R G Karanfilian

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Aggressive revascularization of the ischemic lower extremity in atherosclerotic occlusive disease by femoropopliteal (FP) and femorotibial (FT) bypass or profundaplasty (P), as indicated, has been advocated by some authors for all patients. Others have recommended primary amputation, particularly for tibial occlusive disease. To clarify this clinical(More)
The ability to predict successful healing of ulcerations and amputations of the ischemic forefoot continues to be a major clinical challenge, particularly in diabetic patients whose systolic Doppler ankle pressures are often artifactually elevated. We have used the techniques of laser Doppler velocimetry (LD) and transcutaneous oxygen tension monitoring(More)
In planning the management of a colonic injury, several factors must be taken into account, including the age of the patient, the cause of the wound, the time lapse from injury to operation, area and the type of wound, the amount of fecal soilage, and the number and extent of associated injuries. For extensive wounds with associated injuries, fecal(More)
This is the first report, to our knowledge, of a case of massive subcutaneous emphysema during totally preperitoneal laparoscopic hernia repair causing a "respiratory acidosis" with a systemic pH 7.20 and a pCO2 of 64 and PO2 of 84. The acidosis was corrected by increased mechanical ventilation. It appears that because of its lack of defined borders, the(More)
Dieulafoy's lesion is a vascular malformation, usually of the stomach but occasionally of the small or large bowel. It is an uncommon but clinically significant source of massive upper gastrointestinal (GI) hemorrhage. The lesion is generally located high on the lesser curvature in the proximal stomach. Although most bleeding can be controlled(More)
The advent of noninvasive screening tests has allowed the identification of an increasing number of patients with asymptomatic carotid stenoses. The management of these patients must be individualized, as the preferred method of therapy has not been established. Such a solution ultimately requires a prospective randomized trial to define the natural history(More)
Records of 102 patients with gunshot and stab wounds to the chest but with normal roentgenogram of the chest upon admission were reviewed. There were no delayed hemothoraces or pneumothoraces. The three complications probably resulted from admission to the hospital and would not have occurred if the patients had maintained their normal daily activities. The(More)
Utilizing a model that compares the effects of chemotherapeutic agents given regionally vs systemically in the same animal, the effects of cis-dichlorodiammine platinum (II) (cis-platinum) were evaluated. Squamous cell carcinoma was implanted at the bases of both ears of Fisher-344 rats. By retrograde cannulation of a branch of the external carotid artery,(More)