ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Surgical pathology reports for the last four years were scanned for patients under the age of 40 with the diagnosis of respiratory tract carcinoma. A total of ten patients were identified and subsequently investigated for a history of marijuana use. Among these, seven revealed a history for significant exposure; five were categorized as heavy users and at least two as regular users. In view of these findings and a recent literature sampling, regular marijuana use appears to be an additional significant risk factor for the development of respiratory tract carcinoma.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Disruption of the posterior pelvic ring caused by vertical shearing forces is associated with significant morbidity and mortality. We reviewed the intermediate results in 18 patients who had 20 disruptions of the posterior pelvic ring. Depending on the location of the injury, patients were treated by either skeletal traction or open reduction and internal fixation. Patients who had open reduction and internal fixation had a significantly shorter hospitalization, a shorter confinement to bed, a shorter time to full weight-bearing, and fewer early complications. In addition, on intermediate follow-up, these patients had less back and leg pain and fewer gait disturbances, and were more likely to be able to do heavy work. Further study is needed to determine whether these results will be preserved on long-term follow-up.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A retrospective study of temporal artery biopsies done over one decade in four Nashville hospitals yielded 412 procedures on 394 patients. Diagnosis was obtained in 17%, and the procedure was helpful in 21% of patients. Only two complications were recorded. There was no correlation between length of biopsy specimen and diagnostic yield. The Nashville experience with temporal artery biopsy is probably representative. Some refinement of procedure application appears necessary.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Management of asymptomatic mediastinal cysts in adults is controversial. In the past, these cysts were excised primarily to establish a diagnosis. Presently, computerized tomography (CT) of the chest can diagnose the majority of mediastinal cysts, based on their smooth contour and low density; however, CT diagnosis of a mediastinal cyst based on density can be erroneous. In six patients, we established the diagnosis of mediastinal cyst by percutaneous needle biopsy (PNB) without complication. In four of the patients, PNB was done as an outpatient procedure. Follow-up in five patients ranged from three months to three years, with no increase in the size of the cyst; in the sixth patient, surgical excision showed a hygroma. Thus, diagnosis of a mediastinal cyst can be safely confirmed by PNB. We suggest that these asymptomatic patients can be followed up without the need for surgical excision.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A prospective observational study of 324 cases was conducted in a busy ambulatory care setting to evaluate the sensitivity, specificity, predictive values, and accuracy of spot urine urobilinogen and urine bilirubin assays as screening tests for serum liver function test (LFT) abnormalities. High positive predictive values (88% for at least one abnormal LFT) make the evaluation of positive urine screens detected during routine health care maintenance examinations imperative. Because extraneous factors may influence both urine and serum test results, however, urine assays obtained as a screening parameter in clinical presentations (abdominal pain, jaundice, constitutional symptoms, etc) have only limited clinical utility. The high proportion of false-negative results for both urine assays renders their statistical properties unacceptable as screens in these clinical situations.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

We reviewed the records of patients with cecal volvulus at three affiliated hospitals of Eastern Virginia Medical School to elucidate its incidence, patterns of presentation, and current methods of surgical management. We identified 109 patients in whom a discharge diagnosis of intestinal obstruction due to volvulus was made from 1966 to 1985. In 12 patients (11%) laparotomy showed the volvulus at the terminal ileum and cecum. The presenting symptoms in this group were distention in ten (83%), pain in seven (58%), obstipation or constipation in two (17%), and diarrhea in one (8%). Diagnosis was achieved by plain abdominal films in five (45%); barium enema was obtained in six patients and was diagnostic in five (83%). Two patients had delay in diagnosis with subsequent gangrene of cecum; one of them died. No deaths occurred in the group with viable bowel. Treatment was by simple detorsion without fixation in two (17%), detorsion with cecopexy in two (17%), tube cecostomy in three (25%), and ileocolectomy in three (25%). Simple detorsion was not followed by recurrence of the volvulus in any case in this series. Cecopexy for viable colon and ileocolectomy for gangrenous colon appeared to have the lowest rates of complications.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Penetrating trauma to the buttock is an injury with potential impact on multiple body systems. The purpose of this study was to review our experience with penetrating trauma to the buttock, to establish the frequency of system injury and related morbidity and mortality, and to make recommendations for the evaluation and management of these injuries. Among the 56 system injuries, soft tissue injuries predominated. Of the 25 operative procedures done, eight were for wound care and debridement and seven for rectal injuries; three were orthopedic, two vascular, three genitourinary, and one neurosurgical. One patient had examination under anesthesia, and one had laparotomy for missile trajectory. There were no deaths in this series. Morbidity consisted of nerve injury/defect in three patients-, stroke in one patient, and impotence in one. An understanding of the systems at risk in penetrating buttock trauma is necessary for prompt multisystem work-up.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Intracranial tuberculoma has become a rare cause of space-occupying intracranial lesions in childhood, but it must still be considered in the differential diagnosis. Tuberculosis remains a significant disease in developing countries and in the United States, and tuberculoma is a well known presentation of childhood tuberculosis. This diagnosis must be considered especially in persons traveling or living in developing countries and in immigrants from third-world areas. We report three cases of tuberculoma in children seen during one year at our institutions to illustrate the need for continued suspicion. We summarize the clinical presentation and current treatment recommendations and review the available literature.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID