Search

A 54-year-old man underwent total knee arthroplasty, during which organic plant material was incidentally discovered within the prepatellar bursa. A combination of high-dose antibiotic-loaded bone cement to implant primary components and an extended course of postoperative antibiotics were used to lower the risk of periprosthetic joint infection (PJI). One year after operation he remains infection-free with improved mobility and decreased pain.Presented with the risk of unexpected tissue contamination, the team used both high-dose antibiotic cement and a course of postoperative antibiotic therapy. This infection prevention strategy is a reasonable course of action in patients at high risk for primary PJI.

This essay investigates the liminal place in the canon of “Shakespeare's paratexts”, emphasising the importance of recent work on prefatory and terminal materials to Shakespeare's early playbook publications, such as character lists, prefatory addresses and commendatory verses. The editorial treatment of paratexts in The New Oxford Shakespeare, especially their scholarly curation and placement in its old-spelling Critical Reference Edition rather than its Modern Critical Edition, raises questions about where Shakespeare begins and ends, and how we situate him in relation to other agents of textual production. I propose the need to challenge the perceived opposition between “Shakespearean text” and “non-Shakespearean paratext”, and to consider the possibilities – raised by work in early modern paratext studies – of editing Shakespeare's paratexts as “parerga”, “metatexts”, or even just “texts”. In short, I ask, why does front matter matter when it comes to Shakespeare's changing canon?

The sixteenth and seventeenth centuries saw an enormous proliferation of printed vernacular texts that discussed and illustrated the female reproductive organs. These gynaecological and obstetrical texts, which included midwifery manuals as well as sections in large anatomical works, inflamed moral outrage (even within the medical establishment) and were stigmatised as forms of pornography. While literary, social and medical historians have addressed the relationship between medical and erotic literature in the early modern period, little has been written on the significance of book history to such discussions. In particular, paratexts (not only title-pages, dedications and prefaces, but also readers’ annotations) can tell us much about the connections between the rhetorical or ‘literary’ qualities of these books and their material life during publication and reading processes. Focusing on Helkiah Crooke’s anatomical work Mikrokosmographia; or a Description of the Body of Man (1615, 1616, 1618, 1631, 1651) and its ‘portable’ octavo epitome Somatographia Anthropine (1616, 1634) as a case study, this chapter combines archival work with analysis of rhetoric and illustrations to examine the ways in which paratexts negotiated anxieties attendant upon publishing women’s ‘secrets’ in early modern England. It considers how prefatory writers—not just authors but also translators and publishers—justified the publications to ‘legitimate readers’ (modest women and medical professionals) and admonished the intrusiveness of ‘illegitimate readers’ (laymen). These writers employed rhetorical strategies which, while explicitly establishing the publications’ legitimacy, fetishised the books as marketable erotic objects, making them more attractive to consumers driven by prurient curiosity. Through bibliographical analysis of a wide range of copies based in the UK, the USA, and Canada, comparisons are drawn between the implied readers constructed by medical paratexts and the actual readers (both male and female) who produced their own.

Charles Christopher Hunter (“Chris”), born in Nottingham, was the youngest of five children (two girls and three boys) born to the son of Mr and Mrs C W Hunter. His education, which began in earnest at High Pavement Grammar School, Nottingham, continued through graduation from Guy’s Hospital Medical School, University of London, leading to postgraduate status at the regional school of psychiatry, University of Southampton. Unlike many of today’s university freshmen, in 1968 Chris left his Nottingham home, carrying a trunk full of belongings, to find his own way to Guy’s medical school. This was the beginning of a full …

Renal pseudotumor composed of an over-growth of normal parenchymal tissues is an occasional sequela of a variety of insults to a kidney.These insults may be related to a kidney’s function or its development.Only a few of the congenital or developmental malformations responsible for producing pseudotumors have been described in the literature. The angiographic demonstration of renal pseudotumors seen in the kidneys of 2 patients with ectopic arterial supplies is described in this report.The mechanism of pseudotumor development in these malformations is also discussed.

The subphrenic space, lying below the diaphragm, above the transverse colon, is divided into upper and lower compartments by the liver. On the left side, the lower compartment has two subdivisions, separated from each other by the lesser omentum, stomach, and anterior layers of the greater omentum. One of these two inferior subdivisions is located anteriorly; the other lies posteriorly and is commonly called the lesser omental bursa, the foramen of Winslow providing its only communication with the greater omental sac or peritoneal cavity. Infection followed by abscess formation may occur in any of the subdivisions of the subphrenic space, usually being secondary to inflammation elsewhere. Of a series of 3,533 subphrenic abscesses collected by Ochsner (1) 31 per cent originated in the appendix, 29 per cent in the stomach and duodenum, and 13 per cent in the liver and biliary passages; 25 per cent represented extension of thoracic lesions into the subphrenic space, and 2 per cent were secondary to trauma. I...

