Issue - Southern Medical Association

Editorial

CME REEXAMINED

Primary Article

The Religious Medical Model: Holy Medicine and the Spiritual Behavior Inventory

ABSTRACT: This paper describes the history and basis of the Spiritual Inventory from its beginning. Initially, the Inventory took the form of a casual interview. The advantage of an interview is clinical judgment and the ability to diagnose the spirituality of the patient. Analysis of spiritual behavior is a useful…

Primary Article

Seizures and Hypothermia Due to Dietary Water Intoxication in Infants

ABSTRACT: I retrospectively describe 20 episodes of water intoxication in 19 infants, with hypothermia, seizures, and hyponatremia. Overdilution of formula or aggressive supplementation with water or clear juices were documented in 16 of the 20 episodes. Seizures and respiratory distress were severe enough in six cases to require intubation and…

Primary Article

Pharmacologic Erection Program for the Treatment of Male Impotence

ABSTRACT: Recent advances in the understanding of the physiology of the erection process have led to exciting new diagnostic and therapeutic techniques in the management of impotence. Intracavernous injection of pharmacologic agents can be used to both diagnose and treat certain types of impotence. At the Nashville Impotence Center we…

Primary Article

Incidence of Serum Acid Phosphatase Elevation After Transurethral Prostatectomy

ABSTRACT: Serum acid phosphatase levels were measured in 402 patients after transurethral resection of the prostate for benign adenoma. All patients had normal preoperative serum acid phosphatase levels (< 0.8 IU/L) and the tissue specimen was histologically benign in all patients. Ninety-three patients (23%) showed normal postoperative serum acid phosphatase…

Primary Article

Tissue Expansion in Reconstruction

ABSTRACT: Tissue expansion offers a new alternative in plastic surgery. Its applications are numerous for reconstruction of the scalp, head and neck, trunk, breast, and extremity. Over the past year I have used tissue expansion for reconstruction in 13 patients, with multiple expanders in six patients. Complications included two exposed…

Primary Article

Roentgenologic Diagnosis of Stress Fractures and Stress Reactions

ABSTRACT: We examined 26 athletes with continued pain after strenuous exercise. We found stress fractures in 15 patients, all of whom had positive roentgenographic studies. Seven of these 15 also had bone scans, all of which were positive. Five patients had stress reactions, all of which showed positive results on…

Primary Article

Pain Relief After Arthroscopy: Naproxen Sodium Compared to Propoxyphene Napsylate With Acetaminophen

ABSTRACT: We compared naproxen sodium (550 mg) and propoxyphene napsylate with acetaminophen (PN/A, 100 mg with 650 mg) for pain relief after arthroscopy or arthroscopic meniscectomy. Fifty-two patients entered this multicenter, double-blind, randomized, parallel trial. In each drug group, pain intensity values dropped consistently throughout this six-hour study from mean…

Primary Article

Carotodynia Exposed: Hyoid Bone Syndrome

ABSTRACT: The hyoid bone syndrome, first described in 1954, is manifested by tenderness near the greater horn of the hyoid bone. In 1968, the syndrome was reported to be a form of insertion tendinosis, and injection of procaine HC1 with corticosteroid at the tip of the greater horn was found…

Primary Article

Laryngeal Carcinoma in Situ: A Therapeutic Dilemma

ABSTRACT: Two patients having laryngeal carcinoma in situ and seven having carcinoma in situ with microinvasion were treated with laser mucosal dissection of the vocal cords followed by vaporization of adjacent or deeper tissue that appeared abnormal through the operating microscope. In these early cases the depth of vaporization was…

Primary Article

Surgical Management of Congenital Conductive Deafness

ABSTRACT: Todays otologic surgeon has the opportunity to restore normal serviceable hearing in patients with congenital conductive deafness using tympanoplasty with ossicular. chain reconstruction, stapedectomy, or fenestration of the horizontal semicircular canal. The particular surgical approach used is determined by the abnormalities found in the congenitally deformed ear. I report…

Primary Article

Apheresis in a Community Hospital: Six Years Experience

ABSTRACT: We present our six-year experience with apheresis in a community hospital in northern Virginia. A total of 2,892 procedures were done, including 2,232 thrombocytaphereses on normal donors for collection of platelets and 660 therapeutic plasma exchanges in patients having a variety of disorders. We hope our experience will be…

Primary Article

Platelet Satellitism: A Possible Mechanism

ABSTRACT: Markedly increased platelet surface-bound IgG was found on platelets collected in citrate and heparin in a patient with platelet satellitism. The level on platelets collected in EDTA was mildly increased. However, neutrophils from this patient collected in EDTA had markedly increased surface IgG due to attached platelets, while no…

