SMJ // February 1987, Volume 80 - Issue 2
Commentary
IMMEDIATE BREAST RECONSTRUCTION
Primary Article
Immediate Breast Reconstruction After Mastectomy Using a Permanent Tissue Expander
ABSTRACT: We describe a new breast implant that greatly facilitates immediate breast reconstruction after mastectomy. Through a detachable filling reservoir, the implant can be filled with saline by percutaneous injection; this allows the empty implant to be placed in position and filled only after viability of the flaps is assured….
Primary Article
Bile Reflux Gastritis
ABSTRACT: Bile reflux gastritis is a disabling postgastrectomy condition characterized by abdominal pain, bilious vomiting, and weight loss. The syndrome appears to be caused by free enterogastric reflux of bile and other proximal small bowel constituents. Endoscopic confirmation of bile reflux and documentation of gastritis support the diagnosis but are…
Primary Article
Normal Hearing in Patients With Acoustic Neuroma
ABSTRACT: We reviewed the cases of 614 patients who had operation for acoustic neuroma. In 38 cases, hearing was either normal or decreased symmetrically. Almost all patients had unilateral otologic complaints. All patients with unilateral otologic complaints should be evaluated for acoustic neuroma even if results of routine audiometry are…
Primary Article
Cochlear Implant: Audiometric Results With a Single-Channel Device
ABSTRACT: With the FDA approval of the first cochlear implant device in November 1984, the possibility of the perception of sound became a reality for the profoundly deaf individual. The cochlear implant group of Cincinnati was involved in the coinvestigator study before the approval of the device. This paper presents…
Primary Article
Heat of Intramedullary Reaming
ABSTRACT: Cortical ischemia and necrosis after intramedullary reaming are well documented. Numerous authors have described ischemic changes attributed to mechanical disruption of the arterial system of the intramedullary canal. Few have investigated the potential thermal injury during extreme temperatures generated during intramedullary reaming. We reamed the medullary canal of cadaveric…
Primary Article
Carcinoma of the Piriform Sinus
ABSTRACT: Carcinoma of the piriform sinus is one of the most aggressive tumors of the head and neck region. Almost 80% to 90% of the patients will be first seen in the advanced stages. No method of treatment is satisfactory. We present results of various methods of treatment, of which…
Primary Article
Haemophilus ducreyi Infection in South Florida: A Rare Disease on the Rise?
ABSTRACT: Increased numbers of patients with genital ulcers sought medical attention in the Palm Beach County, Florida, Sexually Transmitted Disease clinics from Aug 1, 1982 to Aug 31, 1983. We established that a small proportion of subsequent cases of genital ulcers were caused by Haemophilus ducreyi, the etiologic agent associated…
Primary Article
Positive Results of Endocervical Curettage as an Indication for Conization of the Cervix
ABSTRACT: At University Hospital of Jacksonville (Fla) during the years 1981 through 1984, 37 patients had conization of the uterine cervix for the sole indication of dysplastic cells found on endocervical curettage. Eighteen of the 37 (48.7%) were found to have a more dysplastic lesion than that diagnosed by colposcopic…
Primary Article
Caustic Ingestion and Its Sequelae in Children
ABSTRACT: Management of caustic ingestion in children remains a difficult challenge, with the outcome ranging from an asymptomatic state to intractable esophageal strictures. We reviewed the cases of 56 children ranging in age from 10 months to 5 years treated from 1973 to 1984 at the University of Florida. For…
Primary Article
Overnight Hernia Repair: Updated Considerations
ABSTRACT: Since 1976 we have repaired 2,325 inguinal or femoral hernias in 1,517 patients; 90% of these patients were admitted on the morning of surgery, and 91% were discharged the day after surgery. To better address the problem of declining strength in repaired tissues, we now use onlay or underlay…
Primary Article
Arteriovenous Fistulas of the Large Vessels of the Neck: Nonsurgical Percutaneous Occlusion
ABSTRACT: We describe the nonsurgical treatment of arteriovenous fistulas of the large vessels in the neck using three different means of endovascular occlusion of these large lesions, which are surgically difficult to approach and treat.
Primary Article
Testicular Seminoma: Effectiveness of Primary Radiation Therapy
ABSTRACT: We retrospectively studied 44 patients with testicular seminoma treated with primary radiation therapy at the Bowman Gray School of Medicine from 1972 through 1982. The 26 patients with stage I disease received infradiaphragmatic irradiation. Eleven of the 12 with stage II disease, the three with stage III disease, and…
Primary Article
Respiratory Insufficiency in Adult-Onset Acid Maltase Deficiency
ABSTRACT: Although the adult form of acid maltase deficiency is characterized by weakness of the limb girdle muscles, weakness of the respiratory muscles out of proportion to that of the limb muscles may make the diagnosis less obvious. We present four patients aged 35 to 57 with respiratory muscle weakness…
Primary Article
Influence of Folk Medicine on the Family Practitioner
ABSTRACT: The practice of folk medicine in the United States is increasing. Awareness by the family practitioner is essential in order to effectively communicate and successfully recommend medical treatment to those patients who hold belief in these traditional practices. Root medicine is particularly thriving in the southeastern United States. The…
Primary Article
Changes in End Tidal CO2 and Arterial Blood Gas Levels After Release of Tourniquet
ABSTRACT: We studied nine healthy adult patients having orthopedic surgical procedures requiring the use of a tourniquet under general anesthesia with controlled mechanical ventilation to determine changes in end tidal CO2 (EtCO2) and arterial blood gas values after tourniquet deflation. After deflation of the tourniquet, EtCO2 and PaCO2 increased maximally…
Primary Article
Screening of Jaundiced Neonates for Glucose-6-Phosphate Dehydrogenase Deficiency
ABSTRACT: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is transmitted as an X-linked recessive disorder, and thus female infants are expected to be only rarely affected. Review of the records of 1,478 jaundiced newborn infants (728 boys and 750 girls) screened for G6PD deficiency at the Foothills Provincial Hospital in Calgary showed 41…
Review Article
Osteoporosis
Current Concepts
Schizophreniform Disorder: A Diagnostic Dilemma
ABSTRACT: The DSM-III diagnostic criteria for schizophreniform disorder, mainly based on duration of symptoms, are insufficient to furnish a good treatment strategy. In recent literature, schizophreniform disorder has been grouped either with the schizophrenias or with the affective disorders. Scandinavian researchers have described two other groups of psychotic disorders that…
Article
Dealing With AIDS and Fear: Would You Accept Cookies From an AIDS Patient?
ABSTRACT: Acquired immunodeficiency syndrome (AIDS) has engendered a crisis of fear among the public and health professionals alike. In addition to the myriad anxieties that generally accompany dying and death, AIDS patients must deal with numerous additional fears. In rushing to treat the physiologic aspects of AIDS, health professionals have…
Medical Education
Culture as a Determinant of “Humanistic Traits” in Medical Residents
ABSTRACT: In this cross-cultural study of Puerto Rican and Texas physicians, we have tested the hypothesis that physicians “humanistic attributes” are culturally related. Differences (P = .05 to .01) were found between mean responses of the two groups of residents to seven of the questions on the Totalitarian-Authoritarian-Dogmatism scale. Factor…
