West Virginia University Medical Center Research Articles

Regional Anesthesia in Infants, Children, and Adolescents

Department of Anesthesiology, West Virginia University Medical Center, Morgantown, West Virginia 26506.James C. Eisenach, M.D., Editor.Regional Anesthesia in Infants, Children, and Adolescents. Edited by Bernard Dalens. Williams & Wilkins Waverly Europe, 1995. Pages: 550. Price:$105.00.Whereas other anesthesia books contain large sections on the topic of pediatric regional anesthesia, Regional Anesthesia in Infants, Children, and Adolescents remains the only textbook currently on the market that is devoted entirely to the subject of pediatric regional anesthesia. The strongest feature of the book is that it is produced by a renowned group of authors who have a vast and broad experience in the use of regional anesthesia techniques in pediatric patients. They have taken the knowledge they have gained from their many protocoled outcomes studies and coupled this information with a thorough review of the world literature, not just the English language literature, to create a commendable piece of work.The translation from French to English by Rita Khandawala is very professional, and leads one to believe that the book was originally written in English. However, the text is not without error, and some of the mistakes are substantial. Legends are reversed in tables, and several drawings, while anatomically correct, are incorrectly labeled. These errors lead this reviewer to suggest that this book may be more useful to the experienced regional anesthetist, who can recognize the errors, and may not be for neophytes just learning pediatric regional anesthesia techniques.Two blocks are synonymous with the Dalens' name, the fascia iliaca technique for neuroblockade of the lumbar plexus and the parascalene approach to blockade of the brachial plexus. It is this reviewer's opinion that these blocks are major and important advances in pediatric regional anesthesia; however, in the original journal articles, the supporting artwork lacked detail, size, and color. These aspects made it very difficult to understand the landmarks and fascial planes inherent to the successful placement of these blocks. Unfortunately, once again, the plates in the textbook lack the size, labeling, and color needed to render them supportive and useful. Two full-color pages would have made a remarkable difference.Perhaps the best single aspect of the book is the wonderful chapter on “Pharmacology” by Isabelle Murat. In just 30 pages, she helps one understand why children obtain dense blocks with dilute local anesthetic solutions such as 0.125% bupivacaine and why neonates are at increased risk of local anesthetic toxicity. This chapter and the authorship by Professor Dalens on the majority of the remaining clinically relevant chapters in the book make it a reasonable buy for $105.00.L. M. Broadman, M.D., Department of Anesthesiology, West Virginia University Medical Center, Morgantown, West Virginia 26506.

Long-term survival after endobronchial fire during treatment of severe malignant airway obstruction with the Nd: YAG laser : Denton RA, Dedhia HV, Abrons HL, Jain PR, Lapp NL, Teba L. Pulmonary Disease Section,Division of Critical Care Medicine, West Virginia University Medical Center, Morgantown, WV. Chest 1988;94:1086-8

Long-term survival after endobronchial fire during treatment of severe malignant airway obstruction with the Nd: YAG laser : Denton RA, Dedhia HV, Abrons HL, Jain PR, Lapp NL, Teba L. Pulmonary Disease Section,Division of Critical Care Medicine, West Virginia University Medical Center, Morgantown, WV. Chest 1988;94:1086-8

Increased Mortality Rates after Cataract Surgery: A Statistical Analysis

One hundred ninety-three patients 50 to 89 years of age had cataract surgery between January 1, 1979, and December 31, 1980, at West Virginia University Medical Center, Morgantown. In comparison with 182 patients who elected one of three other surgical procedures, cataract surgery patients had a significantly higher mortality rate (P = 0.0005) than control group patients, according to life-table analysis estimates adjusted for age and sex. Patients with adult onset diabetes mellitus had slight increased survival and did not alter relative mortality. The authors' results support the hypothesis that senile cataracts may reflect systemic factors in addition to localized ocular disease.

Early Detection of Spina Bifida with MRI

Department of Neurosurgery and Neuroradiology, 3612 Basic Science Addition, West Virginia University Medical Center, Morgantown, W. Va., 26506.

Myokymia induced by timber rattlesnake venom: [formula omitted], J.F. Brick, K. Apelgren and J.E. Riggs (Dept. of Neurology, West Virginia University Medical Center, Morgantown, WV 26506, U.S.A.)

