Fredarick Gobel - Academia.edu (original) (raw)
Papers by Fredarick Gobel
Zeitschrift Fur Orthopadie Und Unfallchirurgie, 1999
Zeitschrift für Orthopädie und Unfallchirurgie
The present work aimed at evaluating the radiological mid-term results of femoral components of d... more The present work aimed at evaluating the radiological mid-term results of femoral components of different materials in an identically designed total knee system. 31 knees with zirconium femoral components and 32 standard femoral components were evaluated about 4 years following surgery using the Roentgenographic Evaluation and Scoring System of the Knee Society. In both groups, the implant position was correct. There was a statistically significant higher rate of radiolucent lines in zones 1 and 4 at the tibia site in the zirconium group. Our clinical results disagree with the results of biomechanical studies of the same type of prosthesis. However, there are some findings from animal studies showing that zirconium ions may inhibit the mineralisation of osteoid, which could be an explanation for the higher rate of radiolucent lines seen in the present study.
Human pathology, 1978
A 57 year old male first developed progressive neuropathy of the lower extremities and then simil... more A 57 year old male first developed progressive neuropathy of the lower extremities and then similar involvement in the upper extremities. Two years later he developed dyspnea and then complete atrioventricular block requiring the use of a permanent cardiac pacemaker. An older brother had an almost identical clinical course, including the installation of a permanent pacemaker. Both died of left ventricular failure. An endomyocardial biopsy revealed extensive amyloidosis and fibrosis of the myocardium. This is the first report of a myocardial biopsy showing amyloid on electron microscopy.
Catheterization and Cardiovascular Diagnosis, 1985
A deformable soft-tipped angiographic catheter has been designed and developed to reduce vascular... more A deformable soft-tipped angiographic catheter has been designed and developed to reduce vascular trauma during coronary arteriography. In order to test the ability of the catheter tip glide over vascular endothelium, the coefficient of resistance was tested using fresh human aortic tissue. The mean frictional coefficients of resistance (FRc) for the soft-tipped catheter, as compared with two commonly used catheters (N = 10/group), were .78 +/- .08 units for the soft-tipped catheter and 1.10 +/- .10 (p less than .006) and .98 +/- .10 (p less than .034) for the conventional catheters. This demonstrates a significant 23% reduction in FRc with the soft-tipped catheter. The ease of penetration into a wax media was also measured using the soft-tipped catheter and compared with the same two conventional catheters. The indentation depths for the soft-tipped catheter and the two other catheter groups (N = 7/group) were 140 +/- 18 micron, 246 +/- 15 micron and 318 +/- 20 micron, respectively. This represents a 56% decrease in indentation depth with the soft-tipped catheter. Histologic studies in canines have demonstrated considerably less endothelial damage and subsequent intimal proliferation in the aorta and coronary ostia with the soft-tipped catheters compared with control catheters. It is concluded that a soft-tipped angiographic catheter is less traumatic to vascular tissue and may offer a safer approach to intravascular studies.
Background—The Post Coronary Artery Bypass Graft Trial, designed to compare the effects of 2 lipi... more Background—The Post Coronary Artery Bypass Graft Trial, designed to compare the effects of 2 lipid-lowering regimens and low-dose anticoagulation versus placebo on progression of atherosclerosis in saphenous vein grafts of patients who had had CABG surgery, demonstrated that aggressive lowering of LDL cholesterol (LDL-C) levels to ,100 mg/dL compared with a moderate reduction to 132 to 136 mg/dL decreased the
Catheterization and Cardiovascular Diagnosis, 1998
The frequent use of diagnostic coronary arteriography and its importance in evaluating results of... more The frequent use of diagnostic coronary arteriography and its importance in evaluating results of intervention in clinical trials emphasize the necessity of continued assessment of procedural risk. Several studies have described such risks, but they have often included a diverse group of patients with varying levels of clinical stability. Furthermore, this risk has not been well established in a population of patients with saphenous vein bypass grafts. There is need to define the risk of coronary arteriography in a group of patients who are both clinically similar and stable, and to evaluate the influence of improved technology and increased operator experience on the risk of the procedure. The National Heart, Lung, and Blood Institute-funded Post Coronary Artery Bypass Graft Trial offered the opportunity to evaluate the risk of elective diagnostic coronary arteriography in clinically stable patients studied at two points in time: pre-enrollment and 4-5 years after study entry. In this group of 2,635 angiograms from clinically stable patients over 5 years there were no deaths and the risk of myocardial infarction was 0.08%, while 0.7% had clinically important complications. Non-elective, urgent studies (311 angiograms) on unstable patients were more likely to include angioplasty and were associated with a risk of death of 0.6% and myocardial infarction of 1.3%. Complications did not vary with age or gender. Vascular trauma was more likely to occur using the brachial than the femoral artery entry sites. These results indicate that elective angiography on stable patients can be accomplished with a very low risk of mortality (0% in this study) or serious cardiovascular complication. This supports the safety and usefulness of angiography for clinical intervention trials.
