Brooke General Hospital Research Articles

Use of prophylactic antimicrobial drugs to prevent postoperative wound infections

From March 1, 1966 through March 31, 1967, 525 patients on the General Surgery Service of Brooke General Hospital underwent abdominal surgery during which the gastrointestinal or the biliary tracts were open. In three (1.5 per cent) of 189 patients who received prophylactically a combination of penicillin G, chloramphenicol, and methicillin before, during, and immediately after operation wound infections developed, whereas wound infections occurred in thirty-seven of 336 control patients. The difference in incidence of infection between these two groups of patients is highly significant (p < .001) and suggests that the prophylactic use of antibiotics in these patients reduced the incidence of wound infection. Specific groups of patients in whom the incidence of wound infections apparently was reduced significantly by prophylactic administration of antibiotics included those who underwent cholecystectomy, emergency gastric surgery for bleeding, elective gastric surgery, and emergency colostomies. In view of the high degree of statistical significance in the difference in incidence of wound infection in the totals of treated and control patients, the lack of statistically significant difference in incidence of wound infections between treated and control subgroups of patients undergoing other abdominal operations probably can be attributed to the small number of patients in these groups.

ACUTE ARTERIAL INJURIES TREATED BY THE UNITED STATES ARMY MEDICAL SERVICE IN VIETNAM, 1965–1966

Chief, Thoracic-Cardiovascular Surgery Service, Brooke General Hospital, Brooke Army Medical Center, Fort Sam Houston, Texas; Formerly Chief Consultant in Surgery to Surgeon, United States Army Vietnam

Osteotomy of the clavicle in surgical reduction of anterior sternoclavicular dislocation.

Medical Corps. U. S. Army From the Orthopaedic Surgery Service, Beach Pavilion, Brooke General Hospital, Brooke Army Medical Center, Fort Sam Houston, Texas

A Comparative Study of Penetrating Wounds of the Abdomen Treated at Brooke General Hospital from 1948–1963

A Comparative Study of Penetrating Wounds of the Abdomen Treated at Brooke General Hospital from 1948–1963

CONVERSION OF ISOTONIC EXERCISE UNIT FOR ISOMETRIC EXERCISE.

Journal Article Conversion of Isotonic Exercise Unit for Isometric Exercise Get access Warren W. May, Warren W. May First Lieutenant, Amsc From the Physical Therapy Section, Brooke General Hospital, Brooke Army Medical Center, Fort Sam Houston, Texas.The isotonic exercise unit used was the N/K table manufactured by the N―K Products Company, Santa Cruz, California.There is no expressed or implied Army approval of or preference for the product referred to over like or similar products of another company. Search for other works by this author on: Oxford Academic Google Scholar Carol R. Reiner Carol R. Reiner First Lieutenant, Amsc From the Physical Therapy Section, Brooke General Hospital, Brooke Army Medical Center, Fort Sam Houston, Texas.The isotonic exercise unit used was the N/K table manufactured by the N―K Products Company, Santa Cruz, California.There is no expressed or implied Army approval of or preference for the product referred to over like or similar products of another company. Search for other works by this author on: Oxford Academic Google Scholar Physical Therapy, Volume 45, Issue 9, September 1965, Pages 879–880, https://doi.org/10.1093/ptj/45.9.879 Published: 01 September 1965

PRIMARY ASPERGILLOSIS OF THE PARANASAL SINUSES AND ASSOCIATED AREAS.

The LaryngoscopeVolume 75, Issue 5 p. 768-773 Article Primary aspergillosis of the paranasal sinuses and associated areas James F. Hora MC., Corresponding Author James F. Hora MC. Major Fort Sam Houston, Texas From the Otolaryngology Service, Department of Surgery, Brooke General Hospital, Brooke Army Medical Center, Fort Sam Houston, Texas This material has been received by the Office of The Surgeon General, Department of the Army, and there is no objection to its presentation and/or publication. This review does not imply any indorsement of the opinions advanced or any recommendation of such products as may be named.Dept. of Surgery, Brooke Gen. Hosp., Army Med. Center, Ft. Sam Houston, TexasSearch for more papers by this author James F. Hora MC., Corresponding Author James F. Hora MC. Major Fort Sam Houston, Texas From the Otolaryngology Service, Department of Surgery, Brooke General Hospital, Brooke Army Medical Center, Fort Sam Houston, Texas This material has been received by the Office of The Surgeon General, Department of the Army, and there is no objection to its presentation and/or publication. This review does not imply any indorsement of the opinions advanced or any recommendation of such products as may be named.Dept. of Surgery, Brooke Gen. Hosp., Army Med. Center, Ft. Sam Houston, TexasSearch for more papers by this author First published: May 1965 https://doi.org/10.1288/00005537-196505000-00004Citations: 131 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 Volume75, Issue5May 1965Pages 768-773 RelatedInformation

