Supraventricular dysrhythmias are the most common cause of rhythm disturbance in the adolescent. With advances in surgical techniques and medical management, more children will be entering adolescence and, as a result, a higher incidence of dysrhythmias will be encountered. Appropriate management of supraventricular tachycardia requires precise determination of the mechanism, ...

Intraoperative spinal sonography (IOSS) has significant impact on the surgical management of spinal lesions. This paper describes the techniques involved, illustrates the sonographic anatomy of the spinal canal and its contents and discusses the role of IOSS in the surgical management of spinal trauma, spinal tumors, spinal stenosis and congenital ...

The management of a case of quadrilateral flexural contracture in a 10-year-old pony is described. The animal was restored to normal appearance and function through a combination of surgical desmotomy and management techniques; the importance of analgesia and exercise as adjuncts to surgery is emphasised. The aetiology and pathogenesis of ...

Experience in the use of a ureteric nipple in ten patients with bilharzial strictures of 15 ureters is presented. It is recommended that this method should be the procedure of choice in the surgical management of selected cases of bilharzial ureteropathy. The need for further experience in its use in ...

To compare the knot reliabilities of two kinds of synthetic absorbable suture material, twelve different knots commonly used in surgical practice were tested. Twenty tests were performed on each knot, i.e., ten with Dexon-S (uncoated) and ten with Vicryl (coated). The knots made with Dexon-S were found to slip less ...

Keratomycosis often follows ocular trauma caused by vegetable matter. Medical management sometimes is unsuccessful, and surgical intervention is required. Débridement, penetrating keratoplasty, and lamellar keratoplasty in conjunction with an inlay conjunctival flap have all been proved effective. Three case reports illustrate the usefulness of lamellar keratoplasty and conjunctival flaps in ...

The management of trophic ulcers, the most common wound in hypesthetic or anesthetic tissue, is reviewed. Pressure from an extrinsic source is the most important factor leading to development of the lesion, but the threshold for ulceration is markedly lowered by impairment of protective vasomotor reflexes and metabolic responses. Prevention ...

Twelve kinds of knots commonly used in surgical practice were tested with respect to holding power, expressed as loop-holding capacity. Two synthetic absorbable suture materials were used: nonlubricated polyglycolic acid (Dexon-S) and lubricated polyglactin-910 (Vicryl). The knots were selected on the basis of an inquiry among 25 experienced gynecologists, well ...

The management of a broken short 30-gauge hypodermic needle after an inferior alveolar dental nerve block in a 3-year-old child is discussed. Because of the possibility of the needle migrating toward vital structures, and because of the psychologic and medicolegal implications that could arise, we believed that the needle should ...

An epigastric lump was found in 24 out of 55 cases of acute pancreatitis. Phlegmon was seen in 18, pseudocysts in five and abscess in one. These lumps present difficult diagnostic and management problems. Close monitoring of the signs and symptoms should serve as a guideline for rational medical or/and ...

Despite proven guidelines, rational management proposals, and effective surgical therapies, surgical resections not in accord with national norms continue to be used. Refinement of existing knowledge can improve the marginal results of the past. A simple overview is presented. Management of cancer of the cecum, ascending colon, hepatic and splenic ...

The management of frontobasal skull fractures must be dealt with in a multidisciplinary manner. The advent of computed tomography has simplified the emergency radiologic investigation and expedited immediate surgical intervention. The major problem to be dealt with is closure of the frontobasal dura, which we accomplish by using an autogenous ...

Amoebiasis is a world-wide parasitic infestation but is more prevalent and virulent in warm countries. Of 33 patients with amoebic liver abscess (ALA) seen over a 5-year period, 24 had intrathoracic complications. Management consisted mainly of the administration of the antiamoebic agent metronidazole (Flagyl), repeated needle aspiration of ALA and ...

The management of a pelvic lymphocele is initially expectant. Surgical intervention is not utilized until major problems occur. The first reported case of a postsurgical pelvic lymphocele managed by the use of a percutaneous indwelling catheter inserted and monitored with ultrasound guidance is presented. If this technique proves to be ...

In the recent Falklands campaign four Army Field Surgical Teams were deployed in the two phases of the war. They functioned as Advanced Surgical Centres and operated on 233 casualties. There were 3 deaths. The patterns of wounding and the methods of casualty management are discussed and compared with other ...

In recent years the trans-sphenoidal approach to the pituitary gland has come into vogue and a study of the surgical anatomy of the sphenoid sinus has become increasingly important in order to avoid many surgical mishaps. Moreover, the sphenoid sinus has complicated relationships and its diseases may and do give ...

