George C. Henegar

Thorotrast-induced cancer in man

The case history is presented of a malignant tumor in man attributed to the injection of Thorotrast. 55 references. (C.H.)

Current concepts in parenteral nutrition.

Surgical stress causes specific physiologic and biochemical alterations. Hypothalamic-pituitary stimulation leads to increased production of antidiuretic hormone, thyrotropin and adrenocorticotropin, affecting water balance, catabolism, renal reabsorption of sodium, and excretion of potassium. Gastrointestinal fluid loss in 24 hours may be more than twice the plasma volume. In addition to water, calories must be provided to meet the energy requirements of body metabolism and prevent excessive catabolism. Potassium loss must be replaced when parenteral feedings are the sole source of nutrition. An intravenous fat emulsion is available which provides a high caloric intake in a relatively small amount of fluid.

Gastrointestinal Hemorrhage from Duodenal Diverticula Review of the Literature and Report of a Case

SummaryA review of the literature of bleeding duodenal diverticula is presented. Two adequately documented cases of bleeding from duodenal diverticula have been found. A third case is described of massive gastrointestinal hemorrhage from such a lesion, which was adequately controlled by surgery, although death followed, caused by overwhelming postoperative pneumonia. The uncontrollable or recurrent gastrointestinal bleeding in a patient with a radiographically demonstrable duodenal diverticulum and no other significant lesion should be considered an indication for exploration.

Total body composition in cirrhotic patients with metabolic alkalosis, hypokalemia, hyperammoniemia, and portacaval shunt

Abstract Results of our studies in 112 cirrhotic patients indicate the presence of metabolic alkalosis in 25 per cent. Potassium depletion as indicated by total body potassium studies was found to be important in the pathogenesis of metabolic alkalosis. Replacement of potassium reverses the alkalosis and the associated coma. Portacaval shunt exerts no beneficial effect on the abnormalities in total body composition found in patients with cirrhosis.

Excretion of oleandomycin in human bile

SummaryAfter oral and intravenous administration of oleandomycin, peak serum levels were observed 1 hour after the last dose and peak bile levels 6–8 hours after the last dose. Detectable amounts of oleandomycin were observed as long as 13 hours after the last dose.The drug is concentrated in the liver and excreted into the bile, and it occurs in bile in higher concentration than in the serum.The concentration of oleandomycin in bile as compared to serum was less in 2 patients with impaired liver function than it was in 3 patients with normal hepatic function.The amount of drug recovered in bile was sufficient to be bacteriostatic to some strains of organisms sensitive to the drug.