Changes in central and peripheral hemodynamics during prolonged anti-orthostatic hypokinesia as a model of weightlessness

Central and peripheral circulation was studied rheographically in 6 test subjects during a 30-day bed rest experiment and in 9 test subjects during a 49-day bed rest. The bed rested subjects were kept in a head-down position at an angle of --4 degrees. At an early stage of the experiments the cardiac output and stroke volume increased, the total peripheral resistance decreased, the tone of major regional vessels decreased and that of small vessels increased. During the 3rd-7th weeks the changes were just the opposite: cardiac output and stroke volume decreased, the total peripheral resistance increased the tone of major regional vessels increased and that of small vessels decreased. At the end of the bed rest experiment the cardiac output and stroke volume increased and the tone of regional vessels changed accordingly. Circulation parameters returned to the pretest level, at least, 3-4 weeks after the end of the best rest experiments.     

Changes in the central hemodynamics in the surgical treatment of abdominal aorta aneurysm

The algorythm of examination and treatment of patients with an abdominal aorta aneurysm was proposed.     

Cerebral hemodynamics during carotid massage in patients with carotid sinus syndrome

The effect of cardioinhibition and/or vasodepression on cerebral hemodynamics assessed by transcranial Doppler has been investigated during carotid massage in 11 patients (62-87 years, mean age 72) with carotid sinus syndrome. The patients were tested in the OOO mode (n = 11) with six tested in the DDD mode. Carotid massage in the OOO mode decreased mean arterial pressure by 44% (P < 0.01) and mean cerebral blood flow velocity by 50% (P < 0.01). Although not significant, cerebrovascular resistance increased transiently by 17% during massage, then decreased by 31% upon recovery. Carotid massage in the DDD mode decreased arterial pressure by 30% (P < 0.01), cerebral blood velocity by 23% (P < 0.01), and resistance by 15% (P < 0.05). The decreased cerebral perfusion induced by cardioinhibition and/or vasodepression results from the delayed onset of cerebral autoregulation. Pacing in the DDD mode temporarily assists the critical period preceding the onset of cerebral autoregulation that plays a key role in preventing the deleterious effects of vasodepression.     

Clinical use of leeches in reconstructive surgery

Although medicinal bloodletting with leeches is a practice that dates back 3500 years, leeches have been used in reconstructive surgery for only the past 35 years. In this article, the indications, mechanisms of action, and guidelines for using leeches in reconstructive surgery are reviewed.     

Tissue adhesives and applications in plastic and reconstructive surgery

A prospective randomized trial was carried out to evaluate the efficacy of fibrin glue in preventing lymphorrhea after axillary lymphadenectomy in breast cancer. One hundred and eight breast cancer patients, operated on by two senior surgeons, were randomized into two groups: group 1 (n = 58) without fibrin glue and group 2 (n = 50) with 2 ml of fibrin glue applied to the axillary dissection area at the end of the lymphadenectomy procedure. Early postoperative morbidity was 2/58 and 0/50 in groups 1 and 2, respectively. Mean daily postoperative drainage was significantly greater in group 1. The mean cumulative drainage quantity 6 days after the operation was 407.8 ml and 214.4 ml in groups 1 and 2, respectively (p = 0.001). The mean postoperative hospital stay was 10.1 days and 8.0 days in groups 1 and 2, respectively (p = 0.006). One delayed seroma was observed in each group. Fibrin glue seems to reduce daily postoperative drainage and hospital stay, but did not affect delayed seroma formation after axillary lymphadenectomy for breast cancer.     

Digital imaging for plastic and reconstructive surgery

Porcine-specific polymerase chain reaction (PCR) and a pig-rodent somatic cell hybrid panel were used to map two members of the MyoD gene family. MYOD1 was assigned to pig chromosome 2 and MYF5 to chromosome 5.     