A new surgical treatment of pseudarthrosis humeri needed specific anesthesiological management. The relevant problems for the anesthesiologist were the following: one year prior to the present admission the patient suffered from a polytrauma with contusio cerebri and had, as a result of prolonged intubation during the following period of intensive ...

Hospitals are often faced with the problem of apparent inefficiency or ineffectiveness of operating room management. There can be many contributing factors, and a systematic approach is needed to solve this problem. The article delineates eight management components and suggests that implementation and continuous evaluation of these components will promote ...

The management of a case of status asthmaticus complicated by surgical emphysema is described. In view of voice changes, intubation was necessary but intermittent positive pressure ventilation was considered unwise, because of the surgical emphysema. A means of maintaining adequate sedation in an intubated patient whilst allowing spontaneous respiration is ...

Accurate histologic interpretation of small laryngeal biopsies is often obfuscated by tangential sectioning of the specimen. The natural tendency of the tissue specimen to curl and suboptimal orientation of the specimen account for the tangential cuts. Use of a biopsy specimen mount eliminates this problem. The biopsy specimen mount also ...

Surgical management of deformity due to premature closure of the distal ulnar growth plate in a growing dog is discussed. The method of management selected was ulnar diaphyseal ostectomy with transphyseal wiring of the distal radius. Elbow subluxatin and degenerative joint disease as a consequence of premature ulnar closure are ...

This article examines two criteria for a definition of applied behavior analysis. The criteria are derived from a 19th century attempt to establish medicine as a scientific field. The first criterion, experimental determinism, specifies the methodological boundaries of an experimental science. The second criterion, philosophic doubt, clarifies the tentative nature ...

A review of the different bougies used over the years confirms that the dilators presently available are adequate for the conservative management of oesophageal benign strictures. Most of these are of an old but well-tested design. Several additional techniques may have to be tried in difficult patients. Dysphagia can be ...

Surgical treatment is a safe adjunct to the management of the child with osteogenesis imperfecta. Its objectives are to control fractures and correct deformities. It may significantly improve the functional status of the child. The long-range aim of bioscience is to determine and correct this genetic defect and thereby avoid ...

Suppurative thrombophlebitis is a potentially lethal intravascular infection associated with the usage of intravenous catheters. Conventional approaches to management include ligation and excision of involved venous structures. These measures may not be feasible in all situations. This paper describes the successful medical/surgical management of a patient with suppurative thrombophlebitis of ...

Surgical management of selected macular epiretinal membranes is possible through the use of microsurgical pars plana vitreoretinal membranectomy. Visual improvement can be significant with resolution of traction retinal detachment and retinal distortion. Complications are similar to other forms of vitreous surgery. In a series of 9 selected cases with severe ...

Pelvic abscess is a relatively uncommon condition in current surgical practice. However, candidates for higher surgical degrees have shown an inadequate knowledge of the management of the various types of pelvic abscess. This observation includes candidates confining their activities to the surgical aspects of gynaecology. It is considered, therefore, that ...

Idiopathic female intersex presents in the neonate with characteristic anomalies of the external genitalia, complete and separate phallic and vaginal urethras and vesical outlet obstruction. Management of this disorder should initially focus upon adequate urinary drainage and proper sex assignment in the neonate. Successful management and surgical reconstruction of the ...

In the great majority of patients treated with radiation, only transitory injury to the bowel occurs, but in five percent of patients, permanent damage to the small bowel or rectum is seen. Symptoms of radiation enteropathy may begin four to six months after the treatment is completed or may not ...

A review of the history and pathophysiology of sickle cell disease is given. The clinical types (crises) are discussed along with their relationship to surgical occurrences, both elective and emergency. Specifics of perioperative management are discussed and the cardinal features of importance are enumerated. A retrospective study of sickle cell ...

Prolapsed tissues from seven traumatized globes were examined by frozen section prior to primary enucleation or surgical repair. The findings suggest that if retina is identified on such sections, primary enucleation may be justified. If iris, ciliary body, or choroid is found, the decision regarding management must be based on ...

In a study of 390 mylohyoid grooves in dry mandibles and in dissections of the region, the groove conformed to the classic description (that is, it was open along its entire length) in only 83.6% of the cases. In the remaining 16.4%, the sulcus was partially or totally converted to ...

The management of mature subglottic stenosis secondary to endotracheal intubation in infancy and childhood remains a controversial issue. If treated similarly to congenital subglottic stenosis by tracheotomy and a "wait-and-see" period then there is a considerably higher mortality and morbidity for the acquired disease compared with the congenital. Eighteen children ...

