Annales chirurgiae et gynaecologiae
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Comparative Study Clinical Trial Controlled Clinical Trial
A study of cumulative effects and recovery from anaesthesia with intermittent doses of althesin. A comparison with methohexitone.
The cumulative effects and post-anaesthetic recovery of Althesin were studied by comparing the drug with methohexitone in a series of 60 patients undergoing surgery for varicose veins. Anaesthesia was maintained with each anaesthetic agent in 30 patients by administration of intermittent doses of the respective drugs in accordance with the surgical stimulus. When repeat doses were required at intervals of 2 to 5 minutes, the fall off in requirements was observed with both anaesthetics, more distinctly with Althesin than with methohexitone. ⋯ Frequency of nausea and vomiting after anaesthesia was considerably higher in the Althesin group than in the methohexitone group. These symptoms might be toxic due to the excessive dosage given. Using the induction time as a basis for calculation of the potency ratio, Althesin and methohexiton were found to have the ratio of 1:33 (expressed in mu1/kg : mg/kg).
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A case of cardiac rupture secondary to blunt chest injury and its successful surgical repair is described. A review of the literature based on eleven previous similar cases is given.
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One case of an ulcerating paraffinoma of the male mammary gland and another of the penis are reported. The former is the third and the latter the eighth of its kind described in the literature. Psychopathological features were associated with both cases, and additionally impotence with the latter. ⋯ Re-injection of paraffin later required total excision of the entire anterior thoracic skin and subcutaneous tissues and skin grafting. The penile paraffinoma was treated by complete excision and again subsequent skin grafting. Both the functional and cosmetic results of the latter were good.
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Children between the ages 1 to 3 years are particularly prone to burns by their constant desire to pull down containers of hot fluids. The resulting burns produce serious complications such as hypertrophic scars and scar contractures, which can be severe enough to cause growth disturbances. A series of 31 cases of these accidents resulting in the above sequelae was investigated. ⋯ Usually the scald could have been prevented by greater vigilance on the part of the parents. Once late complications have developed, excision of the scar tissue and subsequent skin grafting or other reconstructive procedure should be performed. However, in spite of satisfactory results, these complications have a tendency to recur during the growth period.
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105 valve replacements with the Björk-Shiley tilting-disc prosthesis have been performed in 99 patients with an overall mortality of 12%. The hospital mortality for 73 single aortic valve replacements was 10%, for 24 single mitral valve replacements 13%, and for 5 double valve operations 20%. ⋯ The follow-up period of the first patients with aortic valve replacement is 4 1/2 years, and that of those with mitral valve replacement over 2 1/2 years. The most common late complication in patients with mitral valve replacement was a paravalvular leak (19%), whereas in patients with aortic valve replacement slight haemolytic anaemia (4%) and late thromboembolism (3%) occurred most frequently. 84 of the 87 survivors showed manifest clinical improvement in their preoperative status and increased exercise tolerance.