Kardiol Pol
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Case Reports Comparative Study
[Lung cancer simulating dissecting aneurysm of the aorta].
The report analyzes a rare case of lung cancer presenting as a dissecting aortic aneurysm. A 59-year-old patient was admitted to the Department of Cardiosurgery of the Institute of Cardiology, Poznań Medical School, with a preliminary diagnosis of dissecting aneurysm of ascending aorta. The patient had hypertension treated for 5 years and 3 year history of retrosternal pains. ⋯ The patient died at home after two months of oncological treatment. Autopsy was not performed. In spite of considerable progress of the diagnostic technics both dissecting aortic aneurysm and lung cancer still present a very difficult clinical problem.
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Platelet damage, complement activation and neutropenia during extracorporeal circulation are the result of blood contact with artificial surfaces, mainly in the oxygenator. To evaluate the biocompatibility of the ++auto-oxygenation technique of cardiopulmonary bypass (CPB) 2 techniques of extracorporeal circulation were compared in 40 patients undergoing elective coronary bypass surgery. Patients were studied in 2 groups, 20 patients in each: I (++auto-oxygenation --patients lungs used in CPB) and II (conventional technique of CPB with bubble oxygenator). ⋯ In postoperative period an increase in circulating white blood cells was observed in both groups when compared to pre-bypass time, but the difference between groups was non significant. The level of C3a increased in group I from 244 +/- 46 ng/ml to 418 +/- 34 ng/ml, in group II from 268 +/- 46 ng/ml to 521 +/- 65 ng/ml, p less than 0.001, but in group I the levels were significantly lower, p less than 0.001. The current study confirms that cardiopulmonary bypass results in significant leukocyte and complement activation and supports the theoreticaly better biocompatibility of CPB with lung over oxygenator.
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Emergency coronary bypass for cardiogenic shock has been associated with a high operative mortality. From February 1986 through October 1989, 40 patients with acute myocardial infarction were operated. Ten pts (25%) were in shock despite intensive treatment (intra-aortic balloon pump in 4, catecholamines in 10). ⋯ One pt is in group IV (transplant candidate). Myocardial infarction complicated by cardiogenic shock can produce a mortality rate in excess of 85%. Contemporary medical management has had little effect on mortality, hence effective surgical therapy has evolved for this lesion.
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Comparative Study
[Measurement of arterial blood pressure using the sphygmomanometer-S and the direct method].
Sphygmomanometer--S is the microcomputer device measuring blood pressure (BP) by the noninvasive sphygmooscillographic method following standard algorithm. When compared sphygmomanometer--S with auscultatory method, this device overestimated systolic BP by 7 mm Hg, and underestimated diastolic BP by 9 mm Hg on the average. In other words, sphygmomanometer--S overestimated systolic pressure and lowers diastolic pressure in relation to auscultatory method in the same ratio and value, as the direct method in relation to the auscultatory method. ⋯ The correlation coefficient (r) was 0.97 for systolic, 0.90 for diastolic and 0.92 for mean pressure. Systolic and diastolic pressure measured by the sphygmomanometer--S were 2 mm Hg and mean 0.6 mm Hg higher on the average, than the same pressures obtained by direct method (ryc. 1). These differences were statistically not significant.(ABSTRACT TRUNCATED AT 250 WORDS)