PubMed Health⌕ Search

Biomedical subjects

E W Pollack

Publications and source records attributed to E W Pollack.

4 recordsLinked to original sources
PubMed1980

Surgical anatomy of the thoracic outlet syndrome.

Operative and cadaver dissections have shown that neurovascular compression in the thoracocervicoaxillary region occurs most frequently at the following three levels: the superior thoracic outlet, the costoscalenic hiatus and the costoclavicular passage. At each, a fibromuscular and osseous frame surrounds and fits the neurovascular bundle rather snugly. Pathologic conditions and some normal anatomic variants of the frame or of its contents could lead to contents-container space incompatibility, thus producing symptoms of neurovascular compression. Evaluation of the rigid frame of the region has shown that the first thoracic rib is its key element at all three possible levels of compression. Review of the many possible anatomic variants of osseous, fibromuscular and neurovascular components of the passage illustrates the necessary complexity of any operative attempt intended to detect and treat all possible anatomic causes of compression. Removal of the first thoracic rib, regardless of most other anatomic causes for thoracic outlet syndrome, provides a simple alternative by creating a patulous thoroughfare which eliminates all three possible levels of compression, even when other undetected predisposing anatomic structures are not removed.

Brachial Plexus↗
PubMed1976

Histamine-induced lipid mobilization in humans and dogs.

The effect of histamine on serum free fatty acid (FFA) and glycerol levels was examined in humans and dogs in vivo. By the end of a 15-minute infusion of histamine diphosphate (11 mug of histamine per min i.v.), FFA levels in six male human volunteers had risen from basal values of 424 +/- 41 (mean +/- S.E.M.) to 909 +/- 45 muEq/1, and glycerol levels had risen from 66 +/- 5.5 to 124 +/- 9.3 mumol/1. These effects in man were not blocked by diphenhydramine, an H1-receptor antagonist, but were entirely blocked by propranolol, a beta adrenergic antagonist. Similar infusions of histamine (11 mug/min i.v.) in six anesthetized dogs caused FFA levels to rise from 189 +/- 13 to 461 +/- 92 muEq/1 and glycerol levels to rise from 58 +/- 3.7 to 157 +/- 22.4 mumol/1. These effects in the dog were not blocked by diphenhydramine or by propranolol but were entirely blocked by metiamide, an H2-receptor antagonist. These observations illustrate that low levels of histamine in vivo can produce significant elevations of serum FFA and glycerol levels in both humans and dogs. These results further suggest that the action of histamine in humans is indirect whereas the effect in dogs may be due to a direct action of histamine at the H2-receptor in canine adipose tissue.

Adult↗
PubMed1975

Inferior vena cava interruption: a new indication?

Propagating illofemoral venous thrombosis that occurs despite adequate anticoagulation can be detected by the serial fibrinogen uptake test. Twenty-three patients who were receiving heparin sodium for confirmed iliofemoral thrombophlebitis underwent the serial fibrinogen uptake test. There was an increasing percentage of isotope uptake at the groin and the upper part of the thigh in eight of these patients, three of whom subsequently developed clinical signs, perfusion, and ventiliation lung scan findings compatible with the occurrence of pulmonary embolism. The remaining 15 patients had decreasing serial fibrinogen uptake during heparin therapy and no sequelas indicative of pulmonary embolism. Progressive thrombosis in adequately heparinized patients indicates failure of anticoagulation therapy and, when this occurs, we believe that interior vena cava interruption should be considered before a first, but potentially lethal, pulmonary embolus develops.

Femoral Vein↗