Biomedical subjects
Publications and source records attributed to W E Wheeler.
Leiomyomas involving the small bowel are rare benign tumors comprising 0.2% to 1.8% of all gastrointestinal tumors. We have presented a case with the rare complication of a free perforation between the tumor and the peritoneal cavity, causing an acute abdomen.
Recent literature has reported several series of synchronous adenocarcinoma of the colon, but there has not been a reported case of synchronous squamous carcinoma of the anus and adenocarcinoma of the rectum. This article describes a patient with a large squamous carcinoma of the anus along with a large adenocarcinoma of the rectum, and also discusses a current review of the etiology and treatment of squamous carcinoma of the anus.
The lithotomy position is known to decrease venous blood flow and predispose to lower extremity venous thrombosis. However, arterial thrombosis secondary to surgical positioning has rarely been discussed. One hundred patients underwent measurements of their ankle-arm index, the ratio of their ankle systolic pressure compared to their brachial blood pressure, preoperatively (AAI); immediately after being placed in the lithotomy position (AAII); and immediately prior to returning to the supine position (AAIII). Comparison of all the ankle-arm indexes revealed significant drops between preoperatively and immediately after being placed in the lithotomy position, and between preoperatively (p less than .01) and immediately prior to the supine position (p less than .05). When only preoperative ankle-arm indexes of 0.99 were examined, a very significant drop of p less than .005 was obtained. No significant drop was seen in the group with preoperative ankle-arm indexes less than 0.99. In view of this pressure drop, standard lithotomy stirrups, such as those usually utilized for OB procedures, should be used with caution for procedures requiring prolonged lithotomy position.
A compartmental syndrome arises in situations where increased pressure within a limited space restricts the circulation by lowering the arteriovenous gradient and function of tissues within that space. Hypotension, hemorrhage, arterial occlusion, and limb elevation all appear to reduce the tolerance of limbs for increased tissue pressure. In early cases, patients with decreased levels of consciousness or when clinical evaluation is equivocal, pressure measurements become mandatory. Usually a single pressure measurement at the appropriate time will reveal the need for decompression, although in equivocal cases, a constant pressure measurement becomes necessary. The Wick catheter method has been widely used for this type of measurement, but we have developed a simpler system which is described in this article.
Carcinoma of the male breast is relatively rare and the prognosis is usually more ominous than in the female. Radical mastectomy is advocated for optimal therapy but lesser procedures are used for a variety of reasons. After observing several recent cases of male breast cancer, we reviewed the tumor registries for the past 27 years at Marshall University affiliated hospitals. Thirteen cases were found and evaluated. This article presents treatment, survival and a review of the current therapy.
Seven cases of inflammatory lesions of the kidneys are reported. In 6 of the 7 patients, there were clinical and/or laboratory signs of urinary tract infection. The lesions occurred without any preference to age, sex, or location as to the right or left kidney. The diagnostic approach was individualized, and a correct preoperative diagnosis was made in 6 of the 7 cases. This high diagnostic accuracy was reached by using the following diagnostic principles. The lesions are detected and localized by urography and nephrotomography. Ultrasonography is used to decide whether the mass is solid or cystic. A percutaneous needle puncture is done in cases in which ultrasonography indicates a cystic lesion. The diagnosis of renal cyst is confirmed or excluded by cytology and analysis of the cyst fluid. Renal angiography is performed when the mass displays a solid or mixed ultrasonographic pattern and also in cases of hematuria and in cases in which the clinical symptomatology suggests malignancy.
A twenty-four-year-old black female presented through the outpatient department complaining of "white urine". Pertinent history, physical examination, and diagnostic studies are reviewed with special emphasis on lymphangiography. The literature is reviewed particularly with regard to laterilization of the fistula, thoracic duct obstruction, and methods of therapy.
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Ultrasound is presently the diagnostic procedure of choice in pulsatile abdominal masses. The ease and accuracy of this method have many advantages over aortography, and ultrasonography can accurately define the size of an abdominal aortic aneruysm. In addition, a normal aorta with an overlying mass, or a tortuous aorta which feels unusually prominent, can be detected, and aortography may not be necessary. Although ultrasound can detect involvement of iliac arteries, it does not allow assessment of the position of the aneurysm relative to the renal arteries, or detect involvement of other branch vessels of the aorta. Ultrasound is more accurate that clinical examination, plain roentgenography, aortography, or isotope aortography in the diagnosis of abdominal aortic aneurysms.
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In digestion trials, 16 Holstein cows were fed complete mixed feeds of (a) 75:25, (b) 60:40, (c) 45:55, and (d) 30:70 ratios of forage to concentrate on a dry basis. At an intake of feed for maintenance, digestibility of starch ranged from 96.2 to 96.8%. During the lactation phase when intakes of feed were 2.5 to 3.2 times maintenance, digestibility of starch ranged from 84.7 to 88.1%. Starch in feces represented 2.9, 3.7, 5.5, and 5.9% of the intake of dry matter during the lactation phase, and .6, 1.0, 1.3, and 1.6% of intake at maintenance for the respective rations. At high intakes of concentrate, substantial amounts of dietary starch escaped degradation in the rumen and small intestine and were lost in the feces.
Amphotericin B colloidal solutions were prepared according to the manufacturer's directions and filtered with membrane filters of different porosity to test for particulate matter; and the concentration and in vitro microbiological activity of filtered and nonfiltered solutions were determined. The amphotericin B solutions contained numerous particles. Filtration through 0.85- and 0.45-mum filters did not reduce the in vitro antimicrobial activity, and filtration through 5-, 0.45-, and 0.22-mum filters did not alter the concentration of the drug when assayed spectrophotometrically.