Spontaneous perforation of the gastrointestinal tract in infants during the first few hours or days of life is a paediatric emergency with a very grave prognosis if not treated surgically. The stomach is the most common site of perforation, but occasionally it occurs in the duodenum, small or large intestine. Failure to recognise the condition and carry out early surgical intervention usually results in fatal consequences. There are many causes of gastrointestinal perforation in the newborn. Although the aetiology is uncertain, some of the commonly accepted theories include congestion of the bowel wall secondary to asphyxia or septicaemia (Vargus and Levin, 1959), trauma coincident with delivery (Arnold, 1955), high gastric acidity, peptic ulcer and direct or indirect mechanical injury from lavage tubes, rectal thermometers or resuscitation efforts (Vargus and Levin, 1959). Congenital defects of the musculature, diverticula, meconium stasis, vascular insufficiency, pneumatosis cystoides intestinalis and c...

Benign prostatic hypertrophy is a common disorder which produces clinical symptoms in 30% to 40% of males over 60 years old. Adequate surgical techniques are available for treatment of this disease. However, because the patients are usually elderly, there is frequently coincidental cardiac, renal, or pulmonary pathology adding to the risks of a surgical procedure. A medical therapy which could even delay the need for surgery would be useful. Medical prophylaxis capable of preventing this condition or of arresting its progress would be more useful. Numerous unsuccessful attempts at endocrine therapy for benign prostatic hypertrophy with estrogen or androgen, or both, have been made over the past 30 years. The rationale for such therapy has been based largely upon the hypothesis that altered secretion of testicular steroids occurs and is a factor in the production of benign prostatic hypertrophy. Despite the failure of such therapy in the past, there are

Four patients with extensive, unresectable desmoid tumors were treated with definitive radiation therapy.Three are free of disease 2 years after treatment; the tumor of the fourth has decreased to 20 per cent its former size 1 year after therapy by irradiation.The authors feel that surgery is the treatment of choice in cases of small lesions, but radiation therapy should be attempted in the more extensive tumors. Radical amputation should be reserved for only those patients in whom desmoid tumors failed to respond to radiation treatment.

Stratification in the gallbladder with a radiolucent zone of nonopacified bile may be a physiologic phenomenon during intravenous cholangiography, and should not be confused with floating cholesterol gravel or sludge. A post-fatty-meal and/or delayed films may aid in the differentiation of these two conditions. If a fatty stimulus is given at least 1 hr. prior to the X-ray study, the stratification phenomenon may be avoided.

Multicystic renal disease is a congenital lesion first described in 1936 (Schwartz) following removal of a kidney from a seven-month-old male infant and subsequently classified as a distinct entity in 1955 (Spence). There appears to be no hereditary pattern in multicystic renal disease in contradistinction to polycystic disease (Craig, 1962). Malformations have been described elsewhere in the body including the the urinary system, heart, blood vessels and oesophagus (Parkkulainen, Hjelt and Sirsa, 1959). The lesion may persist into adult life and be accidently discovered. Approximately 20 cases in adults have been reported and all have had unilateral changes (Lalli, 1967). Calcification occurs in about 27 per cent of cases and the excretory urogram reveals no function on the affected side (Craig, 1962). In the majority of cases the ureter is atretic or absent.

In February 1986 when the Non-Traditional Casting Project (NTCP) began its advocacy work to help forge a truly American performing arts, it was not without a great sense of irony. That an organization had to be formed in the mid-Ig8os to advocate for the full participation of AfricanAmerican, Asian-American, Hispanic-American, native American, female, disabled, and other disenfranchised artists in the performing arts was a testimony to our society's failure to acknowledge and accept people of these various groups as individuals and as Americans. This was, after all, over 30 years since the advent of the civil rights movement and more than 20 since the contemporary women's movement began. If these movements, important as they were (and are), had succeeded in re-forming our institutions, rather than merely bending them a little, a Non-Traditional Casting Project would have been superfluous. Unfortunately, although ethnic, female, and disabled persons have been accommodated to an extent in the greater society, their complete acceptance is long in coming. Nowhere is this more apparent than in the performing arts, particularly the theatre.

Case history An eight-year-old girl was referred for intravenous pyelography because of repeated bouts of urinary tract infection. These episodes were associated with frequency, fever and chills. There was no incontinence or flank pain. The patient was of average height and weight for her age. Physical findings were within normal limits. Pertinent laboratory results were limited to the urinary findings where 30-40 W.B.C. per centrifuged high power field were noted and cultures yielded abundant growth of E. coli. An intravenous pyelogram revealed complete triplication on the left (Fig. 1). There were no radiographic findings of chronic pyelonephritis or other abnormality. A cystoscopic examination was subsequently performed and revealed three separate left ureteral orifices within the bladder. The patient was treated with appropriate antibiotics for one