SMJ // April 1977, Volume 70 - Issue 4
Primary Article
Vacuum Aspiration An Efficient Outpatient Screening Technic for Endometrial Disease
ABSTRACTIn an effort to find a safe, efficient, and inexpensive means of ruling out the existence of a neoplastic process causing abnormal vaginal bleeding from the uterine cavity, 103 patients over 34 years of age had preoperative aspiration (Vabra aspirator) of the endometrial cavity. The tissue obtained at the time…
Primary Article
Cardiac Aspect of Cooley's Anemia
ABSTRACTThe short- and long-term effects of multiple versus regularly spaced blood transfusions on cardiac size, electrocardiographic alterations, heart sounds, murmurs, and carotid pulse were studied in 18 children with Cooley's anemia. These parameters were evaluated before transfusions, one week after multiple blood transfusions (when hemoglobin levels had reached normal), and…
Primary Article
Otolaryngology in the Medical School Curriculum
ABSTRACTWhether the family practitioner will emerge as the primary physician in the area of otolaryngology, with the specialist relegated to either a secondary or tertiary role, remains as yet unsettled. Given the uncertainty of the future place of otolaryngology in general health care, more attention should be placed on teaching…
Primary Article
Detecting Ventricular Arrhythmia After Myocardial Infarction Comparison of Holter Monitoring and Treadmill Exercise
ABSTRACTThe effectiveness of Holter monitoring is compared to modified treadmill exercise for detecting ventricular arrhythmia in 54 patients during the third week after a documented myocardial infarction. Treatment with digoxin and antiarrhythmic agents had been discontinued for 48 hours. Whereas 76% of the patients had no PVCs during treadmill exercise,…
Primary Article
The Psychiatrist's Management of Patients With Undiagnosed Brain Neoplasm
ABSTRACTOf 679 patients with brain neoplasms admitted to either a medical school center or a community hospital during a nine-year period, 24 had been examined by a psychiatrist before definitive diagnosis of brain neoplasm. These 24 cases were studied to evaluate the role of the psychiatrist in the management of…
Primary Article
Irradiation Failures in Cancer of the Larynx
ABSTRACTA series of 116 faryngeal carcinomas treated definitively with irradiation over a 91/2-year period is presented. By preliminary follow-up, there have been 20 recurrences, for an initial treatment failure rate of 17%. Of the 20 patients with recurrence, 16 had salvage surgical procedures. Four of the 16 surgical wounds (25%)…
Primary Article
Hypopituitarism A Complication of Diabetes
ABSTRACTHypopituitarism is a rarely reported accompaniment of diabetes mellitus.1,2 Autopsy studies suggest, however, that pituitary lesions are ten times more common in diabetics than in nondiabetics.3,4 Three cases of diabetes with hypopituitarism are reported. We believe that clinically important hypopituitarism may occur more commonly than is suspected in diabetes and…
Primary Article
Fell Tube Insertion After Orthograde Dilatation of Malignant Esophageal Obstruction Palliation and Morbidity
ABSTRACTTwenty-eight patients with malignant esophageal obstruction had palliative treatment using the Fell endoesophageal tube. The usual plan for these patients, irradiation followed by resection, was not followed because of the presence of tracheoesophageal fistula, celiac or hepatic metastases, or marked debilitation which precluded major operation. Palliation was obtained in ten…
Primary Article
Acute Postinfectious Crural Myalgia in Children
ABSTRACTAn outbreak of acute crural myalgia in children is reported. The severe calf pain followed an influenza-like episode, with subsequent complete recovery. Laboratory studies in most cases showed elevated creatine phosphokinase and SGOT values, with a low peripheral white blood cell count. Electromyographic studies were normal. Results of one muscle…
Book Review
Recent Advances in Plastic Surgery
Book Review
Perinatal Medicine
Book Review
Textbook of Paediatric Nutrition
Primary Article
Medicolegal Implications of the Incompetent, Errant, and “Sick” Physician Changing Times
ABSTRACTA great deal of publicity has been given recently to the problems and consequences of incompetent and errant physicians. There has been great clamor on this subject from many sources—the medical profession, the legal community, the legislatures, the judiciary, and the public. All of these interested parties have undertaken studies…
Primary Article
Studies of Serum Testosterone and Its Reduction Products
ABSTRACTLevels of serum testosterone (T) and its metabolites dihydrotestosterone (D) and androstanediol (A) measured by a competitive protein binding method were as follows, respectively: in adult males (mean ± 1 SD), 435 ± 114, 41 ± 11, 43 ± 12 ng/100 ml; in adult females, 30 ± 14, 18 ±…
Primary Article
The Use of the Carbon Dioxide Laser in Plastic Surgery
ABSTRACTFor centuries, surgical technics have included sharp metal instruments for incisions and dissections together with time-consuming clamping and tying of vessels with associated blood loss. The CO2 laser presents the first major change in these basic technics. Our brief experience with the Sharplan 791 indicates consistently marked reduced blood loss,…
Primary Article
Hematuria and Sickle Cell Disorders
ABSTRACTTo examine the relationship between gross hematuria and sickle cell disorders, all patients admitted to Grady Memorial Hospital with the diagnosis of a sickle cell disorder during a 14-month period were reviewed. Of 115 such patients, 65% had sickle cell disease and 35% had sickle cell trait. None of the…
Primary Article
Primary Carcinoma of the Trachea Report of Two Cases
ABSTRACTPrimary carcinoma of the trachea is not common. Of 23 cases diagnosed as “carcinoma of the trachea” at our institution since 1949, 21 actually represented secondary involvement from carcinoma of the larynx, lung, or esophagus. The two cases of primary carcinoma of the trachea are presented. Discussed are the relation…
Primary Article
Predictors of the Duration of Infectious Mononucleosis
ABSTRACTThe clinical course of infectious mononucleosis was monitored in 122 patients to determine predictors of duration of illness. Gastrointestinal symptoms and palatal petechiae were associated with a prolonged recovery period. Multiple regression analysis of quantitative data identified the number of days from onset of symptoms to diagnosis as the only…
Primary Article
Endobronchial Metastases
ABSTRACTSeventeen cases of endobronchial metastases are reviewed. Of these, six had the primary lesion in the breast. Treatment was by resection, radiation, or systemic therapy. Breast cancer patients with long disease-free intervals had the longest survival after bronchial metastases, and those with the most aggressive carcinomas and sarcomas had shorter…
Primary Article
Minoxidil‐Induced Hypertrichosis Treatment With Calcium Thioglycolate Depilatory
ABSTRACTMinoxidil is a new, effective, investigational antihypertensive drug. A serious, cosmetic side effect in women is hypertrichosis. Five female patients with this complication had successful removal of the excessive hair with a calcium thioglycolate depilatory agent.
