SMJ // March 1987, Volume 80 - Issue 3
Primary Article
Adenocarcinoma of the Stomach: Are We Making Any Progress?
ABSTRACT: We studied 2,062 patients with adenocarcinoma of the stomach seen at The University of Texas M. D. Anderson Hospital and Tumor Institute between 1944 and 1984. The distribution by site was cardia 33%, antrum 31%, and body 27%; 9% of the patients had linitis plastica. The raw five-year survival…
Primary Article
Vertical Rectus Abdominis Musculocutaneous Flap for Breast Reconstruction After Irradiation
ABSTRACT: We have used a contralateral vertical rectus abdominis musculocutaneous flap based upon the superior epigastric vessels in six patients to provide coverage after resection of locally recurrent breast carcinoma in irradiated tissues. Primary healing of defects as large as 16 cm × 35 cm has been obtained using this…
Primary Article
Prospective Analysis of the Effect of Incidental Appendectomy on Infection Rate After Cholecystectomy
ABSTRACT: I prospectively studied 100 patients to see whether “incidental appendectomy” with cholecystectomy affects wound infection rate. Randomization resulted in groups similar in age, habitus, and sex. Forty-seven patients had appendectomy. The most frequent gallbladder disease was chronic calculous cholecystitis. Positive cultures were obtained from 11% of gallbladders. The mean…
Primary Article
Retroperitoneal Dissection in Gynecologic Surgery for Benign Disease
ABSTRACT: In this study, the pelvic retroperitoneal anatomy was dissected during 140 consecutive exploratory laparotomies for benign gynecologic disease. In addition, 110 bilateral hypogastric artery ligations were done both to teach the technique and to attempt to determine whether such a procedure reduces blood loss in elective abdominal hysterectomy. Fifty-eight…
Primary Article
Spring Clip Sterilization: Long-Term Follow-up
ABSTRACT: Between 1978 and 1984, 186 women had interval laparoscopic and postpartum Hulka clip sterilization at the University of Missouri Health Sciences Center. We reached 109(58%) of these women for follow-up. All had had their sterilization procedures at least one year earlier, and the average duration of follow-up was 3½…
Primary Article
Vascular Trauma of the Extremities: Factors Causing Failure of Arterial Repair
ABSTRACT: Vascular trauma of the extremities is a significant problem in our society as a result of vehicle accidents and violence. Excellent results of vascular repair can be expected with strict attention to bypass of all damaged vessel, proximal and distal embolectomy, regional heparinization, liberal fasciotomy, fixation of associated fractures,…
Primary Article
Infected Abdominal Aortic Aneurysms
ABSTRACT: We report five cases of infected abdominal aortic aneurysm managed at the St. Thomas Hospital between 1975 and 1985. Two patients died, one before operation, and another during surgical repair of aneurysmal rupture. Three patients survived, all of whom had primary repair of the aorta or in situ Dacron…
Primary Article
Prolonged Rectal Bleeding Associated With Hemorrhoids: The Diagnostic Contribution of Colonoscopy
ABSTRACT: We studied 387 patients with prolonged rectal bleeding and hemorrhoids (grades 2 and 3) routinely examined by anoscopy, proctoscopy, single contrast barium enema, and hemoglobin measurements. Normal results were obtained in 86 patients above the age of 40. Total colonoscopy in these patients revealed one patient (1.2%) with cancer,…
Primary Article
Intraoperative Autologous Transfusion During Major Aortic Reconstructive Procedures
ABSTRACT: To evaluate the benefits and disadvantages of autologous intraoperative transfusion during major aortic reconstructive procedures, we retrospectively studied 50 patients who had major aortic revascularization procedures without the use of autologous transfusion devices (group 1) and prospectively evaluated a second 50-patient cohort having similar procedures, but with the use…
Primary Article
Autologous Transfusion: A Community Blood Bank Experience
ABSTRACT: Interest in the use of autotransfusion has increased greatly, as can be ascertained by looking at usage patterns and literature citations when compared to recent past years. In this paper, we discuss different autotransfusion methods, as well as the clinical experience of a community blood bank over a 3½-year…
Primary Article
Hydroxyurea in the Treatment of Polycythemia Vera: A Prospective Study of 100 Patients Over a 20-Year Period
ABSTRACT: From 1963 to 1983, I treated 100 patients with polycythemia vera, using phlebotomy and the adjunctive agent hydroxyurea. These 78 male and 22 female patients ranged in age from 24 to 88 years (mean 55.7). Duration of therapy ranged from three to 216 months (mean 64.9). The mean daily…
Primary Article
Increased HDL-Cholesterol Levels With a Weight Lifting Program
ABSTRACT: Weight training regimens are generally thought not to improve cardiovascular function or lipid parameters. To evaluate this further, we studied 25 men before and after supervised weight training three times each week for eight weeks. Mean plasma HDL-cholesterol level increased significantly with training, from 38.8 to 44.1 mg/dl, while…
Primary Article
Correlates of Medication Compliance in Non-Insulin-Dependent Diabetes Mellitus
ABSTRACT: Maintaining compliance with medications is important in the management of patients with non-insulin-dependent diabetes mellitus. We examined correlates of medication compliance in 77 patients followed up prospectively for 24 weeks. Of the demographic, socioeconomic, and clinical variables examined, only older age and greater education were related to compliance. While…
Primary Article
Professional Personnel in Health Care Among Secondary School Athletics in Alabama
ABSTRACT: To ascertain the use of professional personnel in health care among secondary school athletics in Alabama, a survey was sent to all high schools in the state. Smaller schools (classified 1A) are located an average of 10.8 miles from the nearest medical facility, while for larger schools (classified 4A)…
Primary Article
Survey of Major Neurologic Disorders in a Biracial United States Population: The Copiah County Study
ABSTRACT: To determine the prevalence of frequently occurring neurologic disorders in a biracial population, a survey of households and chronic care institutions was carried out for all residents of Copiah County, Mississippi. Along with a complete census, interviews were held using extensive questions about diagnoses, signs, and symptoms of neurologic…
Primary Article
Pregnancy Outcome in Mothers With Cystic Fibrosis: Normal Neonatal Immune Responses
ABSTRACT: Although pregnancy with cystic fibrosis (CF) has been associated in previous reports with increased maternal and neonatal morbidity, this may not reflect the current outcome with intense perinatal medical support. This report describes the pregnancy and pregnancy outcome in four women with CF. Although one neonate was delivered prematurely…
Educational Opportunities
Educational Opportunities
Review Article
Bacterial Adherence and Urinary Tract Infection
ABSTRACT: Bacterial adherence is important in the initiation of disease of the respiratory, gastrointestinal, and urinary tracts. This article reviews the mechanisms by which it occurs and presents specific examples of its importance in urinary tract infections.
Current Concepts
Strategies for the Management of Recurrent Furunculosis
ABSTRACT: Furuncles are common infections of hair follicles. Staphylococcus aureus is frequently the causative agent, though other bacteria may also be pathogenic, especially for furuncles in the vulvovaginal area, the perirectal area, and the buttocks. A simple furuncle can be treated by incision and drainage. Systemic antibiotics are indicated in…
Current Concepts
Hepatic Transplantation
ABSTRACT: In this article hepatic transplantation is discussed with respect to selection of patients, indications and contraindications, the donor and recipient operation, complications, and results.
