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Pitfalls In Unqualified Acceptance Of Laboratory Data, Myrton F. Beeler Jan 1973

Pitfalls In Unqualified Acceptance Of Laboratory Data, Myrton F. Beeler

MCV/Q, Medical College of Virginia Quarterly

One can never be absolutely certain that any single laboratory report is correct. As a general rule, therefore, do not undertake potentially serious action on behalf of any patient solely because of a single laboratory report. This is especially important if the result is unexpected or not in harmony with the rest of the clinical information available.

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Haa (Hb Ag) Evaluation-State Of The Art, Ali A. Hossaini, Mario R. Escobar Jan 1973

Haa (Hb Ag) Evaluation-State Of The Art, Ali A. Hossaini, Mario R. Escobar

MCV/Q, Medical College of Virginia Quarterly

In conclusion, this study supports the claim that the RIA is the most sensitive of all assay methods for detection of HB Ag in use today. Because of the inability to verify the presence of HB Ag in those sera positive by RIA alone, however, this claim must be taken only at face value. Further studies are needed to confirm the specificity of these positive reactions.

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Microbial Monitoring, Harry P. Dalton Jan 1973

Microbial Monitoring, Harry P. Dalton

MCV/Q, Medical College of Virginia Quarterly

The need for monitoring both areas for alteration in microbial flora, which may result in invasion or adverse effect on internal organs of the host, has been an accepted scientific fact of modern medicine for years. Questions remain, however, on how much monitoring needs to be done. What areas of the patients and the environment should be tested, and what are the practical uses of the results of such monitoring? Before attempting to answer these questions, let me give you an overview of how microbial monitoring has been used at the Medical College of Virginia hospitals and other institutions to …

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The Pharmacology And Clinical Use Of Lidocaine And Procainamide, J. Thomas Bigger Jr., Elsa-Grace V. Giardina Jan 1973

The Pharmacology And Clinical Use Of Lidocaine And Procainamide, J. Thomas Bigger Jr., Elsa-Grace V. Giardina

MCV/Q, Medical College of Virginia Quarterly

Both procainamide and lidocaine are useful for acutely treating cardiac arrhythmias, and procainamide can be useful in chronic antiarrhythmic regimens. Successful management of cardiac arrhythmias requires knowledge of: 1) the mechanism and natural history of the arrhythmia, 2) the physiologic state of the patient, and 3) the cardiac effects, pharmacodynamics, and general pharmacology of the antiarrhythmic drugs.

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Author Index, Volume Nine, 1973 Jan 1973

Author Index, Volume Nine, 1973

MCV/Q, Medical College of Virginia Quarterly

Author index for MCV/Q, Medical College of Virginia Quarterly, 1973, Volume Nine.

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Recent Studies In The Pre-Excitation Syndrome, E. Neil Moore Jan 1973

Recent Studies In The Pre-Excitation Syndrome, E. Neil Moore

MCV/Q, Medical College of Virginia Quarterly

The Wolff-Parkinson-White syndrome has held an unusual fascination for cardiologists ever since its original description in 1930. Over 60 different theories have been postulated to describe the mechanism of pre-excitation. The recent development of epicardial mapping techniques to define the sequence of ventricular activation, and the introduction of His bundle electrocardiography have provided valuable procedures for studying pre-excitation. This presentation will discuss some of the insights into the mechanism of pre-excitation that have been derived from these two electrophysiological procedures.

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Conducting Pathways Of The Human Heart, Fergus O'M. Shiel, Fabio Gutierrez Jan 1973

Conducting Pathways Of The Human Heart, Fergus O'M. Shiel, Fabio Gutierrez

MCV/Q, Medical College of Virginia Quarterly

For over a century the cardiac beat has been experimentally observed and analyzed. To a surprising degree the relevancy of the early researches persists, and the views of the 19th century investigators though modified, have not been eclipsed by time. It may, therefore, be appropriate to preface this clinicopharmacological seminar on arrhythmias by a brief review of the cardiac conducting pathways whose existence is generally accepted today and to retrace the concepts which led to their discovery.