THE PRESSOR EFFECT OF VARIOUS VASOPRESSOR-OXYTOCIC COMBINATIONS

Anesthesia and Operative Section, 97th General Hospital, New York, New York. The views and opinions expressed herein do not necessarily represent those of the Surgeon General, the Department of the Army, nor the Department of Defense. MAJOR WAYNE M. MUNSON, MC is Chief of the Anesthesia and Operative Section of the 97th General Hospital, APO 757, New York, New York. He received his M.D. degree from the University of Wisconsin Medical School, Madison, Wisconsin, in 1956. He interned at Fitzsimons General Hospital, Denver, Colorado, 1956–1957, and served a residency at Brooke General Hospital, Fort Sam Houston, Texas, 1959–1962. Dr. Munson received the Master of Science degree in anesthesiology from Baylor University, Waco, Texas, in 1963. He is a member of Alpha Omega Alpha and a Diplomate of the American Board of Anesthesiology.

Some Medical Aspects of the History of Fort Sam Houston

Abstract : Today, with an organization of about 90 persons, including a staff of 7 officers and a full quota of 8 residents, the Laboratory Service at Brooke General Hospital has a large and important role. The Fourth U. S. Army Medical Laboratory continues to serve as a reference laboratory for the posts of six States. The laboratory function has evolved considerably from its status in the early hospitals in the 19th century, when not a microscope was present, to its importance today.

Manual of gastro-intestinal endoscopy. By Eddy D. Palmer, Colonel, M.C., Chief, Department of Medicine, Brooke General Hospital, and H. Worth Boyce, jun., Major, M.C., Chief, Gastroenterology Service, Madigan General Hospital. 9 × 6 in. Pp. 133 + vii, with 48 illustrations. 1964. London: Baillière, Tindall &amp; Cox Ltd. 70s

Manual of gastro-intestinal endoscopy. By Eddy D. Palmer, Colonel, M.C., Chief, Department of Medicine, Brooke General Hospital, and H. Worth Boyce, jun., Major, M.C., Chief, Gastroenterology Service, Madigan General Hospital. 9 × 6 in. Pp. 133 + vii, with 48 illustrations. 1964. London: Baillière, Tindall &amp; Cox Ltd. 70s

HYPERTHYROIDISM AND PERIODIC PARALYSIS.

Introduction Disorders of striated muscle are occasionally associated with thyrotoxicosis. Myasthenia gravis, exophthalmic ophthalmoplegia, thyrotoxic myopathy, encephalomyopathy, and periodic paralysis have been described. 1-4 It is the purpose of this paper to report a case of severe hyperthyroidism associated with periodic paralysis and to review the clinical and pathological characteristics of these myopathies. Report of a Case The patient was a 30-year-old Negro who had first been diagnosed as having hyperthyroidism in April, 1961. This was manifested by nervousness, weight loss, tremor, and PBI of 11.6μg% and 13.5μg%. He was treated with phenobarbital, reserpine (Serpasil), and propylthiouracil but discontinued treatment after six months. In June, 1962, he was seen for the first time at Brooke General Hospital (BGH) because of continued nervousness and weight loss, and at that time was found to have a large, diffuse goiter and a 24-hour I 131 uptake of 70%. He was placed on propylthiouracil

Ten-Year Analysis of Primary Bladder Tumors at Brooke General Hospital

Ten-Year Analysis of Primary Bladder Tumors at Brooke General Hospital

NEURILEMMOMA OF THE FACIAL NERVE.

