Subject(s)
Arthritis, Infectious/surgery , Disease Progression , Patient Acceptance of Health Care , Staphylococcal Infections/surgery , Sternoclavicular Joint/surgery , Arthritis, Infectious/diagnosis , Debridement , Drainage , Humans , Male , Middle Aged , Staphylococcal Infections/diagnosis , Sternoclavicular Joint/microbiologyABSTRACT
BACKGROUND: Pleural dissemination of pseudomyxoma peritonei (PMP) is considered an advanced/terminal disease. We review our experience with thoracic cytoreductive surgery (CRS) and intraoperative hyperthermic intrathoracic chemotherapy (HITHOC) for the treatment of pleural recurrence of PMP following previous intraabdominal surgery. PATIENTS AND METHODS: An observational study of five patients with pleural dissemination from PMP treated with thoracic CRS and intraoperative HITHOC with mitomycin C for 90 min at 41.5 degrees C. RESULTS: There were three men. The mean age was 46.5 (10.5) years. Postoperatively, one patient developed Grade I, one patient developed Grade III and one patient developed Grade IV postoperative complication. Two patients had an unremarkable postoperative recovery. Only one patient has died 38 months since treatment from abdominal complication of this disease with no evidence of thoracic disease. The four surviving patients are still alive 4.6-47.4 months after treatment. Two patients have evidence of an intraabdominal recurrence. CONCLUSIONS: Thoracic CRS and intraoperative HITHOC is a safe and effective procedure to treat pleural dissemination from PMP. Long-term disease-free survival can be achieved from this treatment for which no other potentially curative therapy has been described.
Subject(s)
Hyperthermia, Induced/methods , Peritoneal Neoplasms/therapy , Pseudomyxoma Peritonei/therapy , Aged , Chemotherapy, Adjuvant , Disease-Free Survival , Follow-Up Studies , Humans , Intraoperative Period , Length of Stay , Male , Middle Aged , Neoplasm Recurrence, Local , Reoperation , Thoracotomy , Treatment OutcomeABSTRACT
We report a re-do case of severe aortic valve stenosis due to pannus formation 29 years after an aortic Starr-Edwards caged-ball valve implantation. A huge shelf of calcified and thick pannus tissue below the valve had reduced the already small orifice by at least a third in surface area. The explanted Starr-Edwards valve revealed no mechanical or structural failure. Early detection and treatment of pannus outgrowth is essential in order to prevent life-threatening prosthetic valve malfunctions.
Subject(s)
Aortic Valve Stenosis/surgery , Foreign-Body Reaction/surgery , Heart Valve Prosthesis Implantation/adverse effects , Heart Valve Prosthesis/adverse effects , Aged , Aortic Valve Stenosis/etiology , Coronary Artery Bypass , Coronary Stenosis/surgery , Female , Foreign-Body Reaction/etiology , Humans , Recurrence , ReoperationABSTRACT
BACKGROUND: Emergency coronary artery bypass grafting (CABG) is occasionally necessary for failed percutaneous transluminal coronary angioplasty (PTCA). The aim of this study was to assess the outcome of patients receiving emergency CABG after unsuccessful PTCA over a 15-year study period. METHODS: From January 1982 through December 1996, 74 patients underwent emergency CABG after unsuccessful PTCA (crash group). This group was compared with a matched group of 74 patients having primary elective CABG (control group). RESULTS: All 74 crash group patients were to have PTCA of one coronary system. After PTCA failure, 58 patients (78.3%) developed electrocardiographic changes of evolving acute myocardial infarction (AMI). The overall rate of AMI was 8.1% for the crash group and 2.7% for the control group. Two patients in the crash group died, with no deaths in the control group. There was no significant difference between mean in-hospital length of stay. CONCLUSIONS: With prompt, aggressive, and complete myocardial revascularization, patients who required emergency CABG after PTCA failure had an outcome not significantly different from that of patients having elective CABG.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Artery Bypass , Adult , Aged , Aged, 80 and over , Angioplasty, Balloon, Coronary/adverse effects , Cardiopulmonary Bypass , Coronary Artery Bypass/adverse effects , Electrocardiography , Emergencies , Female , Humans , Male , Middle Aged , Myocardial Infarction/diagnosis , Myocardial Reperfusion , Retrospective Studies , Treatment Failure , Treatment OutcomeABSTRACT
"Culture-negative" wound infection and mediastinitis secondary to Mycoplasma hominis have been reported after cardiothoracic surgery but no case cluster has ever been described. We report 4 cases of infection in 3 cardiac and 1 bilateral sequential lung transplant recipient over 3 weeks of hospitalization. Successful treatment was achieved with early aggressive surgical intervention and combination antibiotics of clindamycin, doxycycline and/or ciprofloxacin. This cluster raises the question of nosocomial transmission of infection and supports a recommendation for single-room isolation and universal precautions for infected individuals.
Subject(s)
Cross Infection/microbiology , Heart Transplantation , Lung Transplantation , Mycoplasma Infections/epidemiology , Mycoplasma hominis , Surgical Wound Dehiscence/microbiology , Adolescent , Adult , Cluster Analysis , Cross Infection/epidemiology , Humans , Male , Middle Aged , Mycoplasma Infections/drug therapy , Surgical Wound Dehiscence/epidemiologyABSTRACT
We study the Néel temperature of quasi-one-dimensional S = 1/2 antiferromagnets containing nonmagnetic impurities. We first consider the temperature dependence of the staggered susceptibility of finite chains with open boundary conditions, which shows an interesting difference for even and odd length chains. We then use a mean field theory treatment to incorporate the three-dimensional interchain couplings. The resulting Néel temperature shows a pronounced drop as a function of doping by up to a factor of 5.