SMJ // February 1983, Volume 76 - Issue 2
Retrospective
Pernicious Anemia
Abstract
Developmental Outcome of Infants With Grade III Intraventricular Hemorrhage
ABSTACTTo determine the developmental outcome of premature infants weighing 1,750 gm or less at birth and who had grade III intraventricular hemorrhage (IVH), we followed up ten infants with IVH confirmed by computed tomography (CT) and ten CT-negative control infants until they were 12 months corrected age. The infants were…
Abstract
Excessive Fetal Activity Another Worrisome Sign?
ABSTACTDocumented fetal inactivity is strongly suggestive of fetal jeopardy, but the significance of excessive activity over a prolonged period has not been reported. Using data gathered from fetal movement charts recorded by 931 patients, fetal hyperactivity was defined statistically as 40 or more movements perceived per hour for at least…
Abstract
Profile of Phospholipids in Amniotic Fluid to Assess Fetal Lung Maturity in High-Risk Pregnancy
ABSTACTIn assessing fetal lung maturity, an amniotic fluid profile, consisting of a total phospholipid (as phosphorus) (TPP) and total lecithin (LT) concentration, has been shown to yield a predictive accuracy of 97.5% with a false-negative rate of 2.4%. The LT had a range of specificity of 93% to 99%, whereas…
Abstract
Home Birth Negative Implications Derived From a Hospital-Based Birthing Suite
ABSTACTOur study of 390 patients enrolled in a birthing suite program revealed that antepartum or intrapartum problems allowed only 160 (41%) to actually give birth in the birthing suite. Antepartum complications included premature labor in ten (2.5%), premature ruptured membranes in 31 (8%), postdatism in 50 (13%), preeclampsia in 27…
Primary Article
Cholecystosonography in Detection of Acute Cholecystitis The Halo Sign—A Significant Sonographic Finding
ABSTACTTo evaluate the efficacy of ultrasonography in detecting acute cholecystitis, we retrospectively reviewed the ultrasonic findings after cholecystectomy in 34 patients with acute cholecystitis and 90 patients with chronic cholecystitis. The sonographic findings evaluated included the length and width of the gallbladder, thickening of the gallbladder wall, good identification of…
Primary Article
Bulimia The Binge Eating Syndrome
ABSTACTBulimia occurs in roughly half of obese and anorexic patients. A recent study found 19% of female and 5% of male college students to be bulimic. Binge eating usually comes to the physicians attention from problems associated with purging measures—diuretics, laxatives, or self-induced postprandial vomiting—used by one out of ten…
Primary Article
Transverse Colon Volvulus Diagnosis and Treatment
ABSTACTAlthough considered rare, transverse colon volvulus (TCV) may actually comprise as many as 10% of all cases of colon volvulus. Correct identification clinically is necessary in order to reduce the high mortality. Unlike the treatment of sigmoid volvulus, conservative treatment of TCV is thought to be inadequate. Furthermore, simple proximal…
Primary Article
Breast Reconstruction After Mastectomy
ABSTACTRadical mastectomy inflicts emotional as well as physical scars, and preoperative interviews with the reconstructive surgeon can help to ameliorate some anxiety. There is no evidence of risk to the patient from reconstruction of the breast. Reconstruction is best deferred for four to six months after mastectomy for several oncologic…
Primary Article
Arterial Oxygen Saturation During Meals in Patients With Severe Chronic Obstructive Pulmonary Disease
ABSTACTWith an ear oximeter we measured the arterial oxygen saturation (SaO2) of 33 patients with stable chronic obstructive pulmonary disease (COPD) who were breathing room air (a) under baseline conditions and (b) while eating lunch. Data from each patient were analyzed in two ways: The average baseline SaO2 was compared…
Primary Article
Double-Blind Study of Guanabenz Acetate in Hypertensive Patients
ABSTACTTwenty-five patients with essential hypertension were given 50 mg of hydrochlorothiazide twice daily. Patients were randomly assigned to one of two treatment groups. The group given 6 mg of guanabenz twice daily as well as hydrochlorothiazide showed a significant decrease in systolic blood pressure in the supine, sitting, and standing…
Primary Article
Ocular Melanoma Surgical Experience With “No Touch” Enucleation
ABSTACTThere is a controversy among ophthalmologists concerning the management of ocular melanomas. The “no touch” cryoenucleation technic was designed to prevent dissemination of tumor emboli during enucleation. I have observed no significant complications in five years of experience with this technic. It is a simple, safe, and potentially lifesaving procedure….
