The complex life of Rudolph Matas.
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Biomedical subjects
Publications and source records attributed to J Ochsner.
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Persistent postoperative incisional pain after aortocoronary bypass surgery was reported by a patient in whom allergies to metals contained in the stainless steel suture used for sternal closure were confirmed by patch testing. The symptoms resolved promptly after the sutures were removed.
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The search for the ideal vascular graft is a dream that has eluded surgeons for centuries. Since the introduction of the fabric vascular prosthesis in 1952 by Voorhees, Jaretzki, and Blakemore, a wide variety of materials and designs have been tested. Dacron has withstood the test of time in both the knitted and woven types. Each of these graft designs has its own advantages and disadvantages, but we believe that the interlock construction of the Ochsner series grafts provides a solution to the problems associated with the earlier woven grafts while maintaining the advantages of the woven construction: (1) unraveling has been eliminated, and fraying has been reduced by the use of the interlock stitch; (2) the graft has been made soft and pliable by using three low-twist yarns, avoiding chemical impaction of the yarns, and utilizing a loose crimp; and (3) nonfixation of the pseudo-intima has been corrected by using low-twist, highly filamentous yarns which allow ingrowth of tissue for good fixation.
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Spontaneous atheromatous visceral embolization from diffuse aortic atherosclerotic disease is an unusual and poorly understood entity. We have reviewed our experience with 88 patients who suffered atheromatous embolization from a "shaggy" aorta. Visceral embolization was evident in 36 patients (40.9%). Nine were treated nonoperatively with three patients dying within a week of presentation and an additional five patients dying within five years due to continuing renal and intestinal embolization. Surgical correction was undertaken 28 times in 27 patients. Endarterectomy or graft replacement of the aorta did not necessarily prevent visceral infarction or renal failure. Extra-anatomic bypass with ligation of the distal external iliac arteries appears to be associated with the lowest morbidity and mortality. Anticoagulation of these patients does not prevent embolization and may be contraindicated for long-term management.
Heparin is a drug used widely in almost every field of medicine; nevertheless, very little is known about its discovery. Jay McLean, a second year medical student at Johns Hopkins University, discovered this wonderful drug in 1916 while performing research in the laboratory of W.H. Howell, MD. This is a brief account of the story told by Dr McLean before his death.
A rapid, simple palliative technique for treatment of pulmonary atresia with a one-stage pulmonary valvotomy and central aortopulmonary artery shunt is described.
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