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Biomedical subjects

W H Brott

Publications and source records attributed to W H Brott.

5 recordsLinked to original sources

Drug delivery.

The calculations necessary to allow infusion of a known drug dosage at micrograms per kilogram of body weight per minute are time-consuming and error prone. A simpler method entails multiplication of the patient's weight in kilograms by the factor 15. The resultant figure represents the number of milligrams of drug to be placed in 250 ml of infusate vehicle. The solution, which is delivered through a microdrip chamber (60 gtt per milliliter), will contain 1 microgram per kilogram in each drop. One is thus permitted to define dosage by setting up the solution to have 1 gtt = 1 microgram/kg.

Body Weight

Surgical treatment of left main and left main equivalent coronary artery disease.

There is a tendency to equate left main (LM) and left main equivalent (LME) coronary artery disease in terms of the surgical risk and benefit. Eighty-seven patients with LM disease were compared to 78 patients with LME disease as to operative mortality rate and long-term benefits. One hundred percent follow-up was obtained. Although the two groups were similar preoperatively with regard to age, sex, and ventricular function, the operative results in the two groups differed. There was a significantly higher operative mortality rate in the LM group of patients (12.6% versus 2.5%). However, the incidence of graft patency and relief of symptoms was lower in the LME group of patients. The late mortality rate was 4% in both groups. LME disease appears to represent a subgroup of patients with three-vessel disease and cannot be equated with LM disease.

Coronary Artery Bypass

Thoracic traction for median sternotomy dehiscence.

Standard management of median sternotomy dehiscence sometimes fails to achieve lasting reduction and fixation of the sternal halves. An effective method of external thoracic traction that augments internal fixation of the sternal fracture is presented.

Humans

Value of anterior mediastinotomy in bronchogenic carcinoma of the left upper lobe.

Neoplasms of the left upper lobe may spread directly to the anterior mediastinal group of nodes without involving the inferior tracheobronchial, superior tracheobronchial, or paratracheal nodal chain. Routine cervical mediastinoscopy does not sample the anterior mediastinal node group. Parasternal anterior mediastinotomy was performed in 28 patients with left upper lobe carcinoma and normal findings from cervical mediastinoscopy. Despite the normal findings at cervical mediastinoscopy, 10 of the 28 patients were deemed to have inoperable disease because of spread of the neoplasm to the anterior nodal group or because of direct neoplastic involvement of the aorta or main pulmonary artery. All patients in whom results of anterior mediastinotomy were normal had resectable lesions at thoracotomy. Fourteen of the 16 patients who came to thoracotomy had normal hilar nodes. Parasternal anterior mediastinotomy, introduced by Chamberlain, should be performed in addition to standard cervical mediastinoscopy if the nodal drainage of left upper lobe neoplasms is to be more completely evaluated. Combining these two procedures samples all major drainage pathways except the posterior mediastinal nodal chain.

Carcinoma, Bronchogenic

Secundum atrial septal defect and cleft mitral valve.

The association of a secundum atrial septal defect and mitral insufficiency is not uncommon. Five patients with this combination of lesions are presented and the pathological anatomy of the mitral valve is discussed. All 5 patients demonstrated a similar cleft mitral valve; 2 had cleft valves when only mitral valve prolapse was suspected preoperatively. The surgical implication of these lesions is discussed.

Adult