Irving F. Enquist

Quantitation of local acidosis and hypoxia produced by infection

Increased strength of healing incisions infected with E coli was demonstrated in this experiment. Efforts to measure respiratory gas tensions and pH in these incisions were unsuccessful. Therefore, these moieties were measured in normal and infected wound fluid contained in implanted wire cylinders. The wound fluid from infected cylinders was consistently more acidotic and had a lower pO2 and a higher pCO2 than fluid from unifected wound cylinders.

Statistically controlled evaluation of three methods of management of upper gastrointestinal bleeding: a progress report.

It is difficult, if not impossible, to decide on the basis of data heretofore available which of the various methods of management of massive upper gastrointestinal hemorrhage is the most satisfactory. The magnitude of the problem has been particularly impressed upon us by the frequency with which it is faced in the 500 general medical and surgical beds of the University Divixad sion at the Kings County Hospital. Recourse to the literature has failed to provide a conclusive answer. Most of the reports give information concerning only the results of the emergency treatment by the methods under consideration, and very few deal at all with long-term follow-ups. Perhaps the most distressing factor in trying to resolve this problem from the literature is that there seems to be no agreement among authors as to the criteria for the definition of massive hemorrhage. Obviously, the mortality rates reported by authors who select only very severe bleeders for study will be higher than those reported by authors who report the results from treating all bleeders. Even though there were to be general adoption of a standard set of criteria for determining the severity of bleeding in these cases, other factors make comparison of data from multiple sources dangerous. This was shown clearly in the studies of Mayo and Owens! and of Bock et al.,2 in which they showed that the results they obtained in private hospitals were superior to the results they obtained in charity institutions. In addition, observations which are not simultaneous are suspect because of the consistent advances being made in the field of medicine, such as the coming of the antibiotics, organization of blood banks, better knowledge of surgical physiology, etc. Still another factor of importance is the makeup of the concerned personnel and also the enthusiasm and care which its members contribute to the problem. The aim of the present study is to evaluate three prominent methods of management of massive upper gastrointestinal hemorrhage, with avoidance of the pitfalls indicated above. The severity of hemorrhage has been determined

Validity of the bromsulphalein test in patients with acute severe upper gastrointestinal hemorrhage

Abstract The bromsulphalein retention test has been used as a screening test to detect unsuspected liver disease in 382 patients presenting with acute gastrointestinal bleeding. Sixty-six of these patients showed abnormal retention on the admission test. Later evaluation indicated that only twenty-five of these patients had true liver disease; thirty-five had normal livers and in six patients the liver status could not be determined. The possible factors responsible for abnormal bromsulphalein retention in patients with normal livers are discussed.

Ileostomy Protects Dogs from Meat Intoxication

HILE performing ileostomies in a number of dogs and portacaval shunts in other dogs, we noted that one animal, who had been subjected to both procedures, was exceptionally healthy eleven months later. This was particularly noteworthy because all of our animals with portacaval shunt alone do poorly and die in several weeks or months if not given special care. It is generally accepted that the colon is the primary site of ammonia production in animals and humans; therefore, in the dog with an ileostomy very little ammonia was formed and this might explain his unique course.