Journal of the American College of Cardiology, 2002
Smoking has bean demonstrated to increase rates of hospitalization due to heart failure (HF) in p... more Smoking has bean demonstrated to increase rates of hospitalization due to heart failure (HF) in patients (pts) with heart failure or left ventricular dysfunction (LVD). Whether smoking exerts this effect through ischemic events has not been well established.
The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 2002
We report on four patients with failed resections of the distal ulna causing instability and impi... more We report on four patients with failed resections of the distal ulna causing instability and impingement, who were treated with a tendon allograft to stabilize and buffer the ulnar stump. In three of the four patients the outcome was excellent. We believe that this new technique holds promise as an alternative salvage procedure for the failed Darrach resection.
International Journal of Cardiology, 1981
Striking T-wave inversions were observed in the postoperative electrocardiograms of a 64-year-old... more Striking T-wave inversions were observed in the postoperative electrocardiograms of a 64-year-old woman following an extensive cervical laminectomy. Except for the presence of a trace amount of CK-MB in a single serum specimen all her enzyme and isoenzyme studies were negative, and her clinical course was not suggestive of myocardial ischemia. Coronary angiography, including an ergonovine study, done 6 mth following the laminectomy were normal. Because of the nature of this patient's neurogenic origin of these T-wave changes is suspected.
Critical Care Medicine, 1988
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > April ...
Critical Care Medicine, 1990
Thermodilution cardiac output measurements obtained using a centrally placed introducer sheath we... more Thermodilution cardiac output measurements obtained using a centrally placed introducer sheath were compared with thermodilution cardiac outputs obtained using the right atrial port of a balloon-tip, flow-directed pulmonary artery catheter in 15 patients with cardiac failure. Cardiac output values were obtained by manually injecting 10 ml of iced, D5W alternately through the introducer sheath and the right atrial port of the flow-directed catheter. Thirty cardiac output readings were obtained in the 15 patients. Cardiac outputs obtained using the right atrial port (CORA) did not differ significantly from cardiac outputs obtained using the introducer sheath (COSP) (5.3 +/- 0.2 vs. 5.2 +/- 0.2 L/min). The correlation between CORA and COSP was significant (r = .94, p less than .0001) and could be described by the formula CORA = 0.33 + 0.96 COSP. We conclude that when the right atrial port of a flow-directed catheter is nonfunctional, a thermodilution cardiac output obtained using a centrally placed introducer sheath offers a reliable alternative.
Circulation, 1969
A new, sensitive, qualitative technic is described for detecting small left-to-right and right-to... more A new, sensitive, qualitative technic is described for detecting small left-to-right and right-to-left circulatory shunts. Advantages over other sensitive shunt detection devices are: (1) the use of a readily available, nonradioactive, nonexplosive, nontoxic gas, namely Freon 22; (2) the ability to sample through standard cardiac catheters as small as 5F; (3) an immediate answer due to recording of the gas concentration in blood; and (4) extremely high sensitivity allowing the detection of the smallest left-to-right and right-to-left shunts.
Circulation, 1969
Immediate hemodynamic improvement in patients with complete heart block occurs when the ventricul... more Immediate hemodynamic improvement in patients with complete heart block occurs when the ventricular rate is increased by electrical pacing. During pacing, there is reduction in the pulmonary artery wedge, right atrial, and left and right ventricular filling pressures. The mean rate of ejection, stroke volume, and stroke work decreased following pacing, whereas the ejection time per minute increased, and dye curves assumed a more normal configuration. Very little change was noted in the resting cardiac output.
