Fifteen patients who developed a persistent perineal sinus after excision of the rectum and eight patients with a perineal fistula appearing after treatment of perineal abscesses were treated with instillation of fibrin adhesive to close the sinus or fistula. In 12 patients, the sinus tracts or fistulas were completely and permanently closed (52 percent). In five patients (22 percent), the fistulas healed after two or three attempts, while, in six patients (26 percent), the method failed to provide lasting closure. The method seems to be a valuable alternative in the treatment of a persistent, long and narrow perineal sinus or fistula.

In the present article, cerebral autoregulation capacity was In acute liver failure, massive hepatic necrosis may evaluated in patients with FHF before and after improvement result in impaired regulation of cerebral blood flow of liver function, either spontaneous or following liver trans-(CBF), development of encephalopathy, and cerebral plantation. The patients were followed daily to establish when edema. In 10 consecutive patients with fulminant hethe CBF autoregulation was restored, and if CBF autoregulapatic failure (FHF), CBF autoregulation was found to tion was re-established before complete alleviation of HE. In patients with fulminant hepatic failure (FHF) and in rine 5 to 15 mg/min 01 , and simultaneously measuring V mean . 4,5,8 If some patients with cirrhosis, CBF autoregulation is absent. [4][5][6] V mean increased more than 10%, it was considered significantly The pathophysiological mechanism of impaired CBF autoreg-changed from baseline value and autoregulation thus lost. ulation in acute liver failure remains unknown, but it could HE. The level of HE (grades I-IV) was clinically evaluated daily be caused by toxic substances released from the failing liver. from the time of admission to complete disappearance of HE. 4 (range, 2-8).

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