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From its initial discovery in the Gulf of Mexico in the late 1940s until 1990, Perkinsus marinus, the parasite responsible for Dermo disease in the eastern oyster, Crassostrea virginica, was rarely found north of Chesapeake Bay. In 1990–92, an apparent range extension of the parasite led to epizootic outbreaks of the disease over a 500 km range north of(More)
BACKGROUND Patients with end-stage liver disease frequently incur large-volume blood loss during liver transplantation associated with mechanical factors, preexisting coagulopathy, and intraoperative fibrinolysis. METHODS Between April 1992 and May 1994, the authors of this double-blind, randomized, placebo-controlled study examined the effect of(More)
The postoperative course of 335 adult patients who underwent orthotopic liver transplantation from 1968-1987 was reviewed retrospectively to identify patients who died in the intensive care unit and the causes of death. Forty-four percent of all deaths occurred in the intensive care unit. The mortality rate in the intensive care unit peaked in 1984 (48%),(More)
We have used a remifentanil-based anaesthetic for patients undergoing major abdominal surgery who would normally have gone to the intensive care unit in this hospital. Avoiding intensive care unit admission was considered an advantage as a shortage of intensive care unit beds was leading to the cancellation of operations. We first used remifentanil as part(More)
BACKGROUND Virus inactivation of pooled fresh-frozen plasma (FFP) by the solvent/detergent (SD) method results in a loss of approximately 20 percent of factor VIII. This study aimed to assess the efficacy of SD-treated plasma in correcting the coagulopathy associated with liver disease and liver transplantation. STUDY DESIGN AND METHODS Forty-nine(More)
BACKGROUND The efficacy and effects of epidural analgesia compared with patient-controlled analgesia (PCA) have not been reported in patients undergoing major vascular surgery. We compared the effects of epidural bupivacaine-morphine with those of intravenous PCA morphine after elective infrarenal aortic surgery. METHODS Forty patients classified as(More)
The preferences of 118 elderly patients, aged from 70 to 97 years, concerning the institution of artificial ventilation in the event of an overwhelming illness, were investigated using a questionnaire. Most patients wanted treatment if the outcome was likely to be good, but in approximately half, the desire for treatment declined as anticipated quality of(More)
The effectiveness of epidurally administered morphine in the relief of pain after upper abdominal surgery was assessed in a controlled study involving 20 patients aged 61 to 78 years. Analgesia provided by epidural morphine was comparable to that obtained in matched patients given an intramuscular regime. The total dose required by the epidural route was(More)
The currently used methods of monitoring liver perfusion and oxygenation after liver transplantation have major limitations in clinical use. We describe the use of a multiparameter sensor to enable continuous monitoring of liver tissue oxygen tension, carbon dioxide tension and hydrogen ion concentration in the early postoperative period in 12 patients(More)