Biomedical subjects
Publications and source records attributed to R S Cromartie.
With the renewed interest in the use of autogenous radial arteries in coronary artery bypass grafting, concerns regarding vascular compromise and selection of patients have arisen. In this report, we describe a modification of Allen's test.
Pollution of Florida's waterways is a serious problem. Sources of pollution include sewage, storm water runoff, faulty septic tanks, improperly constructed landfills, and obstruction by causeway bridges. Some of the major causes and solutions are discussed.
The history of surgery for ischemic heart disease is presented beginning with procedures to ablate nerves to the heart in the early part of this century. The evolution of surgical techniques to primary coronary artery bypass grafting is illustrated. Included are subtotal thyroidectomy, pedicle grafting of muscle, omentum, lung, stomach, and jejunum to the pericardium and heart, cardiopericardiopexy, ligation of the great cardiac vein, grafting from aorta to coronary sinus, implantation of arteries into the myocardium, coronary artery bypass grafting, and percutaneous transluminal coronary angioplasty.
Explore the source record for details and available documents.
The superior vena cava (SVC) and thoracic inferior vena cava (IVC) were replaced in 46 dogs with autologous vein, knitted Dacron, glutaraldehyde-fixed porcine pericardium, unsupported polytetrafluorethylene (PTFE), and externally stented PTFE. After 30 days, patency rates were determined by contrast venography and were 100%, 9%, 50%, 75%, and 100%, respectively. The patency rates of Dacron and glutaraldehyde-fixed pericardium are considered unacceptable when compared to autologous vein (p less than 0.05). Stented PTFE exhibited a patency rate equal to that of autologous vein at 30 days, minimal graft reaction, excellent incorporation by host fibroblasts, and a smooth neointima. The external spiral support added to PTFE enchanced the thromboresistance of this graft in the thoracic venous system. Long-term follow-up is required to determine if the stented PTFE prosthesis remains comparable to autologous vein as a venous conduit.
Explore the source record for details and available documents.
Records of 702 patients with carcinoma of the lung seen from 1960 through 1970 were reviewed. The efficacy of various diagnostic and therapeutic procedures was assessed. Salient findings were as follows: Biopsy of nonpalpable ipsilateral supraclavicular lymph nodes was positive for carcinoma in 63 of 286 patients (22%). Even more surprising, biopsy of nonpalpable contralateral supraclavicular lymph nodes was positive for carcinoma in 9 of 38 patients (24%). Accordingly, the importance of biopsy of nonpalpable supraclavicular nodes is to be stressed. Squamous cell carcinoma was the most common type, but adenocarcinoma was more common in women and nonsmokers. Among the 702 patients, 48 (6.8%) were nonsmokers. The 5-year survival for 92 patients treated by lobectomy was 21%; the 5-year survival for 77 patients treated by pneumonectomy was 19%; the 5-year survival among 18 patients have resection of the chest wall in addition to resection of the primary lesion was 22%. Of 12 patients with small cell carcinoma of the lung treated by resection, there was 1 5-year survivor. The overall 5-year survival in the 702 patients was 6.6%.
A technique is described for obtaining exposure of all three parts of the injured subclavian artery through a standard posterolateral thoracotomy and transpleural subperiosteal excision of the first rib. This technique should be considered for repairing injuries of the subclavian artery, especially when the injury is discovered at emergency thoracotomy done because of bleeding.
The records of 40 patients with tuberculous peritonitis treated at Charity Hospitals in Louisiana were reviewed. Thirty-nine patients were Negroes and 24, males. The average age was 36.5 years, with 22 of the patients being between the ages of 20 and 39 years. The most common symptoms were fever, abdominal pain, weight loss and abdominal swelling. The most frequent physical signs were abdominal tenderness, fever and ascites. Diagnosis was made by laparotomy in 24, peritoneoscopy in two, paracentesis in eight, autopsy in four and upon elective hernial repair in two. Four had a previous history of extra-abdominal tuberculous, four were known to have extra-abdominal tuberculosis at the time of diagnosis and four were found to have extra-abdominal tuberculous after the diagnosis of tuberculous peritonitis had been established. The follow-up interval averaged six and one-half years. Six patients died prior to discharge, and six patients died after discharge, none of the latter deaths was established as being due to tuberculosis. Twenty-two patients were alive at the end of the follow-up interval.
A series of 50 combat-injured patients given crash intubation for rapid induction of anesthesia is presented. The technic consisted of injection of 3 mg of d-tubocurarine and 0.4 mg of atropine IV, preoxygenation by face mask for 3 minutes, and then injection of sodium thiopental or ketamine, followed immediately by 60 to 80 mg of succinylcholine IV. Intubation was performed with a cuffed tube after cessation of spontaneous respirations and relaxation of the jaw. In the entire series there was no vomiting or aspiration on induction. Thirty-six patients were induced with thiopental and 14 with ketamine. Three patients given thiopental and 2 given ketamine had a fall in blood pressure to below 100 torr systolic. The average BP change was in a positive direction with both agents.