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Lymphocyte responses
362
Injury:
CHAMPION, H., LONG, W., SMITH, H., SACCO, W., NYIKOS,P., COWLEY,R. ADAMS,and GILL, W. (1974), ’ Indications for early haemodialysis in multiple trauma ‘, Lancer, 1, 1125. Hyperbaric Refusal
oxygen
of transfusion
in acute
blood
loss
in acute blood loss on religious
grounds presents a difficult problem, solved by some by Court Order; others would let the patient lapse into coma when relatives might give consent for transfusion; still others would give transfusion when the patient became unconscious and avoid telling the patient or relatives of this action. Following the experimental work of Boerema on pigs, Hart of the Naval Hospital, Long Beach, USA treated 3 patients who had refused transfusion for acute blood loss, by hyperbaric oxygen with notable success. Treatment in a single place chamber at 2 atmospheres absolute for 60-90 minutes, was repeated when the pulse rate rose above 120 beats per minute, the blood pressure dropped below 100 mm/Hg systolic and the patient became confused. There was a dramatic improvement in all three patients. HART, G. B. (1974), ‘ Exceptional blood loss anaemia. Treatment with hyperbaric oxygen ‘, J.A.M.A.,228, 1028. Searchforthecauseof draws a blank
pulmonary dysfunction
In an attempt to discover the aetiology of pulmonary dysfunction after injury the effect of transfusion after a period of shock of old stored blood containing microemboli was observed in experimental animals.
the British
Journal of Accident Surgery Vol. ~/NO. 4
Other possible causative factors such as anaesthesia, thoracotomy or artificial ventilation were excluded. Signs of pulmonary insufficiency did not develop. TOBY, R. E., KOPRIVA,C. J., HOMER,L. D., SOLIS, R. T., DICKSON, L. G. and HERMAN,C. M. (1974), ‘ Pulmonary gas exchange following haemorrhagic shock and massive blood transfusion in the baboon ‘, Ann, Surg., 179, 316. Prednisolone
and shock
In dogs, a substantial
dose of prednisolone was found to minimize some of the features of pulmonary insufficiency which would otherwise have occurred after a standardized technique of bleeding and reinfusion had produced shock. Neither atropine nor frusemide had any beneficial effect. KUSAJIMA,K., WAX, S. D. and WEBB,W. R. (1974), ‘ Effects of methyl prednisolone on pulmonary microcirculation ‘, Surgery Gynecol. Obstet., 139, 1. Lymphocyte
responses
Major surgical operations in man lead to a fall in the responsiveness of the peripheral blood lymphocytes to the specific tuberculin antigen and to non-specific plant mitogens. The fall in responsiveness appears to be a specific response to trauma rather than a result of general anaesthesia or a redistribution of lymphocite sub-populations. The possible roles of increased corticosteroid secretion or of an unidentified lymphocyte inhibitory factor in the response are discussed. BERENBAUM. M. C.. FLUCK. P. A. and HURST,N. P. (1973), ‘ Depkession ‘of lymphocyte responses after surgical trauma ‘, Br. J. Exp. Pathol., 54, 597.
Book Reviews undisputed. They also know how to write, to stress points without resorting to italics or heavy print and F.R.c.s.(England), F.R.A.c.s., F.A.c.s., F.R.C.S.(Canada), to slip in those characteristically arresting Australian Hon. D.sc.(Punjabi), Consulting Plastic Surgeon, phrases which linger long after one has read the text. Royal Melbourne Hospital, A. R. WAKEFIELD, Every single diagram, table and photograph carries M.s.(Melbourne), F.R.c.s.(England), F.R.A.c.s., fora message. It is a volume which must be read by all merly Plastic Surgeon, Royal Children’s Hospital, those concerned with the surgery of trauma, both Melbourne, and J. T. HUESTON, M.s.(Melbourne), those in training and those who consider themselves F.R.c.s.(England), F.R.A.c.s., Honorary Plastic Surtrained. It must also be given an assured place on the geon, Royal Melbourne Hospital. 10 x 8 in. Pp. 390 shelves in our medical libraries and only be withdrawn with 310 illustrations 1973. London: Churchill from circulation when the next edition appears. Livingstone. E4.00. MICHAELN. TEMPEST The appearance of yet another edition of this remarkable book is adequate testimony of its popularity and Burns and their treatment. Second edition. By proof of its surgical need. But it is far more than a J. F. K. MUIR, M.B.E., v.R.D., M.B., B.S., M.s., F.R.c.s., guide to action in hand surgery. It is a brilliant and T. L. BARCLAY,M.B., CH.M., F.R.C.S. (Ed.), 1974. exposition of the principles of the surgery of trauma London: Lloyd-Luke (Medical Books), E3.50. and the philosophy of reconstructive surgery. It is written by an Antipodean triumvirate of plastic Most modern textbooks of surgery either ignore surgeons whose personal surgical achievements are completely the topic of burns and scalds or grant it a not confined to the hand and whose authority is few miserable pages which are an insult to the most
Surgery of Repair as Applied to Hand Injuries. Fourth edition. By B. K. RANK, K.c.M.G., h%.s.(Melbourne),
Injury:
CHAMPION, H., LONG, W., SMITH, H., SACCO, W., NYIKOS,P., COWLEY,R. ADAMS,and GILL, W. (1974), ’ Indications for early haemodialysis in multiple trauma ‘, Lancer, 1, 1125. Hyperbaric Refusal
oxygen
of transfusion
in acute
blood
loss
in acute blood loss on religious
grounds presents a difficult problem, solved by some by Court Order; others would let the patient lapse into coma when relatives might give consent for transfusion; still others would give transfusion when the patient became unconscious and avoid telling the patient or relatives of this action. Following the experimental work of Boerema on pigs, Hart of the Naval Hospital, Long Beach, USA treated 3 patients who had refused transfusion for acute blood loss, by hyperbaric oxygen with notable success. Treatment in a single place chamber at 2 atmospheres absolute for 60-90 minutes, was repeated when the pulse rate rose above 120 beats per minute, the blood pressure dropped below 100 mm/Hg systolic and the patient became confused. There was a dramatic improvement in all three patients. HART, G. B. (1974), ‘ Exceptional blood loss anaemia. Treatment with hyperbaric oxygen ‘, J.A.M.A.,228, 1028. Searchforthecauseof draws a blank
pulmonary dysfunction
In an attempt to discover the aetiology of pulmonary dysfunction after injury the effect of transfusion after a period of shock of old stored blood containing microemboli was observed in experimental animals.
