plasma volume loss observed was less than that observed with nicotinic acid administered preburn. A single 0.2‐mg dose of MIC/kg body weight given 2½ hours after a 15% body surface area third‐degree flame burn significantly reduced the plasma volume loss during the next 4 hours. This effect of MIC was approximately the same as that observed with nicotinic acid under the same conditions. The differences between nicotinic acid and MIC under thse conditions were the size of the dose of drug required (0.2 mg/kg of MIC versus 15 mg/kg of nicotinic acid) and the duration of action of the drug (greater than 3 hours for MIC versus 1 hour for nicotinic acid).

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;A study of hemorrhagic shock in anemic dogs suggested a difference in pulmonary histopathology between animals treated with azathioprine and animals in a control group. Hemorrhagic shock for 2 hours without reinfusion produced definite changes in pulmonary anatomy by conventional histology and electron microscopy. The changes consisted of interstitial edema, vascular congestion, and focal atelectasis. Electron microscopic studies showed accumulation of edema fluid with disruption of Type II pneumocytes and the collagen fibrils in the alveolar‐capillary interstitium. Azathioprine ameliorated the shock state.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;We have previously described the isolation of a lipoidal splenic extract (LSE) that demonstrated a variety of hematologic effects including inhibition of platelet aggregation both in vivo and in vitro. Since endotoxin causes platelet aggregation and microembolism the protective effect of LSE in endotoxemia was examined in the present study. Both young and elderly Swiss mice given LSE 2‐3 hoursbeforeendotoxin challenge showed a statistically significant increase in survival compared with saline‐treated controls. However, no significant improvement in survival was noted when LSE was administeredat the same timeas endotoxin. These results add further support to the role of the spleen in the control of infection.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;A series of 298 forestry injuries and fatalities were studied. The patients form three groups, those with fractures and/or soft‐tissue injuries, those injured by chainsaws, and fatalities. Wide publicity is suggested in order to reduce the number of patients injured in forestry work.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID