Issue - Southern Medical Association

Editorial

MEDICAL CARE IN THE 1980s

Primary Article

Complex Thoracic Wounds: Muscle and Musculocutaneous Anatomy in Closure

ABSTRACT: Closure of the infected sternotomy has been facilitated by the use of the pectoralis major musculocutaneous flap and has been well described. This paper describes six cases of more complex infected thoracotomies and the methods of closure. Knowledge of the dual blood supply of many of the thoracic musculocutaneous…

Primary Article

Surgically Correctable Fecal Incontinence

ABSTRACT: A significant percentage of children who are fecally incontinent are so from improper operation or failure to recognize a surgically correctable problem. Over the past five years, we have managed ten children who had operations for anorectal problems and two with anterior anus. Seven were seen after poorly positioned…

Primary Article

Cholangiography and Bile Cytopathology in the Diagnosis of Biliary Tract Obstruction

ABSTRACT: Both percutaneous and endoscopic cholangiography identify strictures, stones,and other causes of biliary obstruction. With a radiologic diagnosis, benign and malignant causes of biliary obstruction can often be differentiated, but cholangiography does not provide a pathologic diagnosis. Therefore, we recommend cytologic excamination of bile obtained during cholangiography to provide pathologic…

Primary Article

Liver Cirrhosis and Biliary Surgery Assessment of Risk

ABSTRACT: Operations on the biliary tract in cirrhotic patients are reported to have a higher than normal risk of operative morbidity and mortality. We reviewed 39 cases from two university-based hospitals over a five-year period. Each patient had biliary tract surgery and biopsy-proven cirrhosis. Eight patients died (21%), and major…

Primary Article

Percutaneous Transhepatic Catheterization in Reconstructive Surgery of the Biliary Ducts

ABSTRACT: Preoperative placement of a No. 9 percutaneous transhepatic drainage catheter for two to three weeks greatly improves the condition of the patient who has suffered operative damage to the hepatic bile ducts. At operation the previously placed catheter serves to identify the proximal portion of the damaged bile duct,…

Primary Article

Carcinoma of the Duodenum

ABSTRACT: Primary duodenal carcinoma is an uncommon tumor that tends to be diagnosed late in its course because of a symptom complex compatible with many benign diseases. We reviewed the cases of five patients with duodenal adenocarcinoma treated at Norfolk General Hospital from 1973 to 1983. Periampullary tumors were excluded….

Primary Article

Inadequate Tetanus Protection Among the Rural Elderly

ABSTRACT: Three cases of tetanus occurring in a community in southern West Virginia in five years prompted a survey of. the immunization status of the population of this region. An immunization history was obtained from 540 consecutive patients seen at three different health care facilities. Of these, 386 (71.5%) had…

Primary Article

Hand Infections in the Elderly

ABSTRACT: Diagnosis and management of hand infections in the elderly can be challenging. The general principles of rest, elevation; compresses, and drainage when appropriate apply. Antibiotics are important to therapy. Review of data from elderly patients and comparison with a younger population having identical infections show a number of important…

Primary Article

Type 8 Pneumococcal Pneumonia: An Outbreak on an Oncology Ward

ABSTRACT: An outbreak of four cases of type 8 Streptococcus pneumoniae pneumonia occurred on an Oncology Ward during a five-day period. All four patients had underlying malignancy and were in close proximity to each other on an open ward. No other patients or hospital personnel had type 8 S pneumoniae…

Primary Article

Health Beliefs, Compliance, and Control of Diabetes Mellitus

ABSTRACT: The problem of compliance and control in the treatment of diabetic patients is widely recognized. However, compliance research is contradictory and impractical as a basis for intervention to improve the patients adherence to his medical regimen. Health beliefs may provide an opportunity to intervene to improve compliance and control…

Primary Article

Initial Experience With a New Prosthetic Angioaccess Device

ABSTRACT: Long-term vascular access has increased longevity for many patients with end-stage renal disease. Much of the hospitalization in this group of patients continues to be for maintenance of reliable vascular access. Thrombosis, infection, aneurysm, and stenosis lead to serious morbidity. The Hemasite angioaccess system has been introduced in an…

Primary Article

Brain Metastasis: Analysis of Patients Without Known Cancer

ABSTRACT: Our retrospective review of the charts of patients receiving radiation therapy for brain metastasis revealed that one third presented neurologic symptoms without prior diagnosis of cancer. Lung cancer was detected in two thirds of this group, and in one third, the primary site remained unknown. There was good clinical…

Review Article

Primary Sclerosing Cholangitis

ABSTRACT: Primary sclerosing cholangitis is a chronic, cholestatic disease affecting the biliary tree. Recent data suggest an autoimmune etiology. Clinical findings, roentgenographic characteristics, and compatible liver histology will help in establishing the diagnosis. There is no known treatment for cure, though relief of symptoms may be accomplished with certain drugs,…

Article

Defense Against Nuclear Weapons: A Decision Analysis

ABSTRACT: Response to the public health threat posed by nuclear weapons is a medical imperative. The United States, in contrast to other nations, has chosen a course that assures maximal casualties in the event of a nuclear attack, on the theory that prevention of the attack is incompatible with preventive…

Case Report

Response of Tularemic Meningitis to Antimicrobial Therapy

Case Report

McArdles Disease in an Elderly Woman

Case Report

Alveolar Cell Carcinoma: Diagnostic Pitfalls in Evaluating the Chest Roentgenogram

Case Report

Renal Angiomyolipoma: Definitive Diagnosis by Ultrasonography and Computerized Tomography

Case Report

Primary Therapy for Small Cell Lung Cancer Reversing the Eaton-Lambert Syndrome

Case Report

Unilateral Duplex Horseshoe Kidney With Ectopic Ureterocele

Case Report

Familial Infantile Myasthenia Gravis: A Preventable Cause of Sudden Death

Case Report

Fetal HydrocephaluS: A Case of Ventricular-Amniotic Shunting

Case Report

Mexiletine: Long-term Follow-up of a Patient With Prolonged QT Interval and Quinidine-Induced Torsades de Pointes

Case Report

Influenza and Mania: A Possible Connection With the Locus Ceruleus

Clinical Brief

Placement of Enteric Feeding Tubes Using Guidewire Technique

Breif Report

Five Cranial Nerve Palsies in a Diabetic Man

Breif Report

Postpartum Osteitis Pubis

Breif Report

Massive Hydrothorax Complicating Occult Cirrhosis

Breif Report

Pleuropulmonary Whipples Disease

Breif Report

Late Development of Electrocardiographic Abnormalities After a Stroke

Breif Report

Ventricular Tachycardia Due to a Transvenous Catheter Pacemaker

Breif Report

Extrapulmonary Small Cell Cancer of the Retroperitoneum

Breif Report

Cyclophosphamide-Associated Hepatotoxicity

Breif Report

Oral Antibiotic Therapy for Osteomyelitis of the Foot in Diabetic Patients

Breif Report

Nasal Papillomas: Successful Treatment With Podophyllin

Letter to the Editor

Ventricular Premature Complexes and Diagnosis of Acute Ml

Letter to the Editor

Subclavian Steal

Letter to the Editor

Streptococcus agalactiae Monarthric Arthritis

Letter to the Editor

Hyperbaric Oxygen Therapy in Clostridial Infection