the British
Journal of Accident Surgery Vol. ~/NO. 4
Other possible causative factors such as anaesthesia, thoracotomy or artificial ventilation were excluded. Signs of pulmonary insufficiency did not develop. TOBY, R. E., KOPRIVA,C. J., HOMER,L. D., SOLIS, R. T., DICKSON, L. G. and HERMAN,C. M. (1974), ‘ Pulmonary gas exchange following haemorrhagic shock and massive blood transfusion in the baboon ‘, Ann, Surg., 179, 316. Prednisolone
and shock
In dogs, a substantial
dose of prednisolone was found to minimize some of the features of pulmonary insufficiency which would otherwise have occurred after a standardized technique of bleeding and reinfusion had produced shock. Neither atropine nor frusemide had any beneficial effect. KUSAJIMA,K., WAX, S. D. and WEBB,W. R. (1974), ‘ Effects of methyl prednisolone on pulmonary microcirculation ‘, Surgery Gynecol. Obstet., 139, 1. Lymphocyte
responses
Major surgical operations in man lead to a fall in the responsiveness of the peripheral blood lymphocytes to the specific tuberculin antigen and to non-specific plant mitogens. The fall in responsiveness appears to be a specific response to trauma rather than a result of general anaesthesia or a redistribution of lymphocite sub-populations. The possible roles of increased corticosteroid secretion or of an unidentified lymphocyte inhibitory factor in the response are discussed. BERENBAUM. M. C.. FLUCK. P. A. and HURST,N. P. (1973), ‘ Depkession ‘of lymphocyte responses after surgical trauma ‘, Br. J. Exp. Pathol., 54, 597.
Book Reviews undisputed. They also know how to write, to stress points without resorting to italics or heavy print and F.R.c.s.(England), F.R.A.c.s., F.A.c.s., F.R.C.S.(Canada), to slip in those characteristically arresting Australian Hon. D.sc.(Punjabi), Consulting Plastic Surgeon, phrases which linger long after one has read the text. Royal Melbourne Hospital, A. R. WAKEFIELD, Every single diagram, table and photograph carries M.s.(Melbourne), F.R.c.s.(England), F.R.A.c.s., fora message. It is a volume which must be read by all merly Plastic Surgeon, Royal Children’s Hospital, those concerned with the surgery of trauma, both Melbourne, and J. T. HUESTON, M.s.(Melbourne), those in training and those who consider themselves F.R.c.s.(England), F.R.A.c.s., Honorary Plastic Surtrained. It must also be given an assured place on the geon, Royal Melbourne Hospital. 10 x 8 in. Pp. 390 shelves in our medical libraries and only be withdrawn with 310 illustrations 1973. London: Churchill from circulation when the next edition appears. Livingstone. E4.00. MICHAELN. TEMPEST The appearance of yet another edition of this remarkable book is adequate testimony of its popularity and Burns and their treatment. Second edition. By proof of its surgical need. But it is far more than a J. F. K. MUIR, M.B.E., v.R.D., M.B., B.S., M.s., F.R.c.s., guide to action in hand surgery. It is a brilliant and T. L. BARCLAY,M.B., CH.M., F.R.C.S. (Ed.), 1974. exposition of the principles of the surgery of trauma London: Lloyd-Luke (Medical Books), E3.50. and the philosophy of reconstructive surgery. It is written by an Antipodean triumvirate of plastic Most modern textbooks of surgery either ignore surgeons whose personal surgical achievements are completely the topic of burns and scalds or grant it a not confined to the hand and whose authority is few miserable pages which are an insult to the most
Surgery of Repair as Applied to Hand Injuries. Fourth edition. By B. K. RANK, K.c.M.G., h%.s.(Melbourne),