Emil A. Naclerio

The “v sign” in the diagnosis of spontaneous rupture of the esophagus (an early roentgen clue)

Abstract 1. 1. X-ray films in two cases, both showing localized mediastinal emphysema in the lower mediastinum, are presented herein. This roentgen sign, together with the characteristic history, should be diagnostic. 2. 2. The cases clearly reveal the clinical picture which is so characteristic of spontaneous rupture of the esophagus and also bring to light problems which arise in its management.

Follow-up electrocardiographic changes in penetrating wounds of the heart treated surgically.

1 From the Department of Surgery, Harlem Hospital, New York, and the Department of Medicine, New York University Postgraduate Medical School, New York. The first reference in the English literature to an electrocardiographic study of a penetrating wound of the heart appeared in 1924 (1). Thereafter, only a few papers trickled in (2-12), and in most instances they discussed single cases or groups of three or four. The interval between the original electrocardiogram taken soon after injury and those observed during a follow-up study consisted of but a few weeks or at most 2 to 3 months. The earlier tracings showed only the conventional limb leads, but with the introduction of precordial leads to the

Indications for pulmonary resection

Abstract 1. 1. An outline of conditions which may require pulmonary resection is presented. 2. 2. Serious cardiac disease, borderline ventilatory function, advanced age or a combination of factors that combine to form the so-called “poor surgical risk” may preclude surgical intervention. 3. 3. Brief comments relative to the disease processes outlined are made.

Traumatic injury to lung

Abstract A brief consideration has been made of the pathology of the principal types of lung trauma with incident or closely allied trauma to chest wall and pleura. It has been emphasized that failure of respiratory function secondary to a number of mechanisms is the lethal factor in most of these injuries. Specific injuries are discussed and outlines of therapy given, based largely upon our experience in the management of cases at Harlem Hospital.

Indications for pulmonary resection: Special reference to extent of operation

Abstract 1. 1. The fundamental principles governing the removal of lung tissue are stated. 2. 2. The various conditions are discussed with respect to factors determining the extent of resection. 3. 3. An outline of indications for pulmonary resection is presented.

Portable unit for prone position surgery.

Abstract Advantages of the prone position for thoracic surgery are briefly discussed. A portable unit for this purpose is presented. Its chief advantages are that it can be easily transported and assembled and that it can be used with any standard operating table. The unit is described and its special features outlined. Up to the present time the unit has been used for fifty-five thoracic operations and has proven to be most satisfactory.

Operative positions and approaches in pulmonary surgery: Value of the suspended prone position

Abstract The author has attempted to evaluate the advantages and disadvantages of the suspended prone position as contrasted to the advantages and disadvantages of the lateral and supine positions. Data has been presented to show that normal pulmonary function is least disturbed by the suspended prone position. It has been shown further that during surgery, the dangers of contralateral spillage, hypoxia, carbon dioxide retention and respiratory fatigue are minimized by this position. In addition ideal conditions are obtained for optimum exposure. Since some surgeons still report complications resulting from the use of the prone position, the author has briefly described a specially designed apparatus which has proven thoroughly satisfactory in his experience.