Draining sinuses are considered a major complication of decubitus ulcers in spinal cord injury patients. Of 144 such patients with decubitus ulcers admitted in 1975 and 1976, 15 had draining sinuses. Twenty-one sinograms were obtained in the process of their evaluation prior to treatment. In 6 patients, sinography resulted in ...

Clinical and pathological findings in 15 patients with carcinoma of the midthoracic esophagus were analyzed. The author concluded that preoperative radiotherapy reduces tumor size and improves resectability. Longer follow-up is required to determine whether or not preoperative radiotherapy improves survival rates in these patients.

Invasive malignant melanoma of the conjunctiva is a rare neoplasm fatal in 40% of cases. Accepted techniques of surgical management include wide local excision, conjunctivectomy, and exenteration. Recently lymphatic dissections have been proposed, but not described, for invasive conjunctival melanoma. We present five cases of invasive conjunctival melanoma, including two ...

The authors review their clinical experience in diagnosis and management of over 2,500 cases of pressure sores, of which more than half (1,351) required surgical operations. Pressure sores have been classified in 4 grades, a classification that the authors believe is helpful in planning treatment. Different conservative regimens of management ...

There continue to be marked differences of opinion regarding how to manage duodenal ulcer disease. Recent developments in medical management which appear of major importance include the development of antagonists of H2-receptors of histamine, the prostaglandins, and transendoscopic instrumentation. Intractability of duodenal ulcer continues to be an over-used category which ...

We have had the opportunity to employ the CO2 surgical laser with suspension laryngoscopy and microscopic adaptations to treat a variety of laryngeal conditions over two years. Each type of laryngeal condition is discussed, and the benefits of laser management is evaluated. This type of laryngeal management is compared with ...

The modern medical and surgical treatment of ulcerative colitis has been detailed. Whilst improvements in medical management have been few in the past decade there have been advances in dietary management and in the use of new drugs such as azathioprine and disodium cromoglycate which are currently being evaluated. Sulphasalazine ...

25 years' experience of the open surgical management of the lower ureteric stricture is reviewed. An extravesical anti-reflux tunnel procedure has been found to be simple and effective. There is still a place for the Boari procedure or psoas hitch, particularly in the management of a long stricture of when ...

In this article an overview of the problem of impacted canines has been presented and some of the clinical considerations related to surgical management and types of attachments have been discussed. In the orthodontic management of impacted canines the clinician has to make certain decisions regarding one-arch vs. two-arch treatment ...

Premature closure of the distal radial physis can result in severe developmental deformities of the involved forelimb. Recognition of the problem early in its course is necessary to minimize valgus deformity and secondary osteoarthritis of the elbow and carpus. By forcing the radius to elongate, following radial osteotomy and use ...

The clinical features of 106 women who had a secondary postpartum haemorrhage were examined in detail; 39 were managed conservatively, 3 had a vaginal laceration resutured and 64 had a curettage. In 46 patients, material obtained by curettage was examined histologically. The clinical features associated with retained products of conception ...

The review describes and illustrates some veterinary surgical procedures routinely performed by staff surgeons of the Surgical Support Branch, Veterinary Sciences Division, USAF School of Aerospace Medicine. Maintenance and management of the surgical patient, particularly one involved in chronic bioinstrumentation, are discussed. (Author)

The results of a retrospective study of the value of reductive surgery in the treatment of abdominal Burkitt's lymphoma are reported. Nine patients had almost complete removal of the tumour, 16 had little over half of the tumour removed, and 43 underwent biopsy only. All patients subsequently received chemotherapy. There ...

We have reviewed the cases operated upon for correction of congenital aortic stenosis at l'H?pital Ste-Justine between 1959 and 1969.Twenty-five of the 26 patients were readmitted for complete clinical, radiological and hemodynamic investigation. Fourteen had a valvular stenosis, eight a diaphragmatic subvalvular lesion, and three had mixed lesions.The results lead ...

This article discusses long- and short-stretch compression bandages and the theory underpinning their practical application. The Laplace equation is outlined to estimate sub-bandage pressures. Challenges associated with applying therapeutic levels of compression include bandage tension, number of layers, limb circumference and bandage width. Multi-layer bandaging is important for the management ...

Leg ulceration is a complication associated with sickle cell disorders. Caroline Dowsett outlines why this problem occurs and describes the management of a patient with sickle cell disorder who presented with an infected leg ulcer. She concludes that there is a need for more research into the management of these ...

'Hand washing is a practice we perform ritualistically, but as healthcare professionals we need to appreciate its importance in clinical practice and not become complacent about it' (Kerr, 1998).