Biomedical subjects
Publications and source records attributed to J Holder.
A previously healthy 17-year-old lad presented with purulent sinusitis and subsequently developed subdural empyema in association with Pott's puffy tumour. Complete resolution occurred with an intensive antibiotic regime and drainage of the subgaleal space.
Resident physicians' contacts with the legal system during management of abused children may influence their attitudes, which were evaluated in a pilot survey completed by 42 pediatric and medicine/pediatric residents. Although negative attitudes toward attorneys were common, almost all of the residents considered general and hearing-specific legal training to be a legitimate part of their residency program. They reported lower levels of stress of court testimony than expected by the authors. Most who had testified in court believed their testimony had been needed and helpful, but all who believed their testimony had been a waste of time were senior-level residents. Although most residents believed the laws and courts usually work for protecting children, only 8 of the 20 residents who had previously testified in court responded affirmatively, and none of the 10 senior residents who had previously testified held this belief. The disillusionment of senior-level residents appeared to affect attitudes toward patient care less than expected, in that 90% of those who planned to enter private practice indicated they would perform physical abuse evaluations and 70% planned to perform sexual abuse evaluations. Only one resident who did not expect to perform the evaluations gave as a reason the prospect of having to testify in court.
384 patients were subjected to arthroscopy in 1980 and 1981. Pathological findings were obtained in 361 patients, mainly lesions of the meniscus. In 51 patients (approx. 14% of the cases) arthrotomy became necessary for various reasons. 310 patients were subjected to surgery, using the arthroscope. Follow-up examinations showed that the postoperative healing phase and hence also the postoperative inpatient period were significantly reduced compared with those patients who had been subjected to arthrotomy with the same therapeutic effect. Patients who have undergone arthroscopy re-attain their full knee-joint function much earlier than those on whom arthrotomy was performed. Hence, their ability to work is restored more quickly, and they are much sooner able to resume their sports activities.
Of 55 patients undergoing carotid endarterectomy, 16 had abnormal postoperative angiograms by accepted literature criteria. Five of the 16 were symptomatic. The other 11 were neurologically stable or improved from their preoperative condition. None of the 16 patients underwent reoperation. Of those 11 who had abnormal postoperative angiograms but a good clinical result, four had a second postoperative angiogram some months later that demonstrated marked improvement in the appearance of the endarterectomy site. Patients undergoing carotid endarterectomy should not be subjected to routine postoperative angiography without clinical indications nor should they undergo reoperation on the basis of angiographic findings alone without consideration of their clinical status.
A case of an ectopic ureter entering a seminal vesicle cyst and associated with ipsilateral renal agenesis is presented. The differential diagnosis and the embryological explanation of the anomaly are considered.
A practical method for preparing )23-I-rose bengal that allows for its rapid and efficient incorporation into the molecule is reported. Administration of 123-I-rose bengal to normal healthy patients showing the normal uptake and excretory pattern visualized with this radio pharmaceutical is also presented. The overall reduction in imaging time and radiation exposure together with the improved images possible should greatly improve our diagnostic capabilities in evaluating the jaundiced patient.
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