SMJ // June 1979, Volume 72 - Issue 6
Editorial
EXCESSIVE SODIUM IN DRINKING WATER
Primary Article
Spleen Size and Chromosome Analysis as Prognostic Factors in Chronic Myelogenous Leukemia
Of 72 patients with chronic myelogenous leukemia (CML), 37 were Ph1 positive, eight were negative, and 27 were not evaluated for the Ph1 chromosome. Of the 37 patients positive for Ph1, 31 had adequate evaluation. These 31 patients were reviewed for survival with reference to spleen size. Seventeen patients with…
Primary Article
Chronic Granulocytic Leukemia Long‐Term Remission in a Patient With Familial Sarcoidosis
A patient is described who has chronic granulocytic leukemia (CGL) and familial sarcoidosis, and who has been in complete remission for six years after a single course of busulfan therapy. Her bone marrow Philadelphia chromosome persists and the leukocyte alkaline phosphatase activity remains subnormal. Leukocyte alkaline phosphatase levels in nine…
Primary Article
Combined Surgical and Radiation Therapy for Invasive Carcinoma of the Cervix*
Results of combined surgical and radiation therapy for invasive carcinoma in 266 patients treated between 1945 and 1970 are presented. Treatment protocol included radical Wertheim hysterectomy, Taussig node dissection, and deep pelvic irradiation. All cases were staged according to the International Staging System. The five-year survival for patients with disease…
Primary Article
Exfoliative Dermatitis Presenting Sign of Internal Malignancy
Exfoliative dermatitis is most commonly associated with antecedent cutaneous disorders, medications, and lymphoreticular malignancies. Three patients with exfoliative dermatitis associated with internal carcinoma are described. The importance of thorough evaluation of all patients who present with exfoliative dermatitis is stressed.
Primary Article
Gastric Carcinoma in Young Adults
The clinical and pathologic characteristics of gastric carcinoma in patients younger than 30 are compared with those of patients 30 to 39 years of age. Patients in both age groups had similar symptoms, predominantly undifferentiated neoplasms, and poor prognoses. In both groups, there were significant delays in initiation of definitive…
Primary Article
Filtration Characteristics of the Polyester Fiber Micropore Blood Transfusion Filter
The filtration characteristics of a new polyester fiber (Fenwal II) micropore blood transfusion filter were investigated. Filtration of stored human whole blood and packed cells resulted in return of screen filtration pressure (SFP) of the blood to normal. Increased filter weights verified removal of large amounts of debris and microaggregates…
Primary Article
Double Contrast Examination of the Upper Gastrointestinal Tract*
The principles and technic of the double contrast examination of the esophagus, stomach, and duodenum are outlined. Use of the hypotonic agent glucagon improves evaluation of the stomach, but optimal visualization of the duodenum may require reexamination after its effect has worn off. The technic is able to show gastric…
Primary Article
Cystic Lymphangioma of the Spleen
Splenic cysts are uncommon, with fewer than 600 cases reported in the world literature. This report concerns a case of cystic lymphangioma of the spleen, consisting of a large splenic cyst with associated multiple, small, subcapsular cysts and lymphangiectasia. The cysts are lined by endothelium, and they conform to the…
Primary Article
Acute Myelomonocytic Leukemia Coexistent Cytochemical Markers for Monocytes and Granulocytes in the Leukemic Cells
A 22-year-old man presented with mediastinal lymphoma and lymphoblastic leukemia. The leukemic cells in his blood and marrow did not stain positively with Sudan black B, peroxidase, chloroacetate esterase, or nonspecific esterase, and were considered as either lymphoblasts or stem cells. One year after the initial presentation, acute myelomonocytic leukemia…
Primary Article
Allergic Reactivity of the Pikes Peak Region
Despite the introduction of many new species from other areas, a skin test survey of patients visiting our allergy office shows that the plants causing hay fever in this area continue to be the same as in years past. Each physician should evaluate potential allergens in his own area, as…
Primary Article
Unicompartmental Replacement for Medial Compartment Gonarthrosis Preliminary Report
Unicompartmental replacement using the Marmor prosthesis was done in 40 knees (37 patients) with medial compartment gonarthrosis. Of the 27 available for follow-up, results were considered excellent in 18 cases and good in seven, while two cases were considered failures. Meticulous removal of osteophytes by intercondylar burring and accurate alignment…
Primary Article
Transient Erythrocytosis During the Neonatal Period. I Possible Neurologic Complications