Primary Article
Fetal Sex Determined by Ultrasound
ABSTACTIn an ultrasonographic laboratory we scanned 545 consecutive obstetric patients for obstetric indications based on the consultative needs of the physicians involved in their care. We attempted to determine the sex on all fetuses. The gestational age ranged from 15 weeks to term. Fetal sex was established in 196 (36%)….
Primary Article
Comparison of Radiographic and Radionuclide Skeletal Surveys in Battered Children
ABSTACTA review of 13 cases of suspected child abuse in which radionuclide (RN) scans, radiographic skeletal surveys, and sufficient follow-up were available showed that the RN scans were insensitive, even though fractures were more than 48 hours old at the time of the scan. Frequently missed lesions included skull and…
Primary Article
Comparison of Supine, Upright, and Prone Positions for Liver Scans
ABSTACTWe compared liver scan interpretations based on anterior images obtained in the upright, prone, and supine positions. Receiver-operating-characteristic curves were generated for three well trained observers. Results showed that reading the three different views together was more accurate than the reading of any individual image. Furthermore, interpretations based on either…
Primary Article
Radiologic Examination Requisition Procedures A Study of Their Effectiveness in a Community Hospital
ABSTACTI reviewed 100 consecutive radiologic examinations with particular attention to the clinical information included. The referring physician originated this clinical information in only 33% of cases. Other personnel, including nurses and aides, added information on the requisitions 57% of the time. When nonphysician personnel completed the requisitions, 46% of the…
Review Article
Complications of Tubes and Catheters
Article
Disaster Preparedness
ABSTACTThe only rational approach to the potential chaos of a mass disaster is thoughtful predisaster preparation and realistic but optimistic confrontation of the situation. An appropriate response implies accurate assessment of the magnitude of the disaster, the establishment of a reliable and effective communication system, a realistic inventory of and…
Our Medical Heritage
Sciatica and the Lumbar Disk Syndrome A Historic Perspective
ABSTACTThe dynamics of the human spine mark the lumbar disk syndrome and accompanying sciatic complaints as long-standing afflictions of our species. Although Greco-Roman erudition suitably described the ailment, uneven diagnostic and therapeutic acumen confused inquiry for many centuries. Only with the 19th Century advent of improved clinical facilities, pathologic correlation,…
Case Report
Niacin Hepatitis
Case Report
Bronchopulmonary Sequestration as a Rare Cause or Acute, Massive Intraesophageal Bleeding
SUMMARYWe have described a 69-year-old woman with a sequestered segment of lung located in the right upper lobe, with open communication with the esophagus. Investigation of the acute anemia produced by acute blood loss into the gastrointestinal tract led to the diagnosis and treatment of this rare condition.
Case Report
Synovial Sarcoma of Tonsil and Tongue Base
SUMMARYWe report a case of synovial sarcoma of the tonsil and tongue base. Radical surgery is the treatment of choice. Whether planned combination therapy may offer a better prognosis remains to be demonstrated.
Case Report
Toxic Shock Syndrome Manifested as Psychosis
SUMMARYThe patient described had case criteria for diagnosis of toxic shock syndrome (initial illness), manifested as a psychosis, which was unrecognized for eight weeks.
