Jefferson Medical College Hospital Research Articles

Former ASHP Treasurer Joe E. Smith dies at 84

Joe Ephriam Smith, Pharm.D., who in 1967 decentralized the clinical and distributive pharmacy services of a large Pennsylvania hospital and later developed the first pharmacy technician training program to receive accreditation from ASHP, died of heart failure on August 22 at Hahnemann University Hospital in Philadelphia. He was 84 years old. Smith led pharmacy operations at Thomas Jefferson University Hospital in Philadelphia for 31 years, arriving when the facility, which now has 899 beds, was known as Jefferson Medical College Hospital. He received the highest honor in hospital pharmacy, the Harvey A. K. Whitney Lecture Award, in 1988. That same year Smith was named the fourth John W. Webb Visiting Professor in Hospital Pharmacy in recognition of his commitment to hospital pharmacy management and experience as an educator and practitioner. From 1989 to 1995, Smith served as the treasurer of ASHP. “Joe was an incredible individual, leader, and mentor to so many future pharmacy leaders,” said ASHP Chief Executive Officer Paul W. Abramowitz. “I had the honor of serving on the ASHP Board of Directors with Joe during his term as ASHP treasurer, and it was a great experience to have had the opportunity to interact with a true pharmacy legend who contributed so much to our great profession.”

Optimism and Turbulence in the Fifties: The Journal Becomes an “Archive,” January 1950

Abstractsfrom Current Literature ,and4 Book Reviews .Thefirstbookreview was written by Philip Drinker and reviewed the re-vised and enlarged second edition of Alice Hamilton andHarriet L. Hardy’s book, titled Industrial Toxicology . 33 Thesecond book review was written by Constantin P. Yaglouand examined Odors: Physiology and Control by Carey P.McCord and William N. Witheridge. 34 Arthur L. Watkinsreviewed Rehabilitation of the Handicapped: A Bibliogra-phy1940–1946 byMayaRiviere, 35 andthiswasfollowedbyHugo Muench’s review of the book Length of Life by LouisI. Dublin, Alfred J. Lotka, and Mortimer Spiegelman. 36 American Medical Association (AMA)Archives of Industrial Hygiene andOccupational Medicine (October 1950) The AMA-AIHOM officially began with volume 2, issue4inOctober1950,andcontained9articles,asshowninTable 2. The first, “ Pathological and physiological factorsinvolved in the treatment of silicosis in coal miners ,” waswritten by Burgess Gordon and Hurley L. Motley from theBarton Memorial Division and the Department of Medicineat the Jefferson Medical College Hospital in Philadelphia.

Bilateral breast carcinoma

The aim of this study was to compare the outcomes of bilateral breast carcinoma (BBC) patients with those of patients who had unilateral disease. From 1960 to 1995, 1465 Stage 0-III patients with primary breast carcinoma were treated with either mastectomy or breast conservation therapy at the Kimmel Cancer Center of Jefferson Medical College and Thomas Jefferson University Hospital. There were 1315 (89.9%) unilateral, 103 (7.1%) metachronous, and 47 (3.0%) synchronous breast carcinoma patients. Patients with synchronous breast carcinoma were defined as having a contralateral cancer diagnosed within 1 year of initial diagnosis. The percentage of patients with Stage 0-I disease at initial diagnosis was 49.4%, whereas 68% had Stage 0-I disease at subsequent diagnosis. For patients with metachronous breast carcinomas, the median interval between the first and second diagnosis was 44 months (range, 13-287 months). The median follow-up time was 58 months (range, 12-229 months) for patients with synchronous cancers and 87 months (range, 0.25-414 months) for those with metachronous cancers. Rates of overall survival and survival with no evidence of disease (NED survival), local control, and distant metastasis from the time of the second diagnosis were calculated for patients with synchronous and metachronous disease. These figures were then compared with each other and also with those for unilateral breast carcinoma patients. Patients with synchronous and metachronous breast carcinoma had worse 5- and 8-year NED survival rates compared with unilateral breast carcinoma patients, as well as an increased risk of distant metastasis. In multivariate analysis, differences in local control and overall survival were not statistically significant for patients who had bilateral disease compared with those who had unilateral disease. There was no difference when patients with metachronous and unilateral breast carcinoma were compared with respect to local control and overall survival. Patients with bilateral breast carcinoma who present with synchronous disease are at greater risk for distant metastasis than women with unilateral or metachronous breast tumors. There was a trend toward decreased overall survival and local control for patients with synchronous bilateral breast carcinoma compared with patients who had either metachronous or unilateral disease.

