ABSTRACT
A deviation in an indirect measurement of intramural pH below the limits of normality (6.86) was used as a diagnostic test for sigmoid ischemia in 25 high-risk patients undergoing abdominal aortic operations. The clinical diagnosis of ischemic colitis was made by the attending physicians in only two of the 25, on the day after operation in one and three months after operation in another. In neither was the ischemic colitis considered to have been a causative factor in their subsequent deaths. In contrast, six patients developed pH evidence of ischemia on the day of operation. All six subsequently developed a transient episode of guaiac-positive diarrhea, four developed physical signs consistent with ischemic colitis, and four died. Of 19 who did not develop pH evidence of ischemia, none developed guaiac-positive diarrhea, none developed any signs of ischemic colitis, and none died. Stepwise logistic regression showed the duration of pH evidence of ischemia on the day of operation to be the best predictor for the symptoms and signs of ischemic colitis and for death after operation.
Subject(s)
Aortic Aneurysm/surgery , Colon, Sigmoid/blood supply , Ischemia/etiology , Aged , Animals , Aorta, Abdominal/surgery , Body Fluids/metabolism , Carbon Dioxide/analysis , Cardiomyopathies/etiology , Colitis/etiology , Colon, Sigmoid/metabolism , Dogs , Female , Humans , Hydrogen-Ion Concentration , Ischemia/metabolism , Male , Middle Aged , Postoperative Complications/etiology , Pressure/instrumentation , Reoperation , RiskABSTRACT
Presented is a simple method for decompression of a cyst with the use of a modified stent. The patient is instructed in methods of removal, insertion, and irrigation by means of a blunt No. 16 gauge needle. Periodic follow-up radiographic examinations permit reduction in tube length as the defect "fills in".
Subject(s)
Bone Cysts/therapy , Decompression/instrumentation , Jaw Diseases/therapy , Pressure/instrumentation , HumansABSTRACT
The compression effectiveness of the five leading brands of antiembolism stockings was compared and related to criteria previously described (pressure gradient diminishing from 18 mm Hg at the ankle to 8 mm Hg at the thigh). Tests were conducted using a standard leg form in common use within the hosiery industry, fitted with specially developed sensors. All of the stockings achieved pressures higher than recommended-some substantially. Elastic stockings from two manufacturers demonstrated tourniquet effects at the calf. Several brands ceased to preserve a continuously diminishing pressure gradient above the knee. Deviation of leg diameter from standard geometry was accompanied by a substantial increase (decrease) in pressure with increasing (decreasing) girth. Reproducibility of pressure effects produced by identical-sized stockings varied among the brands tested.
