Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
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The authors describe the case-history of a rare covered injury of the musculus pectoralis major, abruption of the attachment of its tendon on the humerus. In the world literature only three major groups were described, the majority of publications pertain only to individual observations. In the development of the injury always a very similar mechanism is involved, a considerable proportion are sports injuries. ⋯ As the loss of function is marked, surgical repair is considered the method of choice. The importance of early operation is emphasized. The described technique of reinsertion produced results satisfactory from the patient's point of view.
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The authors describe a serious anaphylactic reaction after protamine administration and its successful control. In cardiovascular surgery protamine a basic peptide, is used as a matter of routine to eliminate the anticoagulation effect of heparin. The use of this drug is associated with a number of negative haemodynamic reactions, most of them not serious, the incidence of which varies from 0 to 100%. ⋯ Prevention in patients with known risk factors is problematic. Treatment of the allergic reaction to protamine is still symptomatic. In the authors' patient the condition was coped with by administration of colloid solutions, adrenaline and solumedrol.