Archives of Surgery

TALBOTT, JOHN H.

doi: 10.1001/archsurg.1970.01340190003001pmid: N/A

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract One of my concluding assignments as Director of the Division of Scientific Publications of the American Medical Association was the transmission to the Board of Trustees the recommendation of the Editorial Board of the Archives of Richard Warren, MD, as successor to J. Garrott Allen, MD, Chief Editor. Dr. Allen was appointed to the Editorial Board in 1959. He served as chief editor pro tempore when Waltman Walters, MD, was on a trip around the world and since 1962 has served as chief editor. Throughout this latter period "Rich" has been a member of the Board and is thoroughly experienced in editorial matters. It was my pleasure to have known "Rich" during his medical training at the Harvard Medical School and his internship at the Massachusetts General Hospital. This was followed by residency training at the Peter Bent Brigham Hospital and service during World War II with the 5th and

Allen, J. Garrott

doi: 10.1001/archsurg.1970.01340190004002pmid: 5409673

Abstract The duration of incubation for icteric viral hepatitis appears to be shorter for fresh blood, serum, and plasma than for stored serum or plasma, pooled or unpooled. More than half of the cases of serum hepatitis from blood occur prior to the 60th day and three fourths before the 90th day. It has become evident also that one may extend the incubation period for infectious serum and plasma almost at will, especially by the use of ultraviolet light or by storage of liquid plasma or serum at temperatures between 20 and 35 C for three months or longer. Eventually, these extensions of icteric serum hepatitis reach "infinity," in that no cases of serum hepatitis are observed. It is the purpose of this paper to present data from several sources in support of these statements and to discuss their possible relationship to the Australia antigen. In general, the longer the duration References 1. Murray, R., et al: Confirmation of Carrier State by Transmission Experiments in Volunteers , JAMA 143:1072-1074 ( (March 27) ) 1954.Crossref 2. Murray, R., et al: Effect of Ultraviolet Radiation on the Infectivity of Icterogenic Plasma , JAMA 157:8-14 ( (Jan 1) ) 1955.Crossref 3. Murray, R., et al: Effect of Storage at Room Temperature on Infectivity of Icterogenic Plasma , JAMA 155:13-15, 1954.Crossref 4. Redeker, A.G., et al: A Controlled Study of the Safety of Pooled Plasma Stored in the Liquid State at 20-32 C for Six Months , Transfusion 8:60-64 ( (March) -April) 1968.Crossref 5. Allen, J.G.: Immunization Against Serum Hepatitis From Blood Transfusion , Ann Surg 160:752-764 ( (Oct) ) 1964.Crossref 6. London, W.T., et al: Australia Antigen and Acute Viral Hepatitis , Ann Intern Med 70:55-59 ( (Jan) ) 1969.Crossref 7. Prince, A.M.: Antigen Detected in Blood During Incubation Period of Serum Hepatitis , Proc Nat Acad Sci USA 60: 814-821 ( (Oct) ) 1968.Crossref 8. Krugman, S., et al: Infectious Hepatitis , JAMA 200:95-103 ( (May 1) ) 1967.Crossref 9. Giles, J.P., et al: Viral Hepatitis: Australia/SH Antigen and Willowbrook MS-2 Strain , New Eng J Med 281:119-122 ( (July 17) ) 1969.Crossref

Mineiro, Luiz E. G.;Salter, John J.;Orduna, Caesar C.