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The Critical Use Of The His Bundle Electrogram, Benjamin J. Scherlag Jan 1973

The Critical Use Of The His Bundle Electrogram, Benjamin J. Scherlag

MCV/Q, Medical College of Virginia Quarterly

The technique for electrode catheter recording of consistent and stable His bundle activity presently used in the clinical laboratory was initially developed as an investigational tool. In the clinical laboratory, the His bundle electrogram, in conjunction with the surface electrocardiogram--a technique that has been termed His bundle-electrocardiography by Castellano--has provided a more accurate means of localizing the site of conduction abnormality in patients with various forms of heart block. In addition, this technique has been utilized to study various physiological and pharmacological interventions, arrhythmias, and the Wolff-Parkinson-White syndrome.

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Pharmacology Of Antiarrhythmics: Quinidine, Beta-Blockers, Diphenylhydantoin, Bretylium, Albert J. Wasserman, Jack D. Proctor Jan 1973

Pharmacology Of Antiarrhythmics: Quinidine, Beta-Blockers, Diphenylhydantoin, Bretylium, Albert J. Wasserman, Jack D. Proctor

MCV/Q, Medical College of Virginia Quarterly

The electrophysiologic effects of the antiarrhythmic drugs, presented elsewhere in this symposium, form only one of the bases for the selection of a therapeutic agent in any given clinical situation. The final choice depends on the following factors: 1. The specific arrhythmia; 2. Underlying heart disease, if any; 3. The degree of compromise of the circulation, if any; 4. The etiology of the arrhythmia; 5. The efficacy of the drug for that arrhythmia; 6. The toxicity of the drug, especially in the given patient with possible alterations in volume of distribution, biotransformation, and excretion; 7. The electrophysiologic effects of the …

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Neural Effects On Cardiac Rate And Rhythm, H. Page Mauck Jr. Jan 1973

Neural Effects On Cardiac Rate And Rhythm, H. Page Mauck Jr.

MCV/Q, Medical College of Virginia Quarterly

The importance of autonomic discharge emanating from high neural regions rostral to the medulla oblongata on heart rhythm was first recognized in the classical studies by Schiff and Danilewsky during the late nineteenth century. Only in the last two decades, however, has a precise description of these neural effects on heart rhythm become possible. Crucial to these more recent advances have been improvements in technology which have permitted application of discrete electrical stimuli to various regions of the brain as well as continuous monitoring of heart rate and arterial pressure. These studies, reported here, represent a portion of a broader …

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Ambulatory Care For Emphysema And Chronic Bronchitis, Thomas L. Petty Jan 1973

Ambulatory Care For Emphysema And Chronic Bronchitis, Thomas L. Petty

MCV/Q, Medical College of Virginia Quarterly

The immense problem of chronic airway obstruction (CAO)--emphysema and chronic bronchitis--which has now reached epidemic proportions, presents to the practitioner of medicine an increasing number of suffering persons asking for care. These patients are dyspneic, anxious, bewildered by their predicament, sometimes demanding and frightened about prospects for future comfortable life.

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The Pathophysiology Of Respiratory Failure In Chronic Obstructive Pulmonary Disease, John L. Patterson, James P. Baker, Walter J. O'Donohue Jr. Jan 1973

The Pathophysiology Of Respiratory Failure In Chronic Obstructive Pulmonary Disease, John L. Patterson, James P. Baker, Walter J. O'Donohue Jr.

MCV/Q, Medical College of Virginia Quarterly

The most important pathophysiologic aspects of chronic and acute obstructive pulmonary disease involve disturbances in ventilation with resulting derangement of gas exchange in the lung. There is considerable variability in the type of abnormality, the time of its appearance in relationship to the history of the disease, and in the progression of the abnormality in blood gases.

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Mcv/Q, Medical College Of Virginia Quarterly, Vol. 9 No. 2 Jan 1973

Mcv/Q, Medical College Of Virginia Quarterly, Vol. 9 No. 2

MCV/Q, Medical College of Virginia Quarterly

No abstract provided.

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The Respiratory Instensive Care Unit, James P. Baker Jan 1973

The Respiratory Instensive Care Unit, James P. Baker

MCV/Q, Medical College of Virginia Quarterly

This unit functions within the Department of Medicine and as a regular rotation for the second year medical residents and for the straight medical interns. Each of these groups of house officers spends one month in rotation on this service. In addition there are medical students and house officers who elect to spend time on this service available most of the time. The nursing service has been trained by the attending physicians in addition to the senior nurses, and it has a continuing program of review and training of respiratory care skills. With this approach, in addition to having a …

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Urinary Incontinence: A Problem To Hold On To, John H. Texter Jr. Jan 1973

Urinary Incontinence: A Problem To Hold On To, John H. Texter Jr.

