SMJ // September 1977, Volume 70 - Issue 9
Editorial
EDITOR'S NOTE
Commentary
THE SPECIALTY OF FAMILY PRACTICE
Primary Article
Distribution of Physicians in Family Practice and Other Medical Specialties in Texas, 1969–1973 A Statistical Review
ABSTRACT:This article documents distributional patterns of allopathic family practice physicians (including general practitioners) in Texas as compared with allopathic physicians in all other medical specialties in the state during the period 1969–1973, for which there are reliable data. Statistical analysis of this information shows that there was a significant difference…
Primary Article
Nonunion of the Femoral Neck and Avascular Necrosis of the Femoral Head Treatment With Bone Grafts*
ABSTRACT:The use of full-thickness iliac bone grafts shaped into cigar and cigarette forms in the treatment of nonunion of the femoral neck and idiopathic avascular necrosis of the femoral head was studied. Results of 36 operations (18 hips in each category) were classified according to pain, range of motion, function,…
Primary Article
Practical Role for Ultrasound in Diagnosis of Deep Venous Thrombosis of Lower Extremities
ABSTRACT:The Doppler Ultrasonic Velocity Detector has been shown to be of significant value in the evaluation of patients with suspected deep venous thrombosis. Our experience in 121 patients demonstrates a false-negative rate of 10% for “minimal” thrombophlebitis and 3.2% for ileofemoral thrombosis when the Doppler was used as a diagnostic…
Primary Article
Hypocalcemia After Thyroidectomy Mechanisms and Management*
ABSTRACT:Hypocalcemia persists as a problem after thyroidectomy. We reviewed our experience with 245 thyroidectomies to define the spectrum of hypocalcemia, elucidate the mechanisms of hypocalcemia, and formulate a rational basis for its management. Postoperative hypocalcemia occurred in 8.6% of all patients undergoing thyroid surgery, with incidence the highest in patients…
Primary Article
Hereditary (Familial) Renal Disease Clinical and Genetic Studies
ABSTRACT:Four or more generations of three Oklahoma-Kansas families in which multiple members have been found to have glomerulonephritis or interstitial nephritis have been studied. Twenty-five of 146 members in kindred A, 16 of 50 members in kindred B, and 33 of 156 members in kindred C were identified as probably…
Primary Article
Aortocoronary Bypass Early Results of Operations in Community Hospitals of Greater New Orleans
ABSTRACTAll 588 aortocoronary bypass operations performed in the community hospitals of greater New Orleans before 1974 are reported. Hospital mortality averaged 8.7% (4.3% for one bypass; 6.4% for two; 10.3% for three or more; 26% when bypass was combined with another cardiac procedure). Mortality ranged from 5% to 31% among…
Primary Article
Management of Infantile Asthma
ABSTRACTInfantile asthma is an important pediatric problem and may cause substantial morbidity and mortality in this age group. The pathophysiology of allergic asthma involves a type I hypersensitivity reaction that is mediated by reaginic antibodies of the IgE class. Various factors predisposing to infantile asthma have been suggested but not…
Primary Article
Anisometropic Amblyopia and Its Treatment
ABSTRACTFull optical correction and closely supervised occlusion were effective in producing substantial visual improvement in 15 of 17 patients with anisometropic amblyopia. The age of patients varied from 2 to 12 years and all were followed for at least one year.
Primary Article
Thoracic Duct Injuries
ABSTRACTChylous fistulas are an infrequent result of injury to the thoracic duct during radical neck dissection. Leakage of lymph from a fistula which is allowed to persist will cause such serious postoperative problems as metabolic deficiencies, flap elevation, suture breakdown with hemorrhage, and infection. There appears to be no valid…
Primary Article
Biology of Psychoses Past Research and New Frontiers
ABSTRACTThis paper reviews major research developments in the biology of mental illness. Theories concerning schizophrenia and affective disease are shown to be based on the mode of action of drugs discovered in the 1950s and used in the treatment of these disorders. Discovery of the endorphins and the development of…
Primary Article
Wound Management After Trauma to the Colon
ABSTRACTThe records of 62 patients with injury of the colon were reviewed to ascertain the contribution of technics in wound care to morbidity. Primarily closed wounds had a very high frequency of infection (56%). Wounds treated by delayed primary closure or secondary intention developed infection in 19% of patients. Infection…
Primary Article
Is Postoperative Proximal Decompression a Necessary Complement to Elective Colon Resection?
