American journal of surgery
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Review Case Reports
Injuries to the inferior vena cava and their management.
Injuries to the inferior vena cava are being seen with increasing frequency in the civilian population. A review of the experience at UCLA/Harbor General Hospital Medical Center over a ten year period (1966 to 1976) discloses thirty-four patients with major injuries to the inferior vena cava, with an overall mortality of 53%. ⋯ Technical considerations regarding identification and handling of inferior vena caval injuries are presented. The mortality rate for major inferior vena caval injuries remains distressingly high and serves as a challenge for future improvement.
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Case Reports
Carcinoma of the colon in the adolescent: a report of survival and an analysis of the literature.
A case of adenocarcinoma of the transverse colon in a fourteen year old girl is presented. Five years after radical resection of this Dukes' C2 lesion, the patient is alive and well without recurrent disease. ⋯ An increased incidence of colloid carcinoma is noted. The etiology and pathogenesis of large bowel cancer as it pertains to childhood are reviewed.
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Eighteen brands of cuffed endotracheal tubes, including those with the new low pressure cuffs, were evaluated and compared. Experiments were performed in vitro on excised dog tracheae to measure the mucosal pressure exerted by the inflated cuffs. Pressure was measured directly with a mechanical sensor. ⋯ The data showed that, when inflated sufficiently to seal within the trachea, stiff cuffs reduced blood flow more than compliant cuffs. With all cuffs, blood flow was reduced more at the mucosa than at deeper regions of the tracheal wall. It was concluded that for clinical use, compliant cuffs are preferable to stiff cuffs because they should cause less ischemia.
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Surgical extirpation of the primary tumor has traditionally been utilized as initial treatment for sarcomas in children. The present report, however, demonstrates that sarcomas are optimally treated by means of a coordianted multidisciplinary approach. The latter offers the potential for achieving improved survival and preservation of organs and limbs, particularly for structures of the head and neck, for extremities, and in the genitourinary system.