doi: 10.1001/archsurg.1970.01340190008003pmid: 5409677

Abstract Carcinomaing from the nail bed is infrequently reported and probably rarely seen. Only 24 cases had been reported until 1964.1 It is of a low grade malignancy and has been reported to develop following chronic paronychia and trauma.1-5 Cure has occurred following limited amputation of the involved finger.1,5 The following cases are the only ones in the records of the Pathology Department at the Harlan Appalachian Regional Hospital. Report of Cases Case 1 (HARH 2991).—The patient was a 58-year-old white woman who was seen in September 1967 because of a painful mass under the nail of the right fifth finger. She had noticed the mass about two months previously, following trauma to the finger. On examination a round, smooth, hard mass, 5 mm in diameter, was noted beneath the nail. No lymph nodes were palpable in the right upper arm. Amputation through the distal phalange, proximal to References 1. Boyes, J.H.: Bunnell's Surgery of the Hand , ed 4, Philadelphia: J. B. Lippincott Co., 1964. 2. Silverman, I.: Epithelioma Following Chronic Paronychia , Amer J Surg 29:141-142 ( (July) ) 1935.Crossref 3. Ellis, V.H.: Squamous Cell Carcinoma of the Nail Bed , J Bone Joint Surg 30-A: 656-658 ( (Nov) ) 1948. 4. Levine, J., and Lisa, J.R.: Primary Carcinoma of the Nail , Arch Surg 38:107-112 ( (Jan) ) 1939.Crossref 5. Russell, L.W.: Primary Carcinoma of the Nail , JAMA 144:19-21 ( (Sept) ) 1950.Crossref

Sasmaz, Orhan;Petridis, Ispiro;Alican, Fikri

doi: 10.1001/archsurg.1970.01340190010004pmid: 5409682

Abstract This condition was originally described as a clinical entity by Richardson1 in 1857. More than a century later Jones and Merendino found reports of 250 such cases in the world literature and reported four cases of their own.2 Recently, several more cases have been described by various groups of authors.3-7 However, timely diagnosis is still a challenge for the clinician because it appears that at least 80% of cases are diagnosed retrospectively. We believe, therefore, contribution of another report on the subject with a discussion of pertinent points might help the clinician to recall this entity in the differential diagnosis of a variety of acute abdominal conditions which it does mimic. Report of a Case A 62-year-old woman was admitted to our emergency service with the complaint of a tender mass in the left inguinal area. She had a cold for ten days with severe coughing spells. References 1. Richardson, S.B.: Rupture of the Right Rectus Abdominis Muscle From Muscular Efforts: Operation and Recovery, With Remarks , Amer J Med Sci 33:41-45 ( (Jan) ) 1857.Crossref 2. Jones, T.W., and Merendino, K.A.: The Deep Epigastric Artery: Rectus Muscle Syndrome , Amer J Surg 103:159-169 ( (Feb) ) 1962.Crossref 3. Cusack, J.D., and Lawler, F.C.: Hematoma of the Rectus Abdominis Muscle Simulating an Acute Abdomen in Pregnancy , Illinois Med J 126:668-671 ( (Dec) ) 1966. 4. Moses, M.C., and Swartley, R.N.: Subcutaneous Rupture of the Rectus Abdominis Muscle With Incarcerated Hernia and Bowel Obstructions , Amer J Surg 110:958-959 ( (Dec) ) 1956.Crossref 5. Backwinkel, K.: Rupture of the Rectus Abdominis Muscle , Arch Surg 90:35-37 ( (Jan) ) 1965.Crossref 6. Stiles, Q.R.; Raskowsky, H.J.; and Henry, W.: Rectus Sheath Hematome , Surg Gynec Obstet 121:331-333 ( (Aug) ) 1965. 7. Jackson, P.P., and Gray, E.J.: Abdominal-wall Hematomas , Arch Surg 92:194-197 ( (Feb) ) 1966.Crossref 8. Brodel, M., and Cullen, T.S.: Lesions of the Rectus Abdominis Muscle Simulating an Acute Intraabdominal Condition: I. Anatomy of Rectus Muscle , Bull Hopkins Hosp 61:295-312 ( (Nov) ) 1937. 9. Young, H.B.: Hematoma of Rectus Sheath , Lancet 1:1165-1166 ( (June) ) 1965. 10. Teske, J.M.: Hematoma of Rectus Abdominis: Report of a Case and Analysis of 100 Cases From Literature , Amer J Surg 71:689-692 ( (May) ) 1946.Crossref 11. Cullen, T.S.: Lesions of Rectus Abdominis Muscle Simulating Acute Intraabdominal Conditions: II. Hemorrhage Into or Beneath Rectus Muscle Simulating Acute Abdominal Condition , Bull Hopkins Hosp 61:317-348 ( (Nov) ) 1937. 12. Aird, I.: Companion in Surgical Studies , Edinburgh: E. & S. Livingstone, Ltd., 1957. 13. Fothergill, W.E.: Hematoma in the Abdominal Wall Simulating Pelvic New Growths , Brit Med J 1:941-942 ( (Jan 5) ) 1926.Crossref 14. Thorek, M., and De Vera, L.B.: Hematoma of Rectus Abdominis Muscle: Report of Case, Discussion of Entity and Review of Illustrative Cases From Literature , J Int Coll Surg 22:519-534 ( (Nov) ) 1956. 15. Chapman, N.D.; Nyhus, L.M.; and Harkins, H.N.: Abdominal Paracentesis in Diagnostic Aid , JAMA 170:1625-1628 ( (Aug 1) ) 1959.Crossref

