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Showing papers in "Southern Medical Journal in 1975"


Journal ArticleDOI
TL;DR: A complete understanding of male pattern baldness is essential for consistently good results with hair transplantation, and its use in determining the incidence in 1,000 white adult male subjects is reported.
Abstract: The need for a widely accepted, accurate, and reproducible standard of classification for male pattern baldness has increased with the advent and increasing popularity of hair transplant surgery. This report establishes such a classification, and reports its use in determining the incidence of male pattern baldness at various ages in 1,000 white adult male subjects. The action of testosterone as an incitant in male pattern baldness is well known, but this study points out the continued effect of time, even in later years. Since most hair transplant surgery is peformed on subjects with male pattern baldness, and because the success of hair transplant surgery is largely dependent on proper patient selection, a complete understanding of male pattern baldness is essential for consistently good results with hair transplantation.

695 citations


Journal Article
TL;DR: Fifty-one extremities with ipsilateral tibial and femoral fractures are reviewed and most of the 47 patients are young men who have multiple injuries with high velocity trauma.
Abstract: Fifty-one extremities with ipsilateral tibial and femoral fractures are reviewed Some children are included in the study Most of the 47 patients are young men who have multiple injuries with high velocity trauma The involved extremities are classified according to the injury site: Type 1 fractures involve both shafts; type 2-A fractures involve the knee joint; type 2-B fractures involve hip or ankle joints Complications are frequent Delayed union or nonunion occurred in 446% of the total number of bones involved Sixty to seventy percent of the adult patients showed significant permanent functional disability

104 citations



Journal ArticleDOI
TL;DR: The responses of 50 cervical cancer patients to questions about marital and sexual adjustment are discussed, and interview responses suggest five phases in attitudes and feelings from the time of diagnosis until six months after treatment.
Abstract: The responses of 50 cervical cancer patients to questions about marital and sexual adjustment are discussed. The subjects were predominantly poor, white women from rural areas or small towns. They had to travel 50 to 150 miles to a hospital where half were treated by radiotherapy and half

74 citations



Journal ArticleDOI
TL;DR: A case is presented in which the patient's chief complaint was pain and localized tenderness in the hand which interfered with normal activity and abnormalities of pacinian corpuscles attached to the median digital nerve in the form of a grape-like cluster and a single enlarged corpuscle beneath the epineurium were presented.
Abstract: Symptoms and incapacitation due to abnormal aggregations of pacinian corpuscles are uncommon. Indeed, only three reports have been found in the scientific literature. A case is presented in which the patient's chief complaint was pain and localized tenderness in the hand which interfered with normal activity. Surgical exploration of the palm showed abnormalities of pacinian corpuscles attached to the median digital nerve in the form of a grape-like cluster and a single enlarged corpuscle beneath the epineurium; the abnormality attached to the ulnar digital nerve appeared as an offshoot of hyperplastic corpuscles lying in tandem. The abnormal corpuscles were excised. The symptoms have not recurred to date. These abnormalities in size, position, and number of pacinian corpuscles are compared to the findings of the few other reports in the literature. The neuroma formation found attached to this ulnar nerve has not been cited previously.

48 citations




Journal ArticleDOI
TL;DR: In this paper, a double-blind study compared the effectiveness of thioridazine and diazepam in 40 geriatric patients with various symptoms of senility and found that thioridine was superior to Diazepam for relieving troublesome symptoms.
Abstract: A four-week, double-blind study compared the effectiveness of thioridazine and diazepam in 40 geriatric patients with various symptoms of senility. Patients' progress was evaluated with the Hamilton Anxiety Rating Scale, a Modified Nurses' Observation Scale for Inpatient Evaluation (NOSIE), a global rating of degree of illness, and a global rating of degree of overall change. The data indicate that thioridazine was superior to diazepam inrelieving troublesome symptoms of senility.

