Issue - Southern Medical Association

Current Concepts

Anorectal Manometry: Techniques and Clinical Applications

ABSTRACT: Anorectal manometry has gained wide acceptance as a helpful method to objectively assess the apparatus of defecation provided by the anorectal sphincter. The standard manometric evaluation enables measurement of resting and squeeze pressures, as well as of the length of the functional anal canal (high pressure zone [HPZ]). More…

Primary Article

Use of Lumbar Run-up Technique for Cervical Myelography

ABSTRACT: Cervical myelography by lumbar run-up produces excellent radiologic studies in most cases. Use of this technique avoids the hazards and pitfalls associated with a lateral cervical puncture. We discuss 92 cases, with excellent or good results in 98% and nondiagnostic studies in only 2%. Both of the poor technical…

Review Article

Oxyphil Cell Neoplasms of the Thyroid Gland

ABSTRACT: Despite several extensive reviews of the literature within the past decade, the treatment of oxyphil cell tumors of the thyroid gland remains controversial. The foremost questions today concern the acceptable criteria for diagnosis of oxyphil malignancies and the appropriate surgical treatment of these neoplasms. This review provides a forum…

Primary Article

Necrotizing Infections of the Perineum

ABSTRACT: During a 6-year period, 10 patients were treated for severe necrotizing infections of the perineum (Fournier's gangrene) at the Edward Hines Veterans Administration Hospital (Hines, Ill). All were male, and their average age was 60 years. When known, duration of symptoms was 2 to 5 days. Prodromal signs such…

Primary Article

Diagnosis of Myocardial Contusion

ABSTRACT: From July 1988 to July 1990, 159 consecutive cases of major blunt chest injury were evaluated prospectively for myocardial contusion with serial electrocardiographic monitoring, cardiac isoenzyme studies, and two-dimensional echocardiography. One hundred and forty-seven cases in the series were assessable; 97 of the patients were male, and 50 were…

Primary Article

Giant Lipomas of the Hand and Forearm

ABSTRACT: Giant lipomas of the upper extremity are infrequently reported. They can alter function by restricting motion or producing compressive neuropathies. This report of four cases of giant lipoma in the hand and forearm illustrates these functional losses. The role of MRI and CT in preoperative evaluation of these lesions…

Primary Article

Effect of Anabolic Steroids on HIV-Related Wasting Myopathy

ABSTRACT: Human immunodeficiency virus type 1 (HIV-1) is frequently associated with weakness and muscle wasting, referred to as HIV-1 wasting myopathy. This illness, often observed in the advanced stages of acquired immunodeficiency syndrome (AIDS), responds poorly to therapeutic intervention. We describe the cases of three AIDS patients with HIV-1 wasting…

Primary Article

Retroperitoneal Tumors With Vena Caval Extension: A Multidisciplinary Approach

ABSTRACT: In cases of retroperitoneal tumor with extension to the inferior vena cava (IVC), complete resection improves survival, but may require cardiopulmonary bypass (CPB) and hypothermic circulatory arrest (HCA). Since 1985, eight patients at our institution have had complete resection of retroperitoneal tumors with IVC or right atrial involvement. Preoperative…

Primary Article

Surgical Clipping of Difficult Intracranial Aneurysms Using Deep Hypothermia and Total Circulatory Arrest

ABSTRACT: Intracranial aneurysms often present a challenging problem for the neurosurgeon. A variety of techniques have been developed to deal with these lesions. Several subspecialists are frequently involved in such treatment. We present our experience in a community hospital using a previously described technique of hypothermic cardiac arrest and barbiturate…

Primary Article

Smokeless Tobacco Use in an Outpatient Veteran Population

ABSTRACT: Smokeless tobacco use is a significant health risk for carcinoma of the oropharynx, and has a high prevalence in the southern United States. To evaluate the potential demand for a smokeless tobacco cessation program, we surveyed patients attending the General Medicine Clinic of a Veterans Affairs Medical Center. The…

Current Concepts

How Safe Are Silicone Breast Implants?

