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Three children with surgically corrected extrahepatic biliary atresia developed recurrent cholangitis associated with bile lakes that failed to drain via the hepatoportoenterostomy. Surgical or percutaneous drainage of these cysts was followed by both resolution of the infection and spontaneous internal drainage. We postulate that the ongoing inflammatory(More)
A multicomponent noninvasive monitoring system for high-risk critically ill patients was developed and tested in a series of 58 high-risk surgical patients. The system was comprised of a thoracic electric bioimpedance (TEB) method for cardiac output estimation, laser-Doppler velocimeter for small vessel flow, transcutaneous oxygen (PtcO2) sensor for tissue(More)
Fibrin glue (FG), made with highly concentrated human fibrinogen and clotting factors, was used to achieve parenchymal organ hemostasis in patients with disordered coagulation secondary to massive transfusion, chronic disease, and disseminated intravascular coagulation; it was effective in controlling liver hemorrhage in seven patients and in the(More)
Fibrin glue (FG) made with highly concentrated human fibrinogen and clotting factors was used to achieve hemostasis of fourteen renal injuries and to seal three ureteral anastomoses in 15 patients. The cause of injury included twelve gunshot wounds, four stab wounds, and one iatrogenic ureteral injury. The mean intraoperative blood loss was 1.6 +/- 1.1 L(More)
Nonautologous, highly concentrated human fibrinogen and clotting factors were used in the form of fibrin glue to treat three patients with varied surgical problems that were resistant to conventional treatment. Fibrin glue was used to occlude longstanding enterocutaneous fistulae, control liver hemorrhage in an alcoholic patient with coagulopathy, and(More)
The surgical pathology in 42 cases of traumatic triangular fibrocartilage complex (TFCC) disruption comprised a spectrum of injury resulting in five basic stages of increasingly severe ulnar wrist instability. In all cases, detachment of the articular disk from its ulnar insertion was the principal cause of distal radioulnar joint instability; in 28 (67%),(More)
The effect of glucose on intestinal absorption of calcium was studied in the jejunum and ileum of control, diabetic (streptozotocin-induced), and insulin-treated diabetic rats. Intestinal absorption was determined in vivo using an in situ one-pass perfusion technique. In the jejunum of control and diabetic rats, net absorption and unidirectional lumen to(More)
Rational guidelines are provided for the early operative treatment of the severely injured wrist. The prominent anatomic features of the wrist as well as clinically relevant kinematics and pathomechanics are reviewed. Diagnostic and operative techniques applicable to acute injury are described. The authors point out that while the concept of prompt(More)
Intestinal permeability to Ca is greater in infant than in older rats, predisposing the infant rat to hypocalcemia. The present studies compared in suckling and adult rats the amount of Ca lost into the intestinal lumen in relation to plasma Ca during an acute 2-h in vivo recirculation perfusion of the jejunum and ileum with an isotonic NaCl solution either(More)