Giant mediastinal parathyroid adenoma with hypercalcemia.

Parathyroid disease is uncommon, but when found it is always of interest to the physician. Most patients with parathyroid disease also have hypercalcemia. Benign adenomatous disease is the most frequent surgical parathyroid lesion seen.

Tracheobronchial tumor resection.

Primary tracheobronchial nonbronchogenic carcinoma tumors are uncommon. The presence of these tumors may cause asthmatic-like symptoms and marked respiratory distress. When seen, the patients are usually very apprehensive and present difficult decisions regarding treatment and surgery, especially with regard to anesthetic considerations.

Bear mauling: a descriptive review.

Objective: Provide a descriptive review of bear and human interactions in the United States.

Study Design: Descriptive review.

Results: The bear population in the United States includes the grizzly bear, the polar bear, and the black bear, including the glacier phase or blue bear.

Tracheobronchial tumor cast formation and pneumothorax.

A 34-year-old white man was admitted to the hospital for progressive respiratory difficulty, recurrent left pneumothorax, and a diagnosis of aplastic left lung. Further evaluation, including bronchoscopy and CT scan, demonstrated a cast-forming tracheobronchial obstructing tumor. Surgical resection of the tumor through the left chest with left lower lobectomy resolved his symptomatology.

Mesh plug migration into scrotum: a new complication of hernia repair.

Hernia repair is one of the most frequent operative procedures performed throughout the world. The technique has continued to evolve and we now are performing these repairs utilizing mesh as a patch and also as a plug. The mesh plug concept has been advocated by Rutkow and others.

Iatrogenic steal syndromes.

Vascular steal syndromes result from many causes. Most often, however, they are due to arteriosclerotic occlusive disease and involve the innominate and the subclavian vessels. We have seen a number of patients with the steal syndrome and, in review, a number of unusual iatrogenic-induced steal syndromes.

Trans-Antarctic expedition: the second 100 days.

On July 27, 1989, six men and 39 sled dogs embarked on the first trans-Antarctic dog, sled, and ski crossing. Data sheets were developed and a review of their day-by-day reports was carried out. The period of time covered is November 3, 1989, to February 10, 1990.

Unusual and infrequent indications for thoracoscopy.

A number of unusual or uncommon thoracoscopic indications have developed over the years. Pleural tuberculosis and blastomycosis, HIV infections, histoplasmosis, presenting as a nodular process have been diagnosed and treated. Fistulae or tube tract endoscopy may delineate whether a patient has persistence or recurrent carcinoma or tuberculosis through biopsy and culture techniques especially in the post pneumonectomy patient with an air leak.

Complications and contraindications of thoracoscopy.

In many instances surgical intervention in the chest has been replaced by the minimally invasive thoracoscopic or VATS approach. With such a technique there are disadvantages, complications and contraindications that develop or exist. Disadvantages include the loss of tactile sensation and the cost of the procedural equipment.

Thoracoscopic esophageal surgery.

Thoracoscopic surgery has been utilized for both esophageal benign lesions and malignant lesions. Resection of submucosal and mural benign lesions, as well as Heller Myotomy, are prime indications for the procedure. Resection of or staging procedures have been performed by various centers around the world for esophageal carcinoma.

Unusual indications for thoracoscopy.

Thoracoscopy has been utilized in a number of patients with unusual or difficult problems which were not resolved with standard thoracic techniques. These problems have been grouped in: infectious, tumour, iatrogenic and others. Personal experience and a survey of the literature on the subject show that thoracoscopy may be an ideal approach in many cases.

Removal of a well-fixed cementless femoral component with an extended proximal femoral osteotomy.

Removal of a stable, well-fixed cementless femoral arthroplasty component occasionally is necessary because of infection, component malposition, persistent pain, or incompatibility with a femoral revision component. Restricted access to ingrowth surfaces may make implant removal exceedingly difficult and increases the risk of iatrogenic damage to the proximal femur. A new extended proximal femoral osteotomy technique is described for use in removing well-fixed cementless femoral components.