SMJ // November 1982, Volume 75 - Issue 11
Primary Article
Intestinal Vascular Ectasias A New Look at an Old Disease
ABSTRACTSeventeen patients had rectal bleeding and intestinal vascular ectasia. Actual bleeding from the ectasia was seen in five patients. The average age of the 17 patients was 60.2 years, but 41% were under the age of 60. Melena was common initially. Both colonoscopy and angiography had a high degree of…
Primary Article
Stapling in Intestinal Surgery
ABSTRACTAlthough stapling technology was introduced to surgical procedures early in this century, its accelerated use has taken place since 1968. Several methods of restoring interrupted continuity of the large and small bowel are available to the surgeon. The method used is influenced by the level involved, especially as it relates…
Primary Article
Weight Loss and Complications After Four Gastric Operations for Morbid Obesity
ABSTRACTSince April 1975, 292 patients have had gastric operations for morbid obesity: gastric bypass with Roux-en-Y gastrojejunostomy (RY), 105 patients; gastric bypass with loop gastrojejunostomy (loop), 69 patients; greater curvature gastroplasty, 40 patients; and gastric partition with gastrogastrostomy, 78 patients. Follow-up was two years except for the gastrogastrostomy group in…
Primary Article
Histologic and Staging Classification of Breast Cancer Implications for Therapy
ABSTRACTBreast cancer has 20 different histologic descriptions grouped into four categories, A, B, C, and D, based on prognosis. An analysis of 3,902 patients has revealed significant differences in outcome. Class A disease—for the most part in situ—was relatively benign, with a frequency distribution of 5%. Positive nodes were found…
Primary Article
Breast Reconstruction After Modified Radical Mastectomy
ABSTRACTModified radical mastectomy has clearly facilitated breast reconstruction after mastectomy. We emphasize preservation of the nerve supply to the pectoralis major muscle and describe a method of breast reconstruction after modified radical mastectomy.
Primary Article
Carcinoma of the Uterine Cervix Results of Radiation Therapy at a Regional Community Teaching Hospital
ABSTRACTWe analyzed the results of radiation therapy for carcinoma of the uterine cervix in 144 patients treated at a regional referral hospital. The local control was good in early stage disease, with only two pelvic failure in 92 stages I and II patients. Survival at 40 months was 86%, 83%,…
Primary Article
Prostatism and Inguinal Hernia
ABSTRACTWe reviewed a series of 70 patients who had transurethral resection of the prostate to determine the incidence of inguinal hernia. We found inguinal hernias in 20% of the patients, a figure significantly higher than in the general population. In 47% of the patients a hernia was present on admission…
Primary Article
Serum Haptoglobin A Nonspecific Tumor Marker for Renal Cell Carcinoma
ABSTRACTSerum haptoglobin levels were measured in 116 patients with renal cell carcinoma. The overall accuracy of correlation between haptoglobin levels and the presence or absence of known disease was 68% (normal in 87% of patients without clinically apparent disease, and elevated in 58% of patients with disease). The levels appear…
Primary Article
Mycobacterium marinum Infections Diagnosis and Treatment
ABSTRACTMycobacterium marinum is capable of producing prolonged and disabling infections largely because early clinical and laboratory diagnosis is difficult and familiarity with the disease is limited. We present a discussion of the Mycobacterium marinum disease process, clinical and laboratory diagnostic approaches, and current methods of treatment in nine cases of…
Primary Article
Antepartum Treatment of Listeria monocytogenes Septicemia
ABSTRACTMaternal septicemia with Listeria monocytogenes is becoming a more prevalent problem for those dealing with obstetric patients. A flu-like illness is often present in the mother prior to delivery of the infected infant. Treatment regimens have included intravenous antibiotic therapy for the mother and induction of labor. The infant often…
Primary Article
Ultrasonography and Alpha-Fetoprotein Determination for Antenatal Detection of Neural Tube Defects
ABSTRACTWe review our experience in the antenatal detection of neural tube defects in a collaborative study between the prenatal diagnostic program of the Section of Medical Genetics and the Ultrasound Laboratory at the West Virginia University. In West Virginia the incidence of neural tube defects is two to three times…
Primary Article
Persistent Transverse Antral Fold A Radiographic Sign of Benign and Malignant Antral Ulceration
ABSTRACTA persistent, prominent, transverse mucosal fold 5 to 9 mm in width is presented as an indirect sign of benign and malignant antral ulcerations. Normally, transverse mucosal folds become reoriented in the longitudinal direction during systole, and an explanation for the persistence of the transverse fold in patients with antral…
Primary Article
Measurement of the Normal Cervical Cord by Metrizamide Myelography
ABSTRACTA modified C1–2 myelogram, using metrizamide (Amipaque), provides excellent visualization of the cervical spinal cord. The mean values of the sagittal diameter of the spinal cord are given in 100 selected cases. Comparison with these normal values is useful in the preliminary diagnosis of cervical cord atrophy versus syringohydromyelia.
Primary Article
Hemodialysis Adjustment Difficulties of Patient and Family
ABSTRACTA review of the literature revelas some of the adjustment problems present in hemodialysis patients and why some patients can handle these stresses better than others. The adjustment problems of the spouse and children of hemodialysis patients are also explored with attention given to methods of coping with a changing…
Primary Article
Optimal Care and the Law
ABSTRACTThe law pertaining to emergency psychiatric commitment in Tennessee and in many other states interferes with providing desperately needed treatment for a particular subset of patients. We describe representative cases to highlight the problems and the consequences stemming from them.
Primary Article
Hypertension and Primary Hyperparathyroidism A Five-Year Case Review
ABSTRACTAll cases of surgically proven and cured primary hyperparathyroidism, over a five-year period, were reviewed for the presence of hypertension, renal and/or prerenal azotemia, nephrolithiasis, nephrocalcinosis, and patient symptom status. In this group of 23 patients, the prevalence of hypertension was greater than 78% (18 patients), which is statistically significant….
Primary Article
Distribution of Family Practitioners and Other Specialists in Texas, 1973 to 1980 Second Statistical Review
ABSTRACTA follow-up study was conducted at The University of Texas Southwestern Medical School at Dallas to document the changes in the geographic distribution of family/general practitioners and other medical specialists in Texas between 1973 and 1980. Results of the analysis suggest that more physicians are choosing to locate in sparsely…
Review Article
Mixed Connective Tissue Disease An Overview
ABSTRACTMixed connective tissue disease is characterized by overlapping features of classic connective tissue diseases and the presence of antibodies to ribonucleoprotein. Placement of this disorder among the classic disorders still remains controversial. The clinical features, prognosis, and therapeutic features of this syndrome are discussed in this report.
Current Concepts
Computed Tomography for Noninvasive Imaging of the Iliac Arteries
ABSTRACTAngiography has been the standard means of preoperative evaluation of the arterial system. Although the noninvasive modalities (sonography, nuclide “flow” studies, and computed tomography) are also frequently used in preoperative arterial evaluation, they are generally followed by arterigraphy. We propose that in some instances computed tomography may be the sole…
Article
Obesity Reconsidered
Our Medical Heritage
Assessment and Significance of Arthur Conan Doyles Medical Writings
ABSTRACTDoyles medical writings represent a valuable contribution to both the scientific and nonscientific aspects of medicine of the late 19th Century. Up to the present, accounts of these writings have been few, and none of them have been evaluative of their scientific merit. Analysis of Doyles writings on infectious diseases…
