SMJ // February 1976, Volume 69 - Issue 2
Primary Article
Use of Roux‐en-Y Diversion of Duodenal Secretions in the Treatment of Reflux Gastritis
ABSTRACT:Animal experiments and clinical studies suggest that duodenal secretions may be harmful to gastric mucosa after the antrum has been resected. Reflux of duodenal secretions into the gastric remnant after operation for ulcer disease may lead to the symptom complex of reflux gastritis. The injurious agent in the duodenal secretions…
Primary Article
Current Views on the Management of Obesity
ABSTRACT:In the last five years, much information has been gathered about the efficacy of several technics for managing obesity. Hospitalization with fasting, surgery, drugs, weight reducing clubs, and behavior modification methods have proven efficacious for select groups of obese Individuals. Methods of behavior modification appear to offer some of the…
Primary Article
Subluxation of the Carpal Navicular Bone*
ABSTRACT:A review of seven cases of subluxation of the carpal navicular indicated a vast discrepancy in result between those surgically reduced within five weeks and those that persist at two years unrecognized. Perilunar dislocations universally produced subluxations that required open reduction of subluxed naviculo-lunate articulation. With an appreciation of normal…
Primary Article
Pancytopenia and “Capillary Leak Syndrome” With Infectious Mononucleosis
ABSTRACT:A 19-year-old man with documented infectious mononucleosis presented with pancytopenia and a megaloblastic bone marrow. He developed a “capillary leak syndrome” with an expanded plasma volume of 9,290 ml and normal right heart and pulmonary artery pressures. The patient had a dramatic recovery after corticosteroid therapy.
Primary Article
Ipsilateral Fractures of the Elbow and Forearm*
ABSTRACT:One hundred and fifty-one patients with distal humeral fractures admitted to three major hospitals in Atlanta were studied retrospectively. Of these, 15 (10%) also had a fracture of the ipsilateral forearm. These appeared to be more severe injuries with a history of greater trauma and more displacement in the elbow…
Primary Article
Convulsive Toxemia of Pregnancy (Eclampsia)
ABSTRACT:A retrospective study investigated the epidemiologic characteristics of eclamptic patients seen at the University of Mississippi Medical Center. Between January 1955 and June 1973, 194 patients were discharged from our hospital with the diagnosis of eclampsia. Although our incidence of severe forms of toxemia of pregnancy has decreased from 6.8…
Primary Article
Anesthesia and Hepatic Artery Ligation
ABSTRACT:Hospital and anesthesia records of 39 patients who had hepatic artery ligation for severe hepatic trauma were analyzed retrospectively to acquire information on any relationships between choice of anesthetic, preoperative physical condition of the patient, type and incidence of complications, and mortality. Patients who had lost the most blood received…
Primary Article
Methylphenidate A Review
ABSTRACT:Methylphenidate is a useful, proven method for the effective treatment of minimal brain dysfunction (MBD). Dosage should be titrated individually for each patient, and it is best to start with small doses given at least 15 to 30 minutes before meals. Toxicity, side effects, and drug abuse are not major…
Primary Article
Effect of Fluoroscopic Tube Placement on Basal Gastric Secretion Collections
ABSTRACT:To determine whether fluoroscopic positioning of nasogastric tubes is useful in the measurement of basal gastric acid output, four subjects were studied six times each and two subjects ten times each. Fluoroscopic positioning was used or not used according to random sequences. No more gastric juice was obtained in the…
Primary Article
Use of Bovine Heterografts in Intravenous Therapy
ABSTRACT:Thirteen bovine heterografts were placed in nine patients: three for renal dialysis, four for treatment of diabetes mellitus, and six for cancer chemotherapy. One graft became occluded on the night of operation. One graft caused dilation of distal veins sufficient for dialysis and was never used; this graft was occluded…
Primary Article
Clear Corneal Section and Cataract Extraction
ABSTRACT:The technic of clear corneal cataract extraction was used in 365 cases, and the visual and postoperative results are reviewed. Visual acuity of 20/30 or better was obtained in 71% of cases, and there was corneal astigmatism of one diopter or less in 33%. Hyphema and shallow anterior chamber were…
Primary Article
Cholegraphy‐Induced Acute Renal Failure Its Relation to Subsequent Surgical Therapy
ABSTRACT:The cases of three patients who developed acute renal failure shortly after receiving oral or intravenous cholegraphic agents are analyzed, and the pertinent literature is reviewed. Two patients required subsequent surgical intervention: one had cholecystectomy and common bile duct exploration; the other had right hemicolectomy and cholecystectomy for coexistent gangrenous…
Primary Article
Electromyographic Studies in Peripheral Nerve Injuries
Primary Article
Life Stress and Psychiatric Clinic Referral
ABSTRACT:A “life stress” scale is applied to the antecedent events motivating 179 patients to seek outpatient psychiatric help. Intake evaluation reports of patients who kept their appointments at the Adult Psychiatric Outpatient Clinic of Vanderbilt University Hospital over a three-month period were reviewed. Almost half of the consecutive new patients…
Primary Article
Transsexualism A Selective Review
ABSTRACT:Progress in evaluating and treating the patient who seeks a change of sex is reviewed. The causes of ranssexualism and the clinical differentiation of transexualism, transvestism, and homosexuality are discussed. Criteria for selecting candidates for sex reassignment surgery are given, and preliminary results of work at Vanderbilt University are reported.
Primary Article
Edwardsiella tarda Bacteremia
ABSTRACT:Presented are two case reports of patients with Edwardsiella bacteremia who survived after chloramphenicol and gentamicin therapy in one case and cephalothin and kanamycin therapy in the other case. Of four previously reported patients, only one survived. One of our two patients presented with subarachnoid hemorrhage associated with bacterial endocarditis…
Primary Article
Persistent Brow Presentation A New Approach to Management
ABSTRACT:When the fetal vertex is extended on the spinal column and the brow becomes the presenting part, it is termed “brow presentation.” Persistent brow presentation occurs when there is no spontaneous conversion after the onset of active labor. Since there is a risk in the vaginal delivery of such fetuses,…
Primary Article
Effects of Monitoring the Usage of Antibiotics An Interhospital Comparison
ABSTRACT:Use of selected systemic antimicrobial agents at Boston City Hospital (BCH) has been monitored by requiring that choice of those agents be justified to a member of the Infectious Diseases Unit before the agent is dispensed for use in a patient. The amounts of various antimicrobial agents and classes of…
Primary Article
A State‐Wide Survey of Drug Issues in Industry
ABSTRACT:A state-wide survey of 268 industries within the Commonwealth of Virginia indicated that industry appears to have a problem particularly with alcoholism and that the climate concerning the continued employment of persons who were undergoing treatment and the hiring of persons who have successfully completed a drug treatment program appears…
Primary Article
Genital Cytologic Abnormalities in Patients Having Therapeutic Abortion
ABSTRACT:In the three years 1971–1973, 1,032 patients had therapeutic abortions at the Duke University Medical Center. Of these, 99 (9.59%) had abnormal cervical cells on routine preabortion Papanicolaou smears. The patient who presents for therapeutic abortion appears to be at high risk for early cervical neoplasia. Therefore, it is mandatory…
Primary Article
Large State Hospitals Problems and a Solution
ABSTRACT:Periodic outcries have focused attention on gross deficiencies in our large state hospitals. Shortages of psychiatrists, commonly attributed to insufficient funding, also may be due in part to tack of prestige and power, disadvantages of public practice and unrewarding relation-ships with involuntary patients: In spite of discouraging experiences for more…
