Zhonghua wai ke za zhi [Chinese journal of surgery]
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Zhonghua Wai Ke Za Zhi · Dec 1992
[Re-open heart surgery in congenital heart disease. An analysis of 23 cases].
The authors reported 23 cases of re-open heart surgery in 1473 patients with congenital heart disease treated surgically in the last ten years. The incidence was 1.6%. In 13 cases of the 23 re-open heart procedure was performed before closing the chest during the operation because of missed diagnosis in 5, incomplete correction of the anomaly in 5, and injure to important organ in 3. ⋯ The anthers pointed out that accurate diagnosis and error-free operation is of most importance in avoiding re-open heart surgery. Through exploration to the heart after resuscitation during the operation and positive re-opening of the heart when necessary were emphasized. Indication of early and late postoperative re-open heart surgery and methods to prevent its complication were listed.
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Two patients with closed rupture of the cervical trachea secondary to blunt trauma, one secondary to neck injury and the other secondary to thoracic injury, were analysed with those reported else where (58). Signs and symptoms included subcutaneous emphysema, respiratory distress, hoarseness/dysphonia, dysphagia, hemoptysis and so on. We conclude that: (1) the diagnosis of blunt trauma of the cervical trachea requires a high index of suspicion, since this injury can easily be overlooked; (2) tracheostomy is the best means of airway control; (3) good long-term airway quality is best obtained by immediate repair of injuries.
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Twenty-three cases of recurrent gliomas were reoperated upon. The indications and some factors influencing the length of survival time after reoperation were studied. ⋯ Reoperation is not only to prolong life time but also to improve living quality. After reoperation, a comprehensive treatment is needed.
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Zhonghua Wai Ke Za Zhi · Sep 1992
Case Reports[Need for more emphasis on fungal infection in burns].
We have made quantitative bacterial and fungal culture for 148 biopsy specimens from burn patients. Further confirmation was made by frozen section with PAS stain in 82 of the specimens. ⋯ It was also found that the incidence of fungal infections was higher in severe burns. Two rare cases of fungal infection were discovered, one of them was infected by Geotrichum SP, and the patient died; the other an infection by Homodendrum SP on the face, and the finally recovered.
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Zhonghua Wai Ke Za Zhi · Jul 1992
[Multiple organ failure following severe acute pancreatitis: its clinically patterns and pathogenetic factors].
To detect the clinical course and possible pathogenetic factors of multiple organ failure (MOF) after severe acute pancreatitis (SAP), we investigated retrospectively 70 consecutive patients with SAP for a 16-year period. Two different patterns of MOF were identified: rapid-single phase MOF developed early after SAP attack, and delayed tow-phase MOF developed progressively and sequentially with a lag phase. ⋯ Clinical variables associated with the evolution of MOF included early circulatory shock, pancreatic sepsis and severe pancreatic necrosis, which might be the leading one. It is suggested that the generalized inflammatory response triggered by the toxic focus seems to be the final common pathway linking SAP with MOF syndrome.