Anesthetic management of the pregnant burn patient: excision and grafting to emergency Cesarean section.

Pregnant patients with burn injuries present a unique challenge for general medical care and require special anesthetic considerations. A 21 year old woman at 28 weeks' gestation, who suffered 45% total burn surface area partial and full-thickness burns during a fire in her home, is presented. Anesthetic management included preparation and care during excision and skin grafting procedures, and during emergency Cesarean delivery.

Harvey Cushing and the New England Surgical Society.

Harvey W. Cushing, MD, is the most renowned surgeon in American history. Every aspect of his career including his many accomplishments--articles, essays, and vast correspondence--has been documented and analyzed and is the subject of at least 4 biographies and numerous articles and reminisces.

Admission criteria for inpatient substance abuse/dependence rehabilitation: implications for managed care.

In view of recent trends toward the replacement of traditional inpatient rehabilitation programs with nonresidential services, we examined the extent to which patients currently admitted to inpatient rehabilitation for alcohol or drug abuse/dependence met published criteria suggesting a preferential need for inpatient or residential care. Over 90% of almost 300 veterans with a primary DSM-III R diagnosis of alcohol or substance abuse/dependence, admitted to six New York Metropolitan Area Veterans Administration Medical Centers for inpatient rehabilitation, met at least one criterion dimension considered indicative of a need for such services, with over two-thirds meeting two or more dimensions. These findings suggest a continuing need for initial primary inpatient or residential rehabilitation for such patients.

Combined modality treatment of symptomatic pancreatic ductal lithiasis.

Objective: To assess the efficacy and safety of the removal of pancreatic duct stones by a combined modality approach in patients with pancreatic ductal lithiasis and recurrent abdominal pain.

Design: Retrospective review with a mean follow-up of 19 months (range, 1 to 56 months).

Setting: A tertiary care, private community hospital with a university affiliation.

Familial nonmultiple endocrine neoplasia medullary thyroid carcinoma: an evolving clinical entity.

Background: A rare kindred of familial nonmultiple endocrine neoplasia medullary thyroid carcinoma arising from a 73-year-old proband case is reported to further define this distinct entity.

Methods: Twenty-four family members across four generations, four with medullary thyroid carcinoma (MTC) and two with C-cell hyperplasia (CCH), were studied.

Results: Basal calcitonin levels were elevated in three patients with MTC and were normal in one patient with microscopic MTC and two patients with CCH who had persistent subtle elevation in calcium and/or pentagastrin-stimulated calcitonin levels.

Percutaneous tetracycline instillation for sclerosis of recurrent thyroid cysts.

Of 770 hypofunctioning thyroid nodules subjected to needle biopsy since 1977, the fluid of 172 cysts (22%) was aspirated. The fluid, cytologically examined, showed no evidence of carcinoma except in three instances: papillary carcinomas that were subsequently treated surgically. Of the cystic lesions, 19 (11%) recurred and were treated by reaspiration and the instillation of tetracycline hydrochloride into the cyst cavity.

The efficacy of simultaneous fine-needle aspiration and large-needle biopsy of the thyroid gland.

Fine-needle aspirations and cutting needle biopsies were performed on 415 patients with solitary thyroid nodules. All nodules were considered hypofunctioning by scintiscans. Specimens were adequate in 399 patients.

Needle biopsy in the assessment and management of hypofunctioning thyroid nodules.

Needle biopsy of hypofunctioning solitary thyroid nodules provides direct diagnostic information which would be otherwise obtainable only by surgery. The technique is safe and cost-effective. It provides a high diagnostic yield.

The tear-drop capsulectomy and capsulorrhaphy: a new approach in aiding the soft tissue repair of hallux abducto valgus.

Capsular correction is an important part of the repair of hallux abducto valgus. In this paper, the authors discuss the tear-drop method of capsular repair--a method that can be used in all hallux valgus corrections, either alone or in conjunction with the dorsolinear capsulotomy and repair. They believe the tear-drop method has many advantages, among which is the fact that severe splinting and/or casting is not needed and the patient can walk in a surgical shoe almost immediately after surgery.

Averages of glutamine synthetase molecules as obtained with various skin and electron dose conditions.

Averaged projections of individual glutamine synthetase molecules have been obtained by using electron microscopy and image processing. The methodology of correlation averaging under low dose conditions is described in detail. Because of their low signal-to-noise ratio, images made under low dose conditions cannot be directly interpreted in terms of high resolution features.

Reconstruction of glutamine synthetase using computer averaging.

The axial projection of the glutamine synthetase molecule has been reconstructed from electron micrographs of a stained preparation by using a new method of correlation search and averaging. The average over 50 individual molecules appears as a radial pattern with sixfold symmetry. The handedness evident in the average is attributed to nonuniformity of the negative stain.

A study of psychopathology of parents of psychotic children by structured interview.

To improve observer uniformity and objectivity in the psychiatric appraisal of parents of psychotic children, structured psychiatric interviews were administered to 64 parents of psychotic children, including 28 husband--wife pairs and 8 single parents. Judgments were recorded on the Spitzer--Endicott Psychiatric Status Schedule and the past section of their Current and Past Psychopathology Scales. There were no significant differences between fathers and mothers of organic and nonorganic children (children with and without evidence of neurological dysfunction).