SMJ // May 1976, Volume 69 - Issue 5
Original Article
REGIONALIZED EMERGENCY MEDICAL CARE
Book Review
Family Practice
Book Review
Radiologic Examination of the Urinary Tract
Book Review
Renal Disease in Childhood
Book Review
Microbiology
Book Review
Sickle Cell Hemoglobin Molecule to Man
Book Review
The Doctors' Guide to Better Tennis and Health
Book Review
The Prenatal Diagnosis of Hereditary Disorders
Book Review
Facts About Aging
Commentary
Eikenella corrodens Comes of Age
Original Article
Eikenella corrodens Osteomyelitis, Arthritis, and Cellulitis of the Hand
ABSTRACT:Eikenella corrodens was isolated from an orally contaminated hand wound which resulted in cellulitis, osteomyelitis, and arthritis. E corrodens is a gram-negative, microaerophilic bacillus which only lately has received attention as a possible pathogen. The organism grows characteristically as small, corroding, or pitting colonies on blood agar. It typically requires…
Original Article
Fiberoptic Colonoscopy Diagnostic Value in 250 Consecutive Patients
ABSTRACT:Endoscopic findings and accomplishments in 250 consecutive patients are presented. Of these patients, 72% were found to have polyps, cancer, inflammatory bowel disease or other specific positive findings. In almost half of these patients, no definitive diagnosis had been made before the procedure. In half of the patients, new information…
Original Article
Unsuspected Diabetic Glomerulosclerosis
ABSTRACT:Six patients without overt diabetes mellitus underwent renal biopsy for suspected glomerulonephritis. All were demonstrated to have diabetic glomerulosclerosis and subsequently were found to have abnormal glucose tolerance tests. Electron microscopy was critical in making the correct diagnosis in five of six patients. The reported cases represent 3% of a…
Original Article
Penetrating Injuries of the Face and Neck
ABSTRACT:Experience with 547 consecutive cases of cervical and facial penetrating trauma has indicated the value of an individualized approach rather than a firm policy of exploration for all wounds penetrating the platysma. In addition, the accumulated data suggest that the concept of separate classes of carotid injuries based on presence…
Original Article
Clinical Significance of the Biotransformation of Inhalation Anesthetics
ABSTRACT:Inhalation anesthetics, a class of drugs formerly believed to be biologically inert, are now recognized to undergo considerable biotransformation. The viscerotoxicity of certain anesthetics on kidney and liver can be explained in terms of metabolism. The entity of “halothane hepatitis” remains mechanistically and diagnostically a mystery, but if it exists,…
Original Article
A Dynamic Transpatellar Approach to the Knee
ABSTRACT:This paper describes a transverse approach to the knee which gives unequalled access to the joint for extensive synovectomies, extensive surgical debridement, installation of total knee prostheses, or reduction of supracondylar fracture of the femur involving the articular surfaces. The temporary patellar tendon substitution wire is a loop of wire…
Original Article
Intradermal 5‐Fluorouracil in the Treatment of Basal Cell Carcinoma of the Face
ABSTRACT:The intradermal or infiltrative use of 5-fluorouracil by hypodermic syringe has resulted in the salvage of treatment failures of multifocal basal cell carcinoma of the face. This method is simple and safe, and the initial results have been excellent. It is an effective modality, especially in infiltrating lesions, and it…
Original Article
Long‐term Levodopa Therapy for Torsion Dystonia
ABSTRACT:Observation of a 34-year-old woman receiving levodopa for familial torsion dystonia over a four-year period revealed that severe side effects (gastrointestinal problems, dyskinesias, cramps, anxiety) occurred with maximal dosage schedules during the first ten months of treatment. Thereafter, a gradual reduction of the daily dose to 1,500 mg of levodopa…
Original Article
Propeller Injuries
ABSTRACT:Water skiing, boat racing, skin and scuba diving, and pleasure boat cruising are increasing in popularity. As a result the incidence of injuries secondary to motor propellers is becoming more frequent. In a ten-year period from 1963 to 1973, I collected a total of nine cases. In some cases amputations…
Original Article
Naloxone in the Parturient and Her Infant
ABSTRACT:Eighteen women in labor received analgesia with moderately large total doses of meperidine. Various doses of naloxone (8, 12, 18, 27, 40, or 60μg/kg of body weight) were given intravenously to the mothers before delivery in an attempt to find the dose that would prevent neonatal narcotic depression. Maternal and…
Original Article
Herpes Zoster Correlation of Age, Sex, Distribution, Neuralgia, and Associated Disorders