CHEST Journal, 1975
Ten patients with chronic obstructive lung disease (COLD) (group 1) and five patients with combin... more Ten patients with chronic obstructive lung disease (COLD) (group 1) and five patients with combined COLD and cardiac disease (group 2) were studied at rest and during exercise after an intravenous (IV) slaine control followed by IV propranolol (0.2 mg/kg). During rest propranolol did not alter significantly measurements of lung volume in groups 1 or 2. Following propranolol the mean airway resistance (AR) in group 1 increased from 4.49 to 5.2 cm H2O/L/sec (P smaller than 0.02) and airway conductance (Gaw) decreased from 0.28 to 0.24 L/sec-1 cm. H2O1 (P smaller than 0.02). In group 2 following propranolol, the mean AR increased from 3.60 to 4.67 cm H2O1 (P smaller than 0.05), and Gaw decreased from 0.30 to 0.23 L/sec-1/cm H2O1 (P smaller than 0.05). During exercise, from control to propranolol, the heart rate (HR), blood pressure (BP), and heart rate blood pressure (HR x BP) decreased significantly for both groups 1 and 2 except for the systolic pressure in group 2. The duration of exercise and exercising PO2 were not significantly altered from control to propranolol in groups 1 and 2, indicating that the small but statistically significant changes in AR and Gaw did not interfere with symptom tolerated maximal exercise in these patients and were therefore not clinically important.
Archives of Internal Medicine, 1977
Multifocal atrial tachycardia (MAT) was observed in 41 patients, 35 of whom were in acute respira... more Multifocal atrial tachycardia (MAT) was observed in 41 patients, 35 of whom were in acute respiratory distress. A hospital mortality of 37% reflected the seriousness of their underlying conditions. In no patient was the arrhythmia the primary cause of death. The MAT preceded and/or followed atrial fibrillation (AF) or atrial flutter (Af) in 19 patients (46%). The MAT simulated AF in several cases in which P-waves were inconspicuous. Our cases suggest that MAT is not a manifestation of digitalis intoxication. Quinidine sulfate, procainamide hydrochloride, lidocaine, and phenytoin (diphenythydantoin) did not affect the rhythm. Digitalis was usually not effective in slowing the ventricular response in patients with MAT. Propranolol hydrochloride was given to seven patients and was effective in slowing the atrial rate in all cases. An attempt at electrocardioversion was unsuccessful in one patient.
The Annals of Thoracic Surgery, 1986
The effect of two different myocardial preservation techniques on perioperative myocardial necros... more The effect of two different myocardial preservation techniques on perioperative myocardial necrosis during coronary artery bypass surgery was assessed by serial myocardial creatine kinase determinations in 100 consecutive patients operated on by the same surgeon. Topical hypothermia with cold potassium cardioplegia was used randomly in 50 patients (group 11, and topical hypothermia with local interruption of the coronary circulation was used in the other 50 patients (group 2). Myocardial creatine kinase was measured by column chromatography every 6 hours for 36 hours after surgery. There was no significant difference between the two groups in terms of age, sex, functional class, extent of coronary artery disease, number of bypassed arteries, ejection fraction, or cardiopulmonary bypass time. Myocardial creatine kinase release (mean k standard error of the mean) was 193 2 33 IU/L x hours in group 1 patients operated on with cardioplegia and 210 k 31 IU/L x hours in group 2 patients operated on with top-
The Annals of Thoracic Surgery, 1981
Postoperative graft patency and thirteen perioperative variables were evaluated as potential risk... more Postoperative graft patency and thirteen perioperative variables were evaluated as potential risk factors for perioperative myocardial infarction (MI) in 102 consecutive patients undergoing coronary artery bypass grafting. Also, the incidence of perioperative MI and the amount of CK-MB released in the postoperative period were compared in three groups of patients selected according to the myocardial preservation technique employed: (1) topical hypothermia with and (2) without aortic cross-clamping and (3) cardioplegia. A perioperative MI as detected by electrocardiogram, enzymes, and myocardial scintigraphy with technetium 99 developed in 15 patients.
Annales de Chirurgie Plastique Esthétique, 2007
Chromic acid burns can lead to systemic toxicity by cutaneous absorption of the chrome seen surfa... more Chromic acid burns can lead to systemic toxicity by cutaneous absorption of the chrome seen surfaces more than 1% of the total body surface area. In order to illustrate the necessity of anticipate systematically this toxicity by a specific treatment, we describe the case of a patient with systemic toxicity in the least severe situation of chromic acid burn: the chromic acid was diluted to 0,02%, the burn was superficial second degree, both thermic and chemical, on the forearm, and extended only to 1% of the total body surface area. In spite of the specific treatment, our patient had a blood transfer of the chrome, however without any consequences on the renal and hepatic functions. He cicatrised in 2 weeks, and his blood and urinary chromium levels were normalised in 3 weeks. Without this specific early treatment, what would have been the consequences of a systemic toxicity even more important?
