Issue - Southern Medical Association

Editorial

Detection of Recurrent Breast Cancer

Most clinicians attempt to identify and treat recurrent breast cancer at the earliest sign of relapse. In an effort to better define the usefulness of commonly used clinical and laboratory tools in evaluating patients after mastectomy, we retrospectively analyzed 120 cases and reviewed the literature. One hundred fifteen sites of…

Primary Article

Peritoneal Washing Therapy for Pseudomyxoma Peritonei

Two patients with pseudomyxoma peritonei (PP) had repeated intraperitoneal washing with 5% dextrose in water. Both responded to this therapy with decrease in abdominal girth. The second patient is alive, without abdominal distention, more than 112 weeks since beginning peritoneal washing therapy (PWT) for ovarian PP. Biochemical assays of urine…

Primary Article

Trophoblastic Pulmonary Embolism

Trophoblastic embolism is subclinical in normal pregnancy, pronounced in eclampsia, and massive in hydatidiform mole. Self-limited acute respiratory distress arises in 3% to 10% of molar pregnancies at the time of uterine evacuation. Infrequently death occurs; the principal findings are trophoblastic emboli in the pulmonary arterioles, edema of the lungs,…

Primary Article

Colorectal Cancer in Young Adults

The clinical and pathologic characteristics of colorectal cancer in patients younger than 30 years are compared with those in patients 30 to 39 years of age. Patients in the two age groups had similar symptoms, predominantly undifferentiated neoplasms, and poor prognoses. However, when the characteristics of these patients were compared…

Primary Article

Argon Laser Treaatment of Port-Wine Hemangiomas Clinical and Histologic Correlation*

Fifteen white patients with port-wine hemangiomas treated with argon laser had excellent to good cosmetic results without significant scarring. Histologic examination of the treated sites showed dermal fibrosis with preservation of skin appendages. The changes have been stable for a two-year follow-up.

Primary Article

Diagnosis of Postoperative Intra-abdominal Abscess*

Clinical, laboratory, radiologic, and radionuclide findings of 40 patients with operatively proven intra-abdominal abscesses were evaluated to determine their degree of diagnostic accuracy. Correct preoperative diagnosis was established by clinical, laboratory, and simple radiologic technics in 24 (60%) patients, whereas more sophisticated imaging procedures were used in 16. Gallium citrate…

Primary Article

Multilocular Cyst of the Kidney

We describe three cases of multilocular cyst of the kidney, and discuss the presentation, diagnosis, pathologic criteria, and management of this entity.

Errata

CORRECTION

Primary Article

Compression and Elevation of Tissue in Cryosurgical Treatment of Angiomas*

The combination of compression and elevation of the lesion with forceps during cryospray was used in 154 patients with 263 angiomas. The results were consistently good or excellent, regardless of the various vascularity of the tumors.

Primary Article

Obstetric Use of Continuous Epidural Block in a Private Community Hospital Review of 500 Gases

Five hundred consecutive births in which continuous lumbar epidural block was used for analgesia were reviewed retrospectively. We wished to evaluate the safety and practicality of this anesthetic technic as done by practicing obstetricians in a predominately private practice. Although many of the results confirmed those of previous studies, the…

Primary Article

Heart Disease and Pregnancy

Heart disease remains the major nonobstetric cause of maternal death. Changes in maternal physiology, particularly an increase in cardiac output and a decrease in peripheral vascular resistance, result in a major hemodynamic burden for pregnant patients with organic cardiac lesions. An understanding of these changes is essential to properly evaluate…

Primary Article

Useful Triad for Diagnosing the Cause of Chest Pain

In a series of 127 consecutive patients operated on for thoracic outlet syndrome and 100 consecutive patients who had antireflux operations for reflux esophagitis, we found a high incidence of association between thoracic outlet syndrome, reflux esophagitis, and cardiovascular disease. In the group of patients with thoracic outlet syndrome, 35.4%…

