Document 6R5eRO4R774rqYDXqDb6MoE39

ST ^UISWr/iliSITV MEDICAL SCHOOL LIBRARY 1947 'I, Vol. 236 No. 11 CASF. RF.CORDS OF T1IK MASSACIUSFTTS CK.VKRAI. IIOSPITAI. 407 ; tnizes l*erialvted as Sudded ; $e of v; fact scar Siito a | rands 3 the S3 3 s the gree- , : the iilure i astic . In $e of t tion, : hich l. the ", the iout "it of e of J be itics , :rial : sses are their , ex- . be i hey 3 ties : jse. ure :ast ityi in f a ure . of rind i;tn >ft us ds if ite :nc m, : td Adequate experimental trial should precede the clinical use of any untested plastic material in surgery. References 57. Simondt, H. R., and Ellis, C. Handbook oj Plastics. 1083 pp. New York: D. Van Nosirand Company, Incorporated, 1945- 58. Bailey, R. L. Polythene Used in Britain as /mutation in British Airtrap tp4t. it. 1. du Poni de Nemours and Company, Incorporaied. 59. Meyers. L. Intravenous cathcicrizaiion. Am. J. Hurting 45:9j0. 1945. 60. Poppc, J. R., and d Oliveira. H. R. Treatment of syphilitic aneu* ryams by cellophane wrapping. /. Thoracic Sure. IS: 186-195, 1946, 61. Ingraham, F, D., Alexander, K., Jr.t and Matson, D. D. Unpublished data. 62. Huelaebusch, J. B., Foter, M. J., and Gibby, I/W. Effect of rubber tubing upon stability of penicillin and streptomycin solutions. Science 104:479, 1946, 63. Wheeldon, T. Use of cellophane as permanent tendon sheath. J. Boat W Joint Surg. 21:393-396, 1939: 64. McKeever, D. C. Use of cellophane as interposition membrane in synovectomy. J. Bonr tif Joint Surg. 41:576-580, 1943. 65. Harley, G. H., and Breck, L. W. Cellophane in bone and joint sur gery.. Am. J. Surg. 68:229-231, 1945. 66. Donati, D. Ricerche iJlrimenuli sull'uso del cellophane in plastiche durali di varia nrandezza. Bull. d. sc. mtd., Bologna !G9:42S-432, 1937. 67* Christyakov, N. L. Use of cellophane in treatment of wounds. Am. Rtv. Soviet Mtd. 3:490-493, 1946. 68. Page, I. H. Method for producing persistent hypertension by cello phane. Science 89:273, 1939. 6*>. Itten. Producii'-n of per.i.tent .nerial hypertension by cellophane perinephritis, j .1. .W. A. 113:1046-2048. 1339. V 0 Ctracf. I . anj P.tyc. I H. Paihnlo.ica! anatomy of cellophane perlnephrim. Am. /. Path. 16:211-222. 1940. 71. Duuiliiic. f. W. I*.fleet n! cellophane perittephritii on granular cells of luataylmncrular apparatus. Arch. Polk. 33:211.216, 1914. 72. Pcarse, H. I*.. F.xperimcntal studies on gradual occlusion of large arteries. An., Surg. 112:923-937, 1940. 73. Idtm. F.xpcrimenial studies on gradual occlusion ol large arteriee. 7r. Am. S. A. 68:443-457. 1940. r4. Gross, R. I*.. Complete surgical division of patent ductus arteriosus: report of fourteen successful cases. Surg., Gynec fj Obit 78:36-43, -5. Harper, F. R., and Robinson, M. E. Occlusion of infected pacent ductus arteriosus ivith cellophane. Am. ]. Surg. 64:294-296, 1944. 76. Harrison, F. W.. and Cbandy, J. Subclavian aneurysm cured by cellophane fibrosis. Ann. Surg. 118:478-481. 1943. 77. Grant, F. C., and Norcross, N. C. Repair of cranial defects by cranio'. plasty. Ann. Surg. 110:488-512, 1939. 78. Ncv, K.3V. Repair of cranial defects with celluloid. Am. J. Surg. 44: 594-399, 1939. 79. Smith-Peiersen, M. N. Arthroplasty of hip: new method. /. Bonr iS Joint Surg. 21:269-288, 1939. 80. Bake:, D. R. New type ol plastic hip cup for arthroplasty or for ute as artificial femoral head. Culhrir Clin. Butt. 11:133, 1942. 81. BejUs^ J. E. Suture studies: new suture. Arch. Surg. 41:1414-1425, 82. Blaine. G. Experimental observations on use of absorbable and non-absorbable plastic# in bone surgery. Brit. J. Surg. 33:245-250, 1946. 83. Hueper, W. C Martin, G.J., and Thompson, M. R. .Methyl cellulose solution as plama substitute. Am. J. Surg. 56:629-635, 1942. CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL Weekly Clinicopathological Exercises FOUNDED BY RICHARD ,C. CABOT Tracy B. Mallory, M.D., Editor Benjamin Castleman, M.D., Associate Editor Edith E. Parris, Assistant Editor CASE 33111 Presentation of Case A thirty-seven-year-old Swedish asbestos worker entered the hospital because of cough and chest pain. Two and a half years before admission the patient had developed a cough, nasal, congestion, nasal dis charge, fever and shortness of breath that had per sisted one week and had been followed by a dull, aching pleuritic pain along the left costal margin. He was hospitalized for a'week and then rested at home for four months. In the hospital about 1000 cc. of fluid was removed from the left side of the chest. Subsequently, he returned to work and felt well except for a morning cough productive of small amounts of odorless white sputum. Occa sional chest pain and exertional dyspnea were also noted. A year and a half later there was an in sidious onset of weakness and fatigability and a gradual loss of 25 pounds in weight. Three months before entry the pleuritic-pains became persistent, and. the weakness and dyspnea severe, and the patient slept propped on two pillows. Repeated sputum smears were negative for tubercle bacilli. The patient's work consisted in cutting asbestos insulating board; lie denied exposure to undue amounts of dust. There was no history of exposure to tuberculosis. Physical examination revealed the patient to be orthopneic and breathing rapidly at a rate of 30 per minute, with a dry, hacking cough and clubbed ' fingers. There was a slight, shotty, generalized lymphadenopathy. Respiratory expansion on the left was diminished, as were tactile and vocal fremitus and breath sounds. On the right there were increased bronchovcsicular breath sounds and scattered dry rales. The heart and mediastinum were shifted to the right, and the apical beat was maximal in the right midclavicular line. There was a ticktack rhythm with a rate of 110, and a pulsus paradoxicus. The abdomen was normal. . The temperature was 100F. The blood pressure was 128 systolic, 70 diastolic. Examination of the blood disclosed a red-cell count of 4,900,000 and a white-cell count of 12,200, with 77 per cent neutrophils, 16 per cent lympho cytes and 7 per cent monocytes. The urine and stools were normal. X-ray examination showed numerous discrete areas of increased density scat tered over the right lung; pressing on the lower trachea and left main bronchus and deviating them to the right was a large mass measuring 11 cm. in diameter (Fig. 1). A small amount of aerated lung was seen at the periphery of the mass. There was either fluid or, more probably, dense pleural thick ening and collapsed lung between the mass and the lateral costal margin. The left lower-lung field was almost completely opaque. In the hospital the patient's condition became steadily worse. Further x-ray studies showed dis placement of the esophagus to the right (Fig. 2), extensive periosteal new bone formation of the left upper ribs, slight displacement of the stomach to SCF-FA-3200