Evidence Of Obstruction Research Articles

Megalocornea: Report of a Case with Gonioscopic Findings

A detailed study of a case of megalocornea disclosed that: A. With all the present available methods of endocrine study, nothing abnormal could be discovered. B. With the aid of the gonioscope, (1) marked atrophy of the ciliary portion of the iris and the zone of the ciliary body visible in the anterior chamber could be discerned, (2) no evidence of obstruction by anterior peripheral synechia was present, but, on the contrary, a widely open angle and enlargement of the anterior chamber was found. C. In the apparent overgrowth of the entire anterior segment it seemed logical to conclude that only the cornea and scleral limbus were involved, the other portions being merely stretched to conform with this enlargement. From the Institute of Ophthalmology, Columbia-Presbyterian Medical Center.

ACIDOSIS OCCURRING WITH DIARRHEA

During the course of attacks of severe diarrhea, not of the ileocolitis type, in infants, alterations in the respiration are not infrequently encountered. The usual abdominal type of respiration of the young child is succeeded by one which is both costal and abdominal. The most striking feature is the amplitude of the respirations and the distinct effort with which they are accomplished. They are heaving, the thorax being often greatly elevated and depressed and the accessory muscles of respiration brought into play. There is no evidence of obstruction and no cyanosis. The frequency of the respiration is usually increased but not greatly so. Sometimes there is a greater or less alteration of the depth of the individual respirations so that a modified Cheyne-Stokes type results, but in general the excursions of the thorax and abdomen are nearly the same with succeeding respirations. This increased pulmonary ventilation or hyperpnea may go

A Case of Infection of Lymph Glands with Bacillus Paratyphosus B

In March, 1914, the patient noticed, on a march, that the left leg was becoming numb and swollen. Two months later the glands in the left side of the neck were enlarged. He had not suffered any pain. On admission to hospital, June 21, 1914, he still complained of swelling and numbness in the left leg and thigh. The general physical condition and nutrition of the patient were good. He was 70y2 inches in height, and 139 pounds in weight. His skin was relaxed and showed no pigmentation. The mucous membranes were pale. Eyes, ears, and nose showed no significant abnormalities; the teeth were fairly good, but poorly cared for. The cervical glands on the right side, both superficial and deep, were hard and slightly movable. There was a slight infiltration of the surrounding tissue. The skin was not adherent to the glands. On the left side of the neck there was a large mass, hard, discrete, and movable. Pain developed in the glands on the left side of the neck, where there was some redness of the skin. Incision was made and pus drained. Aside from increased resonance in the left infra-clavicular region and a few moist rales in the left side of the chest, the lungs and chest were normal and the sputum negative. The heart and blood vessels were normal. The systolic blood pressure was 135; the diastolic, 70; pulse pressure, 65; pulse rate, 85. There was a slight dilatation of the superficial veins of the abdomen. In the left lower abdomen there was a large, hard, and slightly movable mass. The left internal iliac glands were enlarged, hard, and movable. The left leg at the thigh was IV2 inches larger than the right; at the middle of the calf, 1 inch larger than the right. Edematous swelling was present, as a result probably of pressure by the enlarged iliac glands on the left iliac vessels. The axillary glands on both sides were enlarged, hard, and movable. There was no evidence of obstruction in the upper extremities. The feces were negative. The urine showed a specific gravity of 1.008; hyaline and granular casts, and epithelial cells, squamous and round; genitourinary system otherwise normal. The blood showed 4,300,000 red cells, 10,400 white cells, hemoglobin 73*^, small mononuclears 46.75*^, large mononuclears

Case of Suprapubic Lithotomy in a Child

<h3>BACKGROUND:</h3> Obesity reduces FVC, the most commonly used measurement of vital capacity (VC) and slow VC (SVC). It is unknown whether the difference between SVC and FVC is constant in different body mass indices (BMIs). We hypothesized that the difference between SVC and FVC increases as a function of BMI. <h3>METHODS:</h3> We retrospectively reviewed pulmonary function tests (PFTs) that included spirometry and plethysmography and were performed in adults from January 2013 to August 2013. A total of 1,805 PFTs were enrolled. The non-parametric Wilcoxon signed-rank test was used to compare FVC with SVC, and to compare FEV₁/FVC with FEV₁/SVC ratio. Spearman correlation analysis was used to determine whether BMI has an effect on the discordance between FVC and SVC. Finally, we used the McNemar test for paired binary data to compare the prevalence rate of obstruction when using different measurements of VC. <h3>RESULTS:</h3> In individuals with BMI &lt; 25 kg/m² and no evidence of obstruction in the PFTs, FVC was larger than SVC (<i>P</i> = .03), whereas in overweight and obese individuals, SVC was significantly larger than FVC. The difference between SVC and FVC was positively correlated with BMI (<i>P</i> &lt; .001). One hundred thirty-one patients had a normal FEV₁/FVC but low FEV₁/SVC ratio. Fifty of these 131 individuals also had a normal FVC; the majority of them (46 of 50) had the PFTs for investigation of respiratory symptoms and had BMI &gt; 25 kg/m² (42 of 50). <h3>CONCLUSIONS:</h3> Our results indicate that FVC is larger than SVC in patients with low and normal BMI and no evidence of obstruction in the PFTs, whereas FVC is smaller than SVC in overweight and obese individual. Our findings add to the existing literature that use of FEV₁/FVC may lead to underdiagnosis of obstructive airway disease in overweight and obese individuals.