The American surgeon
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The American surgeon · Mar 1976
Effective surgical palliation of giant compressive bullous emphysema (vanishing lung syndrome): long-term follow-up.
Giant compressive bullous emphysema is rare. The three major considerations for operation involve a breathless patient with giant bullae occupying more than one-third of one lung field who has a positive pulmonary arteriogram revealing diminished blood flow to the involved lung. Finally, we think that the survivors in our series, eight long-term postoperative patients alive one year to 14 years, supply gratifying evidence that surgery can provide effective and safe palliation.
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The American surgeon · Mar 1976
Case ReportsAcalculous clonorchiasis obstructing the common 3ile duct: a case report and review of the literature.
Clonorchis sinensis has a minor incidence in Western countries and most commonly manifests as cholangiohepatitis with secondary bacterial infection. This parasite rarely obstructs the common bile duct without associated biliary stricture, stones or tumor. This paper documents the fourth reported case of acalculous C, sinensis biliary tract obstruction and reviews the world literature.
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The hemodilution technique for cardiopulmonary bypass using blood substitutes for priming has permitted open heart operations in Jehovah's Witnesses who refuse to accept blood, and has reduced the need for massive blood transfusion in certain procedures including aortocoronary bypass. A series of 46 Jehovah's Witness patients underwent aortocoronary bypass procedures. Of these, two patients died, representing a mortality of 4.3 per cent. ⋯ Among these patients not of the Jehovah's Witness religion, blood transfusion was not necessary in about 30 per cent, while the remainder averaged less than two units per patient. Our results with Jehovah's Witness patients encourage our policy of avoiding blood transfusions whenever possible in all operations. Further justification for our conservative attitude is provided by the current shortage of blood in relation to a projected continuous increase of aortocoronary bypass procedures in the future.
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The American surgeon · Aug 1975
Comparative StudyAcute postoperative wound complications after gastric surgery for morbid obesity.
The acute postoperative wound complications of 225 morbidly obese patients undergoing gastric bypass were compared against the complications observed in 225 normal-sized individuals who underwent elective gastric resection for peptic ulcer disease. Not only were there more wound infections (8.9 percent to 5.3 percent) in the obese population, but these infections inflicted more serious complications and a significantly increased hospital stay. While the exact cause of the increase in infections in the obese patients is unclear, it is a real phenomenon to be dealt with in surgery for obesity.
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The American surgeon · Jul 1975
Adult respiratory distress syndrome in postoperative patients: study of pulmonary pathology in "shock lung" with prophylactic and therapeutic implications.
Lungs of 44 patients who died after postoperative respiratory distress and shock had a significantly higher incidence of atelectasis and thromboembolism than did 31 control patients. However, both lesions were as inconstant in occurrence as all other 15 investigated pulmonary changes. ⋯ While possibly a contributing factor, shock is not the most important cause of the pulmonary lesions in postoperative patients. The term "shock lung" should be eliminated and renewed emphasis should be placed on detection, prevention and treatment of the pathogenic mechanisms involved in each individual case.