The LaryngoscopeVolume 74, Issue 1 p. 134-143 Article Neurilemmoma of the facial nerve†‡ James F. Hora Captain MC, James F. Hora Captain MC Assistant Chief Otolaryngology, Brooke General Hospital, San Antonio, Tex.Search for more papers by this authorColonel Aubrey K. Brown Jr. MC, Colonel Aubrey K. Brown Jr. MC Denver, ColoSearch for more papers by this author James F. Hora Captain MC, James F. Hora Captain MC Assistant Chief Otolaryngology, Brooke General Hospital, San Antonio, Tex.Search for more papers by this authorColonel Aubrey K. Brown Jr. MC, Colonel Aubrey K. Brown Jr. MC Denver, ColoSearch for more papers by this author First published: January 1964 https://doi.org/10.1002/lary.5540740117Citations: 13 † From Otolaryngology Service, Department of Surgery, Fitzsimons General Hospital, Denver, Colo. ‡ This material has been reviewed by the Office of The Surgeon General, Department of the Army, and there is no objection to its presentation and/or publication. This review does not imply any indorsement of the opinions advanced or any recommendation of such products as may be named. 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 Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume74, Issue1January 1964Pages 134-143 RelatedInformation

OBSCURE OTALGIA.

The LaryngoscopeVolume 74, Issue 1 p. 122-133 Article Obscure otalgia† James F. Hora Major MC, James F. Hora Major MC Assistant Chief Otolaryngology, Brooke General Hospital, San Antonio, Tex.Search for more papers by this authorColonel Aubrey K. Brown Jr. Mc, Colonel Aubrey K. Brown Jr. Mc From the Otolaryngology Service, Department of Surgery, Fitzsimons General Hospital, Denver, Colo.Search for more papers by this author James F. Hora Major MC, James F. Hora Major MC Assistant Chief Otolaryngology, Brooke General Hospital, San Antonio, Tex.Search for more papers by this authorColonel Aubrey K. Brown Jr. Mc, Colonel Aubrey K. Brown Jr. Mc From the Otolaryngology Service, Department of Surgery, Fitzsimons General Hospital, Denver, Colo.Search for more papers by this author First published: January 1964 https://doi.org/10.1002/lary.5540740115Citations: 3 † This material has been reviewed by the Office of The Surgeon General, Department of the Army, and there is no objection to its presentation and/or publication. This review does not imply any indorsement of the opinions advanced or any recommendation of such products as may be named. 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 Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume74, Issue1January 1964Pages 122-133 RelatedInformation

HYPERVENTILATION AND ABDOMINAL REFLEX INHIBITION IN THE RAT.

Accepted for publication March 8, 1963. Dr. Downes was in the Anesthesia and Operative Service, Brooke General Hospital, Brooke Army Medical Center, Fort Sam Houston, Texas. His present address is: Anesthesia and Operative Service, Letterman General Hospital, San Francisco, California.

ANESTHETIC MANAGEMENT OF THE SEVERELY BURNED PATIENT

Anesthesia and Operative Service, Brooke General Hospital, Brooke Army Medical Center, Fort Sam Houston, Texas

WHIPPLE'S DISEASE WITH ASSOCIATED SPLENOMEGALY AND PANCYTOPENIA.

The protean nature of Whipple's disease (intestinal lipodystrophy) is well recognized. The approximately 80 cases which have been documented since Whipple's description in 19071include as manifestations polyarthritis, polyserositis, visceral and peripheral lymphadenopathy, diarrhea with steatorrhea, weakness, weight loss, abdominal pain, low-grade fever, hypochromic normocytic anemia, hypotension, chronic cough, cutaneous pigmentation, purpuric lesions, and progressive presenile dementia.2-9To our knowledge, however, this case represents the first reported example of splenomegaly and pancytopenia complicating Whipple's disease. Report of Case A 69-year-old white male retired telephone lineman was first admitted to Brooke General Hospital on May 9, 1960, with an eight-year history of frequent intermittent bouts of diarrhea of foulsmelling, bulky, and mucus-containing stools and periodic edema of the lower extremities. He had also gradually lost 20 lb of weight. On physical examination height was 67 in (170.2 cm), weight 113 lb (51.3 kg), temperature 102 F (38.9 C), pulse

The radiographic "colon cut-off sign" in acute pancreatitis.

