Showing papers by "Lenox Hill Hospital published in 1972"

The PMPO syndrome (postmenopausal palpable ovary syndrome).

Abstract: If we are to save more women and diminish the mortality rate from ovarian cancer, we must become more liberal in our indications for operation. We suggest that the palpation of what appears to be a normal-sized ovary for a patient three to five years postmenopausal is indicative of an ovarian tumor and should be investigated promptly. These patients should not be followed and re-evaluated but rather subjected to proof as to the presence or absence of an ovarian tumor. To wait until one feels a solid tumor mass of up to 5 cm. and expect a cure is an exercise in fancy and futility. John Gardner said, “We are all faced with wonderful opportunities brilliantly disguised as insoluble problems.” Ovarian cancer is not insoluble. Perhaps, by adding a small segment at a time, the total picture will emerge to the benefit of our patients. Remember the PMPO Syndrome!

Long term therapy of ulcerative colitis with 6-mercaptopurine: a personal series.

Abstract: Fourteen patients with ulcerative colitis who were considered “failures of therapy with adrenal steroids and salicylazosulfapyridine” but who did not have an absolute indication for surgical intervention were treated with 6-mercaptopurine. The dose ranged from 50 to 150 mg daily and the mean period of treatment was 2 years. The current status is excellent or good in 11, fair in 2 and one patient has had elective surgery. In 8 patients the sigmoidoscopic appearance was recently normal, 6 have not required steroid therapy for many months and in the other 7, maintenance doses have been very small. Transient vomiting complicated therapy in 6 and leukopenia occurred 19 times in 10 patients. No serious complications occurred. The results suggest that responses to 6-mercaptopurine are not as dramatic as those observed with steroids but the former drug has a sustaining or supplementary role. It serves to decrease the frequency and severity of recurrences and eliminates or reduces the need for steroids. Complications are infrequent, not severe, and occur early in the course of therapy so that the drug may be used for long periods. The favorable results justify undertaking long-term, double-blind controlled studies of 6-mercaptopurine therapy in patients with ulcerative colitis when other forms of medical treatment have failed.

Thermodynamic Characterization of the Contractile State of the Myocardium

Abstract: Definition of the contractile state of the myocardium from force, length, and velocity relationships and measurements of ventricular pressure is a continuum mechanics approach that requires a detailed knowledge of the system under consideration or, in the absence of detailed knowledge, the use of suitable conceptual models. In this paper we proposed a simpler, though still rigorous, approach that required only a general, rather than a detailed, a priori knowledge of the system. Using the theory of thermodynamics, we gained some insight into the physical meaning of the time derivatives of the left ventricular pressure pulse. From integrations and normalizations we obtained power-density functions (energy-averaged power density and power-averaged rate of generation of power density). These functions relating the free energy in the myocardium to the pressure in the blood did not require geometric considerations, and they furnished, to a first approximation, a quantification of the contractile state in a population of 26 normal dogs under anesthesia. Moreover, the functions clearly separated the normal state from abnormal ones created by drug intervention, not only in the same dog, but also in different dogs. The functions appeared to be insensitive to volume loading. In two patients studied before and after surgery, these functions also showed significant changes.