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Between 1953 and 1962, 21 patients presented with bronchial strictures. Bronchial reconstruction was carried out on 15 of these while a dermal graft was employed in another six patients. The follow-up period, therefore, is between 10 and 20 years. Bronchial structures lend themselves to satisfactory reconstruction. This review, however, showed that late contraction of a dermal graft may occur even two years after operation. [ABSTRACT FROM PUBLISHER]

The changes in pulmonary compliance have been studied under conditions of total body hypothermia. Five groups of sheep were used; two groups were controls—one for the effects of anaesthesia and the other for normothermic biventricular bypass. The third group was cooled using a femoro-femoral arterio-venous shunt to 20°-23° C. The fourth group was cooled to 15° C. and rewarmed using the Drew technique. The excised lungs of the remaining sheep were studied at 37° and 15° C. (fifth group). The controls showed little change in compliance. The cooled animals showed a decrease in compliance. In the group subjected to hypothermia by the Drew technique, the rewarming phase initially brought a return towards normal compliance. As the temperature rose to 24°-30° C. the improvement in compliance ceased and thereafter compliance decreased for two hours after rewarming. Histologically the lungs were normal. There was no compliance change caused by cooling the excised lungs. [ABSTRACT FROM PUBLISHER]

Unilateral pulmonary oedema is a rare complication in the routine management of spontaneous pneumothorax. Previous reports have emphasized excessive negative intrapleural pressure, rapid re-expansion of the lungs and bronchial obstruction as major factors in the pathogenesis. We have encountered four cases, and at least one of these factors have been absent in each case. Review of the literature, and our own experience suggests that the major factor is chronic and total lung collapse resulting in hypoxia and increased alveolar-capillary membrane permeability. Other factors which may be contributory are discussed.

This paper reports a series of 43 patients with lung cancer treated by means of planned preoperative radiotherapy between 1961 and 1966. A five-year survival figure of 23% is reported for the series. The rationale of the treatment is discussed, together with some clinical situations in which it was felt that this regime had a definite advantage over other methods.

An investigation has been carried out into the cause of accidents involving patient interfaced medical equipment, in a large region over a period of 3 years. In a high proportion of accidents the cause is faulty design, or poor construction of equipment. However, a considerable number can also be attributed to lack of user appreciation of the hazards involved. A few accidents have been caused by inexperienced personnel attempting to service equipment about which they have little knowledge.

This report is of a man who suffered from chronic melioidosis contracted in Malaysia. In the course of the disease he had a lobe of a lung resected, developed empyema and, while this was still draining, developed infection in an ankle. Both the empyema thoracis and the ankle infection were due to Pseudomonas pseudomallel. He now appears to be cured, probably by massive doses of tetracycline.

An expired gas collection and disposal system based on an independent suction pump is described. The halothane concentration in the atmosphere was measured, with and without the system. The increase of halothane concentration was limited to 1 p.p.m. above the theatre basal value with the system in use, and 5 p.p.m. when no venting was used.

Mediastinoscopy was performed on 280 patients. The technique is described. A tissue diagnosis was made at mediastinoscopy in 82 cases (29·2%) and, of these, 34 were primary lung carcinomas, one was a secondary deposit from a Grawiiz tumour, 44 were sarcoid tumours and three lymphomas. Of 112 patients with carcinoma for whom the diagnosis was proved at mediastinoscopy, or for whom a negative mediastinoscopy result could be verified at thoracotomy, mediastinoscopy proved to be useful for 94 (83·9%). Of 48 patients with suspected sarcoid, mediastinoscopy gave a positive result for 44 (91·6%). There were only two complications in this series.

The use of a vaginal speculum to gain access to the mediastinum through the neck is described. This enables manipulative procedures to be carried out which include biopsy and also the placement of an electrode in the region of the sino-atrial node where a cardiac pacemaker is being used.