Endoscopic application in aesthetic and reconstructive facial bone surgery

Twenty-three cases of endoscopically assisted facial bone surgery were performed over the past 3 years. Our series is consistent with 16 cases of aesthetic contouring surgery and 12 treatments of facial bone fracture, including three cases for recontouring of frontal bone, three cases for recontouring of zygoma, endoscopically assisted correction of three zygomatic and blowout fractures, four cases for rhinoplasty and septoplasty for deviated nose, and three cases for mandible contouring surgery. To accomplish this technique, a rigid 4-mm, 30-degree down-angled endoscope was used. The frontal bone or zygomatic arch was approached endoscopically through two or three small incisions on the frontal or temporoparietal scalp. All endoscopic instruments were then manipulated through these incisions. The approach for endoscopically assisted rhinoplasty is the same as with standard rhinoplasty procedures. The approach for zygoma complex and maxillary sinus needs an intraoral incision. Recontouring of zygoma, mandible, and nasal dorsum by an air-driven burr and rasp was performed with endoscopic visual assistance. A plate and screw fixation for zygomatic arch fracture requires an additional small skin incision over the plate for the trocar method. The duration of follow-up ranged from 6 months to 30 months. The postoperative course was satisfactory with a few complications. The extra time needed for the endoscopic procedures was less than 1 hour. Endoscopically assisted facial bone surgery can be performed with adequate visualization and direct manipulation of all facial bones. Complications usually associated with extensive incisions in the bicoronal approach may be avoided. Poor visualization in the conventional approach for operation of orbit, nose, maxillae, and mandible may be avoided by use of the endoscope. This technique may prove to be ideal for aesthetic surgery for facial skeleton with smaller scar and less morbidity.     

Stereotype biases: A reconstructive analysis of their role in reconstructive memory.

In an extension of a study by M. Snyder and S. W. Uranowitz (see record 1980-05464-001), Exp I attempted to isolate retrieval from interpretive processes and distinguish between memory for wording and for meaning. 90 undergraduates read a case history, and 1 wk later received a stereotype label followed by a test of recognition memory. Ss showed better memory for items taken verbatim from the case history and were able to discriminate between items in which the heterosexual, neutral, or lesbian alternatives were correct. No differences were found between the 2 memory instructions and no effect was found for the stereotype label. A subsequent replication of the original Snyder and Uranowitz study (Exp II, 90 Ss) also failed to find an effect of the label or for the timing of that label. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in the intracardiac hemodynamics of patients with essential hypertension during korinfar treatment

A study is presented of the structure and function of the heart in the diastole in 39 patients during corinfar treatment of essential hypertension. It was established that effective corinfar monotherapy of patients with moderate essential hypertension was associated with arteriolo- and venodilating effect of the drug with prevalence of the preloading effect. Changes of the intracardiac hemodynamics resulted in changes of the left ventricular systole phase structure, namely, its transformation in the direction of myocardial hypodynamia.     

Proplast implants used in otology and in facial reconstructive surgery

Proplast, a self-stabilising alloplastic material, was evaluated in ear surgery and in facial reconstructive surgery. Proplast implants were used on 33 patients to reconstruct the ossicular chain (total or partial ossicular replacement prosthesis), or to rebuild the mastoid cavity. The lack of extrusion over a 24-month period is encouraging. In facial reconstructive surgery 11 patients received Proplast implants to augment and restore facial contours. Contamination with saliva remains a problem, owing to the high porosity of Proplast, which could harbour infection. When Proplast was sterile when implanted, no extrusion appeared over a 12-month period. Although the patients presented here were followed up for a relatively short time, they provide reason for some optimism that the vexed question of alloplastics applied in the field of ear, nose and throat surgery may be solved.     

Results of reconstructive surgery in renal hypertension]

A traumatic macular hole has never been seen immediately after the causal accident. We examined a case of macular hole within half an hour of the injury and photographed it within three hours. We comment on the genesis of traumatic macular edema.     

Spectrum of cartilage grafting in cutaneous reconstructive surgery

BACKGROUND: The use of cartilage grafts in cutaneous reconstructive surgery is becoming increasingly common among dermatologic surgeons. OBJECTIVE: Our purpose was to describe the indications, technical application, results, and complications associated with cartilage grafting in cutaneous reconstructive surgery. METHODS: The spectrum of cartilage grafting is reviewed, and illustrative examples are provided. RESULTS: A well-planned application of cartilage grafts in cutaneous reconstructive surgery can provide exceptional results, permitting restoration of impaired anatomic free margins as well as maintenance of the functional patency of key anatomic structures such as the nasal valve. CONCLUSION: Cartilage grafting in cutaneous reconstructive surgery is an important method to ensure optimal reconstructive outcomes. Dermatologists involved in reconstructive surgery will experience improved results through the application of these techniques.     

