Biomedical subjects
Publications and source records attributed to S Gassner.
A previously healthy young male developed unilateral pulmonary oedema immediately after re-expansion of an intentionally collapsed lung after transaxillary sympathectomy. The pulmonary oedema was localised to the contralateral, uncollapsed lung.
Mechanical ventilation in status asthmaticus is associated with a significant mortality and morbidity. To facilitate intermittent positive pressure ventilation (IPPV), we have used continuous IV thiopental (thiopentone) together with traditional ventilatory techniques. With this policy, we were able to achieve rapid correction of arterial blood gas tensions in a group of 20 severe asthmatics requiring IPPV. By 1 hour, peak airway pressure (PAP) had fallen from 58.6 +/- 15.7 to 30.2 +/- 10.9 cm H2O (p less than 0.001). During the same period, PaCO2 fell from 51.3 +/- 15.3 to 40.17 +/- 8.2 mm Hg (p less than 0.05) and pH rose from 7.25 +/- 0.1 to 7.33 +/- 0.1 (p less than 0.001). Morbidity was low and in particular, no episode of barotrauma was noted. All patients survived the acute attack and were successfully liberated from the ventilator. We conclude that these results are largely attributable to our use of early and continuous IV anesthesia induced by thiopental.
The aim of this study was to further understanding of development during the crucial second year of life. The study employed a naturalistic, semistructured situation for the observation of mother-child behavior. The experimental stimulus was the progressive diversion of the mother's attention away from her child. This diversion evoked separation anxiety in the child and the individual and interactive regulatory behaviors of the mother-child pair. Concurrently, the child's behavior was observed in a play group situation. One set of rating scales was devised for assessment of the mother-child interaction, and another set for assessment of the child's functioning in the play group. The major hypothesis was that maternal and child behaviors that foster the child's successful handling of phase-specific stresses and developmental tasks will be positively correlated with the child's functioning in the play group. This hypothesis is supported by the findings of the study.
The effects of chemical sympathectomy with 6-hydroxydopamine (6-OH-DA) on the sensitivity of guinea-pig heart to catecholamines were studied. Heart rate at rest and chronotropic effects of catecholamines remained unchanged after chemical sympathectomy, while the arrhythmogenic effects of epinephrine, norepinephrine and isoprenaline were potentiated markedly. Our results indicate that chemical sympathectomy with 6-OH-DA produced post synaptic denervation supersensitivity in the heart ventricles.
Two pregnant women with severe status asthmaticus unresponsive to intensive medical treatment are reported. Termination of pregnancies by cesarean section was followed by a dramatic improvement within 24 h. Termination of pregnancy is indicated in life-threatening status asthmaticus.
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Any chronic inflammatory condition of the middle ear may bring about bone destruction. Today, in the antibiotic era, this destruction concerns mostly the ossicular chain. Any one of the ossicles or all of them together may be partially damaged or completely destroyed (Sadé et al, 1981). Hearing is usually impaired if the stapes or the incus or both of them are damaged. To overcome the resulting hearing deficit, various surgical techniques, using various materials, have been introduced, with various degrees of success. The most problematic situation encountered surgically is the one in which the stapes is missing, and it is with this situation that the present study deals. The surgical solution so far advocated has been in the form of a surgical bridge or columella between the mobile footplate and the drum. The columella (Fig. 1) is made out of bone or some non-organic biocompatible material. Often, however, this solution is not very successful, for two reasons: A. Instability of the columella (prosthesis) is often unavoidable because of its slim attachment to the footplate; B. Biologically, an incompatibility between the drum and the prosthesis is all too often present, when the latter is made of plastic materials. These columellas have been found, sooner of later, to extrude. It is the purpose of this communication to report a new technique and a new concept, which tries to overcome the above shortcomings, using a different type of stapes-replacing prosthesis.
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Irrigation of the eye and adnexa is a way of removing damaging material and treating different diseases by applying medicants in the irrigant in humans and in laboratory animals. A system for controlled eye irrigation in animals is presented, suggesting possible use in human patients as well.
Fracture healing was studied in 28 rabbits after their femurs had been osteomized using the carbon dioxide laser. Twenty rabbits whose femurs were osteotomized by means of a Gigli saw served as the control group. Fracture healing was initially delayed in the laser cut femurs, yet after 60 days no significant difference between the groups could be detected. The initial delay was caused by thermal damage to the laser cut bone edges. Further fragmentation of the damaged bone occurred during the immediate postoperative period.
An experiment was carried out to ascertain the fate of the bared muscle following the repair of huge midline hernias with the "reverse sheath" method. Thirty-five patients have undergone operation by this method over the past five years, with excellent results. Experimental stripping of abdominal fascia was done on 35 rats. The bare rectus muscle was examined 1, 3, 5, 8 and 11 months after the operation. No regeneration of fascia was seen. The missing fascia was replaced by scar tissue. The results are important with regard to the support of the abdominal wall after repair of midline abdominal hernia by the above-mentioned method.
The CO2 laser beam was used to create defects 3 mm in depth in the distal growth plate of one femur in a group of 59 rabbits. In most of the 32 rabbits in which the defect was created on the lateral aspect of the epiphyseal plate the procedure resulted in the subsequent development of valgus deformity and shortening of the femur. In most of the 27 rabbits in which defects were produced both medially and laterally to the epiphyseal plate there was a subsequent marked shortening of the bones. Histological studies revealed that the laser-induced defects of the growth cartilage led to epiphysiodesis and premature disappearance of the epiphyseal growth plates.
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The construction and use of a permanent, implanted plastic camnula for intraventricular injections in rat brain is described. The cannula can be used in either acute or chronic experiments.
The CO2- laser knife was used for partial nephrectomy in an experimental study of 20 mongrel cats. Of these, 16 survived, two died of peritonitis, and two died of unrelated causes. The inherent characteristics of precision and hemostasis of this modality, already found useful in controlling complications in other fields of surgery, proved to be a safe and effective method for partial nephrectomy as shown by angiography and histopathologic examinations of the operated kidneys at 0, 7, 14, 21, and 90 days after surgery. Complications such as hemorrhage or urinary fistula were nonexistent.
A method is described for segmental esophageal replacement in dogs, with one of three types of tissue substitute: pericardium, fascia lata and aortic homograft. The experiments involving the thoracic esophagus failed owing to the development of acute mediastinitis and sepsis. The most promising results were obtained in animals in which an aortic homograft was used to replace the cervical sigment of the esophagus. Eight of the 12 animals with aortic homograft survived and gained weight until killed one to six months after operation. The overall results suggest that aortic homograft may have a potential clinical application in cases in which esophageal replacement is necessary.
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