Dynamic adaptation of the blind pointing characteristic to stepwise lateral tilts of body, head, and trunk.

Blind pointing (i.e. pointing to visual targets without seeing the pointing arm) was investigated in normal subjects in response to stepwise lateral tilts (20 degrees) of the body, head, and trunk.

Senning repair for transposition of the great arteries without patch augmentation of the septum.

Forty-three consecutive patients with previous balloon atrial septostomy have undergone a Senning type repair of transposition of the great arteries without patch augmentation of the atrial septum. A technique was used that allows expansion of the atrial septum without the use of additional foreign or autogenous materials. The operative (30-day) mortality rate was 4.

Oral cholecystography vs gallbladder sonography: a prospective, blinded reappraisal.

In a prospective, blinded study of 205 patients, oral cholecystography (OCG) and sonography were compared in terms of how well each screened patients for gallbladder diseases. Among 23 patients who had pathologic confirmation of the diagnosis at cholecystectomy, OCG correctly diagnosed 20 cases (87%) while sonography diagnosed 18 (78%). Among 54 patients with an abnormal OCG and/or sonogram, OCG detected 47 (87%) while sonography detected 44 (81%).

Progressive roentgenographic appearance of caustic esophagitis.

We observed progressive roentgenographic changes in five patients who had caustic esophagitis after accidental ingestion of a liquid alkali. Initial endoscopic examination showed moderate caustic esophagitis in all patients, and esophageal atony and poor distension were early roentgenographic observations. Esophageal strictures developed 13 to 44 days after caustic ingestion in all patients.

Cellular morphology and distribution on a stretching blood-material interface.

In order to investigate the interactions of cellular elements and protein on constantly deforming (fatiguing) blood contact surfaces, a series of ex vivo canine arteriovenous shunt experiments were conducted. While fresh blood was flowing through Silastic tubing shunts, portions of the tubing were stretched 20 to 60% at a frequency of 20 to 90 cycles per minute for 10 to 90 min. The surfaces of the tubing that were stretched were compared with control tubing surfaces taken from the arterial side of the test segment using scanning electron microscopy and interference phase contrast microscopy.

Surgery without angiography for neonates with aortic arch obstruction.

Traditional diagnostic assessment of the neonate and infant with congenital abnormalities of the aorta causing left ventricular outflow tract obstruction has required catheterization and angiography. However, these patients frequently present critically ill and invasive diagnostic procedures may be associated with significant risks. Two-dimensional echocardiography has been used for aiding diagnosis of aortic arch abnormalities, but there has been little information concerning its use as the definitive imaging technique for preoperative assessment.

An unusual complication of left ventricular pseudoaneurysm: hemoptysis.

Left ventricular aneurysm is a common sequela of anterior myocardial infarction. At the time of coronary artery bypass grafting, resection of this aneurysm is frequently undertaken to alleviate symptoms of heart failure and/or refractory ventricular tachycardia. Complications related to aneurysmectomy are uncommon.

Surgical management of extracranial carotid artery aneurysms: report of 17 cases.

This article reviews the operative techniques, results, and complications associated with the treatment of 17 extracranial carotid artery aneurysms encountered in an overall experience of 6,096 carotid endarterectomies during a 24-year period. All 17 patients were operated upon because of severe symptoms and the potential for stroke. Eight patients underwent an aneurysmorrhaphy with Dacron-patch angioplasty; 7 had resection of the aneurysm, with end-to-end anastomosis and Dacron-patch angioplasty; and 2 underwent clipping of the aneurysm.

Impact of the barium enema on patient management.

The medical records of 214 consecutive inpatients who had a barium enema examination were reviewed, and the clinical indications, efficacy of the barium enema, and patient outcome were correlated to determine the impact of the barium enema on patient management. The most frequent indications were rectal bleeding (33%), abdominal pain (31%), anemia (17%), weight loss (12%), and previous lesions needing reevaluation (12%). Diverticular disease (30%), colonic polyps (10%), and primary or secondary malignancies (12%) were the most common abnormalities detected radiographically.

Radiologic evaluation of esophageal dysphagia.

In patients with dysphagia, the radiographic examination evaluates both structural and functional abnormalities of the esophagus. Radiologic examination is more appropriate than endoscopy for initial screening of patients with dysphagia (Table 6). Endoscopy is more expensive, generally requires sedation, and is associated with a small but definite risk to the patient.

Massive upper gastrointestinal hemorrhage in an infant following cardiac surgery.

This is a case of massive upper gastrointestinal hemorrhage and hematoma formation in a 32-day-old infant following uneventful repair of congenital heart disease. Stress ulcers and gastrointestinal hemorrhage are rare complications of cardiac surgery in the young. Conservative management often fails and early surgery can be lifesaving.

Fast three-dimensional imaging of cerebrospinal fluid.

The RARE method is based on the principle of echo imaging to generate images with high T2 contrast. Since RARE is a fast imaging method, it can be used to acquire a high-resolution three-dimensional data set in less than 15 min. Thin slices from such a three-dimensional data set provide detailed information about the ventricular system.

Incessant ventricular tachycardia in infants: myocardial hamartomas and surgical cure.

Infants with incessant ventricular tachycardia (occurring greater than 10% of the day) have generally been described in pathologic studies. This report describes 21 patients with incessant ventricular tachycardia present greater than 90% of the day and night; the age at diagnosis ranged from birth to 30 months (mean 10.5 months).

Radiographic evaluation of esophagus immediately after pneumatic dilatation for achalasia.

Forty-one (98%) of 42 patients with achalasia of the esophagus had pneumatic dilatation performed successfully using the Brown-McHardy dilator. One to four dilatations (mean, 1.9) were done on each patient with inflation pressures of 8-15 psi (mean, 11.