The clinical differential diagnosis of the “acute abdomen” is well known. The actual diagnosis, however, is often fraught with much misgiving. Many times the clinician is confronted with the necessity of watchful waiting and careful neglect at one end of the spectrum and the vigorous diagnostic exploratory laparotomy at the other. In this situation it is the place of the radiologist to direct attention toward a particular diagnosis, if possible, and suggest further procedures which might be helpful in attaining that end. Acute pancreatitis is one cause of the acute abdominal syndrome in which radiology can contribute a great deal toward the diagnosis. This is particularly important, since surgical intervention should be avoided in this entity. At least twenty-three possible roentgen abnormalities have been reported as occurring in association with acute pancreatitis (12). Unfortunately, many of these are observed so infrequently or are so non-specific that they are of little diagnostic aid. Much emphasis has been placed upon the regional abnormalities of the bowel pattern in this disease. In 1950 Grollman, Goodman, and Fine (6) introduced the term “sentinel loop” for the localized ileus involving the jejunum. This is now an established radiographic sign of acute pancreatitis and has been reported as occurring in as high as 55 per cent of the cases (12). Less well known are the adynamic changes in the large bowel. Price (10), in 1956, was the first to document these changes. In reporting 3 cases, he described an “isolated gaseous distension of the ascending colon and hepatic flexure, with sharp delimitation of the gas shadow just to the left of the hepatic flexure.” This he called the “colon cut-off sign.” Many articles have since appeared in the literature referring to this colon cut-off, but often with different meaning. Stuart (13) describes an absence of gas in the mid-transverse colon in his cases. The hepatic and splenic flexures contained gas which appeared to be sharply demarcated from the central segment. Schwartz and Nadelhaft (11) reviewed 11 cases of acute pancreatitis showing the “colon cut-off sign.” They found that the splenic flexure was the most commonly narrowed area and were of the opinion that narrowing in this location with dilatation of the colon proximally is consistent with the radiographic diagnosis of pancreatitis. Recently we became aware of a rather frequent occurrence of this distal “cut-off sign” in cases of acute pancreatitis in our hospital. Over a dozen such cases were encountered in less than a year, and frequently we were able to suggest the diagnosis on the basis of the x-ray findings alone. This experience prompted us to review 93 cases of pancreatitis diagnosed in the last five years in Brooke General Hospital (Fort Sam Houston).

Effect of anesthetic agents on patients receiving reserpine therapy.

Captain Munson, Anesthesia and Operative Service, Brooke General Hospital, Brooke Army Medical Center, Fort Sam Houston, Texas. Lt. Col. Jenicek, U. S. Army Command and General Staff College, Fort Leavenworth, Kansas

Anesthetic management of the severely burned patient

The concentration of burned patients at Brooke General Hospital has afforded the opportunity to evaluate the factors influencing the choice of anesthesia and its effect upon patients. Each phase of postburn recovery has been described in terms of physical condition ot the patient. The requirements of surgical procedures and the respiratory and circulatory demands have been discussed, with special emphasis on problems directly related to the airway, myocardium and metabolism. The role of the anesthesiologist is defined in terms of total care of the patient during each phase or type of treatment. Finally, an approach to the anesthetic management of the burned patient, based on physiologic and pathologic changes, has been formulated and found to be applicable to most patients.

Clinical Laboratory Evaluation of the "Pinhead Method' for Total Leukocyte Counts

Clinical Laboratory Evaluation of the "Pinhead Method' for Total Leukocyte Counts Get access Robert M. Greendyke, Captain, MC, USA Robert M. Greendyke, Captain, MC, USA 1Pathology Service, Brooke General Hospital, Brooke Army Medical Center, Fort Sam Houston, Texas Search for other works by this author on: Oxford Academic Google Scholar American Journal of Clinical Pathology, Volume 36, Issue 3_ts, September 1961, Pages 281–284, https://doi.org/10.1093/ajcp/36.3_ts.281 Published: 01 September 1961 Article history Received: 06 January 1961 Revision received: 10 February 1961 Accepted: 02 May 1961 Published: 01 September 1961