Transient paralysis of the diaphragm following radical neck surgery.

We have observed transient diaphragmatic paralysis with high alveolar to arterial oxygen partial pressure difference following radical neck surgery. Patients required supplemental oxygen for maintenance of arterial oxygenation. Patients following radical and neck surgery should be followed with chest roentgenograph to exclude pneumothorax and diaphragmatic paralysis and arterial blood gases in the immediate postoperative period.

Reduction of enflurane-induced spike activity by scopolamine.

The possibility of enflurane-induced spike activity being related to a cholinergic mechanism was investigated. Thirty mongrel dogs were anesthetized with an inspired enflurane concentration of 3.5 +/- 0.

Significance and application of blood gas determinations from the left atrial catheter.

Left atrial catheters are used to measure left heart filling pressure in patients after open-heart surgery. It was observed that in some patients blood gases obtained from the left atrial catheters had a markedly higher PO2 as compared to PaO2 in the presence of severe hypoxemia. Twenty-five patients were studied consecutively; pulmonary venous admixture calculated from arterial blood was higher in 19 patients and lower in 5 as compared with that calculated from blood withdrawn from the left atrial catheter.

The anesthetic and perioperative management of a patient with documented hereditary angioneurotic edema.

A patient with documented hereditary angioneurotic edema was admitted for elective surgical extraction of 3 impacted 3rd molars under local anesthesia. In order to increase his C'1-INH level, he was prepared for operation with 2 units of fresh-frozen plasma 24 hours preoperatively. Postoperatively, he was observed in the ICU for 24 hours and on the ward for 2 days, and was discharged without any complications from the surgical trauma.

Whipple's disease with minimal intestinal involvement.

An uncharacteristic case of Whipple's disease is reported, in which, although overt intestinal involvement was absent, and there was only a patchy histological lesion, the diagnosis was confirmed by electron-microscopic examination of peroral intestinal biopsies.

Respiratory distress with left aortic arch, right descending aorta, and right ligamentum arteriosum: a case report.

A 7-year-old girl manifested the rare anomaly of a ventricular septal defect (VSD) with left aortic arch, right descending aorta, and right ligamentum arteriosum. After open-heart surgery to correct the VSD, symptoms of tracheal obstruction on spontaneous breathing developed, due to tracheal compression by the right ligamentum arteriosum. The compressed segment of the trachea was found to be thin and unstable following division of the ligamentum.