SMJ // April 1983, Volume 76 - Issue 4
Editorial
“PRIMUM NON NOCERE”
Editorial
J.M.K
Retrospective
Historical Review of Early Dermatology
Primary Article
Occult Sclerosing Carcinoma of the Thyroid Potential for Aggressive Biologic Behavior
A 46-year-old woman with a 6 mm occult sclerosing thyroid carcinoma had multiple neck metastases and a distant metastasis over an eight-year period. The neoplasm metastasized to cervical lymph nodes, to soft tissues of the neck, and to the right humerus. She had tracheal cutaneous and tracheal esophageal fistulas after…
Primary Article
Smooth Muscle Neoplasms of the Stomach
We reviewed the records of 31 patients with smooth muscle tumors of the stomach seen at the First Surgical Department, Medical School, University of Athens, Greece, between the years 1961 and 1981 with special emphasis on the clinical data, diagnosis, and pathology. The majority of patients were symptomatic and were…
Primary Article
Acidosis and Other Metabolic Abnormalities Associated With Paint Sniffing
Acidosis (arterial pH 6.88 to 7.38) and many other metabolic abnormalities were found in eight patients observed during 16 hospitalizations for paint sniffing. In four episodes, a high anion gap was found, perhaps secondary to an accumulation of metabolites of toluene. The anion gap was normal during 12 episodes, of…
Primary Article
Cephapirin Therapy in Infective Endocarditis
Ten patients, eight of them heroin addicts, with infective endocarditis were treated with cephapirin. Causative organisms included Staphylococcus aureus in six patients and viridans streptococci, S bovis, and S pneumoniae in one patient each. In one of the patients with endocarditis, both S aureus and an organism of the beta-Streptococcus…
Primary Article
Successful Management of Decubitus Ulcers by the General Surgeon
Decubitus ulcers were handled by an aggressive routine of early wide excision and immediate advancement-rotation flaps of the thigh under antibiotic coverage. Of 23 patients referred for decubitus ulcers in two years, 20 were so managed, with primary healing in 15 and secondary healing in an additional four. There has…
Primary Article
Diabetic Nephropathy With Superimposed Immune Complex Glomerulonephritis
We describe six diabetic patients with superimposed immune complex glomerulonephritis. Renal manifestations included sudden change in renal function with hematuria in three patients and massive proteinuria in the other three. Renal histology showed the characteristic changes of diabetic nephropathy along with those of immune complex glomerulonephritis. Biopsy revealed the explanation…
Primary Article
Diabetic Neuropathic Pain Control by Amitriptyline and Fluphenazine in Renal Insufficiency
Seven patients with diabetes of ten to 24 years duration and renal insufficiency were treated with fluphenazine and amitriptyline in an attempt to control severe pain in the extremities. Six patients had relief of pain within five days of initiation of therapy. One patient had no pain relief despite mood…
Primary Article
Comparison of Cardiovascular Risk in Maximal Isometric and Dynamic Exercise
With the hypothesis that isometric exercise testing offers important clinical information yet is neglected because of overemphasis on its risk, we compared it with dynamic testing for variables indicative of myocardial ischemia. In a medical office, 287 patients were each subjected once to both a one-minute maximal handgrip stress test…
Primary Article
Skull Roentgenography in the Evaluation of Head Injury
The role of skull roentgenograms in determining choice of therapy, hospital admission, and length of hospitalization was evaluated in 106 consecutive patients with head injury. Thirty patients were discharged from the emergency room after initial evaluation and had uneventful recovery. Seventy-six were admitted and discharged without operative treatment one to…
Primary Article
Fractures of the Shaft of the Femur Treated With a Single AO Plate
During a ten-year period 37 femoral diaphyseal fractures were treated by a solitary AO (Arbeitsgemeinschaft füUr Osteosynthesefragen [Association for the Study of Problems of Internal Fixation]) plate. Thirty fractures united following the internal stabilization. The seven that received an autogenous cancellous bone graft with the plate united. Twenty nongrafted fractures…
Primary Article
Acute Upper Gastrointestinal Bleeding in Patients With Portal Hypertension A Correlation of Endoscopic Findings With Etiology
Esophagogastric variceal hemorrhage is a common cause of upper gastrointestinal bleeding in patients with portal hypertension. In addition, it is now recognized that patients with alcohol-induced chronic liver disease and portal hypertension frequently bleed from acute mucosal lesions. Since alcohol can cause these lesions in the absence of portal hypertension,…
Primary Article
Clinical Expression of Sickle Cell Anemia in the Newborn
The clinical records of 14 neonates with hemoglobin S homozygosity were reviewed. The infants were identified through a statewide cord blood testing program in Georgia for abnormal hemoglobins. Nine of the 14 patients had neonatal jaundice, most likely due to hemolysis. In one patient, significant anemia appeared as early as…
Primary Article
Driving With Epilepsy A Contemporary Perspective
A committee of concerned neurologists in cooperation with the Tennessee Department of Safety and other agencies reviewed the present state licensing rules for epileptics and offered recommendations for amendments. Epileptics, diabetics, and patients with cerebrovascular disease have an accident rate of approximately twice that of the general population. Seizures probably…
Primary Article
Postresection Bronchopleural Fistula Detection by Regional Ventilation-Perfusion Studies
In three patients, bronchopleural fistula developed after right pneumonectomy for bronchogenic carcinoma. In each instance, radiologic and clinical evidence was inconclusive. Xenon 133 regional ventilation-perfusion studies confirmed the diagnosis of a bronchopleural fistula in both the immediate and late postoperative periods.
Primary Article
Corticosteroids in the Management of Allergic Rhinitis
Allergic rhinitis unresponsive to conservative therapy with antihistamines, decongestants, and environmental control may require the use of corticosteroids for symptomatic relief, even while hyposensitization is being carried out. Such therapy may be given orally, intramuscularly, as a nasal aerosol, or by intraturbinal injection. This discussion deals with the characteristics and…
Review Article
Lupus Nephritis The Dogma Deliberated
Current Concepts
Endoscopic Sclerotherapy for Management of Variceal Bleeding
Our Medical Heritage
History and the Understanding of Acupuncture Anesthesia
Observations of western surgeons in China during the mid-18th Century give a valuable historical perspective to the evaluation of acupuncture anesthesia.