Buffalo General Hospital Research Articles

Book Reviews

Book reviewed in this article:Esophagography in Anomalies of the Aortic Arch System, By A. C. Klinkhamer. Pp. 126. Excerpta Medica Foundation, Amsterdam, 1969.Gastro‐Intestinal X‐Ray Diagnosis: A Descriptive Atlas. By D. H. Cummack, E. & S. Livingstone, Edinburgh and London, 1969Text‐Book of Radiology. Edited by David Sutton assisted by R. G. Grainger. E. & S. Livingstone Ltd., Edinburgh and London, 1969Roentgen Diagnosis of Rheumatoid Arthritis. By David L. Berens, M.D., Clinical Associate in Radiology, Buffalo General Hospital, Assistant Clinical Professor in Radiology, State University of New York, Buffalo, Chief of Radiology, St. Joseph Intercommunity Hospital, Buffalo, New York; and Ru‐Kan Lin, M.D., Clinical Associate in Radiology, Buffalo General Hospital, Assistant Clinical Professor in Radiology, State University of New York, Buffalo, Chief of Radiology, La Fayette General Hospital, Buffalo, New York. Pp. 337. Liberally illustrated. Charles C. Thomas, Springfield, Illinois, 1969Atomic Medicine. Edited by Charles F. Behrens, E. Richard King and James W. J. Carpender. The Williams and Wilkins Company, Baltimore, 1969.

MEDICAL NEWS

<h3>Penicillin Schedule—Not Dosage—May Be Crucial</h3><h3>Reported Failures May Be 'Related To Faulty Timing'</h3> Timing, rather than the amount of the drug given, may be the most important factor in intravenous penicillin therapy, according to Martin E. Plaut, MD, chief of the infectious disease service at Buffalo (NY) General Hospital. "I think many reported failures of penicillin therapy are related to faulty timing," he told Medical News during an interview. "Our studies show that the halflife of penicillin G in the serum of individuals with normal renal function is about 35 minutes. The amount of penicillin in their blood was almost undetectable by the methods used six hours after an injection of 5 million units. When you give such patients bolus injections twice a day, you aren't doing them much of a favor." Dr. Plaut, who is also assistant professor of medicine at the State University of New York

Ciliated epithelia of the human uterine mucosa.

From the Department of Pathology, State University of New York at Buffalo; the Department of Pathology, Buffalo General Hospital; and the Department of Pathology, E. J. Meyer Memorial Hospital, Buffalo, N. Y. The author expresses thanks to Mrs. M. Peutch for technical assistance. Submitted for publication Aug. 17, 1967.

Delayed Thrombocytopenic Purpura After Diminutive Gold Therapy

OF THE VARIOUS forms of gold toxicity, thrombocytopenia is among the most dreaded. Occasionally, small amounts of gold have been found to produce purpura, or this manifestation could be delayed many weeks or months from time of injection. 1 It thus seems appropriate to report the case of the patient who developed thrombocytopenia seven months after having received a total gold dose of 50 mg. (For uniformity, all dosages of gold salts reported in this paper are in terms of metallic, or elemental, gold.) Report of a Case A 57-year-old white bus driver was admitted to the Buffalo General Hospital on Dec 29, 1964, with severe epistaxis. He had been well until two years previously, when his extremities became painful and swollen. Ten months prior to admission, four 12.5-mg gold doses (in the form of 25 mg gold sodium thiomalate) were administered at 14-day intervals, for a total of 50

INTRAOPERATIVE FLUID THERAPY

Department of Anesthesiology, State University of New York at Buffalo, and Buffalo General Hospital, Buffalo, New York

Gout

Gout Get access Gout. Ed. 2. By John H. Talbott, A.B., M.D., D.Sc. (Hon.), Director, Division of Scientific Publications, American Medical Association; Editor, Journal of the American Medical Association; Formerly Professor of Medicine, University of Buffalo School of Medicine; Physician-in-Chief, Buffalo General Hospital, Buffalo, New York, x and 261 pp., 78 figs., 4 tables. $8.50. New York: Grune & Stratton, 1964 Ira Gore Ira Gore Boston, Massachusetts Search for other works by this author on: Oxford Academic Google Scholar American Journal of Clinical Pathology, Volume 44, Issue 3, 1 September 1965, Page 344, https://doi.org/10.1093/ajcp/44.3.344a Published: 01 September 1965

ACUTE MONARTICULAR ARTHRITIS AFTER VACCINATION. REPORT OF A CASE WITH ISOLATION OF VACCINIA VIRUS FROM SYNOVIAL FLUID.

