RESUMO
The small bowel is a difficult organ to examine clinically and study diagnostically. The SBFT study is an adequate screening tool for evaluation of the small bowel, but if there is a moderate to high index of suspicion of an undetected tumor, enteroclysis is better than upper GI series with SBFT for preoperative diagnosis of such lesions. Based on the above findings, we recommend that any patient with symptoms and findings highly suggestive of small bowel tumor, especially chronic GI blood loss with a negative work-up, be viewed with a high index of suspicion and his case investigated aggressively, using enteroclysis followed by exploration.
Assuntos
Adenocarcinoma/diagnóstico , Neoplasias do Jejuno/diagnóstico , Adenocarcinoma/fisiopatologia , Adenocarcinoma/cirurgia , Humanos , Neoplasias do Jejuno/fisiopatologia , Neoplasias do Jejuno/cirurgia , Laparotomia , Masculino , Pessoa de Meia-IdadeRESUMO
Rigid plate and screw fixation is the mainstay of treatment for complex fractures of the facial skeleton. Complications of plate and screw fixation include prominence, infection, exposure, and migration. Five hundred and seven patients undergoing plate and screw fixation for facial fractures (1112 fractures) from 1983 to 1988 were followed for complications. Sixty-one patients (12 percent) required hardware removal. The location on the facial skeleton influenced symptoms and the rate of hardware removal. Infection and exposure may be decreased with antiseptic irrigations, avoiding mucosal damage, attention to proper mucosal closure, and correct placement of plates. Prominence may be decreased by the use of microplates in the supraorbital, frontal, and naso-orbital-ethmoid locations.
Assuntos
Placas Ósseas , Parafusos Ósseos , Ossos Faciais/lesões , Fixação Interna de Fraturas/efeitos adversos , Fraturas Cranianas/cirurgia , Adolescente , Adulto , Idoso , Feminino , Migração de Corpo Estranho , Humanos , Infecções/etiologia , Masculino , Pessoa de Meia-Idade , Reoperação , Estudos RetrospectivosRESUMO
The effects of hyperbaric oxygen (HBO) during tissue preservation on flap survival have been investigated in free flaps in rats. Groin skin flaps were harvested, stored in either room air or HBO (100% oxygen at 2.9 atm absolute) at 23 degrees C for 18 hours, and transplanted to the contralateral groin. Free flaps exhibit a high incidence of complete necrosis in the room air control. The survival of free flaps stored under HBO increased from 10% to 60% (p less than 0.05) after 18 hours of preservation. Skin flaps exhibited an increase in tissue hypoxanthine by 3.6-fold normal after 18 hours of storage in room air. HBO preservation prevented the accumulation of hypoxanthine and inhibited xanthine oxidase. Inhibition of the xanthine oxidase system may be one of the mechanisms of improved success of skin flap transplantation.