Foreword Topics in Magnetic Resonance Imaging

From the Department of Radiology. Jefferson Medical College and Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, U.S.A.

The Classic

Mütter Lecturer on Surgical Pathology in the College of Physicians of Philadelphia, and Surgeon to the Jefferson Medical College Hospital, and to the Philadelphia Hospital

Childhood sacrococcygeal epidermoid cyst

<h3>To the Editor.—</h3> A defect during the complex embryological development of the sacrococcygeal area may give rise to a wide variety of lesions. The lesions presenting in the pediatric age group include benign and malignant teratomas, duplication cysts, anterior myelomeningoceles, neurogenic tumors, and, rarely, chordomas.¹Sacrococcygeal epidermoid cysts have been reported mainly in the female adult and are uncommonly encountered in pediatric practice.^2,3A 4-year-old male child with a precoccygeal epidermoid cyst is the subject of this case report. <h3>Report of a Case.—</h3> A 4-year-old Negro boy was admitted on Feb 16, 1969. to the pediatric surgical service of the Jefferson Medical College Hospital because of a posterior rectal mass. Six days before, during evaluation for nausea, vomiting, and abdominal pain, the mass was palpateld on rectal examination. The child's symptoms regressed spontaneously after 24 hours, and he remained asymptomatic until admission. A history of intermittent constipation since

Childhood Sacrococcygeal Epidermoid Cyst

To the Editor.— A defect during the complex embryological development of the sacrococcygeal area may give rise to a wide variety of lesions. The lesions presenting in the pediatric age group include benign and malignant teratomas, duplication cysts, anterior myelomeningoceles, neurogenic tumors, and, rarely, chordomas. 1 Sacrococcygeal epidermoid cysts have been reported mainly in the female adult and are uncommonly encountered in pediatric practice. 2,3 A 4-year-old male child with a precoccygeal epidermoid cyst is the subject of this case report. Report of a Case.— A 4-year-old Negro boy was admitted on Feb 16, 1969. to the pediatric surgical service of the Jefferson Medical College Hospital because of a posterior rectal mass. Six days before, during evaluation for nausea, vomiting, and abdominal pain, the mass was palpateld on rectal examination. The child's symptoms regressed spontaneously after 24 hours, and he remained asymptomatic until admission. A history of intermittent constipation since

Television fluorodensitometry: A new approach to flow analysis during routine arteriography : N. R. Silverman, Jefferson Medical College Hospital, Philadelphia, Pa.

Television fluorodensitometry: A new approach to flow analysis during routine arteriography : N. R. Silverman, Jefferson Medical College Hospital, Philadelphia, Pa.

Thermography in the diagnosis of breast cancer.