Willhoite, Maj David R.;Moll, Lt Col Joseph H.

doi: 10.1001/archsurg.1970.01340190013005pmid: 5409670

Abstract Volkmann's ischemia in the lower extremity is a not uncommon complication of injuries or operations to the lower extremity (Fig 1). It is our intent in this discussion to point out the importance of the early recognition and treatment of impending ischemia in the lower extremity, whether it be due to a closed injury (anterior compartment syndrome) or to a severe fracture with laceration of a major vessel in the lower extremity. Our principles of treatment of impending ischemia will be emphasized, especially the prompt performance of extensive fasciotomy. Seddon reported 15 cases of Volkmann's ischemia in the lower extremity, four of which were due to operations on the leg.1 The remainder was due to injuries, either a fracture or crushing soft tissue injuries to the lower extremity. In four of the 15 cases reported by Seddon, amputation was required. Owen and Tsimboukis reviewed 100 fractures of the tibia References 1. Seddon, H.J.: Volkmann's Ischaemia in the Lower Limb , J Bone Joint Surg 48:627-636 ( (Nov) ) 1966. 2. Owen, R., and Tsimboukis, B.: Ischaemia Complicating Closed Tibial and Fibular Shaft Fractures , J Bone Joint Surg 49:268-275 ( (May) ) 1967. 3. Ellis, H.: Disabilities After Tibial Shaft Fractures , J Bone Joint Surg 40:190-197 ( (May) ) 1958. 4. Thomson, S.A., and Mahoney, L.J.: Volkmann's Ischaemic Contracture and Its Relationship to Fracture of the Femur , J Bone Joint Surg 33:336-347 ( (Aug) ) 1961. 5. Dehne, E., and Kirz, F.K.: Slow Arterial Leak Consequent to Unrecognized Arterial Laceration , J Bone Joint Surg 49:372-376 ( (March) ) 1967. 6. Holmes, W.; Highet, W.B.; and Seddon, H.J.: Ischaemic Nerve Lesions Occurring in Volkmann's Contracture , Brit J Surg 32:259-275 ( (Oct) ) 1944.Crossref

Wakabayashi, Akio;Beron, Edward;Lou, Mary A.;Mino, John Y.;Costa, Iseu A. da;Connolly, John E.

