The report has been divided in two parts. In the first part, the authors review the chief features of the alveolar-capillary membrane permeability. In the second part, are described the early ultrastructural changes observed in the sheep lung, three and twenty-four hours after the haemorragic shock indication. At third hour, the lesions showed a very heterogeneous distributive pattern. The interstitial oedema was the most striking feature at this time, but some important morphological lesions within endothelial and epithelial layers could be also observed. A large amount of neutrophyls on the way to degranulation or already degranulated were observed in the interstitium especially in the most damaged areas. The morphological status of the junctional complex was normal. After twenty-four hours, typical hyaline membranes and areas of well developed alveolar oedema could be seen.

Animals↗

PubMedDate not supplied

[Hypovolemic shock lung and the post extracorporeal-circulation-lung: ultrastructural comparison].

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Animals↗

PubMedDate not supplied

Lumbar vertebrectomy for the treatment of bone tumors: surgical technique.

The authors describe lumbar vertebral resection for the treatment of bone tumors by double approach (posterior longitudinal with the patient in prone position, and retroperitoneal lobotomy in lateral position), usually performed in one-stage surgery. The indication includes aggressive benign tumors (e.g., stage 3 giant cell tumor, osteoblastoma) and low-grade malignant tumors (e.g., chordoma, chondrosarcoma). In these cases an oncologically adequate surgical margin may be obtained, provided that the neoplasm is entirely or largely intracompartmental and at least one of the vertebral pedicles is uninvolved. The different stages of surgery and anesthesia-related problems are described, and possible complications are discussed.

Anesthesia↗

PubMedDate not supplied

Anesthesia and perioperative treatment in large resections of the pelvic girdle.

The authors examine 24 patients submitted to resection of the pelvic girdle in neoplastic pathology, illustrating the perioperative anesthesiologic procedures used. Sudden variations in blood and plasma volume and increasing hypothermia constitute the main problems. The prevention of hypothermia and continuous invasive monitoring of hemodynamic parameters and of oxygen saturation in mixed venous blood (SvO2) are of primary importance.

Adolescent↗

PubMedDate not supplied

The gamma nail and the compression-sliding plate in the treatment of pertrochanteric fractures: anesthesiologic aspects.

The authors compare the results obtained in a group of 100 patients submitted to pertrochanteric osteosynthesis during the year 1991 (50 with a gamma nail and 50 with a compression-sliding plate) based on parameters of anesthesiology. The same type of anesthesiology was used in all 100 of the patients, as similar were the general clinical conditions of the patients, ASA classification, and the mean value of preoperative hemoglobin. The gamma nail proved to be preferable in terms of a shorter amount of time required for surgery, a minor loss of blood intra and postoperatively, and minor incidence of complications.

Aged↗

PubMedDate not supplied

[Experimental isovolemic hemodilution. Study of tissue perfusion with Hb 3% in swine].

BACKGROUND: The aim of the study is to evaluate the limits of the compensatory mechanisms and the tissue damages caused by the low oxygen content during severe normovolemic hemodilution in pigs. METHODS: The experimental procedure was performed in 10 animals after general anaesthesia was induced and iso-hypervolemic hemodilution to Hct 10% was maintained for five hours without any intensive care. Hemodynamic, biochemical and ultrastructural parameters were detected before and at the end of hemodilution in addition to analysis of oxygen delivery/uptake and mitochondrial enzymes function. RESULTS: The collected data show: the initial good compensatory mechanism was subsequently exhausted; five animals demonstrated cardiac ischemia and low CO and two of them died before the end of the experiment; no hemodynamic and hemoxymetric data predicted the cardiac ischemia; the dilution caused alterations of some detected biochemical parameters such as hemocoagulation; no evidence of morphologic and ultrastructural tissue damage or interstitial edema; decreasing in mitochondrial enzymes activity significant only for NADH-related. CONCLUSIONS: In conclusion, it seems that, in pigs at least, the compensatory mechanisms can keep a sufficient tissue oxygen supply throughout the experimental time with the exception of cardiac muscle.

Animals↗

PubMedDate not supplied

Vertebral tumors: differential diagnosis between primary and secondary neoplasms.

The authors discuss the criteria of differential diagnosis between primary and secondary tumors, emphasizing the role played by biopsy.

Biopsy, Needle↗

PubMedDate not supplied

Major vertebral surgery: intra- and postoperative anaesthesia-related problems.

A personal experience concerning vertebral excision and resection in a single stage for neoplasm is discussed. The surgery requires anaesthesia of long duration, hemodynamic stability, compensation of significant blood loss, monitoring of heat loss, maintenance without injury of prolonged prone position. Experience, with 24 cases lasting an average of 14.5 hours proves that inhalation or intravenous anaesthesia with a strong analgesic component is satisfactory. Normal heat saving systems reduce intraoperative hypothermia. Transfusion is always abundant, autologous contribution is moderate. Hemodilution is well-tolerated up to Hb 7%; below this amount there may be problems of a hemodynamic and coagulative nature. The quantity and quality of filling is guided by monitoring of pre-loading pressures and availability of oxygen. There were no critical complications; all of the patients left the hospital in good condition.

Adult↗