[Technical variants of median sternotomy].
Various modifications of the technique of median sternotomy are described. Advantages thus obtained with respective to saving time and better haemostasis are explained.
Biomedical subjects
Publications and source records attributed to R Parravicini.
Various modifications of the technique of median sternotomy are described. Advantages thus obtained with respective to saving time and better haemostasis are explained.
A case of volvulus of ectopic spleen mistaken for twisted ovarian cyst is described. Attention is drawn to six points: 1) the rarity of the condition; 2) the persistent uncertainty concerning its aetiopathogenesis, even though over a century has passed since the first case was reported; 3) the mechanism leading to twisting of the spleen stalk; 4) the absence of specific symptoms and the consequent impossibility of preoperative diagnosis in most cases; 5) the ready confusion with ovarian cyst; 6) the reasons for supposing that the reported case was the result of congenital factors.
The need for adequate protection of the myocardial tissue during open heart operations has proved to be of considerable importance in view of the conditioning value of the functional anatomical state of the myocardial fibre on the outcome of the surgery itself. After a review and description of the most widely used methods of protection, the Authors draw on the data in literature in order to trace a critical profile of each method, outlining its merits and defects in the light of present experience.
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The thickening of the gallbladder wall in patients with ascites is commonly related to hypoalbuminemia and/or portal hypertension. To evaluate the pathogenetic role of these two factors, we correlated gallbladder wall thickness (GBWT) with the albuminemia and the serum-ascites albumin gradient (SAAG), an index of portal hypertension, in 47 patients with ascites caused by cirrhosis of the liver or abdominal malignancy. We found a thickened gallbladder wall in 30/47 patients. The correlation between GBWT and SAAG was 0.64 (n = 47 p less than 0.001). No correlation was found between GBWT and albuminemia (r = 0.04). We suggest that the sonographic finding of ascites and gallbladder wall thickening should be considered a valuable sign of transudative ascites and of portal hypertension whatever its cause.
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