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Biomedical subjects

D Albo

Publications and source records attributed to D Albo.

At least 37 records · Page 2Linked to original sources
PubMed1989

Atraumatic hemobilia arising from a cirrhotic liver.

Biliary hemorrhage may occur in a variety of clinical settings, but spontaneous hemobilia has not been reported from a cirrhotic liver. We describe a case of major hepatic hemobilia in a patient with cirrhosis and no history of trauma. A 50-year-old woman had abdominal pain, melena, and profound anemia. An extensive workup did not show the site of bleeding but did show a mass in the gallbladder. Cholecystectomy was performed, and at operation the patient was found to have cirrhosis and portal hypertension. The gallbladder "mass" was simply an organized clot, and hemorrhage recurred postoperatively. On reoperation, bleeding from the ampulla of Vater was observed, confirming the diagnosis of hemobilia. She was treated with angiographic interruption of hepatic arterial flow, at which time bleeding ceased. Her total transfusion requirements included 46 units of blood. Through 16 months of follow-up the patient has had no recurrent bleeding and no evidence of encephalopathy. This case demonstrates that spontaneous hemobilia may indeed arise from a cirrhotic liver. Proximal interruption of arterial flow is usually not recommended for hemobilia, especially in the presence of portal hypertension and cirrhosis, but may be life-saving in selected patients.

Cholecystectomy↗
PubMed1985

Femorofemoral bypass with an infrascrotal perineal approach for the patient with an infected groin wound.

A technique is presented for revascularization of patients having a groin wound infection, which minimizes the risk of recurrent graft infection. A femorofemoral bypass with a subcutaneous perineal tunnel is constructed farther from the infected groin wound than the standard subcutaneous suprapubic tunnel. The route of the graft appears to result in neither excessive tension on the graft when the leg is abducted nor kinking of the graft when the leg is adducted. Long-term follow-up will be needed to compare the patency of this route with the standard suprapubic tunnel in patients with an infected groin wound who require a femorofemoral bypass graft.

Arterial Occlusive Diseases↗
PubMed1985

Indium 111-labeled leukocyte scanning for detection of prosthetic vascular graft infection.

Recent animal and human studies have suggested that positive indium 111-labeled leukocyte scans may help establish the diagnosis of vascular graft infection; however, there is little information available about the predictive value of both positive and negative leukocyte scans in larger groups of patients. In this study 31 indium 111 leukocyte scans were performed prior to definitive treatment in 21 patients with suspected vascular graft infections. Patients with more than one leukocyte scan performed had either anatomically distinct sites of infection or rescanning of a potentially infected site after definitive treatment. Scans were performed according to the method of Baker et al., attaching 500 muCi of indium 111 to leukocytes with imaging 24 hours later. All patients with positive scans underwent surgical exploration of the area of leukocyte accumulation, with documentation of purulence and culture of the graft. Patients with negative scans were treated as if scan results were indeterminate and underwent surgical exploration for usual clinical indications; if no exploration was performed, the patient was followed up closely for at least 1 year. Twelve of 12 positive scans showed purulence or culture evidence of infection with three different organisms; in 15 instances of negative scans, two operations were performed with one infection noted, whereas no patient without surgery has had a graft infection at 10 months follow-up. In addition to localizing graft infections, two scans demonstrated a nonvascular site of infection. Positive scans also helped determine the extent of infection along the graft, allowing better planning of the surgical procedure. These results indicate that indium 111-labeled leukocyte scans help document and localize prosthetic vascular graft infections.

Aged↗
PubMed1978

Compliance as a factor effecting the patency of a copolyurethane vascular graft.

A new solid-wall vascular graft which has a compliance approximating that of the natural artery has been prepared from a copolyether-urethane material. Six of nine of these compliant grafts implanted in dogs were patent on removal, the longest implant time being 77 days for a 4-mm I.D. femoral artery graft. This is in contrast to noncompliant grafts of the same copolyurethane in which failure usually occurred within 48 hr.

Animals↗
PubMed1977

Preoperative selection of patients for lumbar sympathectomy by use of the Doppler index.

Yao and Bergan [8] have shown that an ankle systolic index of more than 0.25 is associated with a high rate of success from lumbar sympathectomy. This association has been borne out in our small series. We have also suggested that diseases that obviously compromise collateral circulation might be a relative contraindication to sympathectomy. Although incomplete, literature on collateral flow in relation to sympathectomy tends to confirm this idea. Consideration of such diseases as a contraindication to sympathectomy might further increase the success rate after sympathectomy. Regardless, ankle systolic index alone appears to be a reliable objective, non-invasive method of selecting patients with an increased chance of success from lumbar sympathectomy.

Adult↗
PubMed1977

Spontaneous hepatic rupture in pregnancy.

Hepatic rupture as a late complication of toxemic pregnancy is a rare yet lethal condition requiring rapid recognition and surgical management. The clinical triad of toxemia, right upper quadrant pain, and sudden hypotension is the diagnostic hallmark of presentation. Most patients present near the time of delivery and are found to have subcapsular hematomas of the right hepatic lobe with free rupture into the peritoneal cavity and resultant exsanguinating hemorrhage. The association of toxemia and disseminated intravascular coagulation with secondary microembolic damage to the liver and other organs has been discussed. Basic surgical principles in the managment of hepatic subcapsular hematomas, and the prolonged postoperative course and frequent complications in these patients have been stressed.

Adult↗
PubMed1976

A clinical catheter for continuous blood gas measurement by mass spectrometry.

A new Teflon catheter for continuous in vivo measurement of blood gases by mass spectrometry has an outer diameter of 0.032 in. and can be inserted through percutaneous puncture with an 18-gauge needle. Response time (63% of a total change) is 40 s for oxygen and 65 s for carbon dioxide. When calibrated in analyzed gas at 37 degrees C, the catheter-mass spectrometer system has been shown to analyze tonometered blood with an error of 1.6% for oxygen and 1.9% for carbon dioxide. Temperature dependence is 2.0% per degrees C for oxygen and 1.6% per degrees C for carbon dioxide. The catheter was thrombo-resistant during in vivo use in seven dogs and measurements compared favorably with results of blood sample analyses by standard hospital methods. Compared with previous devices, the new catheter provides size and convenience, advantages that make it more applicable for routine clinical use.

Animals↗
PubMed1976

Multifactor evaluations of surgical trainees and teaching services.

Surgical education has been exposed to increasing challenges as students have moved from the highly structured environment of a university hospital into a variety of clinical settings within the community. Presented with a general surgical service that uses ten relatively autonomous teaching services in seven hospitals, we have developed a computer-based evaluation system designed to provide quality control and a feed-back loop for trainee, teacher, and service. Trainees were rated by comparing them to their peers, with the chief resident as a reference standard. Profiles of each teaching service also were developed and compared one to the other. The results of both studies over a one year period are presented.

Educational Measurement↗