Apical mass presentation of brachial plexus Schwannoma.

Neurogenic tumours arising from the brachial plexus are rare. Most of these present as palpable cervical mass with tenderness and pain radiating to the arm along the distribution of the affected nerve. Here we report a case with radiological presentation mimicking an apical mass in the right chest with minimal symptoms.

Medium-term clinical results after the Senning procedure with haemodynamic and angiographic evaluation of the venous pathways.

Objective: To assess the clinical condition of patients and the adequacy of their newly constructed venous pathways after the Senning operation for simple transposition of the great arteries.

Patients And Design: All 34 patients who had the Senning operation between March 1983 and December 1986 were reviewed. Survivors had detailed cardiac catheterisation studies one to two years later and clinical evaluation two to six years after surgery.

Patterns of ductal tissue in coarctation of the aorta in the first three months of life.

A possible relationship between recurrence of coarctation and the presence of residual ductal tissue in the aorta was studied by defining the presence and pattern of ductal tissue in aortic segments from 23 patients less than 3 months of age who underwent resection of coarctation of the aorta. The surgical policy was to perform extensive excision of the coarctation, including a wide margin of descending aorta beyond the ductus arteriosus. Histologic examination showed that there was a circumferential sling of ductal tissue extending from the ductus arteriosus and surrounding the aorta at the level of the coarctation shelf in 22 specimens.

Distal aortic pressure during coarctation operation.

Mean distal aortic pressure (DAP) was monitored continuously during operative repair of coarctation of the aorta in 67 children more than 1 year of age between 1982 and 1987. At initial test clamping a DAP of 45 mm Hg or more was considered adequate. In 42 patients (group A), DAP exceeded 45 mm Hg and the operation proceeded.

Management of severe chest injuries.

Anoxia and haemorrhage are the causes of early death in patients with severe chest injuries. Early recognition with prompt resuscitation is the cornerstone of their management. Intensive care and a cohesive multidisciplinary approach to patients with associated multiple injuries are important.

Coexistent cardiac tumours and malformations of the heart.

Cardiac tumours and anatomical malformations of the heart may produce similar clinical signs and symptoms. The coexistence of these two abnormalities complicates diagnosis and probably adversely affects prognosis. We present a review of four cases of this rare combination.

Aspergillus ball thrombus occluding a homograft conduit.

Almost total occlusion of an aortic homograft conduit by a ball of Aspergillus terreus was found postmortem in a 6-month-old infant following repair of a type I truncus arteriosus. Signs of pulmonary hypertensive crisis, fever, anaemia, and thrombocytopenia were present. However, blood cultures were persistently negative.

Long-term results of the "palliative" Mustard operation.

A long-term follow-up study after 41 palliative Mustard operations for transposition of the great arteries and pulmonary vascular obstructive disease is presented. The operations were performed from 1973 to 1980. Mean pulmonary arteriolar resistance was 13.

Effect of adenosine deaminase inhibitors on the heart's functional and biochemical recovery from ischemia: a study utilizing the isolated rat heart adapted to 31P nuclear magnetic resonance.

The concept of limiting irreversible damage due to ischemic arrest by inhibiting nucleoside breakdown was tested in the isolated perfused rat heart. Functional recovery measurements were combined with continuous high-energy phosphate measurements by means of 31P nuclear magnetic resonance (NMR) and with nucleoside release measurements in the reperfusion period. The adenosine deaminase inhibitors erythro-9-(2-hydroxy-3-nonyl) adenine (EHNA) and 2'-deoxycoformycin (DCF) were given 5 min before ischemia and for the first 5 min of reperfusion.

Factors associated with periprosthetic leakage following primary mitral valve replacement: with special consideration of the suture technique.

Among 435 patients without native valve endocarditis who were followed up to 69 months after primary mitral valve replacement, 25 developed documented periprosthetic leakage. In 10 patients this was associated with prosthetic valve infection. No evidence of prosthetic infection was found in the remaining 15 patients with documented leakages, and they form the basis of the study.

A case of false aneurysm of the right ventricle.

False aneurysms of the right ventricle are rare and potentially fatal. A patient is described in whom a trilocular false aneurysm arose from the antero-inferior border of the right ventricle and entered the left hemi-diaphragm. It was successfully treated by closure of the communication with the right ventricle and relief of pulmonary stenosis with right ventricular outflow tract reconstruction.

Preoperative carcinoembryonic antigen levels correlated with postoperative pathological staging in bronchial carcinoma.

Serum carcinoembryonic antigen (CEA) levels were obtained before operation in 214 patients undergoing diagnostic tests for suspected bronchial carcinoma, and the results correlated with the postoperative, pathological stage of disease. Positive CEA levels (greater than 10 ng/ml) were observed in 40% (8/20) of stage 1, 58.5% (31/53) of stage 2, 85.