ABSTRACT: The Food and Drug Administration's recent decision to limit the use of silicone gel breast implants was surrounded by a great deal of misleading information in the popular press. This article outlines the most relevant information available in the literature on the most often raised safety issues, including the…

Primary Article

Use of Tympanic Thermometers to Screen for Fever in Patients in a Pediatric Emergency Department

ABSTRACT: The use of tympanic thermometers has markedly increased over the past few years. While some authors have shown high correlation between rectal and tympanic readings, others have found low correlation. After noticing a failure of the tympanic thermometer to detect fever in obviously febrile pediatric patients, we prospectively evaluated…

Primary Article

Prevention of Bicycle-Related Injuries in Childhood: Role of the Caregiver

ABSTRACT: To assess perceptions of bicycle-related head injuries, helmet use, and safety practices, we had questionnaires distributed to caregivers of 2,500 children in the third through sixth grades; 1,006 (40.2%) completed surveys were returned. Eight hundred thirty-two caregivers (82.7%) indicated that they had a child cyclist in their household; approximately…

Primary Article

Safety and Efficacy of Teicoplanin for Bone and Joint Infections: Results of a Community-Based Trial

ABSTRACT: To evaluate the efficacy and safety of teicoplanin in the treatment of gram-positive bone and joint infections, parenteral teicoplanin was used once daily in an average dose of 10.1 mg/kg (range 6 to 12 mg/kg) after loading to treat patients with acute or chronic osteomyelitis and septic arthritis. From…

Primary Article

Continuing Evolution of Regionalized Perinatal Care: Community Hospital Neonatal Convalescent Care

ABSTRACT: We describe the convalescent care of 169 back-transported (to community hospitals) and 285 eligible but not back-transported very low birth weight (VLBW) infants. Eligible infants who were not back transported to a level I or II community hospital were transferred to a level II nursery within the Medical University…

Primary Article

MacFee Incision: A Safe Approach to the Neck

ABSTRACT: We reviewed 37 neck dissections done via the MacFee or double horizontal cervical incision to excise neoplasms located in the oral cavity and oropharynx, with draining cervical lymph nodes. One half of the patients had immediate reconstruction with myocutaneous flaps. Approximately 70% of the patients had advanced tumors and…

Primary Article

Limited Availability of Medications for Cancer Patients

ABSTRACT: We surveyed both chain and independent pharmacies within 10 counties of central South Carolina to determine the availability of certain medications that are often prescribed for patients during cancer treatment. One hundred twenty (59%) of the 202 surveys distributed were returned. Results indicate that many of the 65 products…

Case Report

Anaphylaxis Due to Latex

Case Report

Combined Coronary Artery Bypass and Abdominal Aortic Aneurysmectomy: Appropriate Management in Selected Cases

Case Report

Community-Acquired Xanthomonas maltophilia Pyelonephritis

Case Report

Concomitant Abuse of Clonidine and Heroin

Editorial

LATEX-INDUCED ANAPHYLAXIS

Case Report

Lithium-Induced Nephrogenic Diabetes Insipidus Treated With Indomethacin

Case Report

Metastatic Adenocarcinoma of the Prostate: Presentation as a Pleural-Based Mass

Correspondence

Significant Elevation of CA 19-9 in Chronic Active Hepatitis

Case Report

Spinal Epidural Abscess Due to Aspergillus sp in a Patient With Acquired Immunodeficiency Syndrome

Correspondence

Splenectomy in the HIV-lnfected Patient

Case Report

Systemic Lupus Erythematosus-like Illness Associated With Syndrome of Abnormally Large von Willebrand’s Factor Multimers

Article

Thomas Hodgkin (1798-1866): Physician, Quaker, Social Activist, and Pioneer English Pathologist

Case Report

Torulopsis glabrata in the Neonate: An Emerging Fungal Pathogen

Case Report

Widely Disseminated Pneumocystis carinii Infection Associated With Cytomegalovirus Pneumonitis