MCV/Q, Medical College of Virginia Quarterly

In this presentation attention will be focused on the problem of the urinary incontinence. We will look briefly at the various types and causes for this distressing disorder. Mention will also be made as to treatment with particular emphasis on the surgical correction (or attempts at correction) of the postoperative urine leakage such as one sees following prostatectomy or trauma.

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Microelectrode And His Bundle Studies On Type I And Ii Second Degree A-V Block, E. Neil Moore, Joseph F. Spear Jan 1973

Microelectrode And His Bundle Studies On Type I And Ii Second Degree A-V Block, E. Neil Moore, Joseph F. Spear

MCV/Q, Medical College of Virginia Quarterly

Mobitz classified second degree A-V block into two categories. Mobitz type I, or Wenckebach block, is characterized by a gradual prolongation of the P-R interval preceding the dropped ventricular beat. In Mobitz type II block, the dropped beat occurs without preceding prolongation of the P-R interval. Bundle branch block usually is present in patients with Mobitz type II block. The importance of distinguishing between these two types of A-V block lies in the usual irreversibility and higher mortality of patients with type II A-V block, as contrasted with type I or Wenckebach block. Also, Mobitz type II block frequently progresses …

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Mechanisms Of A-V Block, Leonard S. Dreifus, Joseph Mcmenamin, Demetris Kimbiris Jan 1973

Mechanisms Of A-V Block, Leonard S. Dreifus, Joseph Mcmenamin, Demetris Kimbiris

MCV/Q, Medical College of Virginia Quarterly

Determination of the varieties of A-V block is predicated on the precise identification of the site(s) of conduction delay as prognosis, and therapy must follow on this basis. Further electrophysiologic and pharmacologic studies will undoubtedly reveal other mechanisms on the nature of A-V transmission.

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Carcinoma Of The Prostate: The Great Widow-Maker, John K. Lattimer Jan 1973

Carcinoma Of The Prostate: The Great Widow-Maker, John K. Lattimer

MCV/Q, Medical College of Virginia Quarterly

The percentage of urological cancers is considerable. Of all of the cancer deaths in our country, 10% are urological; in men alone, 18% are urological. It is immediately obvious that a very important aspect of this specialty is the treatment of cancer.

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The Evolution Of Sinoatrial Node Function In Man, J. Thomas Bigger, Harold C. Strauss Jan 1973

The Evolution Of Sinoatrial Node Function In Man, J. Thomas Bigger, Harold C. Strauss

MCV/Q, Medical College of Virginia Quarterly

The function of the sinoatrial node is complex. In nearly all hearts, this small bit of tissue is responsible for spontaneously generating the impulse which will be distributed to the remainder of the heart, maintaining coordinated electrical and mechanical function. In recent years, it has become clear that S-A node dysfunction is not rare, can cause disabling symptoms, and often presents difficult management problems. The challenges presented by the "Sick Sinus Syndromes" have increased our desire to know more about normal S-A node function and about function in disease states.

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Some Mechanisms Of Supraventricular Tachycardia, Gordon Moe Jan 1973

Some Mechanisms Of Supraventricular Tachycardia, Gordon Moe

MCV/Q, Medical College of Virginia Quarterly

Reciprocal rhythm was proposed about 30 years ago by Barker, Wilson, and Johnston as a probable mechanism for the explanation of supraventricular tachycardia. They proposed, on the basis of approximately 100 clinical records at the University of Michigan Hospital, that reentry through the A-V node, better known as reciprocal tachycardia, would account for approximately 40% of their cases. They also postulated that reentry through the S-A node might account for another 40%, and that 20% were probably due to ectopic foci. Ectopic focal activity is demonstrable in the laboratory, and it probably happens in man. Reentry or reciprocal activity through …

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Surgery Of The Adrenal Glands, Arthur W. Wyker Jr. Jan 1973

Surgery Of The Adrenal Glands, Arthur W. Wyker Jr.

MCV/Q, Medical College of Virginia Quarterly

This paper is a surgical overview of adrenal gland disorders and emphasizes new developments in diagnosis and management. Adrenal disorders are relatively rare but clinically, they are very important. If they go undetected, they can produce severe metabolic disturbances which may be fatal.

