Pancreatic injury.

During the ten-year period from 1967 to 1977, 50 cases of pancreatic trauma were reviewed. There were 40 gunshot wounds, six stab wounds, and four cases of blunt abdominal trauma. Ten of the patients died, a mortality of 20%.

The predisposition to infection following hemorrhagic shock.

Subsequent life threatening gram-negative infection in patients successfully resuscitated from hemorrhagic shock is becoming increasingly common. Following hemorrhagic shock and resuscitation, Sprague-Dawley rats were given Escherichia coli intraperitoneally to simulate the clinical setting in which peritoneal contamination and hypovolemic shock occur concurrently. A sublethal dosage of bacteria resulted in a 100 per cent mortality.

Evaluation of burn care in florida.

To determine if additional burn-care facilities or educational programs for burn care were needed within Florida, 73 of the state's 220 hospitals were studied. Data were collected on hospital statistics for a one-year period, as well as on 1656 patients admitted for burns to these hospitals during that year. When results were adjusted for severity of the injury, there was no evidence that outcomes of patients were better in any one or group of the State's eight regions, or in hospitals that had special burn units.

Use of duodenal drainage in the diagnosis of acalculous gallbladder disease.

Because of overreliance on oral cholecystograms, we have re-evaluated a little used laboratory test, duodenal drainage. In a series of 56 patients with normal oral cholecystograms and upper GI series who underwent duodenal drainage and cholecystectomy, 53 (95%) were found to have positive microscopic examinations. We think duodenal drainage is a safe, simple test which should be used as an adjunct to history and physical examination and oral cholecystography.

Spontaneous pneumopericardium.

Spontaneous pneumopericardium is a relatively rare event, although cases have been recorded over the past 130 years. Many were associated with malignancy, trauma, infection or as a complication of recent surgery. Attempts at surgical resolution have been infrequent and survival extremely rare.

Spontaneous pneumothorax: the sharp rib syndrome.

Of 49 patients undergoing operation for benign spontaneous pneumothorax, 28 (57%) were found to have a sharp first or second rib. In a series of 100 patients undergoing thoracotomy for other conditions, only eight (8%) were found to have a sharp rib. The association between sharp ribs, apical scars and bullae, and spontaneous pneumothorax is discussed.

Carbohydrate metabolism and capillary basement-membrane thickness in children. I. cross-sectional studies.

Thirty-nine children from three to 16 years of age were included in this study. Nineteen were diabetics, seven were "suspected" diabetics (with evidence of glucose intolerance but without repeated fasting hyperglycemia), and 13 were controls. Mean glucose disappearance rates (K) during intravenous glucose tolerance tests (IVGTTs) were 2.

The pathophysiology of smoke inhalation injury.

The consequences of near-lethal smoke inhalation in dogs were studied for a 72-hour period following injury. Progressive hypoxemia and decrease in compliance developed. Severe respiratory distress and frank pulmonary edema were not encountered.

Intramural diverticulosis of the oesophagus.

Four cases of intramural diverticulosis of the oesophagus are described, and the findings are reviewed in 12 previously reported cases. Evidence is presented that this condition is a true pulsion diverticulosis due to deranged motor activity and raised intraluminal pressure. It may occur in cases of diffuse oesophageal spasm, or it may follow inflammation, stricture or surgery.

Arm ischemia due to fibromuscular hyperplasia of the axillary artery.

A case of fibromuscular hyperplasia of the left axillary artery is reported. The lesion was bypassed using autogenous saphenous vein. At present writing, nine months after grafting, excellent pulses are present in the arm and the patient has been completely relieved of the ischemic symptoms.