Biomedical subjects
Publications and source records attributed to J Garcia.
Among 442 patients treated by radiotherapy for intrapelvic carcinoma, the clinical findings in 40 patients with intestinal and urological complications are recorded. The incidence and clinical features of radiation injuries, the factors which may predispose to these injuries and the methods of medical and surgical treatment are discussed.
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Two hundred and fifty-five women received clomiphene citrate during a 10-year period. Fifty-six were treated diagnostically and one hundred and ninty-nine therapeutically for infertility. It is concluded that clomiphene may aid in confirming the diagnosis and establishing a prognosis in patients with primary or secondary amenorrhea. The success of clomiphene therapy in patients with anovulatory infertility is related to the etiologic factor responsible for the anovulation, but results can be improved by adjustment of the therapeutic regimen used. In the present series, 48% of the patients who ovulated became pregnant, and 25.3% of the pregnancies were miscarried. Those patients who ovulated spontaneously and became pregnant after having discontinued clomiphene therapy showed only a 10% abortion rate. A review of the results indicates that both the ovulation rate and the pregnancy rate can be improved if adjustments are made in therapy to ensure normal follicular maturation and corpus luteum function.
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Therapy with 910 MeV alpha particles provides a treatment with no mortality and an extremely low morbidity and has been highly successful in the control of pituitary hormone hypersecretion and tumor growth. It is possible to deliver radiation doses to the pituitary gland that are sufficiently high to inhibit or destroy the tumor cells that cause abnormal secretory activity without damaging the surrounding structures. The data demonstrate the effectiveness of this form of treatment in acromegaly, non-functioning pituitary tumors, prolactin secreting adenomas, Cushing's disease and Nelson's syndrome.
A heterogenous group of patients with agenesis of the vagina treated at The Johns Hopkins Hospital between 1956 and 1975 is reported. The split thickness autogenous skin graft technic of McIndoe was used in 44 patients with Rokitansky-Kuster-Hauser syndrome, 9 male hermaphrodites, 7 patients with the testicular feminization syndrome, and in 4 male transsexual patients. Urinary tract abnormalities were found in 49% of patients with the Rokitansky syndrome. The functional results were quite satisfactory. The graft was satisfactory in all but 3 patients who required a partial second skin graft. Rectovaginal fistula with spontaneous closure occurred in 1 patient, and a transsexual patient developed a urethrovaginal fistula which was repaired surgically. Better results with the take of the skin graft have been obtained since a foam rubber vaginal form has been used and routine prophylactic antibiotics administered. Severe condylomata acuminata of the neovagina developed in 3 patients.
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The authors describe a rare 'pseudo-tumour' in the right heart, discovered after a cerebrovascular accident (paradoxal embolus probably). The mass occupied the anterior leaflet of the tricuspid valve. Its mobility and numerous calcifications facilitated diagnosis, determination of its exact position, and evaluation of haemodynamic consequences. The histopathologic features are reported, and its aetiology is discussed.
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We studied simultaneously in serum (S) and CSF (L) the enzyme activities of GOT, GPT, LDH, ICDH, MDH, ALD, and CPK in 28 patients with head injuries divided into three groups according to the severity of the trauma. We found a correlation between severity of brain lesion and enzyme activity. The best correlation was found for SGOT, SCPK, LGOT, LLDH, LMDH and LCPK. We do not believe that enzyme activity is of prognostic value. We think that further studies should be made of the specific isoenzymes of the Central Nervous System.
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Two cases of spinal cord tumour associated with increased intracranial pressure are reported and the 44 cases described in the literature are reviewed. The different hypotheses produced to explain the pathogenic mechanism of this syndrome are discussed. We think that several factors working together, rather than an isolated mechanism, take part in the production of this syndrome.