Continuous cervical epidural anesthesia in reconstructive hand surgery

The objective of this study was to assess the efficacy of a new regimen in eradicating Helicobacter pylori (Hp) in patients with duodenal ulcer (DU) who were previously treated unsuccessfully with standard triple therapy (tripotassium dicitratobismuthate [TDB] 120 mg QID, metronidazole 500 mg TID, and tetracycline 500 mg QID) or proton-pump inhibitor (PPI) dual therapy (omeprazole 20 mg BID and amoxicillin 500 mg QID). The study included 133 consecutive patients aged 17 to 83 years with endoscopically diagnosed DU (diameter > or = 5 mm) in whom standard triple therapy or PPI dual therapy had failed to eradicate Hp. A rapid urease (CLO) test was performed on four biopsy specimens at study entry and at least 1 month after the end of treatment to confirm Hp colonization and eradication, respectively. Patients were considered to be Hp positive if any CLO test was positive within 2 hours, and Hp was considered to be eradicated if all CLO tests were still negative after 24 hours. In 31 randomly selected patients, Hp eradication was confirmed histologically as well. Patients were given omeprazole 60 mg/d (20 mg in the morning and 40 mg in the evening) plus amoxicillin 500 mg QID for 10 days and subsequently were given metronidazole 500 mg TID for 10 days plus TDB 120 mg QID for 6 weeks. One hundred and twenty-four patients were followed up; five (4%) withdrew because of side effects (protracted diarrhea, stomatitis, skin rashes). Per-protocol analysis showed Hp eradication in 113 of 119 patients (95%) and ulcer healing in 118 of 119 (99%). Intent-to-treat analysis showed an Hp eradication rate of 85% (113 of 133 patients) and an ulcer healing rate of 89% (118 of 133 patients). In per-therapy analysis, the Hp eradication rate was 91% (113 of 124 patients), and the ulcer healing rate was 95% (118 of 124 patients). Side effects were observed in 39 of 119 patients (33%) and were generally mild. The four-drug regimen used in this study, when given to patients previously treated unsuccessfully with standard triple therapy or PPI dual therapy, was highly effective in eradicating Hp and healing DUs and had no major side effects.     

Free toe transplantation in reconstructive hand surgery]

PURPOSE: Increased understanding of the early determinants of obesity is essential because of the increasing prevalence of obesity in many industrialized countries. METHOD: As part of the evaluation of a school-based heart health promotion intervention, we measured height, weight, and triceps skinfold thickness at baseline in 2108 students aged 9-12 years (80.5% of eligible students) in 24 inner-city elementary schools located in multiethnic, low income neighbourhoods in Montreal, Canada. Data on student's socio-demographic and lifestyle characteristics were collected in classroom-administered questionnaires, and parents completed an at-home self-administered questionnaire. RESULTS: Overall, 35.2% of boys and 33.0% of girls were overweight (> or = 85th age and gender-specific percentiles from NHANES 11, for body mass index and triceps skinfold thickness); 15.1% of boys and 13.3% of girls were obese (> or = 95th age and gender-specific percentiles for body mass index and triceps skinfold thickness). Younger age, having lived all one's life in Canada, and being of European or Central American/Caribbean family origin were independent correlates of obesity in boys. Younger age, ever smoked, mother obese and father obese were independent correlates of obesity in girls. Girls of Asian family origin were protected. CONCLUSIONS: The very high prevalence of overweight students in this low income, multiethnic population suggests an important need for preventive intervention.     

Technique of vascular reconstructive bench surgery in pancreas transplantation

Vascular reconstructive bench surgery has become a basic step in pancreas transplantation, in order to prevent vascular thrombosis. The Authors describe their experience, also reporting literature results.     

The value of intraoperative cystoscopy in urogynecologic and reconstructive pelvic surgery

OBJECTIVE: Our goal was to evaluate the role of intraoperative cystoscopy during surgery for pelvic organ prolapse and urinary incontinence. STUDY DESIGN: Charts of 224 consecutive patients who had intraoperative cystoscopy performed after urogynecologic surgery were reviewed. RESULTS: Nine injuries occurred that were unsuspected before cystoscopy, for an incidence of 4%. Six ureteral ligations occurred, four after Burch cystourethropexy and two after vaginal culdoplasty. Intravesical sutures were noted after two Burch procedures, and another injury occurred with passage of fascia lata through the bladder during a pubovaginal sling procedure. Eight injuries were managed by removal and replacement of the suture or sling with only one requiring ureteroneocystotomy. When patients with injuries were compared with those without, there were no statistical differences in demographic or surgical parameters. CONCLUSIONS: The potential for damage to the lower urinary tract is significant with complex urogynecologic surgery. Because of the increased and delayed morbidity associated with unrecognized injury, intraoperative surveillance cystoscopy should be considered a part of all such procedures.