Zeitschrift Fur Orthopadie Und Unfallchirurgie, 1999
Zeitschrift für Orthopädie und Unfallchirurgie
The present work aimed at evaluating the radiological mid-term results of femoral components of d... more The present work aimed at evaluating the radiological mid-term results of femoral components of different materials in an identically designed total knee system. 31 knees with zirconium femoral components and 32 standard femoral components were evaluated about 4 years following surgery using the Roentgenographic Evaluation and Scoring System of the Knee Society. In both groups, the implant position was correct. There was a statistically significant higher rate of radiolucent lines in zones 1 and 4 at the tibia site in the zirconium group. Our clinical results disagree with the results of biomechanical studies of the same type of prosthesis. However, there are some findings from animal studies showing that zirconium ions may inhibit the mineralisation of osteoid, which could be an explanation for the higher rate of radiolucent lines seen in the present study.
Human pathology, 1978
A 57 year old male first developed progressive neuropathy of the lower extremities and then simil... more A 57 year old male first developed progressive neuropathy of the lower extremities and then similar involvement in the upper extremities. Two years later he developed dyspnea and then complete atrioventricular block requiring the use of a permanent cardiac pacemaker. An older brother had an almost identical clinical course, including the installation of a permanent pacemaker. Both died of left ventricular failure. An endomyocardial biopsy revealed extensive amyloidosis and fibrosis of the myocardium. This is the first report of a myocardial biopsy showing amyloid on electron microscopy.
Catheterization and Cardiovascular Diagnosis, 1985
A deformable soft-tipped angiographic catheter has been designed and developed to reduce vascular... more A deformable soft-tipped angiographic catheter has been designed and developed to reduce vascular trauma during coronary arteriography. In order to test the ability of the catheter tip glide over vascular endothelium, the coefficient of resistance was tested using fresh human aortic tissue. The mean frictional coefficients of resistance (FRc) for the soft-tipped catheter, as compared with two commonly used catheters (N = 10/group), were .78 +/- .08 units for the soft-tipped catheter and 1.10 +/- .10 (p less than .006) and .98 +/- .10 (p less than .034) for the conventional catheters. This demonstrates a significant 23% reduction in FRc with the soft-tipped catheter. The ease of penetration into a wax media was also measured using the soft-tipped catheter and compared with the same two conventional catheters. The indentation depths for the soft-tipped catheter and the two other catheter groups (N = 7/group) were 140 +/- 18 micron, 246 +/- 15 micron and 318 +/- 20 micron, respectively. This represents a 56% decrease in indentation depth with the soft-tipped catheter. Histologic studies in canines have demonstrated considerably less endothelial damage and subsequent intimal proliferation in the aorta and coronary ostia with the soft-tipped catheters compared with control catheters. It is concluded that a soft-tipped angiographic catheter is less traumatic to vascular tissue and may offer a safer approach to intravascular studies.
Background—The Post Coronary Artery Bypass Graft Trial, designed to compare the effects of 2 lipi... more Background—The Post Coronary Artery Bypass Graft Trial, designed to compare the effects of 2 lipid-lowering regimens and low-dose anticoagulation versus placebo on progression of atherosclerosis in saphenous vein grafts of patients who had had CABG surgery, demonstrated that aggressive lowering of LDL cholesterol (LDL-C) levels to ,100 mg/dL compared with a moderate reduction to 132 to 136 mg/dL decreased the
Catheterization and Cardiovascular Diagnosis, 1998
The frequent use of diagnostic coronary arteriography and its importance in evaluating results of... more The frequent use of diagnostic coronary arteriography and its importance in evaluating results of intervention in clinical trials emphasize the necessity of continued assessment of procedural risk. Several studies have described such risks, but they have often included a diverse group of patients with varying levels of clinical stability. Furthermore, this risk has not been well established in a population of patients with saphenous vein bypass grafts. There is need to define the risk of coronary arteriography in a group of patients who are both clinically similar and stable, and to evaluate the influence of improved technology and increased operator experience on the risk of the procedure. The National Heart, Lung, and Blood Institute-funded Post Coronary Artery Bypass Graft Trial offered the opportunity to evaluate the risk of elective diagnostic coronary arteriography in clinically stable patients studied at two points in time: pre-enrollment and 4-5 years after study entry. In this group of 2,635 angiograms from clinically stable patients over 5 years there were no deaths and the risk of myocardial infarction was 0.08%, while 0.7% had clinically important complications. Non-elective, urgent studies (311 angiograms) on unstable patients were more likely to include angioplasty and were associated with a risk of death of 0.6% and myocardial infarction of 1.3%. Complications did not vary with age or gender. Vascular trauma was more likely to occur using the brachial than the femoral artery entry sites. These results indicate that elective angiography on stable patients can be accomplished with a very low risk of mortality (0% in this study) or serious cardiovascular complication. This supports the safety and usefulness of angiography for clinical intervention trials.