Case Studies1 February 1965Acute Monarticular Arthritis After VaccinationReport of a Case with Isolation of Vaccinia Virus from Synovial FluidHOWARD M. SILBY, M.D., ROGER FARBER, M.D., CORNELIUS J. O'CONNELL, M.D., JULIAN ASCHER, M.D., EDWARD J. MARINE, M.D.HOWARD M. SILBY, M.D.Search for more papers by this author, ROGER FARBER, M.D.Search for more papers by this author, CORNELIUS J. O'CONNELL, M.D.Search for more papers by this author, JULIAN ASCHER, M.D.Search for more papers by this author, EDWARD J. MARINE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-2-347 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptArthritis has been described as an occasional complication of several viral diseases. However, to the authors' knowledge, the isolation of a specific virus from human synovial fluid in such cases has not been reported previously. The present report documents a case of acute monarticular arthritis after smallpox vaccination in which vaccinia virus was recovered from the synovial fluid.CASE REPORTE. J. (BGH 293446), a 65-year-old Negro female, was admitted to the Buffalo General Hospital on June 25, 1963, because of fever and a painful swelling of the right knee. Twelve days previously, at her request, she had been vaccinated...

GAS FORMATION IN THE FETAL CIRCULATION INDICATING FETAL DEATH: REPORT OF 4 CASES.

From the Departments of Radiology and Medicine of the State University of New York at Buffalo and the Buffalo General Hospital, Buffalo, N.Y.

Bishydroxycoumarin (Dicumarol) prophylaxis. Use in the prevention of postoperative thromboembolic complications in surgical patients.

In spite of the general decrease in the postoperative mortality rates during the past several decades, the incidence of thromboembolic complications still ranks high as the cause of postoperative fatalities. In general, the postoperative hospital mortality rate will be approximately 2%, with from 5% to 10% of these fatalities resulting from pulmonary embolization. In a 6-year survey at the Buffalo General Hospital (1944-1949), there were 33,882 operations performed. Fatal pulmonary emboli occurred in 42 patients, or 0.12% of all operative procedures. The postoperative hospital mortality rate for this series was 1.96%, with 6.3% of the deaths attributable to pulmonary embolization. A subsequent 4-year survey (1956-1959) revealed that there were 33,003 operations performed and 38 patients, or 0.12% of the patients, died as a result of pulmonary embolization. The postoperative hospital mortality rate for this period was 2.45%, with 5% of the deaths attributable to a pulmonary embolus. DeBakey,1in

Ovarian conservation.

From the University of Buffalo School of Medicine and the Buffalo General Hospital, Buffalo, New York

Intramural hematoma of the jejunum. A case report.

Two of the authors recently published an article on intramural hematoma of the duodenum (7) in which the literature on this condition was reviewed and a case was reported. Shortly after the appearance of this article an opportunity arose to examine a patient with an intramural hematoma of the jejunum. Intramural hematoma is more rarely seen in the jejunum than in the duodenum, and it seemed worthwhile to report this example, since there were roentgenographic changes which made it possible to establish the diagnosis preoperatively. Case Report C. F., a 52-year-old man, was admitted to The Buffalo General Hospital, Feb. 22, 1960, complaining of abdominal pain, nausea, and vomiting of about five days duration. The pain was crampy in nature at the onset, gradually developing into a generalized abdominal discomfort. The nausea and vomiting became less severe and were accompanied by abdominal distention. Nine weeks prior to the present admission, the patient had a coronary thrombosis and anticoagulant (Dicumarol) therapy was started. Four weeks later he experienced sudden lower abdominal pain, crampy in nature, which recurred several times in the course of the next few days, accompanied by constipation. He was hospitalized in another institution and Dicumarol was discontinued. Laxatives and bed rest relieved the pain. Prior to admission to The Buffalo General Hospital, anticoagulant therapy had again been started. On admission to The Buffalo General Hospital, the patient's temperature was 98.6° F., pulse 116, blood pressure 130/92, respirations 24. He appeared acutely ill and markedly dehydrated. The abdomen was moderately distended, somewhat tense, and diffusely tender. There was rebound tenderness. Peristaltic sounds were absent. On rectal examination, tarry stool was found. The rest of the physical findings were essentially within normal limits. Hemoglobin was 14.0 gm., and the white blood count 18,000, with 6 per cent band forms, 72 per cent filaments, 15 per cent lymphocytes, and 7 per cent monocytes. The urine was cloudy, with a specific gravity of 1.023, negative for sugar, protein +, containing 40 to 60 red blood cells. The blood urea nitrogen was 26, total proteins 5.9 (albumin 4.2, globulin 1.7), Na 145, K 4.6, Cl 89, CO2 15.1; bleeding time two minutes, clotting time three minutes, and prothrombin time “over two minutes.” A Cantor tube was inserted and hydration was started. At this time the gastrointestinal bleeding was attributed to hypoprothrombinemia. Vitamin K1 oxide (Mephyton) was administered intravenously, bringing the prothrombin time down to sixteen seconds. Conservative therapy was continued, with improvement of the clinical picture: progressive relief of abdominal pain, decrease of distention, and return of peristalsis. The hemoglobin was 10.3 gm. on the third day and 8.2 gm. on the fourth day. The Cantor tube was removed, and oral feedings were started. To correct the blood loss, 1,500 c.c. of blood was given.