Primary Article
Unsterile Intermittent Catheterization for Meningomyelocele
ABSTRACTTwenty-five children with meningomyelocele have been managed by clean unsterile intermittent catheterization (UIC). There were 17 satisfactory results, three total failures, and three partial failures under this regimen. Experience, problems, and causes of failure are discussed. UIC offers a definitive form of management for some types of neurogenic bladder.
Primary Article
Myotonic Muscular Dystrophy in Pregnancy
ABSTRACTMyotonic muscular dystrophy is an autosomal dominant disease inherited with variable penetrance. With pregnancy, the myotonia and muscle weakness may increase. There is also an increased incidence of abortion, prematurity, fetal death, labor dysfunction, and postpartum hemorrhage. A description of two pregnant patients and a review of the literature illustrate…
Article
Anorexia Nervosa A Combined Therapeutic Approach
ABSTRACTTen female patients with a diagnosis of anorexia nervosa were treated with a combination of behavior modification and psychotherapy and, when appropriate, psychotropic medication. All patients had favorable weight gain and improvement in adjustment during hospitalization. Later crises for each patient thus far have not significantly affected their weight. Three…
Article
Atopic Dermatitis The Concept of Flare Factors
ABSTRACTA flare factor is a biologic or environmental factor which induces exacerbation of atopic dermatitis. Xerosis, sweating, scratchy clothes, allergy, infection, scratching, allergic contact dermatitis, anxiety, and coexisting disease are potential flare factors. Different patients have different flare factors, and individual patients may have different flare factors at different times….
Article
The Effect of Serum Oncotic Pressure on Serum Cholesterol Levels A Study in “Normal” and Nephrotic Subjects
ABSTRACTClinical data in nephrotic and nonnephrotic subjects were examined to help delineate the mechanism of hypercholesterolemia in nephrotic syndrome. Analyses of the relationship between total serum cholesterol and serum albumin levels and between total serum cholesterol and calculated serum oncotic pressure in 500 nonnephrotic individuals revealed strong positive correlations (r…
Article
Injuries From Sea Urchins
ABSTRACTInjuries from sea urchins result from penetration of the calcareous spines into the skin. Local pain of several days' duration is the most common symptom, but systemic reaction from toxins found in certain species can occur. There is no uniformly accepted successful treatment other than cleansing the wound. Attempts to…
Article
Benign Tumors of the Esophagus Experience With 20 Cases
ABSTRACTBenign tumors of the esophagus are rare and require an alert suspicion for early diagnosis. These tumors may not cause symptoms before attaining large size, yet they may prove fatal when small. Because of the possibility of malignancy and their tendency to obstruct, benign tumors of the esophagus should be…
Article
Arthroscopy Its Role in Treating Nontraumatic and Traumatic Lesions of the Knee
ABSTRACTArthroscopy of the knee is a useful adjunct in the diagnosis and treatment of intra-articular disease. We reviewed 178 patients who had arthroscopy at Duke from November 1972 to May 1975. Anesthesia was either general or local with a block of the intrapatellar fat pad and the intrapatellar branch of…
Current Concepts
Avoiding a Pitfall in Resuscitation The Painless Cervical Fracture
ABSTRACTFor the physician treating an injured patient, it is important to recognize fracture of the cervical spine without neck pain. Films of the cervical spine in patients with head or facial trauma, or patients who are unconscious, inebriated, or have multiple injuries, should be routine and are best obtained by…
Current Concepts
Chloramphenicol Toxicity
Case Report
Massive Cavernous Hemangioma of the Liver
Case Report
Perforating Granuloma Annulare
Case Report
Pulmonary Dirofilariasis Another Coin Lesion
Letter to the Editor
LETTERS TO THE EDITOR
Letters to the Editor are welcomed. They may report new clinical or laboratory observations and new developments in medical care or may contain comments on recent contents of the Journal. They will be published, if found suitable, as space permits. Like other material submitted for publication, Letters must be typewritten…