doi: 10.1001/archsurg.1970.01340190019006pmid: 5409671

Abstract Since Murray et al1 reported the feasibility of a systemicto-coronary artery bypass in 1954, many articles have appeared which have described surgical techniques to anastomose the internal mammary artery to the anterior descending or circumflex branch of the left coronary artery by means of nonsuture techniques,2 temporary internal shunts,3 vascular anastomosing staplers,4 or extracorporeal circulation.5 These technical contributions were aimed to improve the patency rate of the coronary artery anastomosis without reference to the physiological background of the coronary circulation. Coronary bypass inflow is determined by the vascular resistance of the coronary arterial system and the pressure gradient across the anastomosis. If the coronary vascular resistance is constant, the pressure gradient will determine the inflow. It is known that pulsatile pressure contours change as they propagate along the aorta.6 There is also a time lag of pulse wave propagation between the aortic root and References 1. Murray, G., et al: Anastomosis of Systemic Artery to the Coronary Artery , Canad Med Assoc J 71:594-597 ( (Dec) ) 1954. 2. Carter, E.L., and Roth, E.J.: Direct Nonsuture Coronary Artery Anastomosis in the Dog , Ann Surg 148:212-218 ( (Aug) ) 1968.Crossref 3. Absolon, K.B., et al: Surgical Treatment of Occlusive Coronary Artery Disease by Endarterectomy or Anastomotic Replacement , Surg Gynec Obstet 103:180-185 ( (Aug) ) 1956. 4. Carroll, S.E.: Experimental Anastomosis of the Left Internal Mammary Artery to the Divided Circumflex Coronary Artery Using the NRC-Vogelfanger Stapling Device , Canad J Surg 7:463-469 ( (Oct) ) 1964. 5. Julian, O.C., et al: Direct Surgical Procedures on the Coronary Arteries: Experimental Studies , J Thorac Surg 34:654-660 ( (Nov) ) 1957. 6. Luchsinger, P.C., et al: Instantaneous Pressure Distribution Along the Human Aorta , Circ Res 15:503-510 ( (Dec) ) 1964.Crossref 7. Schuldt, H.H., and Krause, H.: Coronary Inflow After Systemic-to-coronary Artery Anastomosis in Dogs , Amer Heart J 72:359-368 ( (Sept) ) 1966.Crossref

Murphy, Gerald P.;Mirand, Edwin A.;Groenewald, Johannes H.;Kenny, Gerald M.

doi: 10.1001/archsurg.1970.01340190022007pmid: 4902487

Abstract Erythropoietin (ESF) is a hormone of renal origin active in the regulation of red cell production.1 Various factors or stimuli are known to result in ESF release. These include bleeding,2 hypoxic hypoxia exposure,3 exogenous androgen administration,4 or cobalt chloride treatment.5 Autotransplanted canine kidneys can respond to various erythropoietic stimuli as can normal intact kidneys.6 The present experiments were conducted to test further the response of animals with renal allografts, with and without various forms of immunosuppression to various erythropoietic stimuli. Materials and Methods Adult male and female mongrel dogs, in healthy condition, underwent bilateral nephrectomy and received a kidney from an unrelated donor. Postoperatively, animals with functioning grafts were either untreated or given yeast respiratory extract (PCO),7 50 mg/kg every other day; azathioprine (Imuran), 5 mg/kg daily, or azathioprine and PCO in similar but combined fashion. Routine biochemical and hematological preoperative and postoperative References 1. Gordon, A.S.: Hemopoietine , Physiol Rev 39:1-40 ( (Jan) ) 1959. 2. Mirand, E.A., et al: Erythropoietin Response to Repeated Hemorrhage in Renal Autotransplanted Nephrectomized, or Intact Dogs , Life Sci 7:689-695 ( (July) ) 1968.Crossref 3. Fisher, J.W., et al: Effects of Cobalt on Activity of Sheep Erythropoietin in Rat Kidney Homogenates , Proc Soc Exp Biol Med 122:1015-1018 ( (Aug) -Sept) 1966.Crossref 4. Mirand, E.A., et al: Effects of Testosterone on Renal Hemodynamics and Erythropoietin Release in Dogs , Invest Urol 4:203-207 ( (Nov) ) 1966. 5. Fisher, J.W., and Langston, J.W.: The Influence of Hypoxemia and Cobalt on Erythropoietin Production in the Isolated Perfused Dog Kidney , Blood 29:114-125 ( (Jan) ) 1967. 6. Murphy, G.P., et al: Erythropoietin Activity in Autotransplanted Canine Kidneys , Arch Surg 99:660-663 ( (Nov) ) 1969.Crossref 7. Murphy, G.P., et al: The Effect of PCO (Yeast Respiratory Stimulator) on Imuran-treated and Untreated Dog Renal Allografts , Surg Forum 20:299-301 ( (Oct) ) 1969. 8. Mirand, E.A.; Prentice, T.C.; and Slaunwhite, W.R.: Current Studies on the Role of Erythropoietin on Erythropoiesis , Ann NY Acad Sci 77:677-702 ( (Jan) ) 1959.Crossref 9. Mirand, E.A., and Murphy, G.P.: Erythropoietin Alterations in Patients With Uremia, Renal Allografts, or Without Kidneys , JAMA 209:392-398 ( (July) ) 1969.Crossref 10. Mirand, E.A.: Extrarenal and Renal Control of Erythropoietin Production , Ann NY Acad Sci 149:94-106 ( (March) ) 1968.Crossref

