ISSN:0038-4348    

出版商:OVID    

年代:1974

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

During the past 12 years, our hemoglobin laboratories have screened blood samples from approximately 40,000 black Americans for the presence of abnormal hemoglobins (Hb). In addition, 2,305 subjects have been studied in three pilot screening and counseling surveys conducted by our Sickle Cell Center. A review of our experience indicates that comprehensive Hb analysis, beginning with Hb electrophoresis, is essential for developing an effective education and counseling program for sickle cell disorders. The 2,305 samples were analyzed by starch gel electrophoresis during a ten-day period; material and reagent costs were comparable with costs of other screening methods. Reporting of abnormal results, education, and counseling were found to be done effectively by specially trained social workers in the home environment of persons affected. A program for training volunteer counselors has been developed and the Sickle Cell Center has assisted peripheral communities in initiating their own screening and counseling programs.

ISSN:0038-4348    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

This paper discusses midline incision, including rectal incision, for delivery. The procedure was done in 262 of 559 consecutive deliveries. There were minimal complications, no fistulas or loss of sphincter control. Use of the procedure is endorsed and the need for early performance and skilled repair is discussed in detail.

ISSN:0038-4348    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

Eighty-one electrodiagnostic conduction studies and Doppler frequency shift evaluations of neurovascular compression through the costoclavicular space were done on 59 subjects. There is a highly significant statistical correlation between normal and abnormal conduction velocities and obstructive changes found with the Doppler unit. Both studies provide significant data in the clinical diagnosis of costoclavicular neurovascular compression disorders. Doppler frequency shift units are relatively inexpensive and may provide a simple, painless, noncomplicated method of evaluation or screening for costoclavicular neurovascular compression syndromes.

ISSN:0038-4348    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

Increasing emphasis on managing acute alcohol- and drug-induced medical-psychiatric conditions demands that rapid screening diagnostic procedures be available to the physician. Since it obviously is useful to have some idea of the blood alcohol concentration (BAC), the feasibility of using plasma osmolality as a reflection of BAC is discussed. The increment in plasma osmolality caused by a unit increase in plasma alcohol is linear, eg, a rise in plasma osmolality of 21.7 mOsm/kg H2O reflects a 100 mg/100 ml increase in plasma alcohol. Since plasma osmolality can be determined rapidly and easily, it can yield useful information and often preface a more thorough biochemical examination. Furthermore, concomitant measurement of urine osmolality can be an indicator of the state of hydration in the acute alcoholic condition. Obtaining an estimate of BAC (by measuring plasma osmolality) allows the physician to correlate signs and symptoms with BAC and to more skillfully plan the psychopharmacologic approach to the patient.

ISSN:0038-4348    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

A case of Dandy-Walker syndrome in a 26-year-old patient is presented. A brief review of the literature is made and compared with the present case. It is suggested that cysts of the posterior fossa, associated with hydrocephalus and dysplasia or agenesis of the cerebellar vermis, represent a congenital malformation having a wide spectrum of expression.

ISSN:0038-4348    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

Thirty-three pancreaticoduodenectomies were performed at the Medical University of South Carolina between 1956 and 1970. Seventeen resections were for adenocarcinoma of the head of the pancreas. Eleven Whipple procedures were performed for cancer arising in the extrahepatic biliary ducts and duodenum. Cancer of the stomach accounted for three pancreaticoduodenectomies. The remaining two procedures were for cystadenocarcinoma of the pancreas and chronic pancreatitis. Twelve resections were performed on clinical evidence alone. Carcinoma was found in every specimen. Biopsy and frozen section were used in the other 21 resections. Resection was undertaken only when there was no gross evidence of lymph node metastases. Still, the pathologic analyses of the specimen revealed nodal metastases in 39% of the pancreatic carcinomas. None of these patients with positive nodes were long-term survivors. There were 14 major complications from the 33 pancreaticoduodenectomies. Failure of the pancreaticojejunostomy was the most frequent complication. Seven patients were operative mortalities. In each surgical mortality, the preoperative bilirubin was markedly elevated. At this writing, eight patients (25%) are alive and free of disease. Carcinoma of the ampulla of Voter had the best survival rate. The worst survival rate was found in carcinoma of the duodenum and carcinoma of the common bile duct. The history and current controversies over this extensive surgical resection are reviewed.

ISSN:0038-4348    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

In order to evaluate the urologic complications following operation for malignant disease of the rectosigmoid colon, 68 patients were given thorough, preoperative urologic examinations. Microscopic study and cultures of the urine should be made of every patient before operation. Preoperative treatment of infection reduces the risk of postoperative infectious complications. The most severe complications arise from the surgical procedures themselves. Routine catheterization of the patient should be employed to protect the bladder from sagging and the detrusor muscle from being weakened. Neither preoperative nor simultaneous prostatectomy should be attempted in these patients. Perineal prostatectomy during abdominoperineal resection may lead to a urinary fistula. The risk of injury to the nerve supply of the bladder is reduced to a minimum if the surgeon locates the proper plane of dissection. Careful dissection also is required during the perineal stage to avoid damage of the urethra and the prostate.

ISSN:0038-4348    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

Two men who had received parenteral pentazocine in large doses for years developed severe chronic cutaneous complications. Skin changes included brawny thickening around the site of injections and large, deep penetrating ulcers. Sclerosis of the skin and subcutaneous tissue became generalized in one patient, resulting in marked immobility of the thorax and extremities and consequent total disability. These changes thus far have been seen only in abusers of pentazocine, and, once developed, may be irreversible.

ISSN:0038-4348    

出版商:OVID    

年代:1974

数据来源: OVID