Journal of the American College of Cardiology, 2002
Smoking has bean demonstrated to increase rates of hospitalization due to heart failure (HF) in p... more Smoking has bean demonstrated to increase rates of hospitalization due to heart failure (HF) in patients (pts) with heart failure or left ventricular dysfunction (LVD). Whether smoking exerts this effect through ischemic events has not been well established.
The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 2002
We report on four patients with failed resections of the distal ulna causing instability and impi... more We report on four patients with failed resections of the distal ulna causing instability and impingement, who were treated with a tendon allograft to stabilize and buffer the ulnar stump. In three of the four patients the outcome was excellent. We believe that this new technique holds promise as an alternative salvage procedure for the failed Darrach resection.
International Journal of Cardiology, 1981
Striking T-wave inversions were observed in the postoperative electrocardiograms of a 64-year-old... more Striking T-wave inversions were observed in the postoperative electrocardiograms of a 64-year-old woman following an extensive cervical laminectomy. Except for the presence of a trace amount of CK-MB in a single serum specimen all her enzyme and isoenzyme studies were negative, and her clinical course was not suggestive of myocardial ischemia. Coronary angiography, including an ergonovine study, done 6 mth following the laminectomy were normal. Because of the nature of this patient's neurogenic origin of these T-wave changes is suspected.
Critical Care Medicine, 1988
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > April ...
Critical Care Medicine, 1990
Thermodilution cardiac output measurements obtained using a centrally placed introducer sheath we... more Thermodilution cardiac output measurements obtained using a centrally placed introducer sheath were compared with thermodilution cardiac outputs obtained using the right atrial port of a balloon-tip, flow-directed pulmonary artery catheter in 15 patients with cardiac failure. Cardiac output values were obtained by manually injecting 10 ml of iced, D5W alternately through the introducer sheath and the right atrial port of the flow-directed catheter. Thirty cardiac output readings were obtained in the 15 patients. Cardiac outputs obtained using the right atrial port (CORA) did not differ significantly from cardiac outputs obtained using the introducer sheath (COSP) (5.3 +/- 0.2 vs. 5.2 +/- 0.2 L/min). The correlation between CORA and COSP was significant (r = .94, p less than .0001) and could be described by the formula CORA = 0.33 + 0.96 COSP. We conclude that when the right atrial port of a flow-directed catheter is nonfunctional, a thermodilution cardiac output obtained using a centrally placed introducer sheath offers a reliable alternative.
Circulation, 1969
A new, sensitive, qualitative technic is described for detecting small left-to-right and right-to... more A new, sensitive, qualitative technic is described for detecting small left-to-right and right-to-left circulatory shunts. Advantages over other sensitive shunt detection devices are: (1) the use of a readily available, nonradioactive, nonexplosive, nontoxic gas, namely Freon 22; (2) the ability to sample through standard cardiac catheters as small as 5F; (3) an immediate answer due to recording of the gas concentration in blood; and (4) extremely high sensitivity allowing the detection of the smallest left-to-right and right-to-left shunts.
Circulation, 1969
Immediate hemodynamic improvement in patients with complete heart block occurs when the ventricul... more Immediate hemodynamic improvement in patients with complete heart block occurs when the ventricular rate is increased by electrical pacing. During pacing, there is reduction in the pulmonary artery wedge, right atrial, and left and right ventricular filling pressures. The mean rate of ejection, stroke volume, and stroke work decreased following pacing, whereas the ejection time per minute increased, and dye curves assumed a more normal configuration. Very little change was noted in the resting cardiac output.
