SMJ // August 1977, Volume 70 - Issue 8
Editorial
OBESITY—THE AFFLUENT DISORDER
Primary Article
Importance of the External Carotid Artery in Extracranial Cerebrovascular Occlusive Disease
We have encountered 12 patients whose symptoms of transient ischemic attacks were due to total occlusion of the internal carotid artery with patency of the intracranial circulation being maintained by collateral circulation from the external carotid artery. In each case there was either tight stenosis or total occlusion at the…
Primary Article
Management of Facial Fractures
Maxillofacial fractures are usually diagnosed easily by history, clinical findings, and standard roentgenograms. Emergency treatment centers around airway management; the conscious patient should be allowed to clear his own airway whenever possible. Treatment of lower and upper jaw fractures focuses on reducing the fragments so that dental occlusion is normal….
Primary Article
Condylar Fractures of the Distal Humerus in Adults
Condylar fractures of the distal humerus are serious and in many instances pose a difficult treatment problem for the orthopedist. From 1969 to 1974, 24 condylar fractures of the distal humerus were treated at the University of Alabama Hospitals. Twenty of the fractures were closed and four were open. Eighteen…
Primary Article
Geriatric Mental Function and Serum Folate A Review and Survey
A review of the growing body of information regarding folic acid biochemistry indicates a relationship between folate metabolism and mental disturbance. Clinical correlations between altered mental functions associated with aging and lowered serum folate values are found to suggest that further studies are warranted. The fasting serum folate levels of…
Primary Article
Fine Needle Aspiration Cytology
Aspirations were done in 221 breasts and 32 extramammary sites with a 25 gauge needle attached to an ordinary 10 ml syringe. The aspirated material was expressed from the needle hub onto a slide, smeared by means of a second slide, air dried, and stained with a Wright-Giemsa solution. The…
Primary Article
Endoscopic Electrosurgical Polypectomies of the Upper Gastrointestinal Tract
The electrosurgical removal of polypoid lesions from the upper gastrointestinal tract with the esophagogastrouodenoscope has proven to be a safe, effective, and relatively inexpensive procedure. Twenty-six polypectomies performed on 24 different patients are presented. Polyps were removed from the distal esophagus, stomach, duodenum, and jejunum. There were no significant complications.
Primary Article
Role of Simple Mastectomy in Treating Patients With Breast Cancer
From 1945 to 1971, 473 patients had simple mastectomies as the primary treatment for their breast cancer (421 had either a simple mastectomy alone π26%π, a simple mastectomy followed by postoperative radiation therapy π64%π, or preoperative irradiation followed by simple mastectomy π10%π). More than one half of these patients were…
Primary Article
Recurrent Subareolar Abscess of the Breast and Squamous Metaplasia of the Lactiferous Ducts A Clinical Syndrome
When squamous metaplasia of the lactiferous ducts occurs, the normal cuboidal epithelium lining the lactiferous ducts is replaced by squamous epithelium, leading to intraluminal accumulation of epithelial debris. Recurrent subareolar abscess is a common co-feature of the disease. The chronicity of suppuration is related to a general unfamiliarity with this…
Primary Article
Fatal Poisoning With Propoxyphene Report From 100 Consecutive Cases
The first 100 deaths caused by propoxyphene and recorded by the Chief Medical Examiner of North Carolina were studied. Victims ranged evenly in age from the second to the seventh decade. Over 65% were suicides with a female to male ratio of 2:1. Blood propoxyphene concentrations of 0.2 mg/dl were…
Primary Article
Reconstruction of the Deep Femoral Artery
This article describes various surgical technics commonly used for reconstructing the deep femoral artery. The applicability, advantages, and disadvantages of various methods also are discussed.