Although it has been demonstrated that thermography is capable of revealing most large breast carcinomas, its ability to detect and localize “occult” or preclinical lesions is still unknown. The accuracy of the method as compared with mammography also remains in question. In June 1964, a Pyroscan4 was made available to the Department of Radiology, Jefferson Medical College Hospital. A comparative study was initiated, utilizing a serial group of patients referred primarily for mammography. Although a high proportion of specific breast abnormalities was anticipated, the material was expected to be sufficiently diverse to provide some indication of the utility of the procedure from the standpoint of detection and mass screening. Literature The literature on surface temperature determinations as a method of detecting breast carcinomas is limited. In 1956, Lawson (5) reported a series of skin temperature measurements made with a contact thermometer over known carcinomas of the breast. In 1957 he described the first examples of the thermographic imaging (6) and in 1958 (7) reported technical improvements in the scanning apparatus. Subsequent studies have been reported by Lloyd-Williams et al. (9–11), whose equipment is similar to that employed in this study, Lawson and Chughtai (8), Gershon-Cohen et al. (3, 4), Wallace et al. (15), Swearingen (14), and Connell et al. (1). Methods The mammographic technic described by Egan (2) was employed on patients in this study. Type AA Industrial film was used simultaneously with Type M to provide overpenetrated as well as optimally exposed films. The advantages of the heavily penetrated film for the examination of dense breasts and the detection of calcium have been reported by Stanton and Light-foot (13). All patients were examined clinically by a physician before mammography, and a standard clinical form was completed. Two Pyroscan (R) units of the type described by Williams et al. (12) were used for the thermography. Several modifications were made to improve detector-cell performance, increase the signal-to-noise ratio, and provide for selection of the polarity of the pictorial presentation. The units produced initially 2 × 2-inch and later 3 × 4.5-inch thermograms on standard newspaper facsimile recording paper. Each complete scan required approximately thirty seconds. The thermal scans were made after reasonable stabilization of the patient's skin temperature above waist level had been obtained by eight to ten minutes exposure in a room maintained at an ambient temperature of 68 to 70 0 F. The patient was seated on an adjustable height bench stool which could be rotated 360° in either direction.

Roentgenographic Osseous Manifestations of the Anemias and the Leukemias

Radiology Department, Jefferson Medical College Hospital, Philadelphia, Penna. Professor of Clinical Radiology and Professor of Pediatrics Radiology, Jefferson Medical College.

Cerebral arterial ectasia with saccular aneurysms.

The term “arterial ectasia” is employed in this communication to describe the fusiform vascular dilatation presumably resulting from an abnormality in the elastic component of the vessel wall. Report of a Case History: The patient, a 54-year-old male, was admitted to the Neurology Service of Jefferson Medical College Hospital, Philadelphia, for the evaluation of eye pain and right facial palsy of eight months duration. Fifteen years earlier tinnitus developed in the right ear. Over the succeeding five years he became deaf in that ear, and a tremor of the hands and slurred speech became apparent. Eight months prior to admission, he awoke one morning with a right facial palsy, which was shortly thereafter complicated by an infection of the right eye, necessitating a partial tarsorrhaphy. Four months later the patient experienced episodes of vertigo. Numerous operations had been performed on his legs to relieve a spastic paraparesis with contractures, supposedly the result of cerebral palsy. For the past ten years he had been unable to have an erection. Frequency, urgency, nocturia, and dysuria were of many years duration. The family and social history were unremarkable except that the patient had never worked. The patient was one of twins. Physical Examination: The patient was a thin white male with a yellowish complexion and soft smooth skin. There was an obvious right facial palsy and partial tarsorrhaphy of the right eye. Axillary and pubic hair were sparse, and other body hair was absent. The testes were small and soft. Neurologic Examination: The patient was markedly ataxic on sitting and unable to stand. Motor strength was preserved in the upper extremities, but there was a spastic paraparesis of the lower extremities with ankle clonus and a positive Babinski sign bilaterally. He had a marked bilateral intention tremor with severe impairment in performance of pronation- supination, hand-patting, and finger-tapping. Cranial nerve examination revealed bilateral optic pallor, nystagmus, diplopia which increased on gaze to the left, and weakness of convergence. The right corneal reflex was depressed as well as all sensation in the first division of the right trigeminal. There was a complete peripheral right facial palsy. Taste sensation was absent in the anterior two-thirds of the right side of the tongue. A GO-decibel loss in bone conduction and no response to caloric stimulation were found on the right. The palate pulled to the left on phonation, and the speech was dysarthric. There was no paralysis of the tongue. Laboratory Findings: The patient had a hypochromic microcytic anemia. Azotemia due to chronic pyelonephritis was superimposed on a neurogenic bladder. Endocrine studies revealed panhypopituitarism with no response to Metapirone stimulation.

TUBERCULOSIS OF THE MIDDLE EAR.

