Dysphagia as the presenting symptom of thyroid cancer.

A 72 year old man presented with progressive dysphagia. A poorly differentiated thyroid carcinoma occluding the esophagus was diagnosed. The trachea was initially unaffected.

Combination of diaphragmatic plication with major abdominal surgery in patients with phrenic nerve palsy.

The role of simultaneous prophylactic diaphragmatic plication during major abdominal operations is evaluated. In five patients with a history of phrenic nerve injury, postoperative ventilation requirements and hospital stay were significantly reduced when synchronous diaphragmatic plication was performed, compared with corresponding values obtained during previous abdominal operation without diaphragmatic plication. In addition, diaphragmatic plication was associated with postoperative improvement of respiratory mechanics and blood gas exchange.

Anaesthetic and perioperative management of paediatric organ recipients in nontransplant surgery.

The number and success rate of paediatric organ transplantation continue to improve yearly, and the number of transplanted children presenting for either elective or emergency nontransplant surgery is expected to increase accordingly. The general considerations related to any transplant recipient are the physiological and pharmacological problems of allograft denervation, the side effects of immunosuppression, the risk of infection, and the potential for rejection. Preoperative assessment of transplant recipients undergoing non-transplant surgery should focus on graft function, the risk of infection, and function of other organs.