Primary Article
Management of Ankylosing Spondylitis With Flurbiprofen or Indomethacin
The effects of flurbiprofen (150–200 mg daily) and indomethacin (75–100 mg daily) were compared in the management of 26 patients with active ankylosing spondylitis in a parallel, double-blind, and randomized trial of six weeks' duration. No patient in either group withdrew from the study because of lack of efficacy of…
Primary Article
Bacterial Flora of Patients With Prematurely Ruptured Membranes
Twenty consecutive patients with premature rupture of the membranes were studied to determine the vaginal, endocervical, and neonatal bacteriologic flora. Patients who had membranes ruptured for more than 12 hours had more anaerobic species isolated from vaginal plus endocervical or endocervical cultures alone than did those patients with membranes ruptured…
Primary Article
Effect of Delta‐9-Tetrahydrocannabinol on Intraocular Pressure in Humans
As early as 1971, it was noted that smoking marijuana lowered intraocular pressure. In this study one of the active components of marijuana, delta-9-tetrahydrocannabinol, was given intravenously to ten subjects with normal intraocular pressures. Two strengths were used—0.022 mg/kg of body weight and 0.044 mg/kg of body weight. Intraocular pressure…
Primary Article
Renal Cell Carcinoma With Erythrocytosis and Elevated Erythropoietic Stimulatory Activity
A case study is presented of a 55-year-old man who had clear cell renal carcinoma with pulmonary metastases and erythrocytosis. The increase in red blood cell mass was associated with an elevation in erythropoietic stimulatory activity in serum, pleural fluid, and tumor-cyst fluid as determined by the exhypoxic polycythemic mouse…
Primary Article
Urinary Estrogens During Late Pregnancy Observations on the Validity of “24‐Hour” Urine Collections and the Estrogen/Creatinine Ratio
The determination of estriol content of the maternal urine in late pregnancy has gained widespread use as a means of assessing the fetoplacental unit. Major drawbacks have included the time lag in obtaining a 24-hour urine collection and obtaining an accurate 24-hour collection. To overcome these problems, it has been…
Primary Article
Ulnar Drift and Metacarpophalangeal Joint Subluxation in the Rheumatoid Hand Review of the Pathogenesis
Ulnar drift and metacarpophalangeal joint subluxation are complicated abnormalities with a wide variety of causes. This paper reviews certain anatomic and mechanical features of the normal hand which predispose toward these abnormalities. In the rheumatoid hand, the major deforming forces include extensor forces, flexor forces, intrinsic forces, and forces from…
Primary Article
Radioimmunoassay of Serum Bile Acid Levels in Biopsy‐Proved Cirrhosis
Serum bile acid levels were determined by a radioimmunoassay for conjugates of cholic acid in 18 patients with biopsy-proved cirrhosis and compared to results of conventional liver function tests. Serum bile acid levels were abnormal in all 18 patients whereas results of the other tests were abnormal in only 50%…
Primary Article
Selection Among Benzodiazepines for Alcohol Withdrawal
Four pharmacologic differences among the benzodiazepines, which are the drugs of choice to conduct alcohol withdrawal, guide selection of the appropriate one: chlordiazepoxide, diazepam, oxazepam, or chlorazepate. Bases for selection include: (1) availability of other than oral dosage forms; (2) differences in additive effect with alcohol in producing central nervous…
Primary Article
Therapeutic Acupuncture A Selective Review
The use and effectiveness of acupuncture has become a major controversy. The limited data on the subject and the wide variety of methods referred to as “therapeutic acupuncture” have added to the confusion. Among physicians who use acupuncture as one modality of treatment, there exist many opinions regarding the definition…
Primary Article
Group B Streptococcal Colonization in a Newborn Nursery Effects of lodophor and Triple Dye Cord Care
Control of nosocomial group B streptococcal (GBS) colonization of newborn infants was attempted in a four-cycle study alternately employing single applications of povidone-iodine (iodophor) and triple dye to the umbilical cord stump and periumbilical area. GBS colonization rates were 49% and 34% following iodophor cord care (cycles I and III)…
Primary Article
Psychiatric Consultations for 112 Pediatric Inpatients
The investigator, a child psychiatry consultant for a pediatric service, studied 112 consecutive consultations, categorizing the presenting psychiatric problems, mental status, psychiatric diagnoses, final physical diagnoses, and psychiatric recommendations. The 112 patients represented 3.4% of all pediatric patients in the same age range admitted to the hospital. Girls comprised 59%…
Review Article
Zinc and Total Parenteral Nutrition
Case Report
Congenital Atresia of the Colon
Current Concepts
Endoscopic Removal of Foreign Bodies Using Fiberoptic Instruments
Article
Eponym The Name's the Same
“We recall him as a tallish, dark figure, that changed very little from middle life to old age; dark eyes that seemed to look past you through his spectacles; black hair; black beard, lengthening and growing grey with age. … We see him presiding at our medical meetings and addressing…
