Knight Army Hospital: 1862-1865.

A cataclysmic civil war produced hundreds of thousands of sick and wounded soldiers. The Knight Army Hospital was built in New Haven to provide for returning soldiers of Connecticut suffering from disease or injury. With a 1,000-bed capacity, it became a city within a city successfully providing comprehensive health care and a variety of other services.

Effect of debt level on the residency preferences of graduating medical students.

Background: The increased educational indebtedness of graduating medical students has led to speculation about the effects of students' debt levels on their choices of practice specialties as evidenced by their residency preferences.

Method: Information was analyzed for 1,658 medical students who graduated from six private medical schools in 1988, 1989, and 1990; 1,431 of these students had educational debts. Chi-square analysis was used to compare the 1,431 students' average levels of indebtedness with their selections of residencies leading to specialties with higher or lower potential incomes.

Technetium Tc 99m plasmin in the diagnosis of inflammatory disease.

The localization characteristics of technetium Tc 99m plasmin were studied in experimental animals to investigate the use of 99mTc-plasmin for imaging inflammatory processes. At various times after abscess induction using turpentine in rats, the in vivo distribution properties of 99mTc-plasmin, gallium citrate Ga 67, 125I-fibrinogen, and 99mTc-human serum albumin (HSA) were studied by gamma-camera imaging. The in vivo binding of each radiopharmaceutical was also tested in rat and human plasma clots.

Oxidative iodine monochloride iodination technique.

The iodine monochloride (IC1) technique is used to radiolabel proteins under mild experimental conditions. Proteins labeled by this technique have been shown to have both in vitro in vivo characteristics often superior to those proteins labeled by the more frequently used chloramine-T method. Although first published more than two decades ago, use of the IC1 technique has largely been superceded by other more recently developed iodination methods.

Bilateral perilunate dislocations: case report with review of literature and anatomic study.

A 33-year-old man suffered bilateral perilunate dislocations with concomitant rotary subluxations of the navicular treated with open reduction and internal fixation. Anatomic studies revealed a thick V-shaped volar radio-carpal ligament one portion of which tethers the lunate to the radius in a sling with the volar ulna-carpal ligament, and the other portion with a variable insertion on either the navicular waist or the capitate, which may account for the variety of the carpus injuries that have been reported.

Total claviculectomy for pathological fractures.

Two patients with pathological fractures of the clavicle were treated by total claviculectomy with relief of symptoms. Subsequent drooping of the shoulder with mild weakness of the affected upper extremity seems related to the loss of normal arcuate shoulder motion that is dependent upon the yardarm function of the clavicle.

Flexor tendon ruptures in the rheumatoid hand: bilateral flexor pollicis longus rupture.

In a 42-year-old male with a 15-year history of rheumatoid arthritis, bilateral rupture of the flexor pollicis longus was associated with subluxation with radial deviation of the carpus and increased angulation of the tendon in relation to the navicular. Flexor tenosynovitis in the rheumatoid hand may present as carpal tunnel syndrome or ruptured flexor tendons. The condition is associated with invasive rheumatoid granulation tissue, vasculitis, ischemic necrosis due to compartment compression, and attrition rupture due to navicular bony protuberance.

A neurologic complication following Monteggia fracture.

Posterior interosseous nerve palsy can occur following a Monteggia fracture by a variety of mechanisms. In this case report of a 35-year-old man the nerve became wrapped around an anterolaterally dislocated radial head in the course of an unsuccessful attempt as closed reduction. Cadaveric dissections demonstrated how reduction of the radial head can be blocked by an enwrapped nerve.

An immunologic approach to tumor imaging.

There seems little doubt that the ability to prepare antibodies with a unique specificity for surface tumor antigens will have a tremendous usefulness in the diagnostic and therapeutics of cancer. This usefulness will be wide-ranged when the antibodies are labeled with radioisotopes as tools for screening for primary lesions to determine the presence and location of metastases. Therapeutically, such preparations can be used to deliver high doses of radiation to specific areas, as carriers of chemotherapeutic drugs, as well as take advantage of the intrinsic cytotoxicity of such materials.