Management of acute laryngeal injury: a critical review

The approach to management of 30 cases of laryngeal trauma coming to open exploration is outlined. Eighteen patients had blunt trauma and 12 had penetrating wounds. Four cases resulted in airway compromise and all were in the blunt trauma group. Although significant granulation tissue response occurred in only eight of 30 cases, it was present in three of the four concluding with stenosis. It is demonstrated that the use of a stent, with a tissue graft, when mucosal approximation cannot be accomplished, facilitates prevention of endolaryngeal distortion and webbing and maintenance of skeletal framework integrity; its use did not predispose to granulation tissue development. A principal etiologic factor in those patients who had good airway but only a fair voice was arytenoid fixation, this despite anatomic reduction when subluxation occurred. Recurrent nerve injury was identified in only one patient. Foremost in management is suspicion and recognition of laryngeal injury in the multiple trauma patient. Once the urgent problems of hemorrhage, shock, and airway are attended to, attention must be directed to a systematic evaluation of the neck and larynx.     

PGM3 locus and its genetic polymorphism in lymphocytes of the pig

PGM3 activity was investigated by means of horizontal starch gel electrophoresis. In the pig of the German Landrace three different phenotypes have been recognized: F, S and FS. Family studies suggest the occurrence of at least two alleles--PGM3F and the PGM3S at an autosomal locus.     

Insulin, glucagon, portal systemic shunting, and hepatic failure in the dog

The cerebrospinal fluid (CSF) composition was studied in 54 premature infants. The pregnancy was normal and the delivery normal and non traumatic in all of them, and the 5 minutes Apgar score ranged from 6 to 9. No abnormalities were found on physical examination including neurological examination. Blood cell countings and blood gasometry were normal. CSF composition was studied as to: total cell count and total protein, glucose, bilirrubin and hemoglobin concentrations. Data found permit to stablish as physiologic the following values: leucocytes, until 16 per cumm; erithrocytes, until 1,280 per cumm; total protein content until 300 mgm/100 ml; bilirrubin until 80 micrometer/1; hemoglobin until 8 micrometer/1; glucose, two thirds of the concentration found in the blood. Protein, bilirrubin and hemoglobin are significantly increased as compared to values found for the CSF of 79 fullterm normal newborn babies evaluated previously. Hemoglobin was not detected in the CSF of any full term newborn baby. The differences found are probably due to a less efficient blood-CSF barrier in premature infants as compared to full-term newborn babies.     

Estimation of body fat in rats by whole-body counting

A method for determining body fat in vivo in rats by whole-body counting of 40K is described. The technique utilizes a Nuclear Chicago Corporation TOBOR system with 5-in thallium-activated sodium iodide crystals. To test the method a regression equation was developed using the 40K counts and body weight of young adult rats weighing 333-788 g; the results were compared with those obtained from the gravimetric determination of fat in the carcass. The correlation coefficient between the two methods was 0.945.     

The surgical management of catheter injuries of the brachial artery

In 84 patients the wrist pulses were lost after diagnostic left heart catheterization via the brachial artery. Sixty-six of these patients underwent surgical exploration of the brachial artery for restoration of pulsatile arterial flow to the hand. This aim was achieved in 64 instances. In all cases, the artery was found to be occluded by fresh thrombus. In 36 patients, balloon thrombectomy and accurate arterial closure were successful. In the remainder, in addition to thrombectomy, indentification of an area of damage to the arterial wall required additional surgical measures, usually in the form of resection and anastomosis. The surgical approach to this problem and the importance of the recognition and treatment of arterial wall damage by the catheter are stressed in this paper.