Symmetrical peripheral gangrene

Two cases of symmetrical peripheral gangrene associated with intracardiac lesions are described. One had a secondary deposit from a uterine leiomyosarcoma in the wall of the right ventricle, the other had a free ball thrombus in the right atrium; there were no valvular lesions in either case. The published reports of this type of gangrene indicate that it may result from (1) va sospastic conditions, (2) small vessel obstruction, or (3) conditions producing a very low cardiac output. The two patients reported are unusual examples of the last.     

Alternative behavioral approaches to the treatment of homosexuality

Two proven procedures are suggested for the substitution of T-drainage. 1. Modified coledochoduodenostomy, i.e. an internal shunt. By this precedure the operative mortality of aged jaundiced patients at risk could considerably be reduced. The key to success in this case is a broad anastomosis. 2. Patients of normal strength are subjected to sphincterectomy through transduodenal exposure and spincter replacement is performed after cleaning of the biliary ducts. The operated area is bridged by trans-cystically placed thin polyethylene tubing. Both procedures have rendered unnecessary the use of T-drainage.     

Fundus flavimaculatus. A clinical classification

Various stages of fundus flavimaculatus seen ophthalmoscopically were correlated with findings on electrophysiologic and psychophysical tests. A new classification of fundus flavimaculatus into stages recognizes the nuances in genetic expression and their correlation with findings on retinal function testing.