SMJ // May 1979, Volume 72 - Issue 5
Editorial
SIDE EFFECTS OF CIMETIDINE
Editorial
THESE ARE THE DAYS
Editorial
ACKNOWLEDGMENT
Primary Article
Hemophilus parainfluenzae Endocarditis
We describe a case of Hemophilus parainfluenzae endocarditis in a previously healthy 26-year-old man, and review 21 cases from the literature. Although H parainfluenzae is considered to be part of the normal flora of the upper respiratory tract in man, it can cause serious disease. H parainfluenzae endocarditis is often…
Primary Article
Infectious Mononucleosis With Severe Neutropenia and Opsonic Antineutrophil Activity
Severe granulocytopenia is an uncommon complication of infectious mononucleosis, only 18 cases having been reported previously. Our review and experience with this case would indicate that (1) severe granulocytopenia is usually diagnosed at about the third or fourth week of illness, (2) bone marrow examination most commonly reveals lack of…
Primary Article
Prolongation of the Q‐T Interval in a Victim of Sudden Infant Death Syndrome Cause or Effect?
A 3-week-old infant died of sudden infant death syndrome (crib death, cot death). Although prolongation of the Q-T interval was found on an electrocardiogram taken at birth, this child appeared to have died of terminal respiratory failure as judged by a postmortem arterial oxygen tension of 4 mm Hg. The…
Primary Article
Posterior Pseudoaneurysm of the Left Ventricle A Prospective Echocardiographic Diagnosis
A 69-year-old man had a posterior pseudoaneurysm of the left ventricle shown by echocardiography and cardiac catheterization. The patient had resection of the pseudoaneurysm and did well. The case illustrates the usefulness of echocardiography for detecting and evaluating left ventricular pseudoaneurysm and die effectiveness of surgery for that entity.
Primary Article
Renal Tubular Dysfunction in Transplanted Kidneys
We studied 15 renal transplant recipients for evidence of tubular dysfunction. Eight patients were hypophosphatemic, and two had systemic acidosis with a urinary acidification defect. Mild aminoaciduria and bicarbonaturia were present in four and 14 patients, respectively. Elevated parathyroid hormone level was found in only one patient. Tubular reabsorption of…
Primary Article
In Utero Distal Pulmonary Meconium Aspiration
We have recently had eight cases of severe meconium aspiration syndrome which occurred despite clearing of the posterior pharynx of meconium after delivery of the head but before delivery of the body. Seven of the eight cases had documented fetal distress before delivery. Two stillborns with meconium aspiration are presented…
Primary Article
Left Main Coronary Artery Disease
Eighteen patients with significant stenosis of the left main coronary artery are reported and compared with 1,040 patients described in the ten largest published series. In comparison to previous reports, our patients have a higher incidence of congestive heart failure, previous myocardial infarction (especially inferior wall), poorer left ventricular function,…
Primary Article
Retrograde Jejunogastric Intussusception
Jejunogastric intussusception is an infrequently reported complication of gastroenterostomy. Prognosis and treatment are functions of the anatomic type (Shackman's classification). Gastroscopy and sometimes subsequent roentgenograms are the major diagnostic tools. Surgical treatment is required in the acute types where incarceration or strangulation occurs, and in the chronic types when function…
Primary Article
Preventing Disruption of Abdominal Wounds
The use of silver wire retention sutures requires added operating room time and expense, and it incurs the potential hazards of caught viscera, the possibility of more adhesions, leakage of intraperitoneal fluid through the exit wound, mild infection of exit wounds, and, on removal of the sutures, pain despite sedation,…
Primary Article
Gastroduodenal Crohn's Disease
Three new cases of gastroduodenal Crohn's disease are presented, two with obstruction and one with massive gastrointestinal bleeding. Of the 124 cases reported in the literature up to 1972, only four had massive gastrointestinal bleeding. An accurate preoperative diagnosis is difficult. When peptic epigastric distress and retention type of vomiting…
Primary Article
Myopathy of Chronic Organophosphate Poisoning A Clinical Entity?
The acute aspects of organophosphate poisoning are well understood. Persistent weakness and muscular wasting in some cases have been attributed to neuropathic effects resulting in muscular atrophy from denervation. Recently, necrosis of skeletal muscle has been induced by chronic inhibition of cholinesterase with organic phosphates in a reproducible experimental model….
