The incidence of pulmonary atelectasis following head and neck surgery is not well reported. This study retrospectively evaluated the incidence of pulmonary atelectasis in 161 head and neck cancer patients, with 152 being evaluable. There were 90 patients evaluated following pectoralis musculocutaneous flap reconstruction with their effective flap size and 71 nonflap patients as a control group. Clinical findings were correlated to radiographic scores. Of pectoralis musculocutaneous flap patients screened for preexisting pulmonary disease (PEPD), nine of 45 (20%) demonstrated pulmonary atelectasis in the first 24 hours compared with 10 of 39 or 25.6% nonflap controls. Major pulmonary atelectasis was not found in the pectoralis musculocutaneous flap patients by scoring criteria, and in only one of 39 (2.6%) nonflap patients. In flaps larger than 40 cm2, the incidence was eight of 37 (21.6%), with no major pulmonary atelectasis noted. Only one of nine (11.1%) patients with radiographic pulmonary atelectasis exhibited clinical symptoms (three of 10 or 30% control). In patients with PEPD and pectoralis musculocutaneous flaps, 22 of 45 (48.9%) had evidence of pulmonary atelectasis in contrast to 13 of 32 or 40.6% controls. There were two of 45 (4.4%) who had major pulmonary atelectasis with zero of 32 in the nonflap group. For flaps larger than 40 cm2, the incidence was 19 of 39 (48.7%) with two of 39 (5.1%) scored as major pulmonary atelectasis. The clinical correlation for this group and the major pulmonary atelectasis group was each approximately 50% compared to 15.4% for nonflap patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Comorbidity↗

PubMedDate not supplied

Nasal mucus clearance in rats: differences with sex and phase of the oestrous cycle.

We studied the changes in airway mucus rheology and clearability, as well as in morphometric indices, between male rats and females in either the oestrous or dioestrous phases of the oestrous cycle. Three-month-old Wistar rats were studied and the phases of the oestrous cycle were determined based on analysis of vaginal smears stained by a modified Shorr's procedure. Nasal mucus samples were analysed by means of magnetic rheometry and determination of in vitro transport rate in the frog palate preparation. In situ clearance on the exposed nasal septum was also determined. The mucociliary velocity in situ was significantly affected by both sex and the oestrous cycle phase. In female rats, dioestrous phase clearance was significantly slower than the oestrous phase one. Clearance in male rats was faster than that of both the phases studied in females. Mucus rigidity of females in the oestrous phase was more rigid than that of females in the dioestrous phase and that of males. Mucus viscosity/elasticity ratio for deformations performed at high frequencies was greater for females in comparison with males. Cough clearability computed on the basis of rheological parameters was predicted to be more favourable in females. There were no significant differences between the three groups in mucociliary clearance in vitro. Morphometric studies of the nasal epithelium showed that epithelial and glandular volumes did not exhibit sex- or oestrous-phase-related differences, but the amount of epithelial acidic glycoproteins was lower in females in the oestrous phase in comparison with males and those in the dioestrous phase, the same trend being observed in the glands of the lamina propria.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMedDate not supplied

Polyester prostheses as substitutes in the thoracic aorta of dogs. II. Evaluation of albuminated polyester grafts stored in ethanol.

In an attempt to find an alternative procedure to the preclotting of porous textile vascular prostheses, the feasibility of an albumin coating and ethanol preservation technique has been evaluated by implanting albuminated polyester prostheses as substitutes in the thoracic aorta of dogs. Nine different grafts representing woven, knitted, and velour constructions were implanted for periods ranging from 4 h to 6 months. At the sacrifice, the grafts were excized for measurement of the thrombogenicity of the flow surface, for pathological examination by light microscopy and SEM, and for quantifying the changes in the textile structure during implantation. Also the kidneys were removed and examined for infarcts caused by trapped circulating emboli. The healing characteristics of the nine different grafts proved similar and followed the same sequence of events as preclotted control grafts. The albumin coating and ethanol preservation resulted in a somewhat slower rate of healing. Yet, given sufficient time, a more completely healed graft was achieved as evidenced by the presence of endothelial-like cells throughout the length of the graft. In addition, the albumin is believed to reinforce the textile structure by reducing the tendency to stretch and dilate in vivo.

Albumins↗