Intra-operative echocardiography: a useful tool in the localization of small intracardiac foreign bodies.

Small intracardiac foreign bodies may be difficult to palpate and localize at surgery using conventional diagnostic procedures. The use of intra-operative echocardiography greatly facilitates the localization of intramyocardial foreign bodies, and minimizes operative time and iatrogenic myocardial damage. A case is presented in which this diagnostic modality was used.

Early use of the Brooker-Wills interlocking intramedullary nail (BWIIN) for femoral shaft fractures in acute trauma patients.

During a 33-month period, 40 multiply injured patients underwent 43 Brooker-Wills interlocking intramedullary nailings (BWIIN) for femur fractures in the setting of a Level I trauma unit. There were 12 open fractures (28%), 66% of the closed fractures underwent BWIIN within the first 24 hours of injury, and 33 fractures (77%) had comminution of Winquist-Hansen Type II or greater, and either static or dynamic locking techniques were used in 38 (88%) of the cases. There were three intraoperative technical problems.

Effect of hypothermia on the twitch and tetanic contractions of denervated rat diaphragm muscle under isotonic conditions.

Effect of hypothermia was studied on the twitch and tetanic contractions of the chronically denervated rat diaphragm muscles under isotonic conditions. The muscles were denervated for 15-20 days and the temperature was lowered from 35 degrees C to 15 degrees C. The results showed that hypothermia and chronic denervation had very little effect on the isotonic contraction parameters since these were found to be unaltered at all temperatures except at 15 degrees C.

Iliac vein to pulmonary artery missile embolus: case report and review of the literature.

Intravascular foreign body emboli, although first reported in 1834, are rare sequelae of penetrating injuries. We report a case of missile embolus to the pulmonary artery after penetrating injury to the left iliac vein and artery. A review of the literature and discussion of appropriate management are presented.

DRG reimbursement for trauma: the demise of the trauma center (the use of ISS grouping as an early predictor of total hospital cost).

All institutional reimbursement for inpatient care in the State of New Jersey is administered by the DRG methodology (Prospective Payment System). This system is essentially identical to federal Medicare. In 1983 our hospital was designated the Level I trauma center for southern New Jersey (population, 2.

Rapid sequence induction with oral endotracheal intubation in the multiply injured patient.

The charts of 1798 consecutive admissions at this level one trauma center to evaluate the practice of emergency airway control were reviewed. A total of 335 patients required endotracheal intubation, 320 oral endotracheal, 12 nasotracheal, and three surgical. A technique of rapid sequence induction (RSI) with oral endotracheal intubation was the method of airway control in 260 spontaneously breathing patients.

Measles case fatality among the under-fives: a multivariate analysis of risk factors in a rural area of Bangladesh.

This study investigated the relationship of measles case fatality among the under-fives with age, case type, complications, sex, mother's education, and household economic condition in a rural area of Bangladesh. A total of 3465 measles cases were detected during 1980 and 61 of them died of measles associated complications within 45 days of rash onset. Case type, sex, mother's education and household economic condition were found to have statistically significant impact on case fatality.

Aortic rupture in blunt trauma.

Traumatic rupture of the thoracic aorta should be suspected in all patients who have a history of severe deceleration injury or blunt chest trauma. A good upright (except in fractured spine) and supine x-rays of the chest using the correct technique are important. Mediastinum widening (subjective impression or mediastinum to chest ratio of 1:4) and/or loss of aortic knob contour or disfigurement should lend more support to a thoracic aortogram.

Wirsungorrhagia or hemoductal pancreatitis: report of a case and review of the literature.

An unusual case of gastrointestinal hemorrhage due to rupture of the splenic artery into the pancreatic duct in a patient with chronic pancreatitis is described. The diagnosis was suspected by observing blood coming from the papilla of Vater during duodenoscopy and corroborated by findings seen on splenic arteriography. Previously reported cases are reviewed.

Colon operations without wound infection. Principles and techniques in 101 cases.

A total of 101 consecutive elective colon operations were performed with no postoperative wound infection. Patients with a wide variety of diagnoses and procedures were included in the series. Many factors contribute to the formation of postoperative wound infections.

Long-term complication of measles in rural Bangladesh.

A small retrospective study carried out in rural Bangladesh identified respiratory illness, diarrhoea and conjunctival dryness as complications of measles. A case-fatality rate of 1.3% was recorded.

Regulation of penicillin acylase in Escherichia coli by cyclic AMP.

1. Cyclic AMP was found to stimulate penicillin acylase activity. 2.

Spectrophotometric method for the estimation of 6-aminopenicillanic acid.

A simple, rapid, and sensitive method is described whereby 6-aminopenicillanic acid can be spectrophotometrically determined in the presence of penicillins and their degradation products without prior separation. d-(+)-Glucosamine is used as reagent. The effect of such parameters as pH, temperature, and time of heating on the formation of the chromophore is described.