The main prerequisites of any surgical procedure are achievement of good visibility and access to the site with minimal bleeding and rapid and painless healing. With the advancement of technology the armamentarium for oral surgical procedures has also widened. The use of alternate methods to the traditional scalpel such as electrosurgery, laser, and chemicals has been widely experimented with. This article aims to report the gingival perfusion pre-operatively and post-operatively, comparing the use of scalpel and electrosurgery in different anatomic sites in patient. Since wound healing is influenced by its revascularization rate, which follows the pattern of new connective tissue formation, the perfusion status of the gingiva has been studied using ultrasound spectral Doppler. The results of our study show that there was 30% more blood flow by 7th day, 19% more blood flow by 15th day and 11% more blood flow by 30th day in sites where the scalpel was used compared with sites where electrosurgery technique was used.
Type D double aortic arch in a five year old boy (with interruption of left arch proximal to left common carotid artery)--with persistent ductus arteriosus and stenosis of right and left pulmonary arteries diagnosed during life is reported. At surgery for P.D.A., the anatomy was confirmed. There was no vascular ring. Types A, B and C double aortic arches with interruption of left arch respectively distal to P.D.A., proximal to P.D.A. and proximal to left subclavian artery have already been reported. Ours happens to be the first case of type D double aortic arch diagnosed ante-mortem and confirmed at surgery.
Chest roentgenograms of 125 patients (115 with pure or predominant mitral stenosis) were studied by the pulmonary arterial angle method to estimate systolic pulmonary artery pressure without prior knowledge of catheterization data. First the angle between the line drawn along the right upper lobe artery and the tangent drawn along the point of junction of superior and lateral borders of the right pulmonary artery was determined. Next the angle between the right middle lobe artery and the descending pulmonary artery is determined. The difference between these angles equals systolic pulmonary artery pressure. Catheter and angle values were identical in 26 patients. There was a 1- to 5-mm difference in 70, a 6- to 10-mm difference in 18, an 11- to 15-mm difference in 8, and a difference greater than 15 mm in 3.
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