The LaryngoscopeVolume 74, Issue 2 p. 198-204 Article Tuberculosis of the middle ear F. Harbert M.D., D.Sc., F. Harbert M.D., D.Sc. Philadelphia, Pa. From the Department of Otolaryngology, Jefferson Medical College Hospital, Philadelphia, Pa.Search for more papers by this authorD. Riordan M.D., D. Riordan M.D. Philadelphia, Pa. From the Department of Otolaryngology, Jefferson Medical College Hospital, Philadelphia, Pa.Search for more papers by this author F. Harbert M.D., D.Sc., F. Harbert M.D., D.Sc. Philadelphia, Pa. From the Department of Otolaryngology, Jefferson Medical College Hospital, Philadelphia, Pa.Search for more papers by this authorD. Riordan M.D., D. Riordan M.D. Philadelphia, Pa. From the Department of Otolaryngology, Jefferson Medical College Hospital, Philadelphia, Pa.Search for more papers by this author First published: February 1964 https://doi.org/10.1002/lary.5540740203Citations: 23 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, Issue2February 1964Pages 198-204 RelatedInformation

Echinococcal Disease of the Lung

A CASE OF hydatid disease is presented which represents some unusual aspects of a disease encountered infrequently in this country. Judged by world standards, the pulmonary cyst in this patient was quite large. In addition, the best available serologic tests for echinococcosis were negative in this patient. A short description of the disease, its natural history, symptoms, and treatment are included. Report of a Case A 21-year-old Creek sailor was referred to Jefferson Medical College Hospital on Sept 19, 1961, after x-rays revealed a large density in his right hemithorax. A farmer and shepherd in his homeland, he had gone to sea two years previously and for the last year was bothered by intermittent right subscapular pain for which he was unable to receive medical attention. When he reached the port of Philadelphia, his complaint of back pain prompted x-ray examination. He was then referred to this hospital for definitive

Ankylosing Spondylitis

* From the Departments of Radiology and Orthopedic Surgery, Jefferson Medical College Hospital, Philadelphia, Pennsylvania.

THE USE OF SILICONE RUBBER IN THE IMMEDIATE RECONSTRUCTION OF FRACTURES OF THE FLOOR OF THE ORBIT.

*Instructor in Surgery, Jefferson Medical College Hospital, Philadelphia, Pennsylvania †Presently Resident, Plastic and Reconstructive Surgery, Columbia Presbyterian Hospital, New York, New York

THE VALUE OF RADIATION THERAPY IN LEIOMYOSARCOMA OF THE UTERUS.

Most reports on uterine leiomyosarcoma state that the lesion is radioresistant (1, 2, 4, 5, 7–10), although significant palliation by radiotherapy to metastatic deposits or to local recurrences following surgical extirpation of uterus, tubes, and ovaries has been described (6). The authors will here summarize pertinent clinical facts about this lesion and detail 4 cases treated at Jefferson Medical College Hospital (Philadelphia), in each of which irradiation appears to have given worthwhile palliation. Incidence In reported series of uterine sarcomas, the leiomyosarcomas make up from 50 to 90 per cent of the total (1–4). Table I lists comparative numbers from three authors. Important also is the question of incidence of sarcomatous degeneration in the benign leiomyomas. Figures vary from 0.13 per cent reported by Corscaden (1) to 0.76 per cent by Kimbrough (12). Vogt reports an incidence of 0.41 per cent in 72,000 cases of myoma (13). No author claims more than 1 per cent, and several factors would appear to operate to reduce this relationship appreciably further, viz: 1. Not all uterine sarcomas are leiomyosarcomas, as illustrated in Table I. Thus many of the earlier reports on incidence of sarcomatous degeneration of fibroids give an overall figure without indicating how many of these lesions were actually indexed mesodermal tumors, stromal sarcoma, etc., all of which can be coincidentally associated with fibroid tumors. 2. There is an appreciable incidence of leiomyosarcoma arising from the myometrium without any associated “fibroids.” Nine of Corscaden's 32 cases did not originate in a myoma; 15 of Aaro's 40 did not (5). 3. A very few “benign” myomas recur or metastasize. 4. There is a serious question as to the validity of the histologic diagnosis of leiomyosarcoma when based on cellular atypism only. Where there is no evidence of invasion of the surrounding myometrium, the tumor is harmless (1). This has been described as a form of “pathologist's cancer” or as the sarcomatous equivalent of carcinoma in situ. Age and Parity The predominant age among patients with uterine leiomyosarcoma is forty through sixty. The authors surveyed listed age ranges of thirty to seventy-four, with a mean of about forty-nine (Corscaden). There is no apparent relation to parity. Total offspring ranged from 0 to 12 in Aaro's series; 45 of his 53 patients were married and 12 of these were nulliparous. Relation to Previous Irradiation Of Aaro's 53 patients, 9 gave a history of previous radium or roentgen therapy to the pelvic organs. In 4 of the 9, tumors were present at the time of irradiation. In the other 5 there was a lapse of fourteen months to six years after irradiation before diagnosis of the uterine sarcoma.