CHEST Journal, 1975
Ten patients with chronic obstructive lung disease (COLD) (group 1) and five patients with combin... more Ten patients with chronic obstructive lung disease (COLD) (group 1) and five patients with combined COLD and cardiac disease (group 2) were studied at rest and during exercise after an intravenous (IV) slaine control followed by IV propranolol (0.2 mg/kg). During rest propranolol did not alter significantly measurements of lung volume in groups 1 or 2. Following propranolol the mean airway resistance (AR) in group 1 increased from 4.49 to 5.2 cm H2O/L/sec (P smaller than 0.02) and airway conductance (Gaw) decreased from 0.28 to 0.24 L/sec-1 cm. H2O1 (P smaller than 0.02). In group 2 following propranolol, the mean AR increased from 3.60 to 4.67 cm H2O1 (P smaller than 0.05), and Gaw decreased from 0.30 to 0.23 L/sec-1/cm H2O1 (P smaller than 0.05). During exercise, from control to propranolol, the heart rate (HR), blood pressure (BP), and heart rate blood pressure (HR x BP) decreased significantly for both groups 1 and 2 except for the systolic pressure in group 2. The duration of exercise and exercising PO2 were not significantly altered from control to propranolol in groups 1 and 2, indicating that the small but statistically significant changes in AR and Gaw did not interfere with symptom tolerated maximal exercise in these patients and were therefore not clinically important.
Archives of Internal Medicine, 1977
Multifocal atrial tachycardia (MAT) was observed in 41 patients, 35 of whom were in acute respira... more Multifocal atrial tachycardia (MAT) was observed in 41 patients, 35 of whom were in acute respiratory distress. A hospital mortality of 37% reflected the seriousness of their underlying conditions. In no patient was the arrhythmia the primary cause of death. The MAT preceded and/or followed atrial fibrillation (AF) or atrial flutter (Af) in 19 patients (46%). The MAT simulated AF in several cases in which P-waves were inconspicuous. Our cases suggest that MAT is not a manifestation of digitalis intoxication. Quinidine sulfate, procainamide hydrochloride, lidocaine, and phenytoin (diphenythydantoin) did not affect the rhythm. Digitalis was usually not effective in slowing the ventricular response in patients with MAT. Propranolol hydrochloride was given to seven patients and was effective in slowing the atrial rate in all cases. An attempt at electrocardioversion was unsuccessful in one patient.
The Annals of Thoracic Surgery, 1986
The effect of two different myocardial preservation techniques on perioperative myocardial necros... more The effect of two different myocardial preservation techniques on perioperative myocardial necrosis during coronary artery bypass surgery was assessed by serial myocardial creatine kinase determinations in 100 consecutive patients operated on by the same surgeon. Topical hypothermia with cold potassium cardioplegia was used randomly in 50 patients (group 11, and topical hypothermia with local interruption of the coronary circulation was used in the other 50 patients (group 2). Myocardial creatine kinase was measured by column chromatography every 6 hours for 36 hours after surgery. There was no significant difference between the two groups in terms of age, sex, functional class, extent of coronary artery disease, number of bypassed arteries, ejection fraction, or cardiopulmonary bypass time. Myocardial creatine kinase release (mean k standard error of the mean) was 193 2 33 IU/L x hours in group 1 patients operated on with cardioplegia and 210 k 31 IU/L x hours in group 2 patients operated on with top-
The Annals of Thoracic Surgery, 1981
Postoperative graft patency and thirteen perioperative variables were evaluated as potential risk... more Postoperative graft patency and thirteen perioperative variables were evaluated as potential risk factors for perioperative myocardial infarction (MI) in 102 consecutive patients undergoing coronary artery bypass grafting. Also, the incidence of perioperative MI and the amount of CK-MB released in the postoperative period were compared in three groups of patients selected according to the myocardial preservation technique employed: (1) topical hypothermia with and (2) without aortic cross-clamping and (3) cardioplegia. A perioperative MI as detected by electrocardiogram, enzymes, and myocardial scintigraphy with technetium 99 developed in 15 patients.
Annales de Chirurgie Plastique Esthétique, 2007
Chromic acid burns can lead to systemic toxicity by cutaneous absorption of the chrome seen surfa... more Chromic acid burns can lead to systemic toxicity by cutaneous absorption of the chrome seen surfaces more than 1% of the total body surface area. In order to illustrate the necessity of anticipate systematically this toxicity by a specific treatment, we describe the case of a patient with systemic toxicity in the least severe situation of chromic acid burn: the chromic acid was diluted to 0,02%, the burn was superficial second degree, both thermic and chemical, on the forearm, and extended only to 1% of the total body surface area. In spite of the specific treatment, our patient had a blood transfer of the chrome, however without any consequences on the renal and hepatic functions. He cicatrised in 2 weeks, and his blood and urinary chromium levels were normalised in 3 weeks. Without this specific early treatment, what would have been the consequences of a systemic toxicity even more important?