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At least 127 records · Page 7Linked to original sources
PubMed1983

Diagnosis and treatment of acute cardiac tamponade by the subxiphoid approach.

Emergency cardiac surgery has been performed on 18 cases of acute cardiac tamponade whose etiologies were as follows: 11 cases of metastatic carcinoma, four cases of idiopathic pericarditis and three with other causes. In most cases, the chief complaint was dyspnea. In many cases, the cardiac silhouette of frontal chest X-ray films showed the shape of a water-filled ice-bag placed on a table. The electrocardiogram showed a low voltage and a flat T-wave in approximately half of the patients. In cases of an echo-free space 1 cm or larger on the M-mode echocardiogram, the average amount of pericardial fluid drained was 850 ml and in those in which the space was less than 1 cm, the average drained was 557 ml. The CT values were 9-40 for patients with malignant pericardial effusion and 20-22 for cases of idiopathic pericarditis. In general, pericardiocentesis was performed in almost all the patients with acute tamponade, but if the drainage was inadequate, the subxiphoid pericardial window procedure was performed under local anesthesia. Surgical invasion in this technique was minimal and the operative results proved effective. For the operation, we resected a 2 X 2 cm pericardial segment. Since two of the patients with malignant pericardial effusion developed postoperative reaccumulation, resection of a 4 X 4 cm segment in the future has been contemplated.

Adult↗
PubMedDate not supplied

[Echography in pneumopericardium. Value of the subxiphoid approach].

Para-sternal echocardiography proved impossible in a case of a large pneumopericardium caused by an oesophageo-pericardial fistula. However, M mode and sector scanning showed separation of the pericardium, giving non-homogeneous echoes, and shaded echographic areas caused by the interference of air which masked all recognisable structures. This occurred in time with systole, a sign which we associate with the pneumopericardium itself.

Echocardiography↗
PubMed1983

Subxiphoid pericardiotomy. A safe, accurate, diagnostic and therapeutic approach to pericardial and intrapericardial disease.

The records of 36 patients who underwent subxiphoid pericardiotomy were reviewed to determine the safety, accuracy, and utility of the procedure. No deaths were attributed to the operation, and complications were minimal. Most operations were performed under local anesthesia. Findings at operation accurately defined which patients required further surgery and which did not. Although clinical, radiographic, and physical findings are inaccurate in determining the nature and extent of pericardial and intrapericardial pathology, a definitive diagnosis was obtained in all diagnostic procedures. Only one patient needed a second operation, attesting to the effectiveness of subxiphoid drainage as a therapeutic modality.

Adolescent↗
PubMed1982

Management of acute cardiac tamponade by subxiphoid pericardiotomy.

Eighteen patients with cardiac tamponade were treated by subxiphoid pericardiotomy performed with the patients under local anesthesia. This group included 9 cases of uremic pericarditis (50%), 5 cases of metastatic cancer (28%), 2 cases of trauma (11%), 1 case of tuberculosis (5.5%), and 1 case of unknown cause. Immediate relief from acute cardiac tamponade was obtained in all 18 cases with only minor and self-limiting postoperative complications, including transient supraventricular arrhythmias (five cases) and fever (five cases). There were no deaths related to either the operative procedure or reaccumulation of the pericardial effusion. The drainage period averaged 9.6 days (range, three to 28 days). Pericardial biopsy was performed in 15 of 18 cases. We conclude that subxiphoid pericardiotomy is a safe and effective method for the management of pericardial effusion of diverse causes. The ability to perform this technique safely using local anesthesia and the capacity to obtain a biopsy specimen under direct visualization make this technique superior to both needle pericardiocentesis and pericardiectomy in the acutely ill patient.

Acute Disease↗
PubMed1982

Morphology of the interlacunar network in four sites of hyaline cartilage of neonatal, juvenile, and adult rats.

The honeycomb matrix and interlacunar network are described and compared in femoral head articular cartilage, proximal femoral physis, xiphoid, and tracheal cartilages from neonatal, juvenile, and adult rats. The honeycomb matrix is morphologically constant in all four sites of all age groups. The network is plentiful in cartilage of neonatal rats, reduced in juveniles, and rare in adults. In a given cartilage site, the network has a constant pattern and concentration gradient among rats of the same age. It is hypothesized that the network functions only during rapid cartilage growth and is not related to weight-bearing. The network is composed of element sheets averaging 0.5 micrometer in thickness, which connect adjacent chondrocytes. Ultrastructurally, the network is observed as the thickened, dense areas of the honeycomb matrix and as nonmembrane-bound channels of granular material. The network and chondrocyte capsules are morphologically and cytochemically similar.

Aging↗
PubMed1981

[Sub-costal xypho-umbilico flap. A new approach to the neoplastic kidney (author's transl)].

The authors suggest a new approach to the kidney tumors: the xypho-umbilical-subcostal flap incision. This incision offers the advantages of the transversal as well as of the longitudinal approaches and gives a very satisfactory exposition of the surgical field. The authors report 52 cases of renal tumors operated on with this approach in the last 5 years: because of the optimal view it allows and of the lack of complications they suggest this incision as a method of choice in the majority of the cases of renal tumor.

Humans↗
PubMed1981

[Production and extracellular arrangement of proteoglycans in the growing hyaline cartilage].

Fixation of hyaline cartilage with potassium ferricyanide in addition to glutaraldehyde and osmium tetroxide leads to a better stabilization of the glycosaminoglycans. The resulting chelate formation enhances the electronmicroscopic density. In active chondrocytes electron dense material is found intracellularly in the rough endoplasmic reticulum, in transport vesicles, in the Golgi apparatus and in big vacuoles. Intercellularly large amounts of the glycosaminoglycans are preserved. The correlations between the macromolecules and the collagenous fibrills are demonstrated.

Animals↗
PubMed1980

Sequential scintiangiography of the hepato-splenic system of xiphopagus conjoined twins.

Scintiangiography of xiphopagus conjoined twins following sequential i.v. injection of Tc-99m sulfur colloid revealed the size, configuration, and anatomic point of fusion of the twins' common liver prior to surgery. Cross circulation was determined to be non-significant by this approach. The technique is presented, compared to other methods, and the benefit of sequential hepatic scintiangiography for xiphopagus conjoined twins is reviewed.

Cross Circulation↗