Interruption of the inferior vena cava is the definitive surgical measure for the control of pulmonary emboli. There is, however, some controversy as to whether the preferred treatment is complete or partial interruption. This report summarizes our experience with 49 patients who underwent partial ligation, using a technique developed in our Department, and 66 patients, who underwent complete ligation of the inferior vena cava. The incidence and severity of sequelae due to venous stasis in the legs were less in the group that underwent partial interruption.

Adult↗

PubMedDate not supplied

The effect of impairment of blood supply to the rat uterus.

Over the last decades much attention has been directed to establishing the cause of altered fetal growth and habitual abortion. Great emphasis has been placed on placental blood flow, but relatively few studies have been published on the effect of impaired uterine blood supply. This study examined the effect of impaired uterine blood flow using the white rat, with its bilateral uterine horns. Three groups of rats with bilateral, left unilateral, or right unilateral artery ligation were compared with a control group for number and weight of fetuses at term. The results showed that the impaired rats produced significantly fewer fetuses than controls (means: 8.59 vs. 11.21, respectively; P less than .001) and those fetuses had lower mean birth weights than controls (5.295 g vs. 5.800 g, respectively; P less than .05). While conception was possible even in rats with impaired uterine blood flow, the differences at term suggest that impairment of the maternal blood flow may contribute toward intrauterine growth retardation and habitual abortion. The clinical significance of these findings and suggestions for future research are discussed.

Animals↗

PubMedDate not supplied

A new technique for vascular anastomoses.

Vascular anastomoses are invariably performed manually and may be difficult technically particularly in smaller calibre vessels. This may be even more pronounced when an emergency situation exists and a surgeon relatively inexperienced in vascular surgery has to deal with the problem. A technique is described allowing for rapid anastomosis of vessels ranging upwards from a diameter of 2.5 mm using incomplete adjustable metal rings. The technique is simple and can be applied by surgeons with minimal vascular training. This could be extremely useful in the emergency situation, particularly when critical ischemia exists. Also, anastomoses of small calibre vessels such as in arterio-venous fistula may be more simply performed by the aid of the described rings.

Arteriovenous Shunt, Surgical↗

PubMedDate not supplied

Juxta-centromeric fragility of chromosomes 1, 2, 9, 16, and immunodeficiency. Special reference to the fragility of chromosome 2 and its oncogenic potential.

Juxta-centromeric fragility of chromosomes 1, 2, 9, 16, has been described at least thrice in unrelated patients in association with combined immunodeficiency. This association has been confirmed by our findings in both immunodeficient and cancer patients. In our opinion, both the fragility and the immunodeficiency are the results of persistent viral infections by certain DNA (i.e.: Herpes-, Papova-) viruses or RNA (retro-) viruses (i.e. HTLV), which are lymphotropic. The immunodeficiency may be due to virus-cell, cell to cell, or virus-virus interactions. According to our findings, centromeric fragility of chromosome 2 appears to have a particular oncogenic potential probably because of its location in proximity to immunoglobulins genes. We suggest that centromeric fragility of chromosomes 1, 2, 9, 16, may be one of the symptoms of an incipient Acquired Immunodeficiency Syndrome (AIDS) which will not necessarily develop fully.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Alteration of pulmonary function by filtration of intravenous nutrient mixture.

In view of contradicting results concerning alteration in lung function during hyperalimentation and the administration of intravenous lipid emulsion, a study was planned to determine possible changes in pulmonary blood perfusion during administration of total nutrient admixture (TNA) and the effect of filtration. Sixteen patients (8 men, 8 women; mean age 65.6 yr) with no previous lung disease received TNA at the rate of 4-5 g lipid/h as preoperative treatment for 5-9 days (mean 6.7 days). The 5-microns filter was randomly used in eight patients. The lung blood perfusion parameters measured repeatedly during this period included blood gases, percentage of the predicted value of vital capacity (VC), and pulmonary diffusing capacity for carbon monoxide (DLCO), as well as the value of the dead space volume and the tidal volume ratio (VD/VT) and the calculated shunt (QS/QT). TNA infusion appears to cause only a slight decrease in PaO2 and DLCO and a similar increase in VC and QS/QT, whereas VD/VT decreased significantly. The latter effect was abolished by filtration of TNA. There were no significant differences between the two groups. We therefore conclude that short-term preoperative administration of TNA at the rate of 4-5 g lipid/h in patients without preexisting lung disease does not jeopardize lung functions. Filtration of the TNA is, however, recommended to avoid the potential hazardous effects of long-term treatment of TNA on lung function.

Aged↗