Introduction A review of the literature on x-ray visualization of the intervertebral disc has led to two conclusions. First, there is a definite need for a detailed account of the technique of disc puncture. Second, the x-ray discogram should be more clearly illustrated since its interpretation could then be more readily understood and coordinated with the clinical picture of low-back pain. The material for this report is based on experiences while working with Feffer.5,6 There is a need for a more accurate method of diagnosis of intervertebral disc pathology. Although helpful, myelography can be confusing and misleading.21Discography, devised by Lindblom,14-20eliminates some of these difficulties and is more accurate as an indicator of intervertebral disc pathology.1-5,9,24,26It gives information that myelography cannot,1,2,5,9e.g., lateral disc. Furthermore, minimal routine x-ray changes are more easily evaluated and correlated with the patient's symptomatology. Discography is not the
The patient with cirrhosis of the liver and bleeding esophageal varices presents a number of serious problems. Diagnosis may occasionally be difficult and the treatment hazardous whether by balloon tamponade or transesophageal ligation. If the patient survives the acute bleeding episode, a period of intensive treatment is necessary to attain a maximum return toward normal liver function. Having accomplished this, an operation of considerable magnitude, frequently under prolonged anesthesia, must be performed. The postoperative period is endangered, in addition to the usual complications, by those untoward events peculiar to this disease, such as liver failure, coma, ammonia intoxication, and hemorrhage. Therefore, any treatment or technique which will enhance the possibility of recovery assumes a degree of importance. This discussion concerns the utilization of hypothermia during anesthesia for portacaval shunt. The Rationale of Hypothermia Linton (1958), one of the pioneers in shunt surgery, has described on several occasions his preference for
Annals of the New York Academy of SciencesVolume 78, Issue 3 p. 924-942 INTRAVENOUS AORTOGRAPHY* Richard H. Greenspan, Richard H. Greenspan Departments of Radiology and Surgery, University of Minnesota Medical School, Minneapolis, Minn.Search for more papers by this authorEugene F. Bernstein, Eugene F. Bernstein Departments of Radiology and Surgery, University of Minnesota Medical School, Minneapolis, Minn.Search for more papers by this authorMerle K. Loken, Merle K. Loken Departments of Radiology and Surgery, University of Minnesota Medical School, Minneapolis, Minn.Search for more papers by this author Richard H. Greenspan, Richard H. Greenspan Departments of Radiology and Surgery, University of Minnesota Medical School, Minneapolis, Minn.Search for more papers by this authorEugene F. Bernstein, Eugene F. Bernstein Departments of Radiology and Surgery, University of Minnesota Medical School, Minneapolis, Minn.Search for more papers by this authorMerle K. Loken, Merle K. Loken Departments of Radiology and Surgery, University of Minnesota Medical School, Minneapolis, Minn.Search for more papers by this author First published: July 1959 https://doi.org/10.1111/j.1749-6632.1959.tb56076.xCitations: 4 † *The work reported in this article was supported by a grant from the Graduate School of the University of Minnesota, and by departmental research funds. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume78, Issue3Radiopaque Diagnostic AgentsJuly 1959Pages 924-942 RelatedInformation
William and John Hunter were born in the Lowlands of Scotland in the beginning of the eighteenth century, in a time of political strife and poverty, when loyalties were sharply divided in relation to the exiled Royal House of Stewart not only between Scotland and England but between roughly equal factions in Scotland itself. The family had originated in the early part of the fourteenth century on the Ayrshire coast, and the name commemorates a royal appointment to preserve the hunting there and in the adjacent islands. The Hunters' father, a farmer, moved thirty miles or so to the east and, as a result of a favorable marriage to Agnes Paul, daughter of the City Treasurer of the City of Glasgow, became a small landowner and built the farm steading of Long Calderwood, until recently preserved unchanged as to structure and environment but now engulfed by the new satellite town