Fourteen patients presented prolonged conduction block (CB) related to hereditary neuropathy with liability to pressure palsies (n = 7), neuropathy with proximal multifocal persistent CB (n = 2), radiation plexopathy (n = 3) and chronic acquired polyneuropathy (n = 2). All subjects presented both single and grouped fasciculation potentials that resulted in visible limb myokymia in 9 patients. This ectopic activity was recorded only in muscles affected by the CB, was more important in severe or complete CB, and often arose from terminal branches of blocked axons. These fasciculations and grouped fasciculations therefore appear to be causally related to the CB. In the presence of localized myokymia, a prolonged CB should be suspected.

GASTROINTESTINAL PROBLEMS IN THE INFANT 2nd ed. Joyce Gryboski, W. Allan Walker. W.B. Saunders, Philadelphia, 1983, $75.00, 765 Pages

Journal of Parenteral and Enteral NutritionVolume 10, Issue 5 p. 540-541 Book Review GASTROINTESTINAL PROBLEMS IN THE INFANT 2nd ed. Joyce Gryboski, W. Allan Walker. W.B. Saunders, Philadelphia, 1983, $75.00, 765 Pages C. Lawrence Kien M.D., PH.D., C. Lawrence Kien M.D., PH.D. Section of Clinical Nutrition, Departments of Medicine and Pediatrics West Virginia University Medical Center Morgantown, WV 26506Search for more papers by this author C. Lawrence Kien M.D., PH.D., C. Lawrence Kien M.D., PH.D. Section of Clinical Nutrition, Departments of Medicine and Pediatrics West Virginia University Medical Center Morgantown, WV 26506Search for more papers by this author First published: 01 September 1986 https://doi.org/10.1177/014860718601000525AboutPDF 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 No abstract is available for this article. Volume10, Issue5September 1986Pages 540-541 RelatedInformation

Characteristics of male alcohol offenders: Katharine G. Ratliff. Indiana Central University; and Thomas E. Ellis. West Virginia University Medical Center

Characteristics of male alcohol offenders: Katharine G. Ratliff. Indiana Central University; and Thomas E. Ellis. West Virginia University Medical Center

Use of the early and acute scales of the children's revision of the Luria-Nebraska neuropsychological battery : Richard A. Berg (West Virginia University Medical Center) and Greta N. Wilkening (The Children's Hospital of Denver)

Use of the early and acute scales of the children's revision of the Luria-Nebraska neuropsychological battery : Richard A. Berg (West Virginia University Medical Center) and Greta N. Wilkening (The Children's Hospital of Denver)

Use of the early and acute scales of the children's revision of the Luria-Nebraska neuropsychological battery

Journal Article Use of the early and acute scales of the children's revision of the Luria-Nebraska neuropsychological battery Get access Richard A. Berg, Richard A. Berg West Virginia University Medical Center Search for other works by this author on: Oxford Academic PubMed Google Scholar Greta N. Wilkening Greta N. Wilkening The Children's Hospital of Denver Search for other works by this author on: Oxford Academic PubMed Google Scholar Archives of Clinical Neuropsychology, Volume 1, Issue 3, 1986, Page 270, https://doi.org/10.1093/arclin/1.3.270 Published: 01 July 1986

Editorial Comment

*Professor Emeritus, Department of Orthopedics, West Virginia University Medical Center, Morgantown, West Virginia.

