Lawrence K. Pickett

Biliary obstruction secondary to hepatic vascular ligation in fetal sheep

Abstract It is possible to operate on fetal sheep from 100 to 110 days of gestation, and perhaps earlier, with survival. It is possible that biliary atresia may result from a vascular anomaly or catastrophe. Fetal operations on fourteen lambs were undertaken, including three sham procedures. Four animals expelled a macerated fetus. Five lambs were born jaundiced. Two lambs were born not jaundiced following vessel ligation. Two lambs who underwent sham operation and delivered at term were not jaundiced.

Steroids, Hypertension, and Fluid Retention in the Genesis of Postoperative Seizures With Inflammatory Bowel Disease in Childhood

Abstract Five of 21 children, with inflammatory bowel disease, including two with ulcerative colitis, and three with Crohns disease had multiple grand-mal seizures during the first 72 hr of the postoperative period. Seizures were controlled with either intravenous phenobarbital or Valium. Significant arterial hypertension reaching a peak of 170–180110–120 prior to the onset of seizures, positive cumulative fluid balance, ranging from 2 to 4 liters without peripheral edema, diminished urine output, and elevated urine specific gravity (1.030–1.050) were observed in the seizure group. The exaggerated ADH response accompanied by a hypertensive episode is conjectured to trigger convulsive activity in a patient having a lowered seizure threshhold from chronic steroid administration.

The Role of Surgery in Neonatal Respiratory Distress

Compression of the newborns lungs by one or another type of space-occupying lesion results in a crisis that can be dealt with only through immediate differential diagnosis followed by appropriate surgery. Most common among these space-occupying lesions are those caused by air trapped inside the pleural cavity or within the lung itself. Dr. Pickett outlines the steps in the essential differentiation and correction.