Primary Article

Emergency Surgery for Pancreatic Pseudocysts

ABSTRACT: Pancreatic pseudocysts are a frequent complication of acute and chronic pancreatitis. The management of acute surgical emergencies associated with pseudocysts is unique. In a series of 117 patients with one or more pancreatic pseudocysts, 32% required urgent operation because of a cyst-related complication. The mean day of pseudocyst diagnosis…

Primary Article

Cold Hemagglutinin Disease in the Operating Room

ABSTRACT: Cold hemagglutinin disease is infrequently recognized before complications ensue. We describe a patient with chronic cold hemagglutinin disease who sustained an acute hemolytic crisis during a routine operative procedure in a cool operating room. Cold agglutinins were present during routine preoperative blood cross matching with the Coombs test positive…

Primary Article

Gallbladder Surgery in Patients Over 60: Is There an Increased Risk?

ABSTRACT: We reviewed the records of 101 patients over the age of 60 who had exploration and cholecystectomy in 1982 at Norfolk General Hospital. There were 52 elective and 49 emergency cases. Women comprised 57.4% of the patients, and almost 50% of the patients were over the age of 70….

Primary Article

Morphologic Effects of Percutaneous Balloon Pulmonary Valvuloplasty

ABSTRACT: Five patients with pulmonary valve stenosis and other cardiac anomalies had elective operative repair after percutaneous balloon pulmonary valvuloplasty. Four had reduction in pulmonary valve gradients from 67 ± 9 mm Hg to 39 ± 9 mm Hg (P<.01), whereas one patient with a dysplastic pulmonary valve did not….

Primary Article

Intra-Arterial Thrombolysis for Acute Limb Ischemia: A Three-Year Experience

ABSTRACT: Peripheral arterial thromboembolism and thrombosis of arterial grafts continue to threaten viability of extremities. Percutaneous intra-arterial thrombolysis (IAT) and angiodilatation have afforded limb salvage in some of these patients. Proper patient selection appears to be the hallmark of success with IAT. During a recent three-year period, we used IAT…

Primary Article

Spironolactone and Estrogen-Progestin Therapy for Hirsutism

ABSTRACT: Sixteen women with hirsutism used spironolactone, 100 mg daily without interruption, plus norethindrone (1 mg) and ethinyl estradiol (35 mg) for 21 of each 28 days. Clinical improvement occurred in 11 of the 16 patients and also in an additional patient when the dose of spironolactone was increased to…

Review Article

Pathologic Features of Sudden Cardiac Death: An Overview

ABSTRACT: Sudden cardiac death is a frequent initial manifestation of underlying heart disease. We review the most frequent pathologic cardiovascular findings in victims of sudden cardiac death. We also discuss the role of exercise as a precipitant of sudden cardiac death.

Current Concepts

Isotretinoin

Article

Ethics and Cancer: A Survey of the Literature

ABSTRACT: We have identified 776 articles, books, book chapters, and letters published since 1945 dealing with both ethics and cancer. Of this number, 473 (61%) were discussions in medical and scientific journal articles; they were published in 188 journals, demonstrating the scattered nature of this literature. The recent increase of…

Case Report

Chronic Relapsing Thrombotic Thrombocytopenic Purpura

Case Report

Cryptococcemia Due to Cryptococcus albidus

Case Report

Cardiac Tamponade in Systemic Lupus ErythematOSUS: An Unusual Initial Manifestation

Case Report

Takayasus Arteritis Diagnosed in a Patient With Long-standing Arthralgias and Arthritis

Case Report

Fistula Between the Left Anterior Descending Coronary Artery and the Pulmonary Artery Causing Angina in Two Middle-Aged Patients

Case Report

“Recurrence” of a Plasma Cell Granuloma 11 Years After Initial Resection

From the Division of Pulmonary Diseases, Departments of Medicine and Pathology, North Carolina Memorial Hospital, University of North Carolina at Chapel Hill

Case Report

Medullary Carcinoma of the Thyroid: Papillary and Pseudopapillary Patterns

Case Report

Transient Diabetes Insipidus and Preeclampsia

Case Report

Disseminated Rhabdomyosarcoma of the Urinary Bladder in an Adult

Case Report

Complete Spontaneous Regression of a Cerebral Arteriovenous Malformation

Breif Report

Compartment Syndrome in the Newborn

Breif Report

Pneumococcal Vertebral Osteomyelitis in an Adult

Letter to the Editor

X-rays and Back Pain

Abstract

X-rays and Back Pain Reply

Letter to the Editor

Mandibular Osteomyelitis

Letter to the Editor

Respiratory Failure After Cordotomy

Letter to the Editor

More (and the Last) on Circumcision

Letter to the Editor

Rash From Nicotine Gum

Letter to the Editor

Helen