Total ovarian, luteal and stromal blood flows were measured with radioactive microspheres (25 mum diameter) in 7 rabbits anaesthetized with sodium pentobarbitone and 23 conscious rabbits at Day 28 of ...gestation. Despite major differences in cardiac output, arterial PO2, PCO2, pH and base status, ovarian tissue blood flows were similar in both groups. In the conscious rabbits total ovarian blood flow was negatively related to arterial pressure, and luteal blood flow was negatively related to pressure and arterial pH. In the anaesthetized rabbits ovarian stromal blood flow was positively related to arterial PO2.
Metastatic disease to long bones is common and often requires stabilization to treat or prevent fracture. Intramedullary fixation is used in many metaphyseal and diaphyseal lesions. The goal of this ...study was to investigate the causes of and risk factors for reconstructive failure in intramedullary fixation of metastatic disease. We performed a retrospective review of 112 consecutive reconstructions for metastatic disease treated with an isolated intramedullary nail. There were 81 reconstructions in the femur, 25 in the humerus, and 6 in the tibia. All included patients were followed until death or reconstructive failure. All surviving patients had a minimum 2-year follow-up.Ten failures required construct revision. Median time to revision was 17.9 months (range, 3-93 months). The causes of failure included surgeon error, tumor progression, nonunion, and hardware failure. Patients with short survival times (P<.001) or a diagnosis of lung cancer (P=.029) were unlikely to fail. Revision was required in 6 solitary lesions (P=.012), 3 cases of lymphoma (P=.002), 3 cases of progressive renal cell carcinoma (P=.040), and 2 radiation-associated fractures (P=.007).Intramedullary stabilization is a successful operation for appropriate lesions. Failures may be minimized with proper implant selection and surgical technique, resection or curettage of renal cell carcinoma, avoidance of radiation-associated fractures, and overestimating patient survival.
Study Objective: To examine current policies on oral intake during labor among hospitals throughout the United States.
Design and Setting: Anonymous questionnaire survey distributed to the directors ...of anesthesia and obstetrics departments of 740 hospitals. Completed surveys were then grouped by number of deliveries performed each year.
Measurements and Main Results: A total of 2,265 surveys were distributed. Of that number, 902 (33% response rate) surveys, representing 740 U.S. hospitals, were returned. Of the surveys returned, 419 surveys were received from obstetricians and 401 surveys were received from anesthesiologists. Oral intake during labor is limited primarily to clear liquids, although hospitals with fewer deliveries allow significantly more oral intake during latent phase than do hospitals with larger services. Allowing nonclear liquids or solid foods is uncommon in either phase of labor, regardless of hospital size.
Conclusions: The results give an indication of oral intake policies used by labor and delivery units in the United States, and they may be helpful for obstetric services that are in the process of developing their own policies.
Giant basal cell carcinoma (BCC) of the chest wall is rare and poses challenges related to resection and reconstruction. A 69-year old man presented with giant BCC invading sternum. Wide resection ...and reconstruction with polymethylmethacrylate and mesh was performed. The soft tissue defect was covered with a pedicled omental flap and skin graft. He developed an infection requiring removal of the mesh construct; however, debridement and antibiotics cleared the infection. This case illustrates the locally aggressive nature of this disease and the need for tertiary-level care.
Solubility coefficients for seven inhalation anesthetic agnets were determined in maternal and fetal blood at 37 C. Halothane, isoflurane, diethyl ether, and nitrous oxide were significantly more ...soluble in maternal than in fetal blood, while methoxyflurane, fluroxene, and cyclopropane were significantly less soluble. Reasons for these differences cannot be accounted for by differences in the type or amount of hemoglobin present.
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