It Has Been Said

IT HAS BEEN SAID and collected by ROBERT BURRELL* "Infectious disease is one of the few genuine adventures left in the world."— Hans Zinsser "For more than forty years I have been speaking prose without knowing it."— Molière "Psychotherapy—The theory that the patient will probably get well anyhow ."—H. L. Mencken "The trouble with being punctual is that nobody's there to appreciate it."— Franklin P. Jones "The English spell much better than they pronounce."—Mark Twain "A jury consists of twelve persons chosen to decide who has the better lawyer."—Robert Frost "I do not have a psychiatrist and I do not want one, for the simple reason that ifhe listened to me long enough, he might become disturbed."—James Thurber "A specialist is one who knows everything about something and nothing about everyone else."—Ambrose Bierce "If you steal from one author, it's plagiarism; if you steal from many, it's research."—Wilson Mizner Material appearing under this title is collected with the aim of making the serious a bit less serious, the ponderous a bit less heavy, and the reading hours a bit more fun. Toward this goal we invite a guest editor of this feature for each issue. Will readers volunteer to share their senses of humor by collecting or recollecting items that have brought smiles to their faces? We invite your participation. ?Address: Department of Microbiology, West Virginia University Medical Center, Morgantown , West Virginia 26506. Perspectives in Biology and Medicine, 28, 4 ¦ Summer 1985 \ 587 "If a doctor were called on to treat typhoid fever, he would probably try to find out what kind of milk or water the patient drank, and perhaps clean out the well so that no one else could get typhoid from the same source. But if a lawyer were called on to treat a typhoid patient, he would give him 30 days injail, and then he would think that nobody else would ever dare to take it. If the patient got well in 15 days, he would be kept until his time was up; if the disease was worse at the end of 30 days, the patient would be released because his time was out."— Clarence Darrow in defense of Loeb and Leopold. "We can't all be heroes because someone has to sit on the curb and clap as they go by."—Will Rogers "Those of us who are physicians are often told that we bury our mistakes; please bear in mind that lawyers live off theirs."—W. K. C. Morgan "Eschew obfuscation."—Graffiiti on wall of men's room in a gas station "Well, if I called the wrong number, why did you answer the phone?"—James Thurber "Incidentally, medicine has another indirect influence on war which is not negligible. There seems little doubt that some of the reckless courage of the American troops in the late war was stimulated by the knowledge that in front of them were only the Germans, but behind them were the assembled surgeons of America with sleeves rolled up."—Hans Zinsser from Rats, Lice and History "Puritanism—The haunting fear that someone, somewhere, may be happy."—H. L. Mencken "Consistency is the last refuge of the unimaginative."—Oscar Wilde "Support the American Bar Association—Send your child to Medical School."—Bumper sticker on car in hospital parking lot "If you prefer ? think, therefore I am' to 'non sum qualis eram,' then you are putting Descartes before Horace."—James Thurber "Gastrointestinal allergy is a diagnosis frequently entertained, occasionally evaluated, and rarely established."—F. J. Ingelfinger "But a theory that does not lead to useful and exciting predictions is like a sterile 'Man O'War.' "—Michael Heidelberger "Help stamp out entropy."—Bumper sucker at MIT "AU professions are organized conspiracies against the laity."—Bertrand Russell 588 Robert Burrell ¦ It Has Been Said and coüected by PAWAN SHARMA* "It is very humbling to realize that there is more information packed into the head of one spermatozoan than there is in all the volumes of the Journal of Biochemistry."—Sir Macfarlane Burnet "A clash of doctrines is not a disaster—it is an opportunity."—Alfred North Whitehead "To be touched with awe...

Current status of the vascular laboratory in the diagnosis of deep vein thrombosis.

The frequency of venous disease probably surpasses that of heart disease and stroke. The fallibility of the clinical diagnosis of pulmonary embolism and deep vein thrombosis (DVT) approaches 50% error in both conditions. Because of the serious errors in omission and commission of the clinical diagnosis of venous thrombosis, a variety of noninvasive diagnostic techniques have been developed within the past decade. The purpose of this paper is to analyze these noninvasive venous modalities with more emphasis on what is available in our vascular lab at Charleston Area Medical Center-Charleston Division, West Virginia University Medical Center.

A critical review of amputation in vascular patients.

A study was made of 53 patients who underwent amputation for peripheral vascular disease over a 5-year period at West Virginia University Medical Center. The follow-up period ranged from 1 to 6 years. Data concerning operative deaths, risk factors, use of prosthetic devices, and ultimate self-sufficient living were obtained. The functional outcome for this group of patients was encouraging with modern prosthetic fitting and social rehabilitation. Approximately 75% of the patients were returned to a useful life with a prosthetic limb or in a wheelchair. Amputation is a less desirable alternative than successful revascularization, but with the prostheses available today, amputation does not foreshadow a dismal existence.

A critical review of amputation in vascular patients

A study was made of 53 patients who underwent amputation for peripheral vascular disease over a 5-year period at West Virginia University Medical Center. The follow-up period ranged from 1 to 6 years. Data concerning operative deaths, risk factors, use of prosthetic devices, and ultimate self-sufficient living were obtained. The functional outcome for this group of patients was encouraging with modern prosthetic fitting and social rehabilitation. Approximately 75% of the patients were returned to a useful life with a prosthetic limb or in a wheelchair. Amputation is a less desirable alternative than successful revascularization, but with the prostheses available today, amputation does not foreshadow a dismal existence.

Banting and Best and the sources of useful knowledge.

