Familial multiple polyposis coli with multiple associated tumors.

A case is described of familial polyposis of the colon, which combines almost every recorded manifestation of the syndrome of associated tumors; namely, carcinomatous changes in the polyps, osteomas of facial and other bones, periampullary carcinoma, transitional-cell carcinoma of the bladder, adrenal adenoma, intra-abdominal fibrous tumors with bowel obstruction, and a remarkable tendency to contain and survive the malignancies.

The clinical use of antishock trousers.

In 34 (71%) of 48 consecutive patients who were in shock (systolic blood pressure less than 80 mm Hg) the application of antishock trousers by ambulance personnel or emergency room staff produced rapid increases of 20 mm Hg or more in the systolic blood pressure. The trousers were applied to a 49th patient only to stabilize a fractured femur. The most common indication for the device was shock resulting from hemorrhage in the upper gastrointestinal tract. Of 20 such patients, 17 (85%) responded rapidly, as did all 5 patients who were treated for a ruptured abdominal aortic aneurysm. The proper application and management of antishock trousers are simple enough for use in the field, although deflation of the device before adequate replacement of fluids would precipitate a return to a state of shock.

Intermittent pneumatic calf compression for prevention of deep venous thrombosis in general abdominal surgery.

A prospective randomized trial is described in 119 patients undergoing major abdominal general surgical procedures. Half of the patients were treated prophylactically with intermittent pneumatic calf compression, begun after the induction of anesthesia and continued until the patient was walking; the other half acted as controls. Deep venous thrombosis was detected by iodine-125 fibrinogen scanning and confirmed by venography, and did not differ significantly in the control and treated groups. One fatal pulmonary embolism occurred in each group. The presence of malignancy of the gastrointestinal tract did not influence the results. The findings suggest that pneumatic compression delayed the development of deep venous thrombosis postoperatively and that perhaps it should be continued until discharge from hospital.

A modification of the Lapidus operation for hallux valgus.

A modification of the Lapidus procedure to correct hallux valgus is described in which the length of the first metatarsal is maintained. One hundred and nineteen operations in 78 patients have been followed up for between two and 16 years. There were excellent or good results in 110 feet (92 per cent).

Effects and prevention of frostbite in wound healing.

Observations on wounds sustained at subfreezing temperatures in husky dogs and in man suggested that exposed wet tissues readily become frozen. Frostbite of wounds caused tissue necrosis, wound sepsis and delayed healing, but immediate wound suture protected against this sequence. To explore the effect of wound closure on healing frostbitten tissue, healing of paired dorsal wounds was studied in 20 rats. In each animal one wound was sutured and the other was left open. In 10 animals both wounds were frozen with Dry Ice. All sutured wounds healed primarily. Most of the control open wounds had healed at 15 days, but in the frozen wounds healing was delayed and infection ensued. It is suggested that at temperatures much below freezing the immediate treatment of a wound should include prevention of frostbite by wound closure.