Acta chirurgica Academiae Scientiarum Hungaricae最新文献

The effect on the kidney of a bilateral transitory occlusion of the ureter was studied. The extent of the oedematous swelling of the kidney was determined and the dilation of the pelvis and the condition of the vessels were studied. Changes were observed in the renal tissue. The vessels appeared to be in a functional spasm, Bowman's capsules and the tubules were dilated and signs of vacuolar degeneration were manifest in the parenchyma. Mannitol administered after relieving the occlusion enhanced renal regeneration. The oedema disappeared in a shorter time than otherwise and the degenerative symptoms ceased.

Acute myocardial damage such as epicardial, intramural and subendocardial haemorrhages and oedema are known to occur after mechanical perfusion. The results of animal experiments showed that local circulatory disturbances (hypoperfusion, hypoxia) due to mechanical damage of the blood (erythrocyte aggregation, denaturation) and or lasting hypoperfusion (microcirculatory hypoxia) are responsible for the acute lesions. In addition, the results offer a morphological explanation for the postperfusion heart failure.

The blood pressure of dogs anaesthetized with 0.1 g/kg of chloralose was reduced to 40 mm Hg by arterial bleeding. Thirty percent of the drawn blood refluxed spontaneously, the rest was retransfused either suddenly arterially or slowly in 15 minutes by the venous route. In other groups a total quantity of 25 ml/kg was drawn from an artery at a rate of 50 ml/kg and after about one minute the entire quantity of blood was rapidly retransfused through the artery. The control group breathed spontaneously, the other groups were given artificial respiration, or the sinus nerves and the vagus were transected separately or simultaneously, or transection was combined with artificial ventilation.

Authors compare data of 1577 elective inductions with 1450 those of spontaneous labor or cases induced post term because of signs of foetal distress during regular assessment. They review the methods of selection and management of planned induction as well as their results. They are as follows: the mean duration of the 1st stage of labor was 4 hours 35 minutes, FHR changes of hypoxic origin in the 1st stage occurred in 6 per cent, scalp blood examinations showed more favourable values than the ones found in uncomplicated, spontaneous labors; the total frequency of operative interventions were 1,84 per cent, we had no perinatal deaths which could be attributed to our policy of selective planned induction of labor.

Dacron-velour (Sauvage) prostheses were implanted into 100 patients 2/3 of the implantation into the vessels of the lower limbs were absolutely indicated 3/6 were performed in combination with other reconstruction methods because of early or late re-obliterations. The prostheses were useful further for obturator, axillo-femoral (popliteal) and supra-aortic bridgings. The prosthesis is considered more advantageous than the traditional artificial veins in the same fields of application. Prosthesis is indicated in the femoro-popliteal section of no own vein is available of if this is not sufficiently long, and if no thrombendarterectomy can be performed or this is unsatisfactory. For bridgings down to the tibials combination of the prosthesis with an own vein can produce highly promising results.

In their discussion of the problem of antibiotic prophylaxis in general surgery the authors maintain that routine-like antibiotic prophylaxis is not indicated in general surgery, but is superfluous and even harmful. So-called "b ind prophylaxis" is senseless and there is no "total prophylaxis". Antibiotic prophylaxis can be successful when it is selective, aimed, adapted to the individual subject and the antibiotic reaches an effective concentration at the appropriate moment not only in the serum but also in the tissues. Infection can be of exogenous and of endogenous origin. Prevention of exogenous infections does not depend upon antibiotic treatment. Antibiotic prophylaxis is contra-indicated when the operation is performed o a clean region. The problem of antibiotic prophylaxis in the course of operations of the bile duct, the stomach, the intestine and pancreas. during appendectomy and colorectal operations is discussed in detail. Post-operative infections of the respiratory tract cannot be prevented by antibiotic prophylaxis. Finally, the authors try to find an answer to the problem when and how antibiotic prophylaxis should be applied, what antibiotic should be used for how long and in what doses.