Prevention of postoperative intestinal adhesions with combined promethazine and dexamethasone therapy: experimental and clinical studies.
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Biomedical subjects
Publications and source records attributed to R L Replogle.
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Pulmonary sequestration is a spectrum of related lesions, each of which may be absent or present: (1) bronchial sequestration of pulmonary parenchyma; (2) arterial supply from systemic circulation; (3) anomalous pulmonary venous drainage to the right atrium; (4) communications between bronchus and esophagus; (5) defects of diaphragm; (6) gross lung anomalies, such as horseshoe lungs or hypoplasia. Any combination of these primary lesions can occur in an individual patient. Diagnosis should be directed towards each component of the spectrum. Of special importance is the venous connection, as anomalous pulmonary venous drainage can involve not only the sequestered segment but the entire ipsilateral lung, making surgical therapy far more complex. Treatment of choice is surgical resection, associated, if needed, with rerouting of the pulmonary venous return. Classification of sequestration of the lung as intra- and extralobar is of secondary importance: these 2 groups do not represent lesions of different embryological significance.
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The history of experimental and clinical attempts at allogenic transplantation of the heart and lungs is reviewed and the physiological, technical and pathological implications of this procedure are illustrated by the unreported case of a 49 year-old male who underwent cardiopulmonary transplantation for terminal respiratory failure due to chronic obstructive airways disease and cor pulmonale. While there have been dramatic complications, the patient survived 23 days without major signs of cardiopulmonary dysfunction. The surgical technique, the post-operative management and the vicissitudes of this third human cardiopulmonary graft are described and the promises of this method discussed.