In order to assess the degree of the pathological changes presenting in the lungs of patients after elective cardiac operations in cardiopulmonary bypass and to determine their prognosis, lung biopsies were taken from the right lower lobe of 36 patients after extracorporeal circulation and studied ultrastructurally. Prepump biopsies from the same presenting anterior portion of the lower lobe of the lung served as controls. Perivascular and interstitial edema featured prominently. Intraalveolar edema and extravasated corpuscular blood elements were observed, too. Damages to the mitochondria and to the lamellar bodies and swelling of the endothelial and alveolar cells were major observations following cardiopulmonary bypass lasting more than 60 minutes. These changes were also prominent in those lungs presenting with severe edema and fibrosis. Many intact type-II pneumocytes presented with enhanced metabolic and secretory activities. Merocrine and apocrine secretions were observed after extracorporeal circulation. The alveoli of the postpump lungs contained numerous detached normal appearing type-II pneumocytes, in contrast to the paucity of such cells in the alveoli of the control biopsies. The prognosis for the patients depends on any one or combination of any of the following factors: the pathological changes present in the lungs prior to the extracorporeal circulation, the duration of the cardiopulmonary bypass, the rate of the elimination of the surfactant and finally the ability of the undamaged type-II pneumocytes to step up the synthesis and secretion of the surface acting agent.

Adult↗

PubMedDate not supplied

The multiple primary lung carcinoma.

Explore the source record for details and available documents.

Adenocarcinoma↗

PubMedDate not supplied

[On the length of the development period of chronic posthepatitis liver diseases].

Explore the source record for details and available documents.

Alcoholism↗

PubMedDate not supplied

[Social structure and social behavior of elderly ambulatory surgical patients].

Geriatric surgery is getting more and more important. Rising expectation of life, improved pre- and postoperative therapy deferred the age limit for elective operations for about 20 years above the former average. In a chance control we examined the social structure and the social behaviour of older ambulant patients suffering from surgical complaints. The arrangement of those patients according to their age, their homing conditions, their working time after their age limit and the general possibilities of communication were analysed. The importance of the social anamnesis for the therapeutic effect was proved. The regular increase of appropriate dwellings for older persons has to be secured. The possibilities contacts between old-age pensioners and social organisations have to be developed furthermore in order to integrate more and more older persons into social life.

Aged↗

PubMedDate not supplied

[Role of surgery in the treatment of severe acute necrotic pancreatitis].

Between May 1975 and December 1991, a total of 208 patients were operated upon for severe acute necrotic pancreatitis. The decision whether to operate on patients with clinical and biologic aggravation despite particularly sustained intensive care was taken after evaluation of ultrasound and CT scan images. Combining pancreatic body resections and necrotic tissue excision with laparostomy and staged lavage drainage reduced global mortality rate from 49.2 to 16.4 p. cent. The criteria used for determining the indication for surgical intervention, and the technical and tactical operative procedures applied allowing this improvement, are described and discussed.

Acute Disease↗