ABSTRACTPostoperative nasogastric suction is not a necessary complement to elective colon resection. We studied two groups of patients who had elective colon resection: nasogastric suction was used in the postoperative management of 53 patients, while 23 patients were managed without nasogastric suction. The morbidity and mortality rates were comparable in…
Primary Article
Value of Bone Marrow Biopsy in the Diagnosis of Amyloidosis
ABSTRACTAmyloid involvement of the bone marrow is not commonly diagnosed before necropsy. Paraffin sections of the trephine bone biopsy specimen are superior to marrow aspiration cell smears for the antemortem diagnosis. Thirteen cases of amyloidosis were diagnosed from the bone biopsy specimen during a ten-year period. Amyloid was detected in…
Primary Article
Hepatitis‐B Surface Antigen (HBsAg) and Antibody (Anti‐HBs) Prevalence Among Laboratory and Nonlaboratory Hospital Personnel
ABSTRACTHBsAg and anti-HBs positivity was determined in hospital laboratory workers and nonlaboratory hospital workers (controls) matched for race and sex and adjusted for age. The combined prevalence of antigen-antibody positivity among white female technicians was 12% versus 0 of controls (P < 0.005). The highest prevalence (18%) among laboratory workers…
Primary Article
Surgical Repair of Old Fourth‐Degree Perineal Lacerations
ABSTRACTThere are four basic surgical procedures for repair of old fourth-degree (complete) perineal lacerations: the layer closure, the Warren flap, Bowers' modification of the usual layer closure, and the Noble procedure. The Noble procedure avoids the deficiencies of the other procedures, and it is recommended as the best choice for…
Primary Article
Comparative Effects of Nondepolarizing Muscle Relaxants on Succinylcholine‐Induced Fasciculations and Postoperative Pain
ABSTRACTThe effectiveness of pancuronium (1.0 to 1.5 mg), d-tubocurarine (3 mg), and gallamine (20 mg) administered three minutes before succinylcholine (1 mg/kg) in preventing muscle fasciculations and postoperative muscle pains was compared in 100 patients. Pretreatment with pancuronium abolished fasciculations and produced rapid and excellent muscle relaxation for endotracheal intubation….
Primary Article
Simplified Hiatus Herniorrhaphy
ABSTRACTA brief synopsis of problems with hiatus herniorrhaphy surgery over its 25-year history includes extensive surgery, recurrences, and postoperative swallowing difficulties. A review of the simple central tendon hiatal herniorrhaphy technic and seven-year results include the adoption of a mersilene strip rather than external rectus fascia in anchoring the esophagogastric…
Primary Article
Polycentric Total Knee Arthroplasty
ABSTRACTPolycentric total knee arthroplasty in 56 patients provided significant relief of pain in 90.7% and a stable knee in 92.7%. Postoperative increase in range of motion averaged 13.7% for all patients (18.5° in rheumatoid arthritis and 8.7° in degenerative arthritis). This increase in excursion is attributed to the design of…
Primary Article
Ovenstone Factor in the Management of Rh Sensitization
ABSTRACTSeveral methods have been developed for analyzing amniotic fluid to aid in the management of rhesus isoimmunization. Because all methods attempt to predict the severity of fetal hemolysis based on the original findings of Bevis and on the amount of unconjugated bilirubin in amniotic fluid as measured by its optical…
Primary Article
Liver Size in Normal Infants and Children
ABSTRACTLiver span of normal infants and children 2 months to 5 years of age was found to be significantly correlated with body height, weight, surface area, and age. However, it was best correlated with body surface area, reflecting a constant relationship between body size and liver size. Assessment of liver…
Primary Article
Hemophilus Endocarditis New Cases, Literature Review, and Recommendations for Management
ABSTRACTRarely is endocarditis attributed to the species of Hemophilus. Most frequently implicated are H aphrophilus and H parainfluenzae, but H influenzae also is seen. We report six cases of endocarditis due to H aphrophilus or H parainfluenzae and review the literature. Emboli to skin, lungs, kidneys, spleen, brain, and other…
Primary Article
Demonstration of Cryoprecipitable Immune Complexes in Pneumococcal Pneumonia
ABSTRACTCold-insoluble protein complexes (cryoprecipitates) can be found in the serum in a variety of infectious diseases. We studied serum cryoprecipitates isolated from three patients with pneumococcal pneumonia by counterimmunoelectrophoresis (CEP) and immunofluorescent technics for the presence of immune complexes. The cryoprecipitates and supernatant serum were tested for pneumococcal capsular polysaccharide…
Review Article
Ultrasonographic Abdominal Aortography
ABSTRACTBG-mode ultrasonography is an easily performed and accurate method of studying the abdominal aorta. The procedure is totally noninvasive and does not require patient hospitalization to detect aortic aneurysmal dilatation. Aneurysm size, extent, and associated aneurysmal clot formation can be determined more accurately than with contrast aortography. Para-aortic abdominal masses…