BANTING AND BESTAND THE SOURCES OF USEFUL KNOWLEDGE GALE W. RAFTER* The discovery of insulin by Banting and Best in 1921-1922 must be characterized as one of the great scientific and humanitarian achievements of this century. Our understanding of proteins as molecules with unique chemical structures that carry information between cells utiUzing specific receptor sites came about with the availability of insuUn. And while insulin's use in the clinic has not eUminated all of the pathology of diabetes, it has extended die lives of millions of diabetics and aUowed them to lead useful lives. The story ofinsulin's discovery possesses many unusual aspects, not the least of which were the inexperience of both investigators in the laboratory and the brief time they worked on the problem. Their accomplishment becomes even more unusual, almost extraordinary, when it is considered in terms of the contemporary debate on die conduct of biomedical research. Examination of the conduct of biomedical research, in the past usually carried out by philosophers and historians of science, has become important to all of us with the realization that there is not enough money to do everything and that choices must be made. The choices are the support of basic research or the support of research directed toward a specific problem. Because of the impatience of people with the development ofnew treatments for disease, the idea that a larger share of available doUars be spent on research directed toward specific diseases has received more support. Many scientists vigorously oppose this idea and argue that basic findings must precede appUed research. In other words, the clinical investigator makes his contribution by making himselfaware ofbasic science findings and then appUes these findings to die prevention, diagnosis, and treatment ofdisease. The flow ofinformation surrounding the discovery ofinsulin appears to have run in the opposite direction, and the purpose of this paper is to try to "¦Professor of biochemistry, School of Medicine, West Virginia University Medical Center , Morgantown, West Virginia 26506.© 1983 by The University of Chicago. AU rights reserved. 0031-5982/83/2602-0336$01 .00 Perspectives in Biology and Medicine, 26, 2 · Winter 1983 | 281 understand how it happened and to see if it tells us anything about the conduct of biomedical research. Confusion abounds when the terms "basic" and "applied" are used to describe research in the biomedical sciences. In contrast to the physical or mathematical sciences, almost all biomedical research is appUed insofar as its problems are first perceived by observing the living organism. In this paper, distinction between the two research strategies is predicated on why the research was done. Comroe and Dripps [1] have previously used this distinction in defining basic biomedical research as investigation of living organism functions without regard to its immediate relation to specific human disease. Thus the discovery ofinsulin is eminently applied research because Banting and Best set out to find a substance useful in the treatment of diabetes. Their goal was reached in less than a year when their first patient, a young man dying of diabetes, was treated successfully with insulin. Preparationfor Research: Selection of the Problem There was nothing haphazard about Banting's decision to give up medical practice to go into the laboratory and work on diabetes. He showed those quaUties of mind and spirit that we associate with good scientists. It is testimony to his intellectual curiosity that he came upon the problem of diabetes as an orthopedic surgeon reading the medical literature. That he was wilUng to give up medicine, which he had prepared for all his adult life, for an endeavor without promise ofsuccess or rewards attests to his commitment. The nature of the problem itself shows his independence of mind. More mature scientists discouraged him from attempting the research, pointing out that it was unUkely that he would succeed when more experienced investigators had already tried and failed. Despite these protestations, convinced he had something to contribute, and as a physician motivated to be useful to patients, Banting moved ahead. Some critics of appUed research have said that a scientist who selects a problem out of humanitarian concerns, which clearly assigns it to applied research, is sullied by the choice. Other critics believe...

Combining Lithium and Antidepressants

1Department of Psychiatry and Lithium Information Center, University of Wisconsin Clinical Sciences Center, Madison, Wisconsin 2Department of Psychiatry, West Virginia University Medical Center, Charleston, West Virginia 3Professional Education and Research, Taylor Manor Hospital, Ellicott City, Maryland

Catheter embolization: Preparation of patient with pheochromocytoma

This is a case report of a patient treated at West Virginia University Medical Center that illustrates the successful use of preoperative percutaneous angiographic embolization of a pheochromocytoma in controlling a malignant hypertensive crisis.

The pain clinic: a unique new prospect for nurses.

Robert E. Pawlicki, PhD, is associate director of the West Virginia University Medical Center Pain Clinic and an associate professor in both the Department of Behavioral Medicine and Psychiatry and the Department of Anesthesiology.

Outpatient treatment of acute herpes zoster neuralgia with continuous thoracic epidural block

Department of Anesthesiology, Pain Clinic, West Virginia University Medical Center, Morgantown, WV 26505 USA

Carcinoma of the penis.

Thirty-five patients with carcinoma of the penis were treated at the teaching hospitals of West Virginia University Medical Center during the last 15 years. All cases were epidermoid carcinoma except for one case of melanoma. Factors adversely affecting prognosis were (1) the presence of clinically palpable lymph nodes, (2) age over 65 at diagnosis, (3) location of the lesion on the shaft of the penis, (4) high stage and poor differentiation of the lesion, (5) primary lesions requiring total penectomy, and (6) proven metastases to lymph nodes.