PROLONGED TOLBUTAMIDE-INDUCED HYPOGLYCEMIA.

THE VALUE of the sulfonylurea compounds as effective hypoglycemic agents, with a relatively low incidence of side effects, has been well established. However, prolonged hypoglycemia accompanying the use of these agents in diabetic, as well as nondiabetic, patients recently has been emphasized. 1-4 It is the purpose of this communication to record another instance of prolonged tolbutamide-induced hypoglycemia characterized by persistent high serum levels of the sulfonylurea after discontinuation of the medication. Report of a Case A 72-year-old white male was admitted to Jefferson Medical College Hospital on March 4, 1962, in a comatose state. The patient had been a mild diabetic for at least 17 years and had been well maintained on 20 units of isophane insulin suspension and diet. Six months previously, following admission of the patient for hydroarthrosis of the right knee, insulin was withdrawn and the patient was treated with tolbutamide in doses of 500 mg

OB DEPARTMENT: Organization and Conduct Of Prenatal Classes and Rooming-In

Click to increase image sizeClick to decrease image size Additional informationNotes on contributorsE. Pauline ShenkThe AuthorMiss Shenk is supervisor of the obstetrical and nursery divisions at the Jefferson Medical College Hospital, Philadelphia. A graduate of the Temple University Hospital School of Nursing, Philadelphia, she received a B.S. degree in nursing education from the University of Pennsylvania.

The Long-Term Response of Diabetes Mellitus to Salicylate Therapy

SALICYLATES, like the sulfonylurea drugs, lower the blood sugar levels of diabetics whether given by the intravenous or oral route. Salicylates, unlike the sulfonylureas, do not appear to affect the blood sugars of normals. The potential usefulness of these drugs in the treatment of diabetes mellitus has been indicated by the results of several short-term clinical trials. The effectiveness of salicylates in the treatment of diabetes for longer periods of time is suggested by our observations in 8 patients whose blood sugars were maintained at satisfactory levels for from 3 to 28 months. We wish to report in detail the case study of one patient who, following a secondary failure of tolbutamide, has been effectively controlled with oral acetylsalicylic acid for 28 months. Report of a Case A 69-year-old housewife was first admitted to the Jefferson Medical College Hospital in 1954, when a diagnosis of pernicious anemia was made, and

The diagnostic value of lymphangiography.

