Biomedical subjects
Publications and source records attributed to R M Soderstrom.
This study confirms that lumbar epidural block is a satisfactory anesthetic technique for outpatient laparoscopic tubal sterilization. Oxygenation during the period of pneumoperitoneum was adequate. The technique resulted in a shortened postanesthesia recovery period and fewer postanesthesia complications. Surgeon, anesthesiologist and patient acceptance was excellent.
Granulomatous hepatitis has been associated with many conditions, including chronic ulcerative colitis and sulfonamide therapy. We report a patient with ulcerative colitis in whom hepatic granulomatosis was associated with salicylazosulfapyridine (Azulfidine). Sulfonamides should be considered a possible cause of hepatotoxicity when used therapeutically in inflammatory bowel disease.
Erythema nodosum is not an uncommon dermatologic entity. Sarcoidosis and streptococcal infection have become the two most common causes, while tuberculosis was the predominant etiology prior to the use of isoniazid. Histoplasmosis and coccidioidomycosis are two important geographic considerations. Laboratory tests should include a PPD test, chest x-ray, throat culture for beta-streptococcus, and ASO titer determination as a minimum. Symptomatic treatment remains unsatisfactory in many cases, although recent success has been reported with oral potassium iodide.
The snare method has proven to be an effective method of tubal resection for sterilization. In the most experienced hands, significant complications are indeed rare. However, the failure rate appears to be higher than that of the coagulation-alone method, at least in the postabortal patient. The necessity for pathologic confirmation, a tradition of surgery, is critically questioned. Additional coagulation of the tubal ends after resection is now recommended, especially in the patient seeking abortion as well as sterilization. The authors await the comparative long-term results of bipolar forceps and the newer mechanical methods of laparoscopic tubal sterilization. It is conceivable that the snare and other unipolar electrosurgical instruments designed for female sterilization will become obsolete.
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The marked enthusiasum recently seen in gynecologic endoscopy has brought forth numerous anecdotes of ingenuity. Without ingenuity, medicine and surgical skills would advance slowly. This anecdotal report is presented not only as information but as a stimulus to the endoscopist to consider new approaches to today's surgical problems. The laparoscope has been used to: 1. remove ectopic pregnancies, excise paraovarian cysts and retrieve foreign objects from the abdomen. 2. explore the abdomen for suspected trauma, 3. evaluate the abdomen and pleural cavity for metastatic disease, and 4. perform lumbar sympathectomy. These and other unusual uses of the laparoscope are presented for the "spelunkers" of modern-day endoscopy.
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Abnormalities of cervical mucus can have a bearing on a woman's fertility. One means of detecting the presence of such abnormalities is the postcoital test (PCT). As part of a population-based case control study of risk factors for infertility, the reproductive, contraceptive, medical, and sexual histories of women seeking treatment for infertility who had abnormal PCT results were compared with those of fertile controls. A greater proportion of infertile women with an abnormal PCT had previously used a diaphragm than had control women (relative risk (RR) = 3.5, 95% CI = 1.1-11.3). The excess risk associated with use of a diaphragm was particularly high for women who had used one for longer than one year (RR = 7.3, 95% CI = 1.4-37.8), or within one year of attempting to conceive (RR = 5.5, 95% CT = 1.4-22.1). No increased risk was associated with the use of other barrier methods, oral contraceptives, or the intrauterine device.
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