SMJ // January 1988, Volume 81 - Issue 1
Primary Article
Melanoma With Metastasis to Regional Axillary or Inguinal Lymph Nodes: Prognostic Factors and Results of Surgical Treatment in 714 Patients
ABSTRACT: In a retrospective analysis of 714 patients with melanoma who had node dissection for histologically positive regional axillary or inguinal node metastases at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston during a 30-year interval (1944 to 1974), with a minimum of ten years…
Primary Article
Epithelial Tumors of the Ovary in Women Less Than 40 Years Old
ABSTRACT: From Jan 1, 1978 through Dec 31, 1983, 64 patients with epithelial ovarian tumors, frankly malignant or borderline, were managed at one institution. Nineteen patients (29.7%) were under age 40. The youngest patient was 19 years old. Nulliparity was present in 32% of this group of patients. Of these…
Primary Article
Cervical Cerclage: A Ten-Year Review in a Large Hospital
ABSTRACT: This retrospective study of 129 pregnancies treated with cervical cerclage was done to analyze differences, if any, in reproductive outcome according to gestational age, race, history of previous successful pregnancy, gravidity, and procedure used (McDonald vs Shirodkar cerclage). Fetal salvage was significantly improved only when cerclage was done before…
Primary Article
Nipple Discharge: Surgical Significance
ABSTRACT: Nipple discharge is an important clinical entity ranking second only to a lump as the most common complaint among 7,588 patients having breast surgery (560/7,588, or 7.4%). In the office and clinic it is even more common, since many patients can be treated medically and do not require an…
Primary Article
Bilateral Pelvic Lymphadenectomy, Iridium 192 Template, and External Beam Therapy for Localized Prostatic Carcinoma: Complications and Results
ABSTRACT: Thirty-five patients with prostatic adenocarcinoma were treated by bilateral pelvic lymphadenectomy and temporary implantation of iridium 192 strands with adjuvant external beam radiotherapy. With the implant the prostate received between 3,200 and 3,500 gray (Gy) followed in two weeks by small-field external beam irradiation for an additional dose of…
Primary Article
Repair of Aneurysms of the Thoracic Aorta 12-Year Experience in a High-Risk Population
ABSTRACT: We present our 12-year experience with surgical treatment of aneurysms of the thoracic aorta in a high-risk patient population. Of 52 patients with aneurysms, 36 patients, aged 19 to 80 years, had operation. In 24 of the 36, there were three or more associated major disease processes, such as…
Primary Article
Delayed Diagnosis in Pediatric Appendicitis
ABSTRACT: Delay in appendectomy occurs from failure to contact a physician, or from a physicians failure to make a proper diagnosis. In our study delay was due to physician error in 32 of 422 children who had appendectomy. Symptoms consistent with appendicitis were documented on the initial visit in each…
Primary Article
Victim Factor Correlates of Traumatic Infant Death in South Carolina
ABSTRACT: In South Carolina over a nine-year period, the adjusted odds that infants who died of injuries had been of low birth weight were 2.65:1 as compared to a live-born control group. The odds that injury victims were black were 1.84:1 as compared to control subjects. For victims of accidents…
Primary Article
Extracorporeal Shock Wave Lithotripsy: Review of the First 100 Cases at the Kidney Stone Center of Southeast Georgia
ABSTRACT: We reviewed the first 100 consecutive patients treated with extracorporeal shock wave lithotripsy (ESWL) at one institution. A total of 115 treatments were delivered to 58 men and 42 women. Patients with calculi of various sizes were treated and compared for (1) length of hospitalization, (2) ancillary procedures, (3)…
Primary Article
Pathologic Fractures of the Humerus
ABSTRACT: In a study of 57 actual or impending pathologic fractures of the humerus in 52 patients with inoperable cancer treated between 1972 and 1982, we retrospectivelyreviewed the charts for analysis and comparison of the functional result and pain relief afforded by the various treatments used. Function of the extremity…
Primary Article
Clonidine Versus Chlordiazepoxide in Acute Alcohol Withdrawal: A Preliminary Report
ABSTRACT: The findings presented here are from the first reported comparison and double-blind evaluation of 20 patients randomly assigned to either chlordiazepoxide (n=10) or clonidine (n=10) for the treatment of acute alcohol withdrawal syndrome. Analysis of the study data demonstrated more favorable scores on tests of alcohol withdrawal symptoms (AWS),…
Primary Article
Reducing the Serum Cholesterol Level With a Diet High in Animal Fat
ABSTRACT: Multiple food allergies required a group of seven patients with elevated serum cholesterol levels to follow a diet in which most of the calories came from beef fat. Their diets contained no sucrose, milk, or grains. They were given nutritional supplements. This is the only group of people in…
Review Article
Chest Pain: A Rheumatologist’s Perspective
ABSTRACT: Chest pain is a frequent patient complaint that requires a careful history and physical examination to determine its cause. Cardiac and esophageal causes of chest pain are common, but musculoskeletal disorders such as Tietzes syndrome, chest wall pain syndromes, fibrositis, inflammatory arthritic conditions, cervical osteoarthritis, and disease of the…
Current Concepts
Idiopathic Thrombocytopenic Purpura in Adults
ABSTRACT: Idiopathic thrombocytopenic purpura (ITP) is a primary immune thrombocytopenia that is typically manifested in adults by acute bleeding, severe thrombocytopenia, and normal to increased megakaryocytes in the bone marrow. Labeling studies suggest that most patients with ITP have an IgG antibody directed against the platelet membrane resulting in sequestration…
