Chances of reducing the formation of immune antibodies after massive transfusions in open heart surgery (author's transl)

Children, young people and women at the age of possible maternity form the majority of patients operated by extracorporal circulation. A longterm planning of these operations should also have donor in call, who are compatible with the patients' Rh groups and Kell antigens. Having practiced such a selection of donors we succeeded in reducing the formation of immune antibodies. 6 out of 330 patients had antibodies, but 4 had been sensibilized before operation. In the case of the other 2 it would not be excluded that they might have been immunized a long time ago. We emphasize the importance of hemodilution, strict indication of every postoperative therapy with red cells and the autologous transfusion.     

Studies on doxycycline levels in human tissues after i.v. administration (author's transl)

Experiments dealing with levels of alpha-6-desoxy-5-oxytetracycline (doxycycline, DOOTC) in human organ tissue after i.v. applications of 2 times 200 mg have been conducted. 100 biopsies yielding 371 samples (generally 4 samples at 70 +/- 14 mg per specimen) were tested against Bacillus subtilis strain ATCC 6633 using the agar diffusion method (test plate: dst-agar Oxoid CM 261, pH 6.3-6.4, basic layer without and overlay with spores). Taking into account the manifold sources of error in diffusion tests, the results should be understood only as a basic outline without overestimating the tabulated figures of the antibiotic contents in tissue. Most of the organs showed DOOTC levels which were distinctly higher than the minimal inhibiting concentration effective against DOOTC susceptible bacteria.     

A panel on vascular surgery (author's transl)

For this second panel by correspondence, we have asked 3 distinguished experts to answer 7 questions and to comment on 3 case histories concerning vascular surgery. Although a direct discussion between the participants was not possible an impressive degree of agreement is here being demonstrated.     

Two cases of intracranial epidural hematoma following open heart surgery (author''s transl)

John Hunter's contribution to the understanding of venereal disease is reviewed. Hunter's evidence for the unitary nature of these diseases is examined and the advances he made in diagnosis, pathology, and management are considered.     

Gastrostomy in paediatric surgery (author's transl)

Gastrostomy has the same field of application as the feeding tube which is introduced either orally or nasally. With careful nursing and surgical technique, only few and slight disturbances are to be expected. This method, however, ist not suited for routine application by the premature baby because of its possible septic complications.     

Angled micro-scissors for after-cataract surgery (author's transl)

A report is given on new micro-scissors for after-cataract operations. Its shape permits a perfect direction of incision in the pupillary region not only form a temporally placed corneal incision but also from all other meridians without its handling being impeded by the orbital border or th nose of the patient. Especially in certain injury sequels and other postoperative conditions the scissors extend the operative possibilities.     

Physiotherapy after lung resection (author's transl)

Physiotherapy for lung resection begins well before the operation and should serve to improve the respiratory function and to prevent complications. The whole training programme should be carried out in an automated manner, this is especially important for the time immediately after the operation. Postoperative physiotherapy aimsat thorough cleaning of the bronchi, adaption of the ventilation, good peripheral circulation and helps to diminish would pain. In a later period physiotherapy should help to rehabilitate the patient's external respiratory function to train the respiratory stereotype and to improve cardiopulmonary effiency.     

Renal failure after open heart surgery

One hundred fifty of 490 patients undergoing open heart surgery had renal failure attributable to cardiopulmonary bypass. In 69, serum creatinine concentrations did not exceed 2 mg/dl and returned to normal by the fourth postoperative day. In 60 patients, serum creatinine attained levels between 2 and 5 mg/dl, oliguria did not develop, and recovery of renal function occurred within 4 to 37 days. Serum creatinine increased to levels exceeding 5 mg/dl in 21 patients, 11 of whom were oliguric. Despite dialysis, 14 of these patients died from cardiac causes or sepsis. Prolonged cardiopulmonary bypass time, hypotension, oliguria, low output syndrome, and hemoglobinemia during open heart surgery correlated with the development of renal failure postoperatively. Although severe renal failure was an uncommon complication after open heart surgery, its occurrence carried a grave prognosis.