A prototype instrument has been constructed to measure individual airborne particles based on their aerodynamic size and their intrinsic fluorescence at selected excitation and emission wavelength bands. The instrument combines features of an aerodynamic particle sizing device with capabilities similar to those of a liquid flow cytometer. The goal of the instrument is to provide real-time data indicative of particle characteristics, and it is especially targeted to respond to bioaerosols from 0.
View Article and Find Full Text PDFFlow in single grafts was compared to flow in sequential grafts with diamond anastomoses to the branches of the right and circumflex coronary arteries. The mean flow was 36 ml/min for single grafts, 51 ml/min for sequential grafts with one diamond anastomosis, and 69 ml/min for sequential grafts with two diamond anastomoses. The flow in two single grafts, 72 ml/min, was significantly more than the flow in sequential grafts with one diamond anastomosis and equalled the flow in sequential grafts with three distal anastomoses.
View Article and Find Full Text PDFMedian sternotomy infections are a difficult and potentially lethal problem. Three patients are presented who manifested variations of this clinical problem, and techniques to treat this complication are described. Successful management entails maximum debridement, elimination of mediastinal dead space utilizing omental or pectoralis major muscle flaps, adjunctive systemic antibiotics, closed irrigation systems, and reconstruction of chest wall stability.
View Article and Find Full Text PDFThe utilization of percutaneous catheterization of the subclavian vein has facilitated access to the central venous system and has been a valuable adjunct in the care of critically ill patients. A total of 60 patients in an intensive care setting had concurrent placement of multiple subclavian lines for fluid administration, hyperalimentation, hemodynamic monitoring, cardiac pacing, or hemodialysis over a 5-year period from 1979-84. This was done primarily because these gravely ill patients required a multitude of diagnostic and therapeutic interventions for their clinical management.
View Article and Find Full Text PDFIn 789 carotid endarterectomies, there were 39 neurologic deficits in 543 cases (7.1%) performed with a shunt and nine neurologic deficits in 246 cases (3.7%) performed without a shunt in a community where surgeons were divided and inflexible with regard to the use of shunts.
View Article and Find Full Text PDFA retrospective study was undertaken to help assess the influence of shunting or nonshunting in the performance of bilateral, staged carotid endarterectomies. During the years 1969 to 1979, 323 consecutive patients underwent 646 staged, bilateral carotid endarterectomies. The indications included 271 patients (83.
View Article and Find Full Text PDFFlow was determined by electromagnetic flowmeter in vein bypass grafts in 20 patients with a totally occluded left anterior descending (LAD) coronary artery and on 61 patients with a partially occluded LAD. The median flow in LAD grafts was 14.5 ml/min with total LAD occlusion, and 40 ml/min with partial LAD occlusion (p less than 0.
View Article and Find Full Text PDFControl of massive hemoptysis by embolization of bronchial arteries was achieved in two patients with bronchopleural fistula. Both patients would have been prohibitive risks for thoracotomy. The indications, contraindications, and technique of the procedure are presented as well as a review of the literature.
View Article and Find Full Text PDFSerial determinations of serum glutamic oxaloacetic transaminase, lactic dehydrogenase, and creatine phosphokinase were performed in 50 consecutive patients undergoing cardiac operation for coronary artery bypass or combined valve replacement and coronary artery bypass. Thirty-seven patients (74%) who demonstrated minimal or no changes on the electrocardiogram manifested a recognizable pattern of distribution of the enzyme sequences. The pattern of these patients served as controls for the detection of abnormal patterns.
View Article and Find Full Text PDFThree hundred seventeen carotid endarterectomies performed on 240 consecutive patients in four Charleston hospitals were reviewed. The overall incidence of stroke was 10.7% and the mortality 3.
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