Regional distribution and accumulation of lead in caprine brain tissues following a long-term oral dosing regimen.

It is well known that the brain is a key target organ for lead (Pb)-induced toxicity, with exposure potentially resulting in numerous adverse neurological effects. However, information on the distribution and accumulation of Pb within different brain regions is scarce. In this study, Pb uptake and accumulation were characterized in brain and related tissues obtained from a convenience sample of goats dosed with Pb.

A Festschrift honoring Norman M. Rich.

A Festschrift honoring forty years of government services, twenty-five years as Founding Chairman of the Department of Surgery at the F. Edward Hébert School of Medicine of the Uniformed Services University of the Health Sciences, Bethesda, Maryland and the seventieth birthday of Norman M. Rich, MD, Facs, DMCC, was held on Friday 26 March, 2004 in conjunction with the 24th Annual USU Surgical Associates Day.

Civil War vascular injuries.

As the result of the insistence of the Surgeon General during the United States Civil War, there was extensive documentation of injuries to major blood vessels and their resulting complications. The specific treatment of vascular injuries during the Civil War was ligation of the injured vessel or amputation. This was before there was any knowledge of the cause and prevention of infection.

Changes in county hospitals during Sheldon's tenure.

Dramatic changes took place in county hospitals during Dr. Sheldon's tenure, 1964 to 1985. The primary impact came from Medicaid and Medicare legislation in 1965.

The pathophysiology of skeletal muscle ischemia and the reperfusion syndrome: a review.

There are two components to the reperfusion syndrome, which follows extremity ischemia. The local response, which follows reperfusion, consists of limb swelling with its potential for aggravating tissue injury and the systemic response, which results in multiple organ failure and death. It is apparent that skeletal muscle is the predominant tissue in the limb but also the tissue that is most vulnerable to ischemia.

Natural history of congenital arteriovenous fistula.

There is no more difficult lesion to manage than congenital arteriovenous fistula. The advanced lesions are extremely vascular and unless they lend themselves to total excision, prompt recurrence is the rule. For the same reason, embolization is not successful and as the major feeding vessels are occluded, access to the tumor becomes more and more limited.

Matas Lecture. Heparin--controversies and misconceptions.

The previous dogmas regarding heparin therapy are currently being challenged. It is apparent that the experimental work on which guidelines for heparin therapy are based do not necessarily have any relevance clinically. Once clotting has been initiated, there are multiple factors that result in a relative refractory response to heparin anticoagulation.

Low-dose heparin thromboembolism prophylaxis.

Objective: To determine a rational approach to heparin dosing for thromboembolism prophylaxis.

Design: Literature review.

Results: Three commonly used heparin dosing regimens were identified: (1) standard low-dose heparin (5000 U administered subcutaneously 2-3 times per day); (2) adjusted-dose heparin (adequate to elevate the activated partial thromboplastin time to 5 seconds above the upper limit of normal); and (3) low-molecular-weight heparin (30 mg subcutaneously twice daily without monitoring).

Ligation and extraanatomic arterial reconstruction for the treatment of aneurysms of the abdominal aorta.

Purpose: Since Blaisdell et al. first described axillobifemoral bypass and aortic exclusion to treat patients at high risk with abdominal aortic aneurysms in 1965, this approach has been controversial. To help define the appropriate application of this procedure, the recent experience of the authors was reviewed.

Development of the city-county (public) hospital.

Prior to 1966, the United States had a two-tiered system of health care. Those patients who could afford the cost of medical care were treated by private physicians in their offices and in private hospitals. For patients who could not afford care, ie, the indigent and retirees over 65 years of age who developed catastrophic illnesses, the city and county (public) hospitals provided the only health care available.

Innovative treatment of deep venous disease.

The Council on Scientific Affairs of the California Medical Association presents the following inventory of items of progress in general surgery. Each item, in the judgement of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item.

Neurologic consequences of cerebrovascular injury.

Because of ongoing controversy, the issue of vascular repair or ligation for patients with cerebrovascular injuries and preoperative central neurologic deficits is frequently debated. A total of 133 patients with penetrating cerebrovascular injuries were analyzed. The frequency of preoperative neurologic deficit was 20% (27 patients).

Visceral injuries.

Abdominal visceral injuries are encountered by every surgeon who deals with trauma. It is simple and useful to divide abdominal visceral injuries into those caused by penetrating mechanisms of injury and those due to blunt mechanisms. Determination of the need for operative intervention is generally easier after penetrating trauma.

Multiple vessel injury to branches of the aortic arch: case report.

A case of multiple injuries to the branches of the aortic arch following blunt trauma is reported. Prompt diagnosis and early operation resulted in a favorable outcome.

Blunt intestinal injury. Keys to diagnosis and management.

Fifty-six patients with blunt intestinal injury seen during 39 months were reviewed for keys to diagnosis and treatment. Motor vehicle accidents were involved in 80% of the cases and seat/lap belts were in use 69% of the time. Blunt intestinal injury was the only abdominal injury in 70% of the cases.