Case Report
Isodicentric X Chromosome in a Girl With Gonadal Dysgenesis
SUMMARYChromosomal analysis on a 15-year-old girl with amenorrhea and lack of secondary sexual development showed a normal X chromosome and an isodicentric X chromosome, 46,X, idic(x) (pter→q23::q23→pter). Thus the patient has duplicated and deleted X chromosome material. There was no evidence of 45,X mosaicism. BrdU-labeling revealed the abnormal X to…
Case Report
Invasive Pulmonary Aspergillosis Associated With Aspergilloma in Sarcoidosis
SUMMARYWe have described two patients with corticosteroid-treated sarcoidosis and with autopsy-proven aspergilloma and diffuse invasive pulmonary aspergillosis. In one, growth of the fungus within a cyst was probably followed by progression to diffuse pulmonary infection. In the second, lung necrosis from invasive infection may have led to the formation of…
Case Report
Invasive Endometriosis of the Terminal Ileum A Cause of Small Bowel Obstruction of Obscure Origin
SUMMARYA 40-year-old woman with a five-month history of intermittent abdominal pain in the right lower quadrant, diarrhea, and signs of small bowel obstruction was thought to have Crohns disease of the terminal ileum. At operation, endometriosis of the terminal ileum was found and treated by resection. Enteric endometriosis is a…
Case Report
Systemic Lupus Erythematosus With Myocarditis Complicating Pregnancy
SUMMARYWe report a patient with systemic lupus erythematosus and myocarditis complicating pregnancy. Cardiomegaly and compensated congestive heart failure persisted postpartum and we had the therapeutic dilemma of a pregnancy six months later. The defined maternal prognosis of a similar disease, peripartum cardiomyopathy, suggested the need for termination of pregnancy.
Case Report
Mediastinal Pancreatic Pseudocyst
SUMMARYWe have described a case of extension into the mediastinum by a pancreatic pseudocyst. This rare phenomenon should be included in the differential diagnosis of mediastinal mass lesions. We advocate the use of CT in evaluating a mediastinal mass to determine its solid or cystic nature, size, extent, and relationship…
Case Report
Maffuccis Syndrome
Case Report
Biliary Reflux Demonstrating an Impacted Ampullary Stone
SUMMARYWe report a case of reflux of barium into the distal common bile duct that directly demonstrated an impacted ampullary stone.
Breif Report
Nonclostridial Gas Gangrene Late Infection After Hip Pinning
SUMMARYAn 86-year-old diabetic man had a late, gas-forming infection about Knowles pins. Although blood cultures were negative, a urinary tract infection followed by infection with the same organism in bone, muscle, and lung strongly supports hematogenous spread of E coli from the genitourinary system in this patient. The genitourinary system…
Breif Report
Multiple Myeloma and Syndrome of Inappropriate Secretion of Antidiuretic Hormone
SUMMARYI have described a patient with multiple myeloma who had hypo-natremia probably secondary to SIADH. Multiple myeloma, heretofore not considered as a cause of SIADH6 should be added to the long list of diseases and drugs that cause this syndrome.
Breif Report
Fatal Subscapular Staphylococcal Abscess
SUMMARYA previously healthy 19-year-old man had a Staphylococcus aureus subscapular abscess after trauma to the shoulder, leading to sepsis, pneumonia, and death. Subscapular abscesses are infrequently described and might represent diagnostic difficulty to the clinician as well as to the unwary autopsy pathologist.
Breif Report
Hemophilic Splenic Rupture Without Thrombocytosis
SUMMARYSpontaneous splenic rupture in hemophilia A is an uncommon occurrence which is difficult to diagnose. We have reported a case of hemophilic rupture of the spleen unaccompanied by thrombocytosis, which has been emphasized as a diagnostic clue to hemophilic splenic rupture. Hence, splenic rupture should still be considered in any…
Breif Report
Tularemia Complicated by Acute Renal Failure
SUMMARYAcute renal failure has been a rare, uniformly fatal complication of infection with Francisella tularensis. The literature suggests that either acute tubular necrosis, interstitial nephritis, or glomerulonephritis may be responsible for this syndrome. We have described a patient with tularemia who had nonoliguric acute renal failure probably due to interstitial…
