SMJ // March 1982, Volume 75 - Issue 3
Editorial
THE IMPACT OF BELIEF
Primary Article
Gynecologic Operative Experience in Women Exposed to DES in Utero
ABSTRACTA review of 309 women exposed to DES in utero revealed 43 major gynecologic procedures, excluding cesarean section, in 33 women (11%) with a mean age of 24.3 years. Pelvic adhesions (54%), ovarian cysts (36%), and ectopic pregnancies (21%) were the major operative findings; no invasive gynecologic malignancies were identified….
Primary Article
Postoperative Morbidity in Cases of Cervical Conization Followed by Vaginal Hysterectomy
ABSTRACTIn an attempt to define a group of patients at risk for relatively increased morbidity who have had vaginal hysterectomy after conization, we retrospectively analyzed patients who had hysterectomy for cervical intraepithelial neoplasia. Patients who had hysterectomy within 24 hours of conization had an overall morbidity rate of 42% and…
Primary Article
Eclampsia Treatment and Referral
ABSTRACTAlthough the recognition and treatment of preeclampsia theoretically should eliminate eclampsia, it has not disappeared and remains a substantial threat to maternal and fetal well-being. The therapy of choice for treatment and prevention of convulsions is magnesium sulfate (MgS04–7H20 USP) and that for severe hypertension is intravenous hydralazine. Delivery of…
Primary Article
Breast Reconstruction After Classic Radical Mastectomy: Use of Omental Pedicled Grafts and Fascia Lata
ABSTRACTThe omental pedicle graft is a technic developed to replace tissues removed by classic radical mastectomies in preparation for constructing a new breast. The graft and the reconstruction may be done in one stage. The advantages of the technic are (1) the tissue is readily available, (2) it can be…
Primary Article
Prosthetic Rehabilitation of Extensive Facial Defects
ABSTRACTPatients with extensive surgical defects of the palate, orbit, or nose are difficult to rehabilitate. Prosthetic rehabilitation in these areas often shortens hospitalization, speeds recovery, and reduces medical expenses. Specific factors in planning treatment are directed toward successful prosthetic rehabilitation, using a team approach, careful patient selection, and specific surgical…
Primary Article
Surgical Treatment of Anterior Diaphragmatic Hernia
ABSTRACTOf ten patients with anterior diaphragmatic hernia treated by operation, only three had shortness of breath and chest pain. The remainder of the patients were referred to us because of a roentgenographic abnormality. All patients have had follow-up of between six months and 11 years without recurrence. Surgical repair is…
Primary Article
Cricothyroidostomy for Airway Access
ABSTRACTDuring the past 4 1/2 years, 43 cricothyroidostomies have been done at the VA Medical Center of Clarksburg, West Virginia, in place of a tracheostomy. Cricothyroidostomy is much easier to perform for the untrained as well as the trained physician. It is recommended for emergency relief of acute upper airway…
Primary Article
Diabetic Gangrene in Black Patients
ABSTRACTWe reviewed diabetic gangrene in 104 American blacks and found that the clinical features were similar to those reported for the general diabetic population. We observed, however, that there was a significant association of hypertension with above-knee and bilateral amputations in our patients (P < .001 and .01, respectively), and…
Primary Article
Pulmonary Artery Catheterization Via the External Jugular Vein
ABSTRACTThe use of pulmonary artery catheters in assessing and managing critically ill patients has become a common practice. The risks associated with insertion of the Swan-Ganz catheter via the internal jugular or subclavian vein include pneumothorax, puncture of the carotid or subclavian artery, mediastinal infiltration, and neurologic damage. I evaluated…
Primary Article
Problems Associated With Establishing a Clinic for the Elderly
ABSTRACTActual use of a newly established geriatric clinic in a low-cost housing unit was appreciably below projected numbers, even though cost and transportation were removed as barriers to care. In a survey of building occupants, 20% were unaware of the clinics existence. More than 90% of the occupants did not…
Primary Article
Erythrocyte Survival in Patients With Porcine Xenograft Aortic and Mitral Valves
ABSTRACTTen patients with porcine xenograft aortic and mitral valve prostheses were studied three to 36 months (mean 15 months) postoperatively for evidence of hemolysis. Studies included complete blood count, reticulocyte count, red cell indices, percentage of schistocytes on blood smears, bilirubin concentration, lactic dehydrogenase, serum iron, total iron binding capacity,…
Primary Article
Early Discontinuation of Anticonvulsants After Neonatal Seizures A Preliminary Report
ABSTRACTSeizures in the neonatal period generally respond well to anticonvulsant therapy, but exposure to anticonvulsant medication during the first few months of life may have a detrimental influence on growth and development. The optimal length of therapy is not known, though there are indications that treatment can be discontinued shortly…
Primary Article
Pharmacology of Kanamycin in the Newborn
ABSTRACTWe studied the pharmacologic effects of kanamycin in three groups of newborn infants: group 1—birth weight (BW) ≤ 2,000 gm, chronologic age (CA) 2,000 gm, CA 2,000 gm, CA 7 to 28 days. The dose of kanamycin was 15 mg/kg/day, administered in two intramuscular doses. Serum kanamycin levels were measured…
Primary Article
Amyloidosis and Factor X Deficiency
ABSTRACTThe association of amyloidosis and factor X deficiency has been reported 18 times. We have added a 19th case and compiled a summary of all previously reported cases. The pathogenesis of this association is discussed and therapeutic recommendations are offered based on the accumulated experience
Primary Article
Acute Renal Failure in McArdles Disease
ABSTRACTA 35-year-old man had acute renal failure and was subsequently diagnosed as having rhabdomyolysis secondary to McArdles disease, a primary myopathy due to myophosphorylase deficiency. Although it is a recognized cause of intermittent myoglobinuria, it has, nevertheless, rarely been associated with acute renal failure. The most likely explanation is that…
Primary Article
Two-Dimensional Echocardiography in Predicting Left Ventricular Wall Motion Abnormalities and Left Ventricular Function
ABSTRACTIn an attempt to formulate a reliable noninvasive method of detecting segmental wall motion disturbances, we examined 25 patients with coronary artery disease by two-dimensional echocardiography (2-DE), standard 12-lead electrocardiography (ECG), and biplane left ventriculography. The 2-DE technic predicted qualitative wall motion abnormalities as defined by ventriculography with a sensitivity…
Primary Article
Electrocardiographic Changes in Acute Pancreatitis
ABSTRACTElectrocardiograms recorded during 50 episodes of acute pancreatitis were analyzed and compared to those recorded during an asymptomatic period. Ten episodes of acute pancreatitis occurred in eight patients with normal ECGs during an asymptomatic period. Nonspecific ST-T changes were recorded in only two of them (one with mild hypokalemia). ECGs…
Review Article
Pheochromocytoma Clinical Diagnosis and Management
ABSTRACTThe incidence of pheochromocytoma among the hypertensive population is less than 1%. One third of the patients have intermittent hypertension, one third have remittent hypertension, and one third have persistent hypertension. The most common symptoms accompanying paroxysms include palpitation, headache, sweating, and pallor. Several familial syndromes have been described and…
Current Concepts
Pneumatic Otoscopy in Infants and Children
ABSTRACTThe pneumatic otoscope is indispensable in evaluating pressure within the middle ear of infants and children by measuring the tympanic membrane mobility. If the eardrum moves normally in response to positive and negative pressure, then a significant ear effusion, suppurative or nonsuppurative, is highly unlikely. Tympanic membrane color, luster, translucence,…
