Establishment of Heterodera glycines in Three Soil Types.

The establishment ofHeterodera glycines race 3, from soil plugs infested with population densities ranging from 0 to 10 eggs and second-stage juveniles per 10 cm(3) soil, was compared in three soils (Haynie sandy loam, Eudora silt loam, and Chase silty clay loam) that were either pasteurized or unpasteurized. Final population densities of H. glycines in soil and on soybean (Glycine max cv.

Ten-year experience with extracorporeal membrane oxygenation for severe respiratory failure.

In the last ten years, 17 patients with respiratory failure refractory to standard ventilator therapy have been treated with extracorporeal membrane oxygenation (ECMO) at the Toronto General Hospital. One patient was treated with ECMO twice. Four perfusions were veno-arterial, the remainder veno-venous.

Mead Johnson Critical Care Symposium for the Practising Surgeon. 2. Complications of monitoring systems.

Current invasive monitoring techniques, although valuable in the care of critically ill patients, also have disadvantages. Complications of these techniques include errors in interpretation of measurements and complications of venous access and indwelling lines. To prevent these, the author recommends a standard routine for inserting and changing catheters, regular calibration of transducers and insertion of Swan-Ganz catheters with the balloon inflated with 1.

Separate extraction of cardiac and pulmonary grafts from a single organ donor.

The scarcity of multiple-organ donors for perfused organ transplantation requires cooperation between various transplanting teams to maximize organ retrieval. We have developed a technique for the extraction of a cardiac and separate pulmonary graft from the same donor. These grafts can then be successfully implanted into two separate recipients.

Technique of successful clinical double-lung transplantation.

Lung transplantation has become a successful method in the therapy for end-stage pulmonary disease. While single-lung transplantation provides benefit to patients with pulmonary fibrosis, bilateral lung transplants are required for septic or emphysematous lung disease. We describe the technique employed in 6 patients to transplant en bloc both lungs with the recipient heart left in place.

Role of pili in adhesion of Pseudomonas aeruginosa to human respiratory epithelial cells.

The ability of pili from Pseudomonas aeruginosa K (PAK) to act as an adhesin to human respiratory epithelial cells was examined using an in vitro adhesion assay. Equilibrium analysis of PAK binding to human buccal epithelial cells (BECs) and tracheal epithelial cells (TECs) by means of a Langmuir adsorption isotherm revealed that the maximum numbers of binding sites per epithelial cell (N) were 255 for BECs and 236 for TECs, with apparent association constants (Ka) of 2.8 x 10(-9) and 5.

Physician-accompanied transport of surgical intensive care patients.

During a one-year period, 107 critically ill adult patients were transferred by a physician-accompanied transport system (PATS). Most patients required both tracheal intubation (82 per cent) and mechanical ventilation (71 per cent), while continuous vasopressor support was required in 27 per cent of transfers. Patients were classified as either potential organ donors (n = 21) or nondonor patients (n = 86).

Esophagectomy for complex benign esophageal disease.

We evaluated the use of total thoracic esophagectomy and replacement with stomach in a group of 21 patients between 1976 and 1986 who had undergone multiple unsuccessful esophageal operations. All patients had between one and four unsuccessful operations for benign esophageal disorders. Sixteen patients had primary motor disorders: achalasia in nine and esophageal spasm in seven.

A prospective evaluation of magnetic resonance imaging, computed tomography, and mediastinoscopy in the preoperative assessment of mediastinal node status in bronchogenic carcinoma.

Computed tomography, magnetic resonance imaging, chest roentgenography, and mediastinoscopy were compared prospectively as staging modalities to assess mediastinal node status in 84 patients with presumed operable bronchogenic carcinoma. Computed tomography was associated with a sensitivity of 71.0%, a specificity of 87.

Effect of Heterodera glycines on Charcoal Rot Severity in Soybean Cultivars Resistant and Susceptible to Soybean Cyst Nematode.

Field experiments were conducted in two soil types in northeastern Kansas to evaluate the influence of Heterodera glycines on the severity of charcoal rot in group III soybean cultivars resistant and susceptible to soybean cyst nematode race 3. Resistant cultivars Asgrow 3307 and Fayette and susceptible cultivars Asgrow 3127, Harper, Pella, Sprite, and Williams 82 were planted in carbofuran-treated and nontreated plots. Heterodera glycines and the charcoal rot fungus, Macrophomina phaseolina, were suppressed by carbofuran treatment in loamy sand, but not loam soil, and by nematode-resistant cultivars in both soils.

Tube drainage of lung abscesses.

We treated 14 patients who had complicated lung abscesses (all over 4 cm in diameter); 9 patients had concomitant respiratory failure requiring mechanical ventilation. A percutaneous tube was inserted in 11 patients (3 subsequently underwent rib resection) and 3 underwent rib resection with operative insertion of the tube. The resultant bronchopleural fistulas did not interfere with respiratory management despite the use of mechanical ventilation, and only 2 patients required subsequent surgical closure.

Gastroplasty and fundoplication for complex reflux problems. Long-term results.

Between 1964 and 1984, 430 patients with complex reflux problems were managed by a modified Collis gastroplasty and partial fundoplication. The indications for selecting the addition of gastroplasty were as follows: (1) obvious acquired shortening due to peptic esophagitis and stricture, and (2) subtler degrees of acquired shortening frequently encountered in cases that required reoperation and in patients with massive sliding hiatal hernia. The addition of gastroplasty in this second group obviates the risk of even minimal tension on the repair.

