Scandinavian journal of thoracic and cardiovascular surgery
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Scand J Thorac Cardiovasc Surg · Jan 1982
Comparative StudyClosed pleural biopsy and fluid cytology in the diagnosis of suspected pulmonary cancer with pleural involvement.
In a retrospective study of 44 cases of suspected primary pulmonary cancer with pleural involvement, the diagnostic value of pleural biopsy a.m. Abrams was evaluated. ⋯ Among the patients under study, closed pleural biopsy combined with pleural fluid cytology proved malignancy in 96% of the cases in which neoplastic disease of the lungs and pleura was otherwise diagnosed. These findings indicate the value of using both fluid cytology and closed pleural biopsy at an early stage of the diagnostic procedure in cases of suspected pulmonary cancer with pleural involvement.
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Scand J Thorac Cardiovasc Surg · Jan 1982
Case ReportsPancoast's syndrome following an intrapleural rupture of a hepatic echinococcus cyst.
A case of Pancoast's syndrome due to a hydatid cyst is described. The cyst developed secondarily, after intrapleural rupture of an echinococcus cyst situated in the liver. The patient was operated and the cyst excised. ⋯ The Horner's syndrome needed longer to subside. Three years after the operation there is still some constriction of the pupil of the right eye. The development of Pancoast's syndrome due to hydatid disease is very rare and this case--caused by a secondary cyst after intrapleural rupture of a similar hepatic echinococcus cyst--is the first described in the literature.
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Scand J Thorac Cardiovasc Surg · Jan 1981
Pulmonary oxygenation, central haemodynamics and glomerular filtration following cardiopulmonary bypass with colloid or non-colloid priming solution.
Plasma colloid osmotic pressure (COP), blood erythrocyte volume fraction (B-EVF), arterial oxygen tension at an inspired oxygen concentration of 30% (PaO2 (FIO2 0.3)), cardiac index, stroke volume, arterial mean pressure, left atrial mean pressure, pulmonary av-difference of oxygen (Ca-v O2) and creatinine clearance were studied in 16 patients during isolated aortic valve replacement. The patients were divided into two groups with different priming solutions in the oxygenator. In the non-colloid group 2,000 ml of Ringerdex was used, while the colloid group had 1,600 ml of Ringerdex and 400 ml of albumin 20% (80 g). ⋯ Cardiopulmonary bypass produced no changes in cardiac index, stroke volume, arterial mean pressure, left atrial mean pressure, Ca-v O2 or creatinine clearance in either of the groups. PaO2 (FIO2 0.3) remained unchanged in the non-colloid group and showed a small but significant reduction (p less than 0.01) in the colloid group. No positive effects of a colloid prime were demonstrated.
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Scand J Thorac Cardiovasc Surg · Jan 1981
Reduced lactate washout from the myocardium after combining St. Thomas I type cardioplegia with topical cooling of the heart. Myocardial oxygenation and performance after cardioplegia in coronary artery bypass grafting patients.
The myocardial oxygen extraction was diminished with a resulting coronary sinus blood oxygen saturation of 48 +/- 5 (SEM) %, as compared to the pre-bypass control level of 30 +/- 1%, two minutes after the ischaemic period in St. Thomas I type cardioplegia (CPL) with topical cooling of the heart during a coronary bypass operation. The myocardial oxygen extraction returned to prebypass levels after ten minutes of reperfusion following ischaemia and remained so after the bypass. ⋯ The greatest arterial-coronary sinus lactate difference in the IITC-group was -1.7 +/- 0.2 mmol/l and in the CPL-group -0.7 +/- 0.2 mmol/l. Cardiac performance (assessed by the CI-PCWP relationship) which was moderately depressed by the anaesthesia and surgery before bypass, returned gradually to the control level within 20 hours after operation. The present study shows that no apparent postischaemic abnormality in myocardial oxygen utilization develops when single dose cardioplegia, together with topical cooling of the heart, is used for myocardial protection, and that the accumulation of myocardial lactate during ischaemia is less during cardioplegia with topical cooling of the heart than during intermittent ischaemic with topical cooling for coronary artery bypass grafting operations.
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Scand J Thorac Cardiovasc Surg · Jan 1981
Use of the activated coagulation time in cardiac surgery. Effects on heparin-protamine dosages and bleeding.
A standard heparin-protamine protocol was used for a series of 44 patients. In a second series of 82 patients. Activated Clotting Time (ACT) by the Hemochron method was used to control heparinization and its reversal with protamine. ⋯ The intra-operative blood loss was on an average 50% less in group II than in group I (p less than 0.001). There was, however, no significant difference in regard to postoperative bleeding. The introduction of the ACT test thus resulted in reduced dosages of heparin and protamine and in a reduction of intra-operative bleeding, while surgical technique seems to be the main factor in the control of postoperative bleeding.