Huller, Tom;Bazini, Yaacov

doi: 10.1001/archsurg.1970.01340190026008pmid: 5409672

Abstract On Oct 21, 1967, the destroyer Eilat was sunk by Egyptian missile boats opposite Port-Said. The sailors deserted the ship and while they were in the water another missile appeared, missing the destroyer and exploding in the water. This underwater explosion resulted in immersion-blast injuries to many of the sailors who survived the direct hit. Blast injuries were described in the early 1920's.1 Some experience with the clinical syndrome, the pathology, and pathophysiology was gained by the Allies and the Germans in World War II. The injury is rare during peace time and there have been no publications on underwater-blast injuries since the end of World War II. This paper deals with 32 blast-injured sailors of the destroyer Eilat who were still in hospital during the second week after the injury. Subserosal hemorrhage or tears of the bowel or both proven at laparotomy were accepted as proof of intraabdominal References 1. Hooker, D.R.: Physiological Effects of Air Concussion , Amer J Physiol 67:219-274 ( (Jan) ) 1923-1924. 2. Schardin, H.: "The Physical Principles of the Effects of Detonation," in German Aviation Medicine World War II , Washington, DC: Government Printing Office, 1950, vol 2, pp 1207-1224. 3. Zuckerman, S.: Experimental Study of Blast Injuries to the Lungs , Lancet 2:219-238, 1940.Crossref 4. Zuckerman, S.: The Problem of Blast Injuries , Proc Roy Soc Med 34:171-188 ( (Jan) ) 1940-41. 5. Wakeley, C.P.G.: Effect of Underwater Explosion on Human Body , Lancet 1:715, 1945.Crossref 6. White, C.S., and Richmond, D.R.: Blast Biology, US, Atomic Energy Commission Report, Tid-5764, 1959. 7. Clemedson, C-J.: Blast Injury , Physiol Rev 36:336-354 ( (July) ) 1956. 8. Wilson, J.V.; Belf, M.D.; and Tunbridge, RE.: Pathological Findings in a Series of Blast Injuries , Lancet 1:257-261, 1943.Crossref 9. Rossle, quoted by Gardini, G.F.: "Pathology of Blast Effects," in German Aviation Medicine World War II , Washington, DC: Government Printing Office, 1950, vol 2, pp 1260-1273. 10. Dean, D.M.; Robinson Thomas, A.; and Allison, R.S.: Effects of High Explosive Blast on the Lungs , Lancet 2:224-226, 1940.Crossref 11. Clemedson, C-J., and Pettersson, H.: Genesis of Respiratory and Circulatory Changes in Blast Injury , Amer J Physiol 174:316-320 ( (Aug) ) 1953. 12. Rossle, R.: "Pathology of Blast Effects," in German Aviation Medicine World War II , Washington, DC: Government Printing Office, 1950, vol 2, pp 1260-1273. 13. Clemedson, C-J., and Hultman, H.I.: Air Embolism and the Cause of Death in Blast Injury , Milit Surg 114:424-437 ( (June) ) 1954. 14. Leavell, B.S.: Acute Heart Failure Following "Blast Injury," War Med 7:162-167 ( (March) ) 1945. 15. Gouze, F.J., and Hayter, R.: Air Embolism in Immersion Blast , US Naval Med Bull 43:871-877 ( (Nov) ) 1944. 16. Benzinger, T.: "Physiological Effects of Blast in Air and Water," in German Aviation Medicine World War II , Washington, DC: Government Printing Office, 1950, vol 2, pp 1225-1259. 17. Stevens, E., and Templeton, A.W.: Traumatic Nonpenetrating Lung Contusion , Radiology 85:247-252 ( (Aug) ) 1965.Crossref 18. Osborn, G.R.: Pulmonary Concussion ("Blast") , Brit Med J 1:506-510 ( (April) ) 1941.Crossref 19. Desaga, H.: "Blast Injuries," in German Aviation Medicine World War II , Washington, DC: Government Printing Office, 1950, vol 2, pp 1274-1293. 20. O'Reilly, J.N., and Roodhouse Gloyne, S.: Blast Injury of the Lungs , Lancet 3:423-428, 1941.Crossref 21. Clemedson, C-J.: An Experimental Study on Air Blast Injuries , Acta Physiol Scand 18 ( (suppl 24) ):1, 1949.Crossref 22. Bazini, Y., and Hirch, M.: Blast Injuries of the Chest , Harefuah 75:401-406 ( (Nov) ) 1968.