Primary Article

Sleep Apnea A Clinical Perspective

We describe the diagnosis and treatment of sleep apnea syndrome (SAS) from a clinical perspective. A model for SAS associated with obesity is presented to aid in the understanding of the pathophysiologic mechanisms involved. Identification, evaluation, follow-up, and treatment are discussed, making use of experience in our sleep laboratory as…

Primary Article

Respiratory Insufficiency Associated With Acute Intermittent Porphyria

Acute intermittent porphyria (AIP) is a disease that may present with gastrointestinal, psychiatric, or neurologic symptoms. We describe two patients in whom AIP was first diagnosed during episodes of acute respiratory insufficiency. The biochemical defects, clinical presentations, pathophysiology, diagnostic criteria, and treatment of AIP are reviewed. We emphasize that AIP…

Primary Article

Coexistent Carpal Tunnel Syndrome and Cervical Radiculopathy (Double Crush Syndrome)

Nineteen patients had coexistent carpal tunnel syndrome (CTS) and cervical radiculopathy (“double crush” syndrome), most commonly at C-6 or C-7. Four others had concurrent CTS and lesions of the brachial plexus. Because clinical features of the three syndromes may be so similar, when they coexisit one of the lesions may…

Primary Article

OPEN INVITATION TO PHYSICIAN-ARTISTS

Primary Article

Pulmonary Arteriography in Patients With Hilar or Mediastinal Masses and Lung Scans Suggesting Pulmonary Embolism

Three patients with clinical features of pulmonary embolism were evaluated by chest roentgenograms, perfusion lung scanning, and pulmonary arteriography. All of them had hilar and/or mediastinal masses which were obvious in one patient, subtle in another, and not discernible in the third. The three patients had abnormalities on lung scans,…

Primary Article

Sensorineural Hearing Loss in Young Children A Systematic Approach to Evaluation

The medical evaluation of an infant or child with a hearing loss usually consists of an extensive battery of tests1 many of them not indicated. After otolaryngologic examination, a systematic approach to evaluation based upon history, age, and positive findings is recommended. Tests necessary to make a presumptive or definite…

Primary Article

Frontal Lobe Lesions and Behavior*

These two case reports illustrate the difficulties encountered in differentiating between functional and organic psychoses. They emphasize the need for an interdisciplinary approach to patients with behavioral disorders.

Primary Article

Downs Syndrome Significance of the Family History

Certain aspects of the family history may suggest that a family is at risk for the inherited form of Downs syndrome (translocation Downs syndrome). There is a series of questions that may be asked when there is a positive family history for Downs syndrome to aid in determining whether a…

Primary Article

Dental Care in Children With Acute Lymphocytic Leukemia

To evaluate the dental status of children with acute lymphocytic leukemia in their first remission, we divided 41 children into age groups in accordance with the National Dental Health Survey. We used the DMF (decayed, missing, filled) index to evaluate dental disease and status of oral hygiene. The study groups…

Review Article

Mild Hypertension Is It important?

Neither blood pressure measurements nor other clinical features permit an entirely adequate characterization of individuals having mild hypertension. However, although any definition of mild hypertension is arbitrary, the concept is firmly established in clinical practice and such classifications can prove useful as operational diagnoses. The relative risk of subjects with…

Current Concepts

Medical Management of the Stuffy Nose

The complaint of nasal congestion is frequently encountered in every field of medical practice. Some instances are easily managed or are self-limited, necessitating only minor symptomatic treatment. Others are quite challenging. This presentation addresses the varied causes of nasal congestion and the means available for their proper medical management.

Article

Recent Advances in Academic Job Placement

With the recent changes in academic medicine, it has become increasingly difficult for a job applicant to assess the true interests of an institution engaged in the recruiting process. The present essay offers a qualitative and semiquantitative evaluation of certain seemingly peripheral areas, which may permit the applicant to assess…