Biomedical subjects
Publications and source records attributed to A Addison.
A case of Dupuytren's contracture is described, in which, both clinically and histologically, knuckle pad lesions involved the extensor tendons. Surgical excision of the Dupuytren's tissue from the dorsal aspect of the proximal interphalangeal joints, freeing of the lateral extensor slips and posterior capsulotomy resulted in marked functional improvement.
Isolated angiitis of the brain in labor and puerperium is described. Persistent headaches in a preeclamptic patient in the postpartum period usually suggests either persistent preeclampsia or subarachnoid hemorrhage. Isolated vasculitis of the brain, which was diagnosed in the present case, should be considered as it responds to medical (pharmacologic) treatment.
Management of a normal-appearing ovary at the time of hysterectomy in a patient with endometriosis externa is controversial. Our experience supports the contention that such ovaries should not be conserved at the time of surgery intended to cure endometriosis.
An analysis of 15 patients with rectovaginal fistulas complicating Crohn's disease, who were managed at Duke Medical Center between 1966 and 1979, is presented. The experience reported suggests that, in carefully selected patients, and with proper timing of operative intervention, the role of primary repair of these fistulas may be more important and yield greater success than is generally maintained in the literature. Selection of the patients, perioperative management, and surgical technique are discussed.
Five children with popliteal webbing and flexion contractures of the knees are described. When their associated anatomical abnormalities are considered, classification into two distinct syndromes, multiple pterygium and popliteal pterygium, is possible and of importance in genetic counseling. Soft tissue surgical corrections of the flexion contractures were undertaken in each case. The operative technique, local abnormalities, and orthopaedic management are discussed.
A modified form of the collateral operation originally described by Dillwyn Evans has been used in severe relapsed club feet to correct the sagittally breached or bean-shaped foot. Forty-five feet in 37 patients were followed up for an average of nine years and nine months. Previous operations had been performed on 42 feet. Thirty out of 45 feet were considered satisfactory at review when evaluated by a simple, functional system of scoring. The majority of the feet were stiff but relatively free of pain and able to fit into normal shoes. The collateral operation was considered successful in 42 feet if the patient's ability to take part in any desired sporting and recreational activities was taken as the criterion for success.
Bartholin's gland carcinoma is an uncommon disease representing 0.1% of all female genital malignant neoplasms. Five Bartholin's gland adenocarcinomas were selected by the criteria of Chamlian and Taylor. Three patients died from metastatic disease within four years; two are free of apparent disease 14 months and 13 years, respectively, after initial diagnosis. Poor prognosis was associated with large tumor size, poor histopathologic differentiation, and lymph node involvement. Transmission electron microscopy verified the glandular nature of the poorly differentiated lesions. All five tumors demonstrated junctional complexes, abundant rough endoplasmic reticulum, secretory vacuoles, and glandular formation. Low levels of estrogen receptor and moderate levels of progesterone receptor were present in the one case measured. Endogenous peroxidase, and inducible enzyme in estrogen-sensitive tissues, was observed in two of the five tumors.
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