Primary Article
Endometrial Hyperplasia A Five‐Year Study
Because of the recent controversy concerning estrogen and endometrial cancer, we studied the possible potential precursor lesions of the endometrium, reviewing 263 patients hospitalized in a community teaching hospital. The estrogen hormonal status, either exogenously or endogenously produced, plays a large role in the histologic structure of the uterine endometrium…
Primary Article
Arthrography in Acute Shoulder Dislocations
Arthrography of the shoulder was performed on 50 patients with acute traumatic shoulder dislocations. The mean interval between injury and arthrogram was 2.3 days, with a median interval of one day. Anterior dislocations occurred in 96% of patients, and posterior dislocations in 4%. Initial dislocations were present in 74%, and…
Primary Article
Pulmonary Function Studies in Acute Pulmonary Histoplasmosis
We performed follow-up pulmonary function studies on three patients with acute pulmonary histoplasmosis over a period of several months, and found that the disease is benign and usually responds well to treatment or is self-limiting. There are four major changes in lung function, namely a restrictive defect, an impairment of…
Primary Article
Preoperative Diagnosis of Splenic Abscess by Ultrasonography and Radionuclide Scanning
Abscess of the spleen is uncommon and potentially lethal, but until recently it was rarely diagnosed except by exploratory celiotomy or at autopsy. Now, with the advent of radionuclide scanning, ultrasonography, and selective angiography, earlier diagnosis is possible in most cases. We report a case of traumatic abscess of the…
Primary Article
Comparison of Butorphanol and Pentazocine as Postoperative Analgesics
Sixty patients with moderate or severe postsurgical pain were randomly divided into three equal groups for a double-blind comparison of the analgesic effectiveness of intramuscular butorphanol (2 and 4 mg) and pentazocine (60 mg). The groups were demographically similar. Pain intensity and pain relief were scored at 10, 20, 30,…
Primary Article
Value of Nephrotomography in Evaluating Nonvisualized Kidney in Renal Absence The Colon Sign
Nephrotomography is a simple, highly accurate, noninvasive procedure and is extremely helpful in differentiating a nonvisualized kidney due to renal agenesis, ectopia, or nephrectomy from other acquired renal diseases. Early recognition of the characteristic malpositioning of the colon, “the colon sign,” eliminates the need for more invasive investigations.
Primary Article
Microsurgical Technics in Reconstructive Surgery of the Fallopian Tube*
Only in the last few years have gynecologists begun to investigate the use of microsurgical technics. Investigators in Europe, Canada, and the United States have recently reported improvements in patency and intrauterine pregnancy rates using these meticulous technics. At Vanderbilt University Medical Center, gynecologic microsurgery has been applied for the…
Primary Article
Assessment of Adenoidal Hyperplasia*
Adenoidal tissue recovered at surgery was weighed to see if it would correspond with clinical evidence of increased secretory otitis media and nasal blockage. It was observed that adenoidal enlargement was directly proportional to the severity of clinical signs and symptoms. This was also predicted by lateral roentgenogram of the…
Primary Article
Serum Ferritin as an Early Determinant of Decreased Iron Stores in Pregnant Women
Serum ferritin has been shown to be an excellent determinant of iron stores. In a consecutive group of women registering at the regular prenatal clinic, we measured serum ferritin, iron, iron-binding capacity, and hemoglobin to determine their hematologic status as to anemia. It was found that serum ferritin is the…
Review Article
Immune Function of the Spleen
Our Medical Heritage
Notes on the History of Leprosy in Louisiana
In the late 1880s it became apparent in Louisiana that leprosy was endemic in the southern part of the state. Initially, the intention was to establish a leprosy hospital in the city of New Orleans, close to medical facilities, and where the bulk of the patients were to be found….
Case Report
Rat Bite Fever Misdiagnosed as Rocky Mountain Spotted Fever
A patient who had been exposed to ticks and who had also been bitten by a laboratory rat developed fever, headache, and a rash. He was treated with chloramphenicol for Rocky Mountain spotted fever, and recovered. Blood cultures, however, grew Streptobacillus moniliformis, a causative agent of rat bite fever. The…
