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Biomedical subjects

I Monies-Chass

Publications and source records attributed to I Monies-Chass.

16 recordsLinked to original sources

Anesthesia and pressor responsiveness in chronic bile-duct-ligated dogs.

Cardiovascular homeostasis is comprised under general anesthesia and in jaundice. Because surgery is often performed on jaundiced patients, it is not altogether surprising that the incidence of perioperative complications is higher in such patients than in nonjaundiced ones. In this study we assessed the potential synergistic effects of anesthesia and jaundice on cardiovascular responsiveness of chronic bile-duct-ligated dogs. Responsiveness to norepinephrine, angiotensin II and isoproterenol was determined before and after chronic bile-duct ligation or sham-operation while the dogs were conscious or under halothane, fentanyl or pentobarbital-sodium anesthesia. These data have shown that halothane- and barbiturate-induced anesthesia do not alter mean arterial blood pressure in unoperated dogs when compared with conscious dogs before laparotomy. Furthermore, these two agents did not modify the pressor, dilator and positive inotropic responses to intravenous infusions of norepinephrine, angiotensin II and isoproterenol. Fentanol, however, reduced mean arterial blood pressure and heart rate without influencing responsiveness to the three vasoactive agents. Blunted responsiveness in the chronic bile-duct-ligated dogs to the three vasoactive agents was observed without any marked changes in mean arterial blood pressure or heart rate. The same blunted responses observed in the conscious, chronic bile-duct-ligated dogs were also seen in the anesthetized, chronic bile-duct-ligated dogs. Halothane caused a marked hypotensive effect in the chronic bile-duct-ligated dogs that was not seen in the sham-operated dogs. Conscious and anesthetized sham-operated dogs responded in the same manner as the conscious and anesthetized dogs before ligation. (ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗

Sodium poisoning: a lethal case of a burned child.

An unusual case of lethal salt poisoning of a burned child is presented. Excessive hypernatraemia and hyperosmolality resulted in an irreversible cascade of events which lead to death despite vigorous attempts to rescue the victim.

Administration, Topical↗

Hidden risk in operating room. Micro-shock.

The risk of electrical micro-shock is recognised in patients undergoing cardiac catheterisation or connected to electronic equipment instruments. The work reported here investigates the possibility of injury by electrical micro-shock when monitoring the central venous pressure as commonly done during surgical procedures. The studies were done on dogs catheterised for the measurement of central venous pressure with the catheter advanced into the right ventricle. It was found that currents less than 500 micro-amperes caused interference with heart rhythm, and in some of the dogs ventricular fibrillation developed. In view of these findings it appears that greater consideration should be given to the risk of electrical micro-shock in patients in whom the central venous pressure is measured.

Animals↗

Hyperbaric oxygenation in peripheral ischaemic lesions in infants.

Acute peripheral arterial occlusion may lead to gangrene, with loss of parts of arms and legs. Three infants with disseminated intravascular clotting developed dark red discoloration of the tips of fingers and toes which progressed proximally. Repeated hyperbaric oxygenation treatments caused regression of the demarcation line and further progression of necrosis stopped.

Arm↗

Use of cimetidine in esophageal atresia with lower tracheoesophageal fistula.

Pneumonia, in infants suffering from esophageal atresia with lower esophageal fistula, is usually caused by gastric reflux through the fistula, In order to abolish the acidity of the gastric content, Cimetidine i.v. infusion was used during the first 12--48 hr after diagnosis, while treating the pneumonia. The amount of Cimetidine required to induce achlorhydria was established by serial aspiration of gastric content, in infants and children with gastrostomies performed for various causes.

Achlorhydria↗

Progressing alterations in transient ischemia of skeletal muscles: an ultrastructural study.

Ultrastructural muscle changes resulting from temporary anoxia and their evolution were studied in dogs. Ischaemia of the hind limb was produced by subcutaneous ligation of all muscles of the thigh and clamping of the femoral artery. Revascularization was obtained by declamping and removal of the muscle ligature. The period of ischaemia ranged from 4 1/2 to 7 h, the latter being the upper limit allowing functional recovery after revascularization. 6-7 h of ischaemia revealed focal degenerative changes of varied intensity. These consisted of enlarged mitochondria with ruptured cristae, small pads of glycogen granules and accumulation of lipid vacuoles. The tubules of sarcoplasmic reticulum contained dense, fine-granular material. Focal myofibrillar destruction and disruption of the Z line were encountered in half of the cases. The myofibrillar damage was more severe 9 days after revascularization of the muscles. The functional recovery of the ischaemic limbs in the present study may be due to the focal nature of these changes.

Animals↗

Embolization of detached fragments of intravenous plastic catheter.

Three cases of embolization by detached fragments of "Intracath" intravenous catheters are described. In two, successful surgical removal was performed, whilst in the third, due to the poor general condition of the patient, no attempt at removal was made and after long-term observation, there were no untoward side effects.

Adult↗

Hyperbaric oxygen treatment as an adjuvant to reconstructive vascular surgery in trauma.

A series of 7 young, healthy persons suffering severe vascular trauma and acute ischaemia of their limbs is presented. Standard vascular repair, although technically successful, failed to achieve satisfactory restoration of the circulation and the limbs remained severely ischaemic. Hyperbaric oxygen treatment at 2-8 atm (approximately 290 kPa) prevented the development of gangrene in all cases. This treatment is considered to be a very useful adjuvant to reconstructive vascular surgery in cases which come to repair late after injury.

Acute Disease↗

Hyperbaric oxygen in acute ischaemia due to allergic vasculitis.

A case of a child with allergic vasculitis to penicillin is presented. The patient received successful treatment with hyperbaric oxygen (HBO) therapy. The pathophysiological mechanism of acute peripheral anoxia and the infleunce of HBO treatment on it is described.

Acute Disease↗

Hyperbaric oxygen in anaerobic infection of the medistinum.

In the last decade hyperbaric oxygen has been recognized as an important therapeutic tool in a variety of instances in which either destruction of anaerobic bacteria is urgent or an improvement in the oxygenation level is mandatory. We have used it successfully in a case of mediastinal anaerobic infection (gas gangrene) after medical and surgical measures had failed to eradicate the disease. The causative organism of gas gangrene, Clostridium perfringens (Welchii), is widely distributed. It may be cultured from the soil, house dust, human skin and faeces, etc. For this reason infection with Clostridium is practically inevitable whenever suitable conditions arise. As an anaerobic bacterium Clostridium Welchii multiplies readily in damaged tissues without contact with the air and devoid of a normal blood supply. This occurs especially in road accidents and war wounds in which broken bones and crushed muscles provide a suitable medium for the infection (Altmeier, 1965). Sometimes this infection can occur too after abdominal or gynaecological operations (Hitchcock, 1965). We present here a case of mediastinal gas gangrene which was caused by perforation of the oesophagus by a swallowed foreign body.

Abscess↗

Massive aspiration during surgery for a hydatid cyst of the lung.

A case of massive aspiration of hydatid liquid during an operation for excision of hydatid cyst of the lung is presented. Some considerations about the treatment and the anaesthetic approach to the problem are given. An analysis of 42 operations performed during 1963-1973 in the Rambam Hospital is discussed. Rupture of cyst with cyanosis and fall in blood pressure occurred in only 5 of these cases and among them, only one patient died.

Adolescent↗