Slapak, Maurice;Beaudoin, Jean Guy;Lee, Hung Mo;Hume, David M.

doi: 10.1001/archsurg.1970.01340190033009pmid: 4902488

Abstract An acceptable method for experimental or clinical auxiliary liver transplantation should fulfill the following criteria: The donor liver must be vascularized sufficiently to prevent shrinkage, dysfunction, and histopathological changes distinct from any subsequent immunological damage. Donor liver function must be easily and accurately assessable so that reliable comparisons can be made of different immunosuppressive methods. Function should be assessable by means of blood biochemical measurements without the need of an external biliary fistula. The method must be sufficiently sparing of technical difficulties and make use of skilled personnel so that a low number of deaths due to technical problems ensue. Thus, experimentally, a sufficiently large number of animals can be maintained for observation and statistical analysis of data. A study of the literature of heterotopic liver transplantation reveals confusing inconsistencies by different authors in the criteria used to assess donor liver function in the presence of a References 1. Couch, N.P.: Supply and Demand in Kidney and Liver Transplantation: A Statistical Survey , Transplantation 4:587-595 ( (Sept) ) 1966.Crossref 2. Slapak, M.; Wigmore, R.A.; and MacLean, L.D.: Twenty-four Hour Liver Preservation by the Use of Continuous Pulsatile Perfusion and Hyperbaric Oxygen , Transplantation 5:1154-1158 ( (July) ) 1967.Crossref 3. Sicular, A., et al: Studies of Rejection of the Homotransplanted Canine Liver , Surg Forum 14:202-204 ( (Oct) ) 1963. 4. Halgrimson, C.G., et al: Auxiliary Liver Transplantation: Effect of Host Portacaval Shunt , Arch Surg 93:107-118 ( (March 4) ) 1966.Crossref 5. Mason, E.C., and Nau, CA.: Cause of Death Due to Liver Autolysis , Surg Gynec Obstet 60:769-781 ( (April) ) 1935. 6. Goodrich, E.O., et al: Homotransplantation of the Canine Liver , Surgery 39:244-251 ( (Feb) ) 1956. 7. Tretbar, L.L.; Beven, E.G.; and Hermann, R.E.: Homotransplantation of an Auxiliary Dog Liver Into the Pelvis: Effect of Portacaval Shunt in the Prevention of Liver Atrophy , Surg Forum 16:219-221 ( (Oct) ) 1965. 8. Starzl, T.E., et al: Experimental and Clinical Homotransplantation of the Liver , New York Acad Sci 120:739-765 ( (pt 2) , sec 8) 1964.Crossref 9. Leger, L., et al: Etat actuel de notre experience de la transplantation hépatique chez l'animal , Mem Acad Chir 8-9:289-305 ( (March) ) 1965. 10. Thomford, N.R.; Shorter, R.G.; and Hallenbeck, G.A.: Homotransplantation of the Canine Liver , Arch Surg 90:527-538 ( (April) ) 1965.Crossref 11. Gliedman, M.L., et al: Heterotopic Liver Transplantation After Liver Damage , Trans Amer Soc Artif Intern Organs 9:205-210 ( (April) ) 1965.Crossref 12. Pangan, J., et al: A Heterograft Model for Auxiliary Liver Transplantations in the Dog , Trans Amer Soc Artif Intern Organs 12:265-270 ( (April) ) 1966. 13. Van der Heyde, M.N.; Schalm, L.; and Vink, M.: The Role of Functional Competition in Auxiliary Liver Transplantation , Transplantation 5:78-80 ( (Jan) ) 1967.Crossref 14. Van der Heyde, M.N., et al: Survival of Hepatectomized Dogs With Partial Liver Transplants , Surgery 59:1079-1082 ( (June) ) 1967. 15. Lee, S.; Edgington, T.S.; and Orloff, M.: The Role of Afferent Blood Supply in Regeneration of Liver Isografts in Rats , Surg Forum 19:360-362 ( (Oct) ) 1968. 16. Marchioro, T.L., et al: Physiologic Requirements for Auxiliary Liver Homotransplantation , Surg Gynec Obstet 121:17-31 ( (July) ) 1965. 17. Hagihara, P., and Absolon, K.B.: Experimental Studies on Homologous Heterotopic Liver Transplantation , Surg Gynec Obstet 119:1297-1304 ( (Dec) ) 1964. 18. Mehrez, I.A., et al: Homotransplantation of the Canine Liver , Ann Surg 159:416-423 ( (March) ) 1964.Crossref 19. Bengoechea-Gonzalez, E.; Awane, Y.; and Reemtsma, K.: Experimental Auxiliary Liver Homotransplantation , Arch Surg 94:1-7 ( (Jan) ) 1967.Crossref 20. Beaudoin, J.G., et al: Evaluation of Heterotopic Liver Transplantation in Dogs , Surg Forum 19:219-221 ( (Oct) ) 1968. 21. Beaudoin, J.G., et al: Heterotopic Liver Transplantation in Dogs: Effect of Biliary Obstruction , Ann Roy Coll Surg Canad 1:71-72 ( (Jan) ) 1967. 22. Mito, M., et al: Partial Heterotopic Liver Homograft in Dogs Utilizing Portal Arterialization , Ann Surg 165:20-32 ( (Jan) ) 1967.Crossref 23. Aoki, H., et al: Partial Liver Transplantation With Primary Revascularisation in Dogs: Preliminary Report on New Methods and Its Theoretical Background , Keio J Med 16:205-221 ( (Dec) ) 1967.Crossref 24. Sigel, B.; Baldia, L.; and Dunn, M.R.: Studies of Liver Lobes Autotransplanted Outside the Abdominal Cavity , Surg Gynec Obstet 124:525-530 ( (March) ) 1967.

