Chest
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A 59-year-old white man had an extensive bronchogenic carcinoma of the right upper lobe. During the course of pneumonectomy, the patient died unexpectedly. ⋯ The cause of the air embolism and subsequent death was almost certainly related to positive-pressure ventilation, allowing entry of air into the systemic venous system through the broncho-azygous vein communication. Because of the clinical implications of this problem, the case is reported, and suggestions for management are offered.
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Comparative Study
Airway response to short-term inhalation of tobacco smoke. Lack of racial differences.
Airway response to short-term inhalation of cigarette smoke was studied in healthy black subjects. We have measured thoracic gas volume, airway resistance, maximum expiratory flow rates, and closing volume in 12 healthy black volunteers before and after smoking a cigarette. ⋯ The results are similar to those previously observed in white subjects. We conclude from our study that the response to short-term inhalation of cigarette smoke is identical in both white and black subjects.
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A second case of malfunction of a Harken disk valve due to undue disk wear is reported. Two and one-half years after aortic and mitral valvular replacement, the patient had paraprosthetic aortic insufficiency and physical findings suggesting intermittent dysfunction of his prosthetic mitral valve. ⋯ At operation, the excised valve showed normal struts and sewing ring but severe disk wear. There was loss of disk substance and rim notching.