Pharyngeal reconstruction: current controversies.

Total pharyngeal reconstruction following ablative surgery has made significant advances over the past 10 years with the development of new techniques and the refinement of older methods. The reconstructive methods utilized by the authors in 26 cases over the past three years are presented. The methods employed were classified into three groups.

Adherence of Pseudomonas aeruginosa to cilia of human tracheal epithelial cells.

Pseudomonas aeruginosa was found to adhere selectively to cilia of human ciliated tracheal epithelial cells (TECs). P. aeruginosa bound in equal numbers to TECs of smokers and nonsmokers, with the mean adhesion index for binding of P.

Characterization of the binding of Pseudomonas aeruginosa alginate to human epithelial cells.

The alginate produced by Pseudomonas aeruginosa has been reported to play a role in the adhesion of this bacterium to epithelial cell surfaces, although some controversy concerning this role exists. To clarify this controversy, we investigated the ability of alginate to bind to human buccal epithelial cells (BECs) and human tracheal epithelial cells (TECs). Alginate from P.

Comparison of regional pulmonary perfusion in lobar pneumonia during high frequency and conventional mechanical ventilation in sheep.

We compared the effects of high frequency jet ventilation (HFV), conventional ventilation (CMV), and spontaneous breathing (SB) on regional pulmonary blood flows (QLLL), standard cardiopulmonary measurements and the serum levels of the first generation metabolites of prostacyclin (6-keto-PGF1 alpha) and thromboxane A2 (TxB2) in established left lower lobe pseudomonas aeruginosa pneumonia in 11 sheep. Gram negative pneumonia resulted in significant increases in alveolar-arterial oxygen gradients [(A-a)DO2] and pulmonary shunt fractions (Qs/Qt), as well as a significant decrease in QLLL during SB. Significant differences in standard haemodynamics, (A-a)DO2, Qs/Qt, and QLLL were not observed when HFV was compared to CMV.

Significance of metastatic disease in subaortic lymph nodes.

Thirty-five patients underwent resection of primary bronchogenic carcinoma of the left upper lobe or left main bronchus in the presence of metastatic disease in subaortic lymph nodes. No patient had metastatic disease in other mediastinal node stations. There was 1 postoperative death.

Technique of successful lung transplantation in humans.

We have performed five single lung transplantations for end-stage pulmonary fibrosis, with four long-term survivors. Two patients underwent right lung transplantation and two underwent left lung transplantation. The procedure is performed with one lung anesthesia, although cardiopulmonary bypass is available on standby if required.

Experimental gram-negative pneumonia produces a hyperdynamic septic profile.

General anesthesia (GA) and extensive surgery undertaken to reproduce a hyperdynamic septic shock syndrome (HSSS) may confound the observed effects of pure HSSS. A large animal model of HSSS without GA or surgery was created in sheep following production of a Pseudomonas pneumonia by direct bronchoscopic instillation into a dependent lobe using only light ketamine anesthesia. Cardiac output rose significantly (5.

Systemic candidiasis in a surgical intensive care unit.

Treatment for systemic candidiasis has often been withheld because of the nephrotoxicity of standard amphotericin B therapy, particularly in immunodepressed patients. The authors describe their experience between 1981 and 1983 with 29 such patients in the intensive care unit who were treated with low-dose amphotericin B. The diagnosis was made when endophthalmitis or persistent fungemia was present, or when Candida was cultured from three or more body sites.

Precision cautery excision of pulmonary lesions.

We have used a cautery dissection technique, initially described by Perelman, to facilitate nonanatomical pulmonary resections in certain instances in which the anatomical location of the lesion made wedge excision by standard methods difficult or impossible. With the precision cautery technique, the raw surface of the lung is left charred and allows minimum or no air leakage following the procedure. We have found this method a useful addition to existing techniques for pulmonary resection.

Prospective evaluation of mediastinoscopy for assessment of carcinoma of the lung.

Between 1979 and 1984, mediastinoscopy was performed on 1,000 of the 1,500 patients admitted to the Thoracic Surgical Service of the Toronto General Hospital with the diagnosis of carcinoma of the lung. In 144 cases, concomitant anterior mediastinoscopy was also performed. Abnormal mediastinal nodes were found in 296 (29.

Effect on cardiopulmonary changes of gram-negative endotoxemia in sheep after type-specific, cross-reactive, and nonspecific immune stimulation.

The purpose of this study was to examine the effects of prior nonspecific immune stimulation (BCG), cross-reactive immunization (E coli J5 0111 whole cells [J5 WC], and core glycolipid [J5 CGL]), and type-specific immunization (Serratia marcescens core glycolipid [SM CGL]) on the cardiopulmonary variables and white blood cell counts of awake, monitored sheep following IV Serratia marcescens endotoxin. Comparison of cardiac output, pulmonary artery pressure, pulmonary capillary wedge pressure, pulmonary vascular resistance, alveolar-arterial oxygen gradients, and total white blood cells lead us to conclude that type-specific immunization (SM CGL) most effectively ameliorates the changes of gram-negative endotoxemia contrasted to nonimmunization. Core glycolipid cross-reactive (J5 CGL) immunization was somewhat more effective than whole-cell cross-reactive (J5 WC) immunization in this regard.