Illumination and access for transaxillary thoracic sympathectomy.
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Biomedical subjects
Publications and source records attributed to J May.
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Nine dysmenorrheic women were run in EMG and thermal biofeedback procedures with concurrent autogenic relaxation practice. Significant reductions in subjective estimates of symptomology associated with dysmenorrhea were noted in all subjects. EMG levels correlated positively with the reductions in symptoms. Thermal levels did not correlate with EMG. In fact no consistent patterns in thermal measures were noted. However, thermal biofeedback cannot be ruled out as an effective treatment for dysmenorrhea since reductions in symptoms occurred during thermal biofeedback training. Another significant aspect of the present study is the effectiveness of long treatment procedures. A six month period was employed and significant reductions in symptoms were noted following two months of biofeedback treatment. Finally, the importance of beginning biofeedback treatment prior to onset of menstrual symptoms is indicated.
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Layer V pyramidal cells of the cat lateral suprasylvian visual areas project to the pontine nuclei. Although all 6 of the suprasylvian visual areas project to the pons, the densest projections are from 3 areas: anterior medial lateral suprasylvian (AMLS), posterior medial lateral suprasylvian (PMSL) and ventral lateral suprasylvian (VLS). The organization of the corticopontine pathway from one of these areas (PMLS) suggests a disproportionate representation of the peripheral visual fields. This pattern of projection would serve to de-emphasize the central visual field.
We found that nonlethal lysosomal enzyme release from human peripheral blood leukocytes during phagocytosis of opsonized zymosan in vitro was modified by the oxygen tension under which the cells were incubated; with decreasing Po(2), zymosan-induced release of lysosomal enzymes was potentiated. The effect on enzyme release could not be attributed secondarily to an effect on phagocytosis, because, as others have reported, Po(2) had little effect on that response. Metabolic responses that accompany phagocytosis were also modified by oxygen tension. Stimulation of oxidation by way of the pentose cycle was further enhanced by increasing Po(2). Conversely, anaerobic glycolysis was promoted by decreasing oxygen tension. ATP levels fell as a function of time and concentration of phagocytic stimulus, mirroring lysosomal enzyme release as modified by Po(2). Cyclic AMP levels fell during phagocytosis and lysosomal enzyme release, a change that could act to facilitate lysosomal enzyme release. However, the fall in nucleotide level was greatest with highest Po(2) (i.e., when lysosomal enzyme release was least). The inverse relationship between oxidative metabolism and enzyme release suggested that a product of oxidative metabolism might adversely influence enzyme release. Sulfhydryl antioxidants (Cysteine, glutathione) and scavengers of oxygen-derived reactants (superoxide dismutase, catalase, benzoate, hypoxanthine, xanthine, histidine, azide) all potentiated zymosan- stimulated enzyme release. These findings are consistent with the interpretation that one or more factors (e.g., superoxide anion, hydrogen peroxide, hydroxyl radical, singlet oxygen), generated in association with the burst of oxidative metabolism which accompanies phagocytosis, acts to inhibit lysosomal enzyme release.
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This report describes a case of traumatic sudden deafness in an adult and the unanticipated clinical problems in providing appropriate amplification and aural rehabilitation. The effect of acoustic distortion on central visual perceptual processes and previously ingrained aural language patterns is presented as a viable explanation. Implications regarding the necessity of evaluating the interaction between the auditory and visual channels are discussed.
The long-term results of autogenous saphenous vein grafts for vascular access were examined in 70 patients. The cumulative patency rate was 66 percent at 2 years and 40 percent at 3 years. No difference could be detected in the occlusion rate of grafts in patients who received a kidney transplant and those who did not. Intraoperative measurement of blood flow through the grafts did not prove useful as an indicator of long-term patency. No deaths were attributable to the grafts, and major complications were limited to infection in three patients and distal ischemia in two; these complications necessitated ligation of the graft in all five patients.
Extraanatomic bypass using polytetrafluoroethylene is a satisfactory alternative to direct aortic surgery in poor risk patients and in patients who have had previous aortoiliac reconstruction. If the disease is limited to one side, a crossover graft gives very satisfactory results with a 1 year cumulative patency of 95.6 percent. Axillofemoral grafts also give satisfactory results, especially if episodes of thrombosis are treated promptly by thrombectomy, in which case flow will be restored in most cases, with an overall 1 year cumulative patency of 89.5 percent.
In summary, the susceptibility of transplant recipients to the development of cancer is dramatically revealed by the oncogenic effects of sunlight. Skin and other forms of carcinoma are aggressive and develop particularly in patients doing well from the immunological point of view post transplantation. Patients with cancer are less susceptible to rejection than those without. Patients with malignancy survive significantly better in the early post transplant years than do those without cancer, but fare much worse later on because of deaths caused by cancer and because of the need to withdraw immune suppressive therapy in those patients with proliferating cancer. Almost 40% of long survivors have cancer, an incidence which continues to increase. Cancer has become a major cause of mortality in long survivors. It seems that, with time, most carcinomas which occur in the general population will occur with increased frequency in renal transplant recipients.
The thoracic aorta can be exposed from an abdominal approach by means of an incision in the diaphragm. This method has been used extensively by Crawford and colleagues but has not been described in detail. Patients with normal renal function before the operation suffered no permanent renal damage from periods of ischemia for up to 45 minutes under normothermic conditions. One patient with impaired renal function before the operation sustained permanent renal damage.