SMJ // August 1982, Volume 75 - Issue 8
Primary Article
Normal Survival Curve After Coronary Artery Bypass
A consecutive series of 2,628 patients subjected to isolated coronary artery bypass have had follow-up for a total of 13,915.5 patient-years. The number of patients surviving without angina decreased from 81% at one year to 36.9% at nine years after operation. Nonfatal myocardial infarction occurred at a rate of 3.1%…
Primary Article
Aortovenous Fistulas Due to Ruptured Infrarenal Aortic Aneurysms Experience With Six Cases
A review of patients undergoing aortic aneurysmectomy between 1970 and 1979 at the Emory University Hospital and the Atlanta Veterans Administration Medical Center disclosed six patients with aortovenous fistulas. Four fistulas were aorta to vena cava; one, aorta to left renal vein; and one, aorta to left iliac vein. Four…
Primary Article
Catheter-Associated Septic Thrombophlebitis
The clinical presentation and results of management of septic thrombophlebitis in 35 patients over a seven-year period are reviewed. There were 25 men and ten women; 20 patients were over age 50. At diagnosis, fever was present in 33 patients (94%), and 33 (94%) had local signs of inflammation. Pus…
Primary Article
Metastasis From Squamous Cell Skin Cancer of the Extremities
In a series of patients with localized squamous cell skin cancer treated at a cancer center, the incidence of metastasis was 1.4%. A premalignant condition, including thermal burns and irradiation dermatitis, was found in 30% of those patients, and 28% had multiple primary skin cancers. Forty-two of the 106 patients…
Primary Article
Management of Wooden Foreign Bodies in the Orbit
Three large wooden foreign bodies were undetected in the orbit despite extensive evaluation and orbital exploration. In two cases there was motility disturbance from orbital inflammation that resolved after late spontaneous extrusion of the foreign material. Recurrent fistula unresponsive to antibiotics persisted in two cases until the wood extruded. Computerized…
Primary Article
Reoperation for Failure of Portoenterostomy
Over a four-year period, 18 children with biliary atresia have required portoenterostomy. Either because of failure of initial biliary output or failure to resume output after an episode of ascending cholangitis, reoperation on the portoenterostomy was performed in ten patients. Each of the patients had essentially no output before curettage….
Primary Article
Colonic Atony in Association With Sigmoid Volvulus Its Role in Recurrence of Obstructive Symptoms
We reviewed a 30-year experience in management of 129 patients with 163 acute obstructions due to sigmoid volvulus. Recurrent obstruction of the colon was observed in 47 (or 45%) of 104 patients who survived their initial obstructive episode: 61% after rectal tube insertion, 45% after detorsion, 33% after sigmoid plication,…
Primary Article
Total Hip Arthroplasty Review of Long-term Results in 185 Cases
Review of 185 consecutive Muller total hip arthroplasties five to nine years after operation showed that 14 patients had died and that three deaths were directly related to the surgery. Of these, 37 patients (54 hips) could not be located and were excluded. Another patient, nonambulatory for an unrelated cause,…
Primary Article
Medical Illness in Psychiatric Patients Barriers to Diagnosis and Treatment
We report a study of 102 consecutive admissions to the acute medical care unit of a large psychiatric hospital. The study was designed to investigate the epidemiology and the barriers to diagnosis and treatment of medical illness among female psychiatric inpatients. The majority of the patients were transferred to the…
Primary Article
Isorhythmic Atrioventricular Dissociation During Enflurane Anesthesia
Isorhythmic atrioventricular dissociation occurs in a substantial number of patients undergoing enflurane anesthesia. It causes a decrease in the systemic blood pressure that may be detrimental, especially in patients with poor cardiac reserve. The most satisfactory method of treating this arrhythmia is to discontinue enflurane and substitute another anesthetic agent.
Primary Article
Urethral Prolapse in Girls
Urethral mucosal prolapse in girls is a difficult problem with a high risk of subsequent meatal stenosis. We describe a simple technic of ligature circumcision followed by plastic repair.
Primary Article
Cimetidine and Acetylcysteine as Antidote for Acetaminophen Overdose
The incidence of acetaminophen overdose, often resulting in hepatotoxicity or even death, steadily increases as its use (instead of aspirin) as an antipyretic and analgesic increases. Acetaminophen-induced hepatotoxicity is thought to be dependent on the dose ingested and the activity of the cytochrome P450 enzyme system. The actual hepatotoxic mechanism…
Primary Article
Malaria in Pregnancy
Recent evidence suggests an increasing incidence of malaria among the civilian population of the United States. The effects of malaria in pregnancy can be serious to both mother and fetus. We present four patients with malaria during pregnancy and review the charts of 18 additional patients with malaria (two of…
Primary Article
Transsphenoidal Surgery for Prolactin-secreting Pituitary Tumors A Study of 28 Cases and Review of the Literature
Twenty-eight patients (22 women, six men) underwent transsphenoidal microsurgery for suspected prolactin-secreting pituitary tumors. Amenorrhea was present in 19 of the 22 women, and galactorrhea, in 21 of the 22 women and two of the six men. Prolactin values preoperatively ranged from 62 to 38,130 ng/ml, and the mean percentage…
Primary Article
Comparison of Filtration Leukapheresis and Centrifugation Leukapheresis in Treatment of Lymphosarcoma Cell Leukemia
A patient with lymphosarcoma cell leukemia resistant to chemotherapy was treated with filtration leukapheresis and centrifugation leukapheresis. Filtration leukapheresis removed only 10“ leukemia cells per 8.5 liters of blood processed, while centrifugation leukapheresis removed approximately six times as many leukemia cells from the same amount of blood. Lymph nodes and…
Review Article
Carcinoma of the Pancreas Diagnosis and Treatment
We made a retrospective analysis of the hospital record of 65 cases of carcinoma of the pancreas occurring over a 16-year period at Bayley Seton Hospital, Staten Island, New York. The male sex predominated; the average age was 62.5 years. About 72% of the tumors were located at the head…
Current Concepts
Acoustic Neuroma Experience With Clinical Diagnosis
This paper deals with current procedures for diagnosing acoustic neuromas and with nine acoustic tumors diagnosed in eight patients during a three-year period. Similarities and differences between findings and expected findings were studied. As a result several diagnostic steps were found to be especially valuable.
Article
Reactions of Families to the Death of a Child With Congenital Heart Disease
We interviewed 57 parents of 33 children who died of congenital heart disease to obtain their descriptions and perceptions of their own grief. Irrespective of the childs age or length of illness, the parents consistently described a grief reaction characterized by an initial period of shock lasting hours to several…