Arteriosclerotic abdominal aortic aneurysm rupturing into the intestine.

RUPTURE of an arteriosclerotic abdominal aortic aneurysm into the gastrointestinal tract is an unusual syndrome; only 52 cases could be found in a careful search of the medical literature published in English. These all ended fatally, but a review of these cases and the experience provided by the case reported here suggest that surgical salvage is possible if this diagnosis is given due consideration in cases of unexplained severe gastrointestinal bleeding in the older patient. Similarly, rupturing aneurysms of other than arteriosclerotic origin have also been reported, such as syphilitic aortitis, mycotic aneurysm, tuberculous adenitis, metastatic carcinoma, and trauma, but these were not included in this review, since they commonly gave evidence of the primary disease and were lesser diagnostic problems. Report of a Case History.— A 74-year-old man was admitted to the Buffalo General Hospital on Sept. 30, 1959, because of 2 weeks of severe pain centering about the

An appraisal of the end-results of treatment in carcinoma of the stomach.

Of 611 patients with carcinoma of the stomach encountered at the Buffalo General Hospital during the years 1939-1955, 27 were alive without evidence of recurrent disease at the end of 5 years—an absolute survivorship of 4.4%. During the last five-year period (1950-1955) the survivorship percentage was 7.2%. An analysis of 18 large series comprising over 12,000 cases reported from all parts of the country during a corresponding period showed an average absolute five-year survivorship of 7.0%. Apparently differences in reported arrest rates were due more to variations in statistical methods than to variations in methods of diagnosis and treatment. The authors give reasons for believing that further therapeutic accomplishment is unlikely through the utilization of current methods of diagnosis and treatment.

Effectiveness of various operations for trigeminal neuralgia.

HE history of trigeminal neuralgia gives eloquent testimony of the deadly, mutilating and disabling extremities to which patients and their surgeons have gone in the attempt to relieve this frightful pain. Much progress has been made, but the continuous development of new procedures shows that perfection has not been attained. With temporal rhizotomy pain could be relieved with a minimal rate of fatality, but at the cost of facial anesthesia, paralysis of the masseter and the risk of corneal ulceration. Sensory rhizotomy and later partial rhizotomy by the suboccipital route diminished these hazards, but at the risk of surgical safety. Later by the temporal approach preservation of the motor root was perfected, leaving facial anesthesia the major hazard. This risk was reduced greatly by partial sensory rhizotomy, but preserving sensory fibers increased the rate of recurrence and the need for secondary operations. In Busch's Clinic, Taarnh0j ~ discovered a new technique by which pain was relieved without anesthesia; this was accepted gratefully everywhere. Unfortunately, this operation also proved to offer less than ideal results, recurrences of pain gradually mounting with the passage of time. Almost simultaneously in 1954 and 1955 came reports from Stender 4 of Berlin and Shelden 2 of Pasadena, California of a new operation so simple in performance and so baffling in mechanism that it has not enjoyed the vogue it seems to merit. Its proponents have advanced hypotheses for its mechanism of effect that are unconvincing to the average surgeon. Having long enjoyed the acquaintance of both these people and being convinced of their integrity, I have adopted their procedure on an empirical basis, leaving explanation of its mechanism to better theorists than am I. Although the presentation may be premature, it was thought that a progress report on the modest series of eases of trigenfinal neuralgia from the Buffalo (New York) General Hospital might be interesting. I am indebted to my colleagues, Doctors Carl Graf and George Cohn, for permission to include their eases in the report, although the bulk of the series is my own responsibility. The temporal rhizotomy referred to here eonsists of the extradural, temporal approach to the ganglion and sensory root performed on the seated patient. The greater superficial petrosal nerve and the trigeminal motor