Wright, Philip W.;Goodhead, Bernard

doi: 10.1001/archsurg.1970.01340190044010pmid: 4243299

Abstract It has been substantiated that vascular phenomena are important in the pathogenesis of acute hemorrhagic pancreatitis.1-3 Impairment of pancreatic blood has been stressed as an important event in the progression of edematous to hemorrhagic pancreatitis; and there is evidence that the extent and the severity of the disease and, in particular, the progression to hemorrhagic necrosis is determined by the development of stasis or thrombosis within the pancreatic microcirculation.3 It has been suggested that impairment of local blood flow in the gland retards the absorption of proteolytic enzymes into the circulation, thereby increasing the susceptibility of the pancreas to further injury by enzymes and toxic products retained in the gland.1 Attempts to modify the course of this disease have seldom taken these factors into account; and it is postulated that if a satisfactory blood flow could be maintained, enzymes and their digestive products would continue to be References 1. Anderson, M.C.: Venous Stasis in the Transition of Edematous Pancreatitis to Necrosis , JAMA 183:534-537 ( (Feb 16) ) 1963.Crossref 2. Anderson, M.C., et al: Circulatory Changes in Acute Pancreatitis , Surg Clin N Amer 47:127-140 ( (Feb) ) 1967. 3. Anderson, M.C., and Schiller, W.R.: Microcirculatory Dynamics in the Normal and Inflamed Pancreas , Amer J Surg 115:118-127 ( (Jan) ) 1968.Crossref 4. Hardaway, R.M., and Burns, J.W.: Mechanism of Action of Fibrinolysin in the Prevention of Irreversible Hemorrhagic Shock , Ann Surg 157:305-309 ( (Feb) ) 1963.Crossref 5. Hardaway, R.M., et al: Studies on the Role of Intravascular Coagulation in Irreversible Hemorrhagic Shock , Ann Surg 155:241-250 ( (Feb) ) 1962.Crossref 6. Pechet, L.: Fibrinolysis , New Eng J Med 273:966-973 ( (Oct 28) ) 1965.Crossref 7. Pechet, L.: Fibrinolysis , New Eng J Med 273:1024-1034 ( (Nov 4) ) 1965.Crossref 8. Engelberg, H.: Heparin, Metabolism, Physiology and Clinical Application , Springfield, Ill: Charles C Thomas, Publisher, 1963. 9. Nemir, P., Jr., and Drabkin, D.L.: The Pathogenesis of Acute Necrotizing Hemorrhagic Pancreatitis: An Experimental Study , Surgery , 40:171-184 ( (July) ) 1956. 