Transient erythrocytosis during the neonatal period may result in serious complications. Among the well recognized problems are respiratory distress, acute heart failure, and death. Little attention has been ascribed to the neurologic complications of a high hematocrit level in the neonatal period. This report describes four pediatric patients with neurologic…
Primary Article
Critical Care and Anesthetic Management of Reye's Syndrome
The encephalopathy of Reye's syndrome is frequently complicated by increased intracranial pressure (ICP) which may lead to death or severe neurologic sequelae. An understanding of the pathophysiology of increased ICP is necessary to prevent further increases in pressure and to reduce pressure while maintaining adequate cerebral perfusion. Four of seven…
Primary Article
Lethal Toothache Parapharyngeal Cellulitis Complicating Dental Infection
Three patients with parapharyngeal cellulitis arising from dental infection were seen by the Medical Service over a period of ten months. Respiratory distress and/or pharyngeal discomfort prompted all patients to seek medical aid. The extent of infection within the parapharyngeal space, the potential for life-threatening complications, and the significance of…
Primary Article
Drowning and Near‐Drowning Current Concepts and Neutrophil Function Studies
A near-drowning by a young man in an indoor pool is reported, and the current concepts of therapy are discussed. Laboratory studies of the patient's neutrophil function and chemotactic response were performed on the day of admission and on hospital days 2 and 4. Neutrophil function and chemotaxis were equal…
Primary Article
Evaluation and Prognosis in Nonorganic Failure to Thrive
The 70 children with failure to thrive (FTT) admitted to our hospital over the last five years were reviewed. After extensive evaluations, only 16% received a diagnosis of an organic disorder. In the nonorganic group, 45% of FTT was secondary to improper feeding and 52% was secondary to environmental deprivation….
Primary Article
Congenital Lobar Emphysema
Congenital lobar emphysema is a rare disorder that may present outside the newborn period. It is generally best treated surgically by excision of the affected lobe. We describe a 6 1/2-week-old infant in whom the initial auscultatory and roentgenographic findings were confusing and of no help in making the diagnosis….
Primary Article
Gunshot Wounds to the Spinal Cord*
A series of 59 patients with gunshot wounds to the spinal cord is presented. Seventeen injuries were cervical, 30 were thoracic, 11 were lumbar, and one was sacral. Twenty-nine patients had immediate complete sensorimotor loss of function, 18 had sensory or motor sparing below the cord lesion, and 12 had…
Primary Article
Family Practice Management of Depression How to Select Tricyclic Antidepressants
The clinically observable symptoms of subjective energy or activity level, sleep disturbance, and weight gain or loss, in that order, can be of help in selecting the tricyclic antidepressants—amitriptyline, doxepin, or imipramine—in the management of depression and associated symptoms.
Primary Article
Coombs'-Positive Hemolytic Anemia and Ibuprofen
A patient who developed an autoimmune hemolytic anemia during treatment with ibuprofen (Motrin) is described. Positive indirect Coombs' reaction was demonstrated with the patient's red blood cell eluate in the presence of the drug, supporting a drug-related immune hemolysis. The positive direct Coombs' reaction to anti-C3 antiserum strongly suggested that…
Primary Article
Serum Levels of Estrone and Estradiol After Implantation of Estradiol Pellets
Serum estrone, estradiol, progesterone, FSH, and LH levels were studied after the implantation of estradiol pellets in female volunteers in the reproductive age group. The estradiol pellets were implanted at six-month intervals. The first implant consisted of four pellets (25 mg each). Subsequent implants consisted of a reduction by one…
Review Article
Coronary Arterial Spasm
Numerous reports have documented the existence and significance of coronary artery spasm in patients with Prinzmetal's variant angina, with or without associated obstructive coronary artery disease. The mechanisms whereby spontaneous coronary arterial spasm is precipitated in variant angina, particularly in patients without high-grade obstructive lesions, is far from clear, but…
Article
Legal Implications of Patient Records
Significant changes have been made by the courts and legislatures on the rights of patients to review or acquire their own medical records. There are great dangers in writing any personal, unscientific comments into the record which could embarrass the physician in court. Attempts to prevent the patient from gaining…
Medical Education
Evaluation of Extramural Programs
Extramural programs may be evaluated in terms of effectiveness in achieving their particular goals. The components of structure, process, and outcome are examined as related sets of program elements. Goals influence appropriate structure in organization, facilities, and manpower. Structure in turn influences process or activities which result in outcome. Outcome…
