Acute traumatic rupture of the aorta. A re-emphasis of repair without a vascular prosthesis

The incidence of acute aortic rupture has paralleled the increasing number of high-speed vehicles on our highways. Repair of acute aortic rupture without a vascular prosthesis has been mentioned frequently but seldom applied. Three consecutive patients with acute rupture repaired without a vascular prosthesis are discussed. The advantages of this technique are reviewed, and technical factors of the operation are described.     

Efficacy of cervical cytologic screening in the control of cervical cancer

Cervical cancer mortality in the U.S. has been declining, and this has been attributed to cervical cytologic screening. This report reviews data on the incidence and mortality of cervical cancer in order to evaluate the effect of cytologic screening. U.S. cervical cancer mortality has been declining consistently since 1946, with little change in the mortality trend after widespread cytologic screening. Incidence of invasive cervical cancer in specific geographic areas has also declined. However, the rate of diagnosis of carcinoma in situ has increased sharply and parallels increasing cytologic screening rates. A causal association of cytologic screening with the decreasing mortality and incidence of invasive cervical cancer cannot be established using current data, especially considering declining mortality prior to widespread screening and increasing removal of women from the population at risk by hysterectomy.     

The depression of T lymphocytes after trauma.

The T lymphocyte count is usually depressed during the first 24 to 48 hours after trauma or operation. It usually starts to return to normal levels by the fifth day after injury. The degree of depression is related to the severity of the injury. Acute infection appears to trigger this depression prior to operative treatment. This transient depression may be a normal physiologic event associated with the stress of trauma or infection.     

Quantitative effects of nasal surgery on olfaction

A prospective study of 100 patients undergoing nasal surgery was done to quantitate the effects of nasal surgery on olfaction. Patients were evaluated pre- and postoperatively with regard to their subjective olfaction, and pre- and postoperative olfactograms were obtained using a simple office olfactometer. Thirty-two patients had normal olfaction during the course of study. Forty-nine improved following surgery. Eight patients had a decrease in olfaction after surgery. Two of these were related to allergic rhinitis. One patient had a total loss of olfaction following a septorhinoplasty. The authors conclude that most patients undergoing nasal surgery will have either an improvement or no change in olfaction after surgery.     

Management of acquired tracheal obstructions in infancy.

Endoscopic resection of tracheal subglottic stenosis can be performed safely and effectively. With careful selection, some stenotic rings can be excised without the requirement for prior tracheostomy. Endoscopic resection does not supplant other methods of dilatation, injection, or stenting of subglottic scars, but early resection in appropriate cases may reduce the number of dilatations and obviate the need for a stent and systemic steroids.