10. Anderson, M.C.: The Relationship of Intrapancreatic Hemorrhage to Pancreatic Necrosis , Arch Surg 83:467-474 ( (Sept) ) 1961.Crossref 11. Popper, H.L.; Necheles, H.; and Russell, K.C.: Transition of Pancreatic Edema Into Pancreatic Necrosis , Surg Gynec Obstet 87:79-82 ( (July) ) 1948. 12. Anderson, M.C., and Bergan, J.J.: Effect of Proteolytic Enzymes on Pancreatic Blood Vessels , Surg Forum 13:304-306, 1962. 13. Block, M.A.; Wakim, K.G.; and Baggenstass, A.H.: Experimental Studies Concerning Factors in the Pathogenesis of Acute Pancreatitis , Surg Gynec Obstet 99:83-90 ( (July) ) 1954. 14. Pfeffer, R., et al: Gradations of Pancreatitis, Edematous, Through Hemorrhagic, Experimentally Produced by Controlled Injection of Microspheres Into Blood Vessels in Dogs , Surgery 51:764-769 ( (June) ) 1962. 15. Adams, T.W., and Musselman, M.M.: Pancreatic Venous Thrombosis as Etiologic Factor in Acute Necrotizing Hemorrhagic Pancreatitis , Surg Forum 4:401-406, 1953. 16. Rich, A.R., and Duff, G.L.: Experimental and Pathological Studies on Pathogenesis of Acute Hemorrhagic Pancreatitis , Bull Hopkins Hosp 58:212-259 ( (March) ) 1936. 17. Smyth, C.J.: Etiology of Acute Hemorrhagic Pancreatitis With Special Reference to Vascular Factors: Analysis of Autopsies and Experimental Investigations , Arch Path 30:651-669 ( (Sept) ) 1940. 18. Wilson, J.S.: Fibrinolysin Treatment of Induced Venous Thrombosis in the Dog , Surgery 48:469-480 ( (Sept) ) 1960. 19. Ambrus, J.L., et al: Clinical Pharmacology of Various Types of Fibrinolytic Enzyme Preparations , Amer J Cardiol 6:462-473 ( (Aug) ) 1960.Crossref 20. Cliffton, E.E.: Review of Clinical Experience With Clot-Lysing Agents , Amer J Cardiol 6:476-485 ( (Aug) ) 1960.Crossref 21. Gerber, P.U.; Meyer, W.H.; and Farrell, J.J.: Experimental Pancreatitis and Fibrinolysin , Amer J Surg 28:445-447 ( (July) ) 1962. 22. Diwok, K.; Gülzow, M.; and Trettin, H.J.: Die Wirkung der ε-Aminokapronsäure auf die experimentelle Pankreatitis der Ratte , Z Ges Inn Med 20:111-112 ( (Feb 15) ) 1965. 23. Nemir, P., Jr.; Hoferichter, J.; and Drabkin, D.L.: The Protective Effect of Proteinase Inhibitor in Acute Necrotizing Pancreatitis: An Experimental Study , Ann Surg 158:655-662 ( (Oct) ) 1963.Crossref 24. Grözinger, K.H., et al: Evaluation of Trasylol in Experimental Acute Pancreatitis , Surgery 56:400-430 ( (Nov) ) 1964. 25. 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