ABSTRACT:The influence of sex and age on the distribution of lesions, incidence of postherpetic neuralgia, and related disorders in herpes zoster is reported. Results were obtained by reviewing the records of 140 outpatients with herpes zoster seen over a ten-year period. Trigeminal involvement and post-herpetic neuralgia were more common in…
Original Article
Hypophysectomy in the Treatment of Disseminated Carcinoma of the Breast and Prostate Gland
ABSTRACT:Transsphenoidal hypophysectomy offers gratifying palliative relief of pain to patients with metastatic cancer of the breast and prostate. This report represents the results of two years' experience with this procedure at Emory University School of Medicine. The physiologic rationale and clinical indications for hypophysectomy are described, as is the operative…
Original Article
Complications of Peritoneal Dialysis
ABSTRACT:Peritoneal dialysis is an easily available therapeutic procedure. The complications noted in 490 dialyses over a six-year period in a university hospital have been reviewed. Seventeen major and 624 minor complications occurred. Only four deaths could be attributed to the procedure itself. Peritoneal dialysis is an effective procedure but one…
Original Article
A New Synthetic Absorbable Suture for Ophthalmic Surgery Laboratory and Clinical Evaluation
ABSTRACT:A new synthetic absorbable suture for ophthalmic surgery—glycolactide—was proved superior to chromic collagen in rupture strength and more predictable absorption time in laboratory and clinical studies. The 8–0 glycolactide showed 30% greater initial strength than 8–0 chromic collagen. One week after implantation in rabbit corneas, the glycolactide retained over 90%…
Original Article
Endoscopic Removal of Gastric and Duodenal Polyps
ABSTRACT:As endoscopic surgery comes into its own, the applications of this modality are increasing. This is well illustrated by the use of endoscopic polypectomy in the colon, and more recently by endoscopic polypectomy in the stomach and duodenum. We can anticipate increased applicability of these technics as the experience widens…
Original Article
General Announcements
Original Article
The Syndrome of Retroperitoneal Hemorrhage and Lumbar Plexus Neuropathy During Anticoagulant Therapy
ABSTRACT:A syndrome of retroperitoneal hemorrhage during anticoagulant therapy associated with nerve involvement in femoral nerve or lumbar plexus is described. Twenty-one cases were collected from the English-language literature, and five new cases were added for review and analysis. In these 26 cases spontaneous hemorrhage occurred under iliopsoas fascia in the…
Original Article
Acupuncture and Sensorineural Hearing Loss A Review
ABSTRACT:The use of acupuncture for treatment of sensorineural hearing impairment is a controversial subject among physicians and audiologists. Until recently, sufficient experimental data were not available to guide those who manage hearing-impaired children and adults. The purpose of this paper is to review current research evidence regarding the use of…
Original Article
Carbon Dioxide Homeostasis During Laparoscopy
ABSTRACT:Arterial blood gases were monitored in ten patients undergoing laparoscopy for diagnostic or sterilization procedure. During constant volume of ventilation, mean arterial co2 tension rose approximately 5 torr following insufflation of the peritoneal cavity with carbon dioxide. Arterial pH changes correlated well with arterial Pco2 changes. There was no significant…
Original Article
Ectopic Pregnancy A Review of 122 Cases
ABSTRACT:Ruptured ectopic pregnancy constitutes a major gynecologic emergency which may result in death. From 1965 through 1973, 122 patients with ectopic pregnancy were treated at Wilford Hall USAF Hospital. Diagnostic procedures, causative factors, and patient management are reviewed and discussed. The most common symptoms were pain (95%), amenorrhea (79%), and…
Original Article
Technic of Deep Hypothermia and Circulatory Arrest in the Neonate and Infant
ABSTRACT:Most congenital heart anomalies now can be surgically corrected in a neonate or very young infant. Because their hearts are so small, it is advantageous to work in a bloodless and motionless operative field. Deep hypothermia with circulatory arrest provides this setting. Physiologic problems associated with hypothermia are minimized by…
Original Article
Penetrating Injuries of the Laryngotracheal Area
ABSTRACT:Penetrating injuries of the laryngotracheal area require immediate maintenance of an adequate airway and prompt surgical exploration and repair. Two basic principles are illustrated by case reports: repairing major vessels before doing the laryngotracheal repair and using adjacent tissues to repair traumatic defects. We suggest a team approach at operation.