Introduction The fact that cancer cells can be identified in the blood stream of patients with malignant disease has been well documented, 1-6 but their isolation and identification is somewhat complicated. Although a number of methods of separation have been reported, all of these methods, including that originally used in our laboratory, 3 seem to us to be either cumbersome or not practical. Accordingly, we recently developed a simplified technique, 7 modifying the streptolysin method originally reported by Malmgren et al. 8 This study compares the results of this simplified isolation technique with several other methods, and amplifies the possible role of surgical manipulation and operative stress in the vascular dissemination of cancer cells. Collection of Samples Blood samples were collected from a number of sites, but in this series primarily from a peripheral vein (antecubital). In several instances samples were obtained from the vena cava via a polyethylene catheter
Plastic and Reconstructive Surgery and the Transplantation Bulletin: October 1960 - Volume 26 - Issue 4 - p 429
Solitary nonparasitic hepatic cysts are rare. Geist 4 collected 193 cases from the world literature up to 1954. Subsequently, 36 additional articles have appeared, making the total well over 200 cases. Others 1-3,5-9 have presented extensive reviews of the pathogenesis, diagnosis, and natural history, as well as treatment utilized in various forms of hepatic cystic disease. The present case of a solitary multilocular cyst is worthy of report, because the main cavity involved the whole of the left hepatic lobe, as well as the entire superior surface of the right lobe. The extent of involvement presented a difficult therapeutic problem at the time of surgery. In contrast to polycystic disease of the liver, which is commonly associated with cystic changes in other organs and frequently terminates fatally at an early age, solitary cysts often produce little or no disability. Characteristically, symptoms first appear in the fourth or fifth decade, with
Although more than 300 cases of jejunal diverticulosis have been reported previously, most clinicians consider this lesion an unimportant postmortem finding and do not usually regard it seriously as a cause of abdominal symptoms. Recent experience with three cases of jejunal diverticulosis, two manifested by severe bleeding and a third by perforation and obstruction, has prompted this report and review of the literature. According to Walker, 1 Astley Cooper first described jejunal diverticulosis in 1807. The first roentgenographic demonstration of jejunal diverticula was in 1920 by Case. 2 The incidence of jejunal diverticulosis in routine gastrointestinal x-ray examinations has variously been reported as 5 in 6,847 (0.0006%), 2 as 1 in 5,000 (0.0002%), 3 and as 3 in 996 examinations (0.03%). 4 Autopsy series have been said to show jejunal diverticula in 9 of 2,820 routine autopsies (0.03% ), 5 and in 3 of 5,000 cases (0.0006%) 6 where such diverticula
Introduction Fibroadenoma of the breast is a slowly growing benign tumor occurring in females usually before the age of 30. The microscopic appearance of the tumor is one of proliferating connective tissue and maturing epithelium. Any fibroadenoma which occupies a major portion of the breast and weighs more than 500 gm. is considered to be a "giant fibroadenoma" by McDonald.8 Fibroadenomata have been recognized as benign breast tumors for many years. Sir Astley Cooper2described the tumors in 1829 as belonging to a group he called "chronic mammary tumors." Seventeen years later Brodie1categorized fibroadenoma as the fourth chronologic stage in a series of breast tumors he called "sero-cystic tumors of the female breast"; he considered giant fibroadenoma as the fifth stage in the evolution of these mammary tumors. The most comprehensive modern study of fibroadenomata of the female breast was made by Oliver9in 1934.