Article1 May 1961THE DIAGNOSTIC VALUE OF LYMPHANGIOGRAPHYLAIRD JACKSON, M.D., SIDNEY WALLACE, M.D., BURTON SCHAFFER, M.D., JOHN GOULD, M.D., SIMON KRAMER, M.D., ARTHUR J. WEISS, M.D.LAIRD JACKSON, M.D.Search for more papers by this author, SIDNEY WALLACE, M.D.Search for more papers by this author, BURTON SCHAFFER, M.D.Search for more papers by this author, JOHN GOULD, M.D.Search for more papers by this author, SIMON KRAMER, M.D.Search for more papers by this author, ARTHUR J. WEISS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-54-5-870 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptLymphangiography, the radiographic demonstration of the lymphatic system by intralymphatic injection of contrast material, has, in our experience, proved to be a new and useful diagnostic tool. Early attempts to visualize the lymphatic system radiographically consisted of either injecting the contrast material into subcutaneous tissues for uptake into adjacent lymphatics,1or direct injection into large palpable peripheral lymph nodes.2-4Kinmonth, in 1955, devised a practical method for direct intralymphatic injection of the contrast material to study lymphedema of the leg.5-9 We have modified this method to gain two important advantages: (1) by slow bilateral injection of the lower extremities we...Bibliography1. Arnulf G: Practical value of lymphangiography of the extremities. Angiology 9: 1, 1958. CrossrefMedlineGoogle Scholar2. CarvalhoRodriguesPereria RAS: La mise en evidence par la radiographie du systeme lymphatique chez le vivant. Ann. d'Anat. Path. 8: 193, 1931. Google Scholar3. ZheutlinShanbrom NE: Contrast visualization of lymph nodes. Radiology 7: 702, 1958. CrossrefGoogle Scholar4. ZheutlinShanbrom NE: Radiographic studies of the lymphatic system. Arch. Intern. Med. 104: 589, 1959. CrossrefMedlineGoogle Scholar5. Kinmonth JB: Lymphangiography in man. Clin. Sci. 11: 13, 1952. MedlineGoogle Scholar6. Kinmonth JB: Lymphangiography in clinical surgery and particularly in the treatment of lymphedema. Ann. Roy. Coll. Surg. Engl. 15: 300, 1954. MedlineGoogle Scholar7. KinmonthHarperTaylor JBKGW: Lymphangiography by radiological methods. J. Fac. Radiol. 6: 217, 1955. CrossrefMedlineGoogle Scholar8. KinmonthTaylorHarper JBGWK: Lymphangiography; technique for its use in lower limb. Brit. Med. J. 1: 940, 1955. CrossrefMedlineGoogle Scholar9. KinmonthTaylorTraceyMarsh JBGWGDJD: Primary lymphedema; clinical and lymphangiographic studies of a series of 107 patients in which the lower limbs were affected. Brit. J. Surg. 45: 1, 1960. CrossrefGoogle Scholar10. WallaceJacksonSchafferGouldGreeningWeissKramer SLBJRAS: Lymphangiograms—their diagnostic and therapeutic potential. Radiology 76: 179, 1961. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication February 13, 1961.From the Departments of Medicine and Radiology, Jefferson Medical College Hospital, and the Department of Radiology, Philadelphia General Hospital, Philadelphia, Pa.†Fellow, National Cancer Institute.Requests for reprints should be addressed to Arthur J. Weiss, M.D., Associate in Medicine, Jefferson Medical College of Philadelphia, 1025 Walnut St., Philadelphia 7, Pa. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byComplications neurologiques de la lymphographie A propos d'un casLymphography in the Diagnosis of Metastases from Carcinoma of the Uterine Cervix Stages I and IIRoentgen Anatomy of the Lymphatic SystemAlterations in Pulmonary Diffusion Capacity after LymphangiographyLymphangiography and Endolymphatic Radiotherapy: General PrinciplesAberrations in Pulmonary Function Due to LymphangiographyRADIOLOGICAL ASPECTS OF THE DISEASEAn injection device for lymphangiographyClinical Aspects of LymphangiographyLymphangiography of the Retroperitoneal Lymph Nodes through the Inguinal RouteLipid Embolism to the Brain after LymphographyIodoliposputosis Following LymphangiographyAnatomic and therapeutic aids of lymphangiography in pelvic malignancyDie Lymphographie im Studium der lymphatischen Verbreitung von b�sartigen Tumoren im Mastdarm-SigmaLymphangiography. An improved technique of lymphatic cannulationDie LymphographieLymphangiography in bancroftian filariasisDie Lymphographie beim Genitalcarcinom der FrauXXIV The Cervical Lymphatics, Human in Vivo StudiesThe technique and clinical application of lymphographyChemotherapy by intralymphatic infusionPostoperative Lymphedema: Etiologic and Diagnostic Factors 1 May 1961Volume 54, Issue 5Page: 870-882KeywordsConstipationDiagnostic radiologyHospital medicineLymphLymphatic systemLymphedemaLymphoma ePublished: 1 December 2008 Issue Published: 1 May 1961 PDF downloadLoading ...