Steroid Therapy in Rheumatoid Diseases

Journal Article Steroid Therapy in Rheumatoid Diseases Get access L. Maxwell Lockie, M.D. L. Maxwell Lockie, M.D. Professor and Head, Attending Physician Department of Therapeutics, University of Buffalo Medical School and Buffalo General Hospital Search for other works by this author on: Oxford Academic Google Scholar American Journal of Hospital Pharmacy, Volume 16, Issue 10, 1 October 1959, Pages 556–558, https://doi.org/10.1093/ajhp/16.10.556 Published: 01 October 1959

Immediate results in the treatment of the perforated peptic ulcer, 1942-1957.

Introduction In 1954, the Statistical Bulletin of the Metropolitan Life Insurance Company published a study of surgical mortality associated with the treatment of various lesions by major surgical operations. 1 In all instances cited, surgical mortality had apparently been reduced during the decade of the 40's by at least one-half and in several instances by more than four-fifths. For several reasons, however, there would seem to be cause for doubt as to whether this marked and well-recognized decrease in general surgical mortality were also true in the case of the acutely perforated peptic ulcer. To obtain more information on this point, we have critically studied all the patients treated for an acute perforation of a peptic ulcer at the Buffalo General Hospital for the 15-year period from Jan. 1, 1942, to Jan. 1, 1957. These cases have been divided for comparison into three groups, each covering a consecutive period of

Teaching in all four years of medical school by a single instructor.

Assistant professor of medicine and a Markie Scholar at the University of Buffalo School of Medicine, the Buffalo General Hospital

Collagen Diseases

Journal Article Collagen Diseases Get access Collagen Diseases. By Talbott John H., M.D., Professor of Medicine, The University of Buffalo School of Medicine, and Physician-in-Chief, Buffalo General Hospital, Buffalo, New York; and Ferrandis R. Moleres, M.D., Training Fellow in Arthritis of the Western New York Chapter of the Arthritis and Rheumatism Foundation. 232 pages, 30 figs., 16 color plates. S6.50. New York and London: Grune & Stratton, Inc., 1956. Charles H. Altshulbr Charles H. Altshulbr Milwaukee Search for other works by this author on: Oxford Academic Google Scholar American Journal of Clinical Pathology, Volume 26, Issue 11, 1 November 1956, Page 1354, https://doi.org/10.1093/ajcp/26.11.1354 Published: 01 November 1956

Diagnosis and management of trigeminal neuralgia.

Journal of the American Geriatrics SocietyVolume 2, Issue 10 p. 634-639 Article DIAGNOSIS AND MANAGEMENT OF TRIGEMINAL NEURALGIA Wallace B. Hamby M.D., Wallace B. Hamby M.D. The University of Buffalo, School of Medicine and The Buffalo General Hospital, Buffalo, N. Y.Search for more papers by this author Wallace B. Hamby M.D., Wallace B. Hamby M.D. The University of Buffalo, School of Medicine and The Buffalo General Hospital, Buffalo, N. Y.Search for more papers by this author First published: October 1954 https://doi.org/10.1111/j.1532-5415.1954.tb02468.xRead the full textAboutPDF 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 Volume2, Issue10October 1954Pages 634-639 RelatedInformation

Fundamentals of Clinical OrthopedicsFundamentals of Clinical Orthopedics. By CasagrandePeter A.. M.D., Orthopedic Department of Buffalo General Hospital, Buffalo Children's Hospital, and the University of Buffalo Medical School; Attending Orthopedist at the Chronic Disease Research Institute of the University of Buffalo, and the Veterans Administration Hospital, Buffalo, N. Y., and FrostHarold M.Jr., M.D., Orthopedic Department of Buffalo General Hospital and the

Fundamentals of Clinical Orthopedics<scp>Fundamentals of Clinical Orthopedics</scp>. By CasagrandePeter A.. M.D., Orthopedic Department of Buffalo General Hospital, Buffalo Children's Hospital, and the University of Buffalo Medical School; Attending Orthopedist at the Chronic Disease Research Institute of the University of Buffalo, and the Veterans Administration Hospital, Buffalo, N. Y., and FrostHarold M.Jr., M.D., Orthopedic Department of Buffalo General Hospital and the