Introduction A comparative evaluation of our results with two procedures—antrectomy with vagectomy and partial gastrectomy with vagectomy—provides us with the data that are necessary in selecting the operative procedure to be used in future cases. In the quest for the development of the ideal operation for duodenal ulcer, application of the currently known physiologic principles of gastric digestion and abnormal functions is paramount. In view of the many recent studies concerning the neurogenic phase and antral stimulatory control of gastric secretion and digestive function, it appeared logical that abolition of these two functions might provide the ideal operative procedure which would result in the least desirable physiologic sequelae. Because of this, a limited gastric resection was combined with a vagectomy. Purpose The purpose of this survey is to present our results, in a comparative manner of the two procedures, antrectomy with vagectomy (A-V) and partial gastrectomy with vagectomy (P-V). The
Introduction Among patients admitted to a pediatric hospital with intussusception all degrees of severity of this disease are seen, from children with unexplained abdominal pain of short duration, to moribund infants who die before effective therapy can be instituted. Current reports have assessed the effectiveness of barium enema reduction in intussusception. 5,15,21,24,30 Other recent articles attest to the fact that intestinal resection may be performed in cases of irreducible or infarcted intussusception with a steadily decreasing mortality. 2,3,17,23 These two subjects seem pertinent to cases falling at the two extremes in the spectrum of disease severity; i.e., hydrostatic pressure reduction is applicable in the early, uncomplicated cases of intussusception, while resection becomes necessary in neglected or unusually malignant ones. The present study attempts to relate these currently prominent aspects of this disease to the general clinical problem of intussusception as seen in a pediatric center. A summary of the experience
POSTLETHWAIT, R. W.; SHINGLETON, W. W.; STEPHEN, C. R.; ANLYAN, W. G. Author Information
Thrombophlebitis cerula dolens (pseudoembolic thrombophlebitis, thrombophlebitis with gangrene, blue phlebitis of Gregoire, acute massive venous occlusion3,4,7,8,10-12,14) is an unusual form of thrombophlebitis that is rarely encountered. The clinical manifestations of the disease are striking and clear, and the treatment of the disease is uncertain.33The prognosis is grave. This form of thrombophlebitis is seldom confused with some other entity. It is a severe form of thrombophlebitis with massive venous engorgement and deep violaceous discoloration of the limb. Arterial insufficiency is a constant finding, and may be so severe that gangrene may occur.17-19,31The arterial insufficiency may be due to reflex arteriospasm, or it may result from actual mechanical obstruction to blood flow due to massive intravenous clotting with trapping of blood in the limb.15,23,25Both factors may be in effect simultaneously. The limb is usually cool, and loss of large amounts of fluid into the tissues
A mass of experimental and clinical data has appeared in the literature in attempts to explain the factors involved in the production of gastric hyperacidity and methods for its control. Various factors—nervous, hormonal, chemical, and mechanical—are recognized as predominating in individual instances. Variations in gastric acidity have been brought about by aggravating or diminishing the activity of each or all of these factors through nutrition, drugs, and surgery and roentgen rays. Studies to determine the effects of the component parts of gastric secretion and the sites of secretion upon acid concentrations have provoked ingenious experiments. Estimations of the rate of secretion; of the chloride, sodium, nitrogen and potassium concentrations, and of the composition of an isotonic buffer containing secretion which is similar to blood plasma and acts by neutralization and dilution of the gastric contents have concerned many investigators. Varied but generally good results have followed attempts to eliminate the
Biliobiliary fistulae constitute one of the nonmalignant complications of gallstone disease. Never diagnosed before the operation—either clinically or roentgenologically—they are exclusively an operating-table finding. They always occur in connection with long-standing lithiasis. In our practice we have been able to observe several patients with this type of complication. Etiologically this condition is directly related to the impaction of stones at some level of the biliary tract, where they originate "decubitus" lesions. The calculus obstructs the bile flow and its pressure on the wall impairs the local circulation at the site of impaction. There is venous congestion, followed later by arterial ischemia, leading to the infarction of the "decubitus" plaque, with or without contamination of the stagnant bile. At the affected zone, the normal elements of the wall are replaced by scar tissue, leaving a "locus minoris resistentiae." The process can more frequently be observed at the neck of
The hemodynamic concept of atherosclerosis considers the laws of fluid dynamics as the primary factor in the pathogenesis of atherosclerosis. The laws of fluid mechanics can account for the localization, progressive development, and varied pathologic appearance of atherosclerotic lesions at specific areas of predilection. These are areas characterized by curvature, bifurcation, branching, tapering, or external attachment. Such locations are subject to a relative decrease in local lateral pressure in accordance with the laws of fluid mechanics. The contributing atherogenic influence of other factors, such as sex, race, diet, nutritional status, habitus, lipid metabolism, drugs, hormones, associated diseases, hypertension and stress, requires further evaluation. It appears that these are secondary factors which may modify the primary hemodynamic mechanism. The Hemodynamic Mechanism Model hydraulic systems based upon specifications of actual autopsy specimens demonstrate that sites of relative decrease in lateral pressure are sites of predilection. The incidence and degree of atherosclerosis at
