Journal of investigative surgery : the official journal of the Academy of Surgical Research
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Comparative Study
Usefulness of Groshong catheters for central venous access via the external jugular vein.
This study was designed to evaluate the usefulness of central venous access via the external jugular vein (EJV) employing Groshong catheters, and to compare the complications with those of conventional internal jugular venous catheterization. Central venous access was achieved by insertion of a single-lumen 4.0 Fr Groshong catheter via the EJV or internal jugular vein (IJV) with a single puncture. Complications associated with insertion and central venous catheter-related bloodstream infection (CVC-RBSI) were evaluated from the database. ⋯ There were no significant differences such complications as malposition, oozing or hematoma formation of insertion site, arterial bleeding, nerve damage, pneumothorax, and phlebitis between IJV-C and EJV-C. Moreover, EJV-C was not associated with morbidities such as pneumothorax, arterial bleeding, and nerve damage. Thus the study concluded that EJV-C using Groshong catheters has no severe complications and has the same rates of CVC-RBSI as conventional IJV-C for central venous access.
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Mizuta's cuff technique in rat lung transplantation (LT) model has some disadvantages, such as twisting of blood vessels or bronchus and being time-consuming, which complicate procedures for anastomosis. This study was performed to investigate the advantage of using a simplified cuff technique in LT. The anastomosis time was compared in two groups. ⋯ The anastomosis time of group II was significantly less than for group I (11.2 +/- 2.1 min vs. 18.1 +/- 3.6 min, mean +/- SD, p < .01). This simple modified cuff technique led to less anastomosis time and avoided potential complications induced by the cuff-tail technique. It has been verified to be a safe, simple, and reproducible technique that can provide us with a more precise assessment in the rat LT model.
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Comparative Study
Gastric mucosal perfusion in dogs: effects of halogenated anesthetics and of hemorrhage.
The gastrointestinal tract is one of the first organs affected by hypoperfusion during hemorrhagic shock. The hemodynamics and oxygen transport variables during hemorrhagic shock and resuscitation can be affected by the anesthetics used. In a model of pressure-guided hemorrhagic shock in dogs, we studied the effects of three halogenated anesthetics--halothane, sevoflurane, and isoflurane--at equipotent concentrations on gastric oxygenation. ⋯ Halothane group showed significant lower PCO(2) gap values than the other groups (p < .05). After 60 min of shed blood replacement, all groups restored hemodynamics, systemic oxygenation, and PCO(2) gap to the prehemorrhage levels (p > .05), without significant differences among groups (p > .05). We conclude that halothane is superior to preserve the gastric mucosal perfusion in comparison to isoflurane and sevoflurane, in dogs submitted to pressure-guided hemorrhagic shock at equipotent doses of halogenated anesthetics.
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Embracing greatness, for surgeons as well as for other professionals, brings about a positive state of mind that permits us and others to better appreciate the performance of our working activities and our lives. Celebrating greatness is unique and should not be overlooked at any time in our professional development. ⋯ Believing in their possibilities of success, promoting their confidence, and celebrating greatness should be important qualities to seek in the life and career of the modern surgical specialist. The surgeon as an individual, as a professional, and as a human being would enormously progress in life and in working endeavors when embracing greatness thoughout personal and professional careers.
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The magic world of the sensational Spanish novel The Shadow of the Wind serves as an excellent background to indicate the importance of forgotten surgical books by surgeons-in-the making or surgeons-in-practice. Why would this book be helpful to surgeons, when it mainly refers to a 10-year-old Daniel, who had been taken by his father to the Cemetery of Forgotten Books? In this cemetery, this unique place, certain books are subjected to oblivion and condemned to be forgotten. ⋯ We have imagined the forgotten books as the surgical books disregarded or lost by a great number of surgical specialists, the forgotten books of surgical history that we do not emphasize in our surgical residency programs. These volumes comprise our own Cemetery of Forgotten Surgical Books.