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The Optimum Treatment For Undescended Testis, John K. Lattimer Jan 1973

The Optimum Treatment For Undescended Testis, John K. Lattimer

MCV/Q, Medical College of Virginia Quarterly

In summary, there are many reasons why orchiopexy should be done, and certainly, the cancer worry is a very distinct one. Yet, I think the psychological reason, the "locker room appearance" situation, is the most frequent, and therefore, an important factor. I do think that we should exercise our favored position of being able to offer hormone treatment first. If that does not work, then go on with surgery as required. The timing, in my opinion, should be to start at the fourth birthday and to have the program completed by the fifth birthday. Although physiological considerations do enter into …

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The Adult Respiratory Distress Syndrome: Clinical Features, Factors Influencing Prognosis And Principles Of Management, Thomas L. Petty, David G. Ashbaugh Jan 1973

The Adult Respiratory Distress Syndrome: Clinical Features, Factors Influencing Prognosis And Principles Of Management, Thomas L. Petty, David G. Ashbaugh

MCV/Q, Medical College of Virginia Quarterly

This report redescribes the adult respiratory distress syndrome and discusses factors which influence prognosis and presents principles of management.

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Introduction, Warren W. Koontz Jr. Jan 1973

Introduction, Warren W. Koontz Jr.

MCV/Q, Medical College of Virginia Quarterly

The Annual Stoneburner Lecture series this year has been devoted to clinical adult and pediatric urology. The purpose of the papers presented was to give the urologist and the primary care physician an overview of the problems and the latest developments and advances in technique. The 26th Annual Stoneburner Lecture series was held February 22-23, 1973.

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Introduction, George P. Vennart Jan 1973

Introduction, George P. Vennart

MCV/Q, Medical College of Virginia Quarterly

This issue of the Medical College of Virginia Quarterly is devoted to the 44th Annual McGuire Lecture Series held in March 1973, under the auspices of the Division of Clinical Pathology, Department of Pathology, and the Department of Continuing Education.

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Medical Management Of Stone Disease, M. J. V. Smith Jan 1973

Medical Management Of Stone Disease, M. J. V. Smith

MCV/Q, Medical College of Virginia Quarterly

The purpose of this review is to try to take a practical approach toward the management of patients with renal calculous disease. This will be a personal approach; I will, however, try to avoid injecting my prejudices and research interests. I want to show that proper management can be achieved even in the most unsophisticated environment.

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Mcv/Q, Medical College Of Virginia Quarterly, Vol. 9 No. 4 Jan 1973

Mcv/Q, Medical College Of Virginia Quarterly, Vol. 9 No. 4

MCV/Q, Medical College of Virginia Quarterly

No abstract provided.

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Clinical Pathological Coreelation Of Chronic Obstructive Pulmonary Disease (Copd), Orhan Muren Jan 1973

Clinical Pathological Coreelation Of Chronic Obstructive Pulmonary Disease (Copd), Orhan Muren

MCV/Q, Medical College of Virginia Quarterly

There are currently 15 million people affected with COPD in the United States. It appears that once the disease is well established or advanced, the ultimate course cannot be altered significantly. Emphasis should be given upon prophylactic measures. Discouragement of cigarette smoking is probably the most important means to reduce the incidence of COPD.

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Recognition Of The Asthmatic Componnent Of Respiratory Failure, John L. Guerrant Jan 1973

Recognition Of The Asthmatic Componnent Of Respiratory Failure, John L. Guerrant

MCV/Q, Medical College of Virginia Quarterly

Respiratory failure from various causes is occasionally associated with or confused with asthma. Therefore, asthma should be considered and looked for in all patients with respiratory failure. Sputum eosinophilia when present is the most important indication that asthma may be important. Steroids used early and aggressively are usually indicated and effective.

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Newer Techniques In Clinical Cytology: Aspiration Biopsy And Brushing Cytology, William J. Frable Jan 1973

Newer Techniques In Clinical Cytology: Aspiration Biopsy And Brushing Cytology, William J. Frable

MCV/Q, Medical College of Virginia Quarterly

Since its introduction some twenty years ago the Papanicolaou technique for cervical-vaginal cytology has had a tremendous impact on the detection of precancerous lesions and in situ cancer in the female genital tract. It has forced the clinician and pathologist to study the "early lesions" of cancer, particularly in the female genital tract and has brought about a better understanding of their biology. Cytology has over the years been extended to other areas, particularly the respiratory tract. Two recent areas of emphasis are the thin-needle aspiration biopsy and direct brushing of mucosal surfaces through the various fiber optic scopes now …

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