Nonoperative extraction of retained common duct stones was successful in 17 patients during the past two years. Eleven required only one manipulation; the largest number of manipulations required was five. The Burhenne catheter and Dormia basket were employed frequently, but were not always effective. When difficulties occurred with their use, Mazzariello biliary forceps resulted in successful stone extraction, particularly in the management of impacted stones. Extraction procedures were performed under fluoroscopic control, usually on an outpatient basis. Recently, we have employed a flexible fiberoptic endoscope that allows visual investigation of suspected defects and decreases fluoroscopic exposure. These results indicate that all patients with retained common duct stones are candidates for sinus tract manipulation six weeks after common duct exploration. It is recommended that secondary operations for retained common duct calculi not be performed until nonoperative extraction has been given an appropriate trial.

Adult↗

PubMed1976

The identification of accelerated coagulability.

Explore the source record for details and available documents.

Blood Coagulation↗

PubMed1976

Thromboelastographic changes in carcinoma: an animal model.

The dynamics of blood clotting using a thrombelastogram (TEG) are depicted after the injection of V2 carcinoma cells or control heterologous peritoneal exudates in New Zealand hares. Changes in the TEG configurations of native blood samples vs. celite activated samples run simultaneously provide a qualitative assessment of the presence of carcinoma.

Animals↗

PubMed1976

In vitro testing of surface thrombogenicity using the thrombelastograph.

Synthetic surfaces can be assessed for their ability to promote or inhibit whole blood coagulation with improved accuracy using a new protocol developed for the Thrombelastograph instrument. Results obtained from the analysis of the hydrodynamic state of blood clotting in Thrombelastograph chambers have enabled a quantitative interpretation of the output of this instrument to be made. The thrombogenic properties of a segmented polyurethane and a polydimethyl siloxane are compared with a preparation of reconstituted elastin. It is seen that a four-fold delay in clotting time is exhibited by reconstituted elastin when it is compared with other biomedical synthetic materials tested.

Adult↗

PubMed1975

Modified radical mastectomy.

This report describes our experience with a technique of modified radical mastectomy involving incision of the lower lateral fibers of the pectoralis major muscle and detachment of the origins of the pectoralis minor muscle. These maneuvers enable sufficient retraction of these muscles to provide excellent axillary exposure while minimizing the danger of traction injury to the neurovascular structures supplying these muscles. The operation has been performed in 20 patients; statistical analysis demonstrates at least as many nodes in these specimens compared to retrospective analysis of nodes recovered from 223 radical mastectomy specimens done during the previous 5 years. The final cosmetic results are superior to those obtained with standard radical mastectomy. These results suggest that this method of modified radical mastectomy should be considered, unless the proximity of the disease to the pectoralis muscles endangers the adequacy of the surgical margins.

Breast Neoplasms↗

PubMed1975