SMJ // December 1984, Volume 77 - Issue 12
Commentary
JOAN OF ARC AND SCIENCE
Primary Article
Joan of Arc and DSM III
ABSTRACT: As an exercise in the use of the current diagnostic manual of psychiatric disorders, the life story of Joan of Arc is summarized from birth until her execution at age 19. Then various psychiatric diagnoses are considered in the light of published criteria, including types of psychoses, psychosexual disorders,…
Primary Article
A Mechanism of Mania and the Chemistry of Dreams: A Hypothesis
ABSTRACT: A suggested cause of mania is asynchrony of two biologic clocks that are involved with the sleep-waking mechanism. Increased norepinephrine in the synaptic clefts of the locus ceruleus could quicken the pace of one clock. That same increase in norepinephrine is a possible inducer of euphoria and hyperactivity in…
Primary Article
Pelvic Arteriography in Obstetrics and Gynecology: Arteriovenous Fistulas and Embolization
ABSTRACT: Pelvic arteriography has become an increasingly useful diagnostic and therapeutic tool in the past decade along with angiography of other areas of the body. A brief historical review of its development in obstetrics and gynecology since 1950 is presented, including placental localization and study of pelvic arterial adequacy. Modern…
Primary Article
Alternative Sites for Continuous Arterial Monitoring
ABSTRACT: During a 13-month period, we studied 148 patients who had percutaneous arterial cannulation for continuous intraoperative, postoperative, and intensive care monitoring. In all patients, alternative arteries were cannulated, which included the brachial (43%), axillary (19%), femoral (28%), dorsalis pedis (8%), and superficial temporal artery (1%). No patient sustained any…
Primary Article
Experience With a Needleless Vascular Access Device (Hemasite) for Hemodialysis
ABSTRACT: Experience with 35 needleless implants (Hemasite) in 27 patients over the past 27 months has shown that this device can provide immediately available painless access in patients lacking adequate veins for a direct internal fistula for hemodialysis. The cumulative patency rate of 46% at two years is comparable to…
Primary Article
Long-term Alimentation by a New Indwelling Tube Gastrostomy Technique
ABSTRACT: Use of a Gore-Tex peritoneal catheter as a feeding gastrostomy tube can virtually eliminate the complications associated with long-term feeding gastrostomy. The tube consists of a radiopaque 18 F silicone rubber catheter having a toadstool-shaped, expanded polytetrafluorethylene flange and cuff around its midportion. Epithelial tissue grows into the interstices…
Primary Article
Hormones in the Etiology and Prevention of Breast and Endometrial Cancer
ABSTRACT: Since the incidence of endometrial cancer among estrogen-treated women at Wilford Hall Air Force Medical Center was not increased as reported by others, a prospective study was begun in 1975. With this data base, the cases of breast and endometrial cancer in estrogen and oral contraceptive users were reviewed….
Primary Article
Disorder of the Pineal Gland Associated With Depression, Peptic Ulcers, and Sexual Dysfunction
ABSTRACT: Depression, peptic ulcers, and sexual dysfunction may be exacerbated by a deficiency of melatonin. Stress and dietary habits may lead to deficiencies of both serotonin and melatonin. Melatonin inhibits the release of cortisol via the release of vasotocin. Abnormal circadian rhythms of cortisol may occur in states of decreased…
Primary Article
Craniopharyngioma Arising in the Pharyngeal Hypophysis
ABSTRACT: Four cases of nasopharyngeal craniopharyngiomas have been previously reported in the medical literature. They were, in fact, only nasopharyngeal extensions of tumors originating in the anterior pituitary of the sella turcica. Pituitary adenomas can arise from any part of the craniopharyngeal canal. Supporting this theory are four reported cases…
Primary Article
Comparison of the Effectiveness of a Beta Blocker (Atenolol) and a Diuretic (Chlorthalidone) in Black Hypertensive Patients
ABSTRACT:A double-blind crossover trial of atenolol and chlorthalidone was done in black Jamaican hypertensive patients. After an initial four weeks of single drug therapy, the beta blocker and thiazide diuretic were used in combination. Chlorthalidone at a daily dose of 25 mg produced a significant (P < .05) fall in…
Primary Article
Electrical Stimulation in Treatment of Delayed Union and Nonunion of Fractures and Osteotomies
ABSTRACT: This study reviews the cases of 52 patients with 52 ununited fractures and osteotomies who were treated with two methods of electrical stimulation, one surgical, the other nonsurgical. Seventeen patients, 14 of whom had concomitant bone grafting, had implantation of a bone growth stimulator. There were three synovial pseudarthroses…
Primary Article
Ileoanal Reservoir: Functional Results and Management
ABSTRACT: Restorative proctocolectomy with ileoanal reservoir is an alternative to Brooke ileostomy. This study of 56 patients emphasizes functional results and management of the loop ileostomy, transient incontinence, frequency of bowel function, constipation, perianal skin, and psychosocial issues.
Primary Article
Acute Yersiniosis and Its Surgical Significance
ABSTRACT: During early 1982, an outbreak of yersiniosis occurred in northern Mississippi. Abdominal pain suggestive of appendicitis was a common manifestation, but laparotomy revealed mesenteric adenitis. Yersinia enteritis should enter the differential diagnosis of acute appendicitis.
Primary Article
Malignant External Otitis
ABSTRACT: Malignant external otitis (MEO) is a potentially life-threatening Pseudomonas infection of the external auditory canal in which rapid diagnosis is the key to proper treatment. We present an anatomic description of the ear and skull base, with a review of the literature on MEO, in the hope that it…
Primary Article
Throat Culture in Impending Peritonsillar Abscess
ABSTRACT:Throat cultures done immediately before the development of a peritonsillar abscess were positive for (β-hemolytic streptococci in only one of 12 cases. To prevent suppurative complications such as peritonsillar abscess, treatment with antibiotics may be indicated in selected severe cases of tonsillar infections despite negative throat cultures.
Primary Article
Life After General Surgery Residency: Subsequent Practice Patterns of Chief Residents
ABSTRACT: No recent reports characterize the practice patterns of graduates of current general surgical residency programs. The University of Louisville Department of Surgery surveyed recent graduates of our program who were established in practice, to determine whether the training they had received had adequately prepared them for their subsequent positions….
Review Article
Exercise Stress Testing
Current Concepts
Electron Microscopy in Determining Origin of Metastatic Adenocarcinomas
ABSTRACT: Light microscopy has limited value in predicting where the primary site of a metastatic adenocarcinoma might be located. In our series, electron microscopy was useful in determining the primary site in approximately 85% of patients with a metastatic adenocarcinoma of unknown origin. This study is based on the ultrastructural…
