Showing papers by "Lincoln Hospital published in 1989"

Compartment syndrome in combined arterial and venous injuries of the lower extremity.

Abstract: In 9 of 45 patients treated for dual vascular injuries of the lower extremity, concomitant fasciotomies were performed at the time of initial surgery for associated soft tissue injury, fracture, or prolonged ischemia. Eight other patients developed compartment syndrome requiring delayed fasciotomy. In seven of them, vein was either ligated or the repaired vein became occluded. In the eighth patient, peripheral venous hypertension was caused by massive swelling of the thigh. In the laboratory, compartment pressure was monitored by wick catheter in 24 hind limbs of 12 dogs subjected to experimental conditions simulating vascular injuries and their management. There was a significant increase in compartment pressure in a group that simulated arterial and venous injuries managed by arterial repair and venous outflow obstruction. Based on our study, we suggest that obstruction to venous drainage and venous hypertension are major factors in the development of compartment syndrome in dual vascular injuries of the lower extremity.

Oropharyngeal angioedema associated with the use of angiotensin-converting enzyme inhibitors.

Abstract: Angioedema that occurs in the head and neck may be a serious and possibly life-threatening condition. We present two cases of oropharyngeal angioedema associated with the use of angiotensin-converting enzyme inhibitors in patients with no underlying renal failure. Angiotensin-converting enzyme-inhibiting agents are now commonly used to control hypertension. Treatment of acquired angioedema is directed first at protecting the airway by careful observation, intubation, or if necessary, tracheostomy. The causative agent is withdrawn, and the patient is treated with antihistamines and steroids until the acute episode resolves. Although not used in our patients, the treatment of angioedema with subcutaneous epinephrine has been described. As more patients are treated with angiotensin-converting enzyme inhibitors, it becomes essential for the otolaryngologist to become aware of this potentially life-threatening complication.

Hypoglycemic hemiplegia in an adolescent with insulin-dependent diabetes mellitus: A case report and a review of the literature

Abstract: A case of hypoglycemic hemiparesis in a fifteen-year-old girl with insulin dependent diabetes mellitus (IDDM) is described. The initial presentation included left facial paresis and muscular weakness of the left upper and lower extremities, associated with a blood glucose level of 31 mg/dL. The patient recovered completely after a glucose infusion. Her neurological examination became normal within 24 hours and remained so for a follow-up period of 6 months. Hypoglycemic hemiparesis is rarely described in children and adolescents.

Second or "Recurrent" Diaphragmatic Hernia Associated with Haemophilus influenzae Pneumonia and Sepsis

Abstract: The following report describes an infant with a second right sided diaphragmatic hernia associated with Haemophilus influenzae type b sepsis

Lyonisation of human aberrant, X-chromosome with deletion of short arm [del (X) (p11)]

Abstract: SummarySummaryA female with secondary amenorrhoea was found to have a complete deletion of the short arm of chromosome X (Xp-) with almost no features of Turner's syndrome. The replication profile on Xq was further evaluated and was found to be compatible with normal Xq using eight normal females as controls. Only G-negative bands were early replicating. The highest incidence of early replicating bands was noted for band q13. It is suggested that q13, q24 and q28 could be critical bands in sexual development, due to the presence of some similarity of replicating pattern.