Jack D. Welsh

Hepatic hemorrhage without rupture in preeclampsia.

HEPATIC hemorrhage with rupture is a serious complication of preeclampsia with a high maternal and perinatal mortality, and the literature states that surgical intervention is indicated.1 , 2 Patie...

Concurrent Cushing's and Zollinger-Ellison syndromes in a patient with islet cell carcinoma: Case report and review of the literature

This report documents the simultaneous occurrence of Cushings and Zollinger-Ellison syndromes in a patient with islet cell carcinoma. The clinical concurrence of these two syndromes has been recorded in only three previous case studies, while three other case reports record evidence suggesting the presence of both gastrin and ACTH within the tumor but without clinical sequelae. In the present report, evidence based on multiple clinical and biochemical data supports the concept that both syndromes are a result of ectopic hormone production by the tumor.

Stricture location in Barrett's esophagus

Twenty-eight patients with Barretts esophagus were studied and strictures were present in 13. Two strictures were malignant. Of the 11 benign strictures, six were located at the squamocolumnar junction, while five were located below the squamocolumnar junction. Contrary to previous reports, benign esophageal strictures often occur below the squamocolumnar junction in patients with Barretts esophagus.

Survey: Use of Clear and Full Liquid Diets with or without Commercially Produced Formulas

A survey of hospital dietitians was taken to determine the usage of clear and full liquid diets in the United States. All of the 299 who responded had these diets in their hospital manuals. Clear liquid diets in 82.3% of the hospitals provided less than 1000 kcal/day, while 27% of full liquid diets contained less than 1500 kcal/day. Both diets were usually taken for 3 or less days. Nearly 75% of those responding rarely used commercially prepared formulas with clear liquid diets whereas commercial formulas were often given with full liquid diets. Higher kilocalories per day are provided when these liquid diets are supplemented with commercial formulas. Prescribing foods only because they are liquid or liquify at room temperature regardless of their osmolarity or kilocalories has little rationale. The addition and/or substitution of newer commercially prepared formulas is suggested.

Vascular responses in the exposed human colon

C ONSIDERABLE USEFUL INFORMATION has b e e n a d d u c e d f r o m t h e s t u d y of e x p o s e d p o r t i o n s of t he h u m a n g a s t r o i n t e s t i n a l t r a c t i n v ivo. I n t he p r e s e n t i n v e s t i g a t i o n two a d d i t i o n a l t e c h n i c s of o b s e r v a t i o n a n d meas u r e m e n t h a v e b e e n i n c l u d e d d i r e c t s t u d y of t h e m u c o s a t h r o u g h ,t d i s s e c t i n g m i c r o s c o p e a n d d e t e r m i n a t i o n s of m u c o s a l t e m p e r a t u r e w i t h a r a d i o m e t e r . T h e o b j e c t i v e has b e e n to i n v e s t i g a t e t h e r e l a t i o n s h i p of c h a n g e s i n m u c o s a l b l o o d f low to m o r e w i d e s p r e a d c a r d i o v a s c u l a r effects .