Original Article
Liquid Crystal Thermography A Measure of Therapeutic Response to Reserpine Given Intra‐arterially
ABSTRACT:Twelve patients with Raynaud's phenomenon secondary to acrosclerosis and/or systemic sclerosis were evaluated before and after intra-arterial administration of reserpine. The irridescent color changes seen with these liquid crystals support recent evidence for short-term effectiveness of reserpine given intra-arterially.
Original Article
Hypocalcemia as a Complication of Jejunoileal Bypass for Morbid Obesity
ABSTRACT:Hypocalcemia following jejunoileal bypass for morbid obesity is not an uncommon occurrence. Three cases of severe hypocalcemia after bypass operation are presented with emphasis on the altered physiology of calcium homeostasis. Recognition and treatment of bypass hypocalcemia can avert a potentially serious complication.
Original Article
Influence of Tidal Volume and Pulmonary Artery Occlusion on Arterial Oxygenation During Endobronchial Anesthesia
ABSTRACT:Arterial blood gases, Intrapulmonary right-to-left shunt, airway pressures, and systemic and pulmonary arterial pressures were studied in 20 patients ventilated through a double lumen endobronchial tube during thoracotomy. Inspired oxygen concentration was 98% to 100%. Blood samples for measurement of blood gases and oxygen content were obtained during ventilation of…
Original Article
Prophylactic Treatment of Umbilical Stump Comparison of Technics
ABSTRACT:Three different technics of umbilical stump treatment (alcohol, “triple dye,” and providone iodine) were compared. The study revealed a significantly lower rate of colonization with coagulase-positive staphylococci in the group of infants treated with “triple dye.”
Original Article
Fractures of the Hip in Childhood
ABSTRACT:Twenty hip fractures in 19 children aged 2 1/2 to 18 were analyzed in a ten-year retrospective review at the University of Alabama Hospitals in Birmingham, Ala. There was one epiphyseal, one intertrochanteric, 4 subtrochanteric, and 14 intracapsular fractures. The mechanism of injury was usually severe trauma with 31% of…
Original Article
Medium and Long Chain Serum Free Fatty Acids in a Case of Reye's Syndrome
ABSTRACT:Elevated serum free fatty acids (FFA) have been implicated previously as the agent causing encephalopathy and fatty degeneration of the viscera (Reye's syndrome). This study documents a decrease in medium and long chain FFA from elevated levels (1.35 mEq/liter) to low levels (0.30 mEq/liter) in a patient successfully treated with…
Review Article
Recent Advances in Viral Hepatitis Part II
Current Concepts
Diagnosis of Infectious Mononucleosis
ABSTRACT:Infectious mononucleosis continues to be an important medical problem of young adults. Diagnosis is based on three principal criteria: (1) a compatible clinical picture, (2) characteristic hematotogic changes, and (3) a positive serology. A relative lymphocylosis of 60% or higher with at least 20% atypical lymphocytes is a common feature….
