SMJ // December 1985, Volume 78 - Issue 12
Editorial
TEACHING IN GERONTOLOGY AND GERIATRICS
Primary Article
Postmortem Evaluation of Alzheimers Disease
ABSTRACT: Postmortem evaluation of ten individuals with a diagnosis of Alzheimers disease (AD) confirmed the clinical diagnostic accuracy at our institution and showed significant ventricular dilatation with reduced brain mass, increased neuritic plaques, neurofibrillary tangles, vascular amyloid, and Lewy bodies in these individuals. A matched control group had no or…
Primary Article
Bowel Cleansing With Polyethylene Glycol Electrolyte Lavage Solution
ABSTRACT: We reviewed our experience with an oral gut lavage solution (GoLYTELY), used as a rapid bowel cleansing preparation, and the prospective clinical trials reported in the literature to compare the overall experience with this type of preparation for colonoscopy and colon surgery. Five studies (546 patients) compared GoLYTELY to…
Primary Article
Flexible Sigmoidoscopy as a Screening Procedure for Asymptomatic Colorectal Carcinoma in Patients With Inguinal Hernia
ABSTRACT: In patients about to have hernia repair, preoperative screening studies for early colorectal cancer using the rigid proctosigmoidoscope and barium enema have previously shown minimal cost effectiveness and poor patient acceptance. Flexible sigmoidoscopy may be more acceptable to patients and of greater diagnostic value. Between October 1980 and December…
Primary Article
Shock Liver
ABSTRACT: The clinical syndrome of “shock liver,” also known as ischemic hepatitis, is characterized by sudden elevation (to more than 20 times the upper limit of normal) of SGOT and SGPT in response to cellular anoxia, followed by resolution to near normal levels within seven to ten days. In our…
Primary Article
Pyogenic Liver Abscess: Changing Epidemiology and Prognosis
ABSTRACT: We reviewed the clinical features, methods of diagnosis, and outcome of 31 patients with pyogenic liver abscess seen at a private community hospital between 1973 and 1980. Two patient groups emerged. Group 1 consisted of 25 patients who had classical signs and symptoms of primary liver abscess. Group 2…
Primary Article
Community-Acquired Febrile Illness in Patients With Prosthetic Heart Valves
ABSTRACT: We prospectively studied 40 patients with prosthetic heart valves and community-acquired febrile illness. The mean age of the group studied was 35.2 + 12.8 years, and the mean length of time that the prosthetic valve had been in place was 53.4 ± 43.7 months. There was a high incidence…
Primary Article
Right Ventricular Visualization by Thallium 201 Myocardial Scintigraphy in Chronic Obstructive Pulmonary Disease
ABSTRACT: The right ventricle is not normally displayed by studies with thallium 201 in patients at rest, but it can be shown by thallium 201 myocardial scintigraphy with pressure or volume overload of the right ventricle and with right ventricular hypertrophy. We sought to determine the frequency of right ventricular…
Primary Article
Incidence of Mammary Intra-arterial Calcification: An Age-Matched Control Study
ABSTRACT: Mammary intra-arterial calcification (MIAC) was seen on the mammograms of 13 of 150 (8.7%) known diabetic patients and 21 of 300 (7.0%) age-matched control patients. Statistical analysis verified no significant difference between the rate of occurrence of MIAC in the diabetic group of patients and the control group. Therefore,…
Primary Article
Cholecystokinin Cholecystography: Is It a Useful Test?
ABSTRACT: We reviewed 57 patients, who during the last four years had cholecystokinin cholecystography during evaluation of abdominal pain, and found this test to be reliable for diagnosing chronic acalculous cholecystitis. Eighty-eight percent of the patients in whom abdominal pain was reproduced during cholecystokinin cholecystography and who had less than…
Primary Article
Avoiding Ureteral Injury During Total Vaginal Hysterectomy
ABSTRACT: One third of ureteral injuries in gynecologic surgery occur during vaginal hysterectomy. The current techniques of dissecting the ureters in abdominal hysterectomy should carry over into vaginal operations. We studied 30 consecutive patients having vaginal hysterectomy by a surgical procedure allowing routine vaginal ureteral dissection.
Primary Article
Effect of High Tension and Relaxing Incisions on Wound Healing in Rats
ABSTRACT: We developed four experimental models of rats and created abdominal wall wounds with various amounts of tension. We made the wounds under normal and high tension, both with and without relaxing incisions, and measured the bursting strengths and the rate of vascularization of the wounds. The results indicate that…
Primary Article
Perilymph Fistula
ABSTRACT: Perilymph fistula occurs when endolymph and perilymph mix, or when perilymph leaks into the middle ear space. Sensorineural hearing loss and/or vertigo may result. This paper reviews the pertinent anatomy and physiology of the inner ear, clinical presentations, diagnosis, treatment, and prognosis as a guide for the clinician.
Primary Article
Parotid Surgery and the Otolaryngologist
ABSTRACT: Otolaryngologists are performing more parotid surgery and are using otologic landmarks and methods to identify and preserve the facial nerve. Over the past 15 years in the Department of Otolaryngology-Head and Neck Surgery at Tulane Medical School, use of the tympanomastoid fissure as a guide to the facial nerve…
Primary Article
Posttransfusion Crises in Sickle Cell Anemia Role of Delayed Hemolytic Reactions to Transfusion
ABSTRACT: We describe ten patients with sickle cell anemia who became acutely ill within a few days after a blood transfusion. Two patients died. In eight cases the posttransfusion detection of alloantibodies suggested that delayed hemolytic reactions to transfusion were involved in precipitating the acute illness. In some cases the…
Primary Article
Rhinoplasty: Clinical Categorization as a Practical Preoperative Guide
ABSTRACT: As progressively more individuals desire rhinoplasty, facial surgeons are experiencing a wider spectrum of potential patients. The young woman in her late teens and 20s once made up the majority of the rhinoplasty case load. Now, the patients desiring aesthetic and reconstructive nasal surgery represent all stages of life….
Primary Article
Excess Leukocytosis (Leukemoid Reactions) Associated With Malignant Diseases
ABSTRACT: Twenty-one patients with malignancy had a peripheral white blood cell count of 50,000/cu mm or more. The malignancies arose from several tissues, especially lung; all were carcinomas except for one osteogenic sarcoma. In no case was there evidence of leukemia as defined by disorderly marrow growth, abnormal chromosomes, or…
Review Article
Sleep, Sleep Loss, and Breathing
ABSTRACT: Sleep and sleep loss have remarkable effects on breathing. Although sleep causes ventilatory disturbances of greater severity and variety than does sleep deprivation, the effects of sleep and sleep loss on respiration are similar. For example, both impair ventilatory drive and arousal responses to a variety of stimuli. Although…
Current Concepts
Acute Aortic Dissection
ABSTRACT: Disease processes affecting the aorta are gaining increasing attention as average longevity of the population in this country increases and as awareness of conditions such as hypertension and atherosclerotic cardiovascular disease improves. Aortic dissection is commonly seen as a manifestation of these processes in the aging population and is…
Medical Education
Analysis of Learning Style
ABSTRACT: Analysis of learning style, a relatively new technique in the field of education, is being used in grade school and college, as well as in graduate and postgraduate training programs. The trend in the health professions to emphasize continuing education has created a need for individual practitioners to understand…