41 citations


Journal ArticleDOI
TL;DR: The prognosis for advanced carcinoma of the gallbladder is grave, but a reappraisal of the histologic and gross presentation of the disease may uncover a group of patients with significantly better prognosis.
Abstract: The prognosis for advanced carcinoma of the gallbladder is grave, but a reappraisal of the histologic and gross presentation of the disease may uncover a group of patients with significantly better prognosis. During any cholecystedtomy, the gallbladder should be opened by the surgeon and frozen sections should be obtained for suspicious lesions. Carcinoma in situ appears to be well treated by cholecstectomy alone. Microinvasive carcinomas of the gallbladder require wider surgical excision

39 citations


Journal ArticleDOI
TL;DR: A case of glaucoma with visual field loss secondary to elevated episcleral venous pressure is presented and recognition of the etiology of such cases is important, since the management of these patients differs from that of patients having primary open-angle glau coma.
Abstract: A chronic elevation of the episcleral venous pressure may occur after venous obstructive disease or arteriovenous fistulas in the orbit, head, neck, or mediastinum. Idiopathic and familial occurrences of elevated episcleral venous pressure have been reported. Association with an increased episcleral venous pressure is a rise in intraocular pressure which, if of sufficient magnitude and duration, may cause cupping of the optic nerve and visual field loss. A case of glaucoma with visual field loss secondary to elevated episcleral venous pressure is presented. Recognition of the etiology of such cases is important, since the management of these patients differs from that of patients having primary open-angle glaucoma.

Journal ArticleDOI
TL;DR: A telephone survey of 240 households selected by a probability sample of an upper middle class suburb of New Orleans was carried out to ascertain the experiences of residents with fire ants from June to August 1973, and may provide a basis for decision as to the need for community efforts in fire ant control.
Abstract: Although the imported fire ant is a known rural problem, the problem it may pose to urban dwellers has not been documented. A telephone survey of 240 households selected by a probability sample of an upper middle class suburb of New Orleans was carried out to ascertain the experiences of residents with fire ants from June to August 1973. Overall, ant stings were reported for 29% of the study population, with sting rates of 55% among children under 10 years old. Among those stung, at least minimal allergic reactions were reported for 17%, and 4.4% required medical consultation. Of households with outdoor premises, 55% reported fire ant infestation, 86% of these used pesticides for fire ant control, and few felt that community assistance was needed for private property. Half of the respondents, however, favored a community control program for public grounds. These data may provide a basis for decision as to the need for community efforts in fire ant control.

Journal ArticleDOI
TL;DR: The occurrence of fatal paralytic ileus with peritonitis in a patient receiving phenothiazines and an antiparkinsonian agent is described.
Abstract: The occurrence of fatal paralytic ileus with peritonitis in a patient receiving phenothiazines and an antiparkinsonian agent is described. Although sporadic reports of this complication have appeared, it has not been emphasized in the literature. Only by being alert to this problem can one hope to achieve earlier diagnosis and begin prompt and appropriate treatment.


Journal ArticleDOI
TL;DR: Patients with neoplasms in any of these locations should have careful inspection of the entire anogenital tract.
Abstract: Carcinoma of the vagina may be found in association with carcinoma of the vulva and cervix. Patients with neoplasms in any of these locations should have careful inspection of the entire anogenital tract. As in all malignancies, early diagnosis and prompt, adequate treatment offers the best opportunity for cure.

Journal ArticleDOI
TL;DR: Ten patients with tuberculosis of the wrist are reported, and in all of the patients the wrist disease became inactive under treatment with isoniazid and para-aminosalicyclic acid.
Abstract: Ten patients with tuberculosis of the wrist are reported. In three, the disease was limited to the tenosynovium and these patients were treated by synovectomy. Seven patients had disease involving the carpal bones. In six of these an arthrodesis of the wrist was done, and solid fusion was attained in four. In all of the patients the wrist disease became inactive under treatment with isoniazid and para-aminosalicyclic acid.

Journal ArticleDOI
TL;DR: It is suggested that in young men, fear of injuring sexuality should not impede selection of appropriate surgical modality, however, it is also suggested that the women's risk of postoperative impairment of sexual function is greater than the man's.
Abstract: A survey of the sexual changes in patients having abdominoperineal resection for ulcerative colitis was made at the Medical College of Georgia. The incidence of impotence in our series is zero. Only one of our female patients had a successful pregnancy. The other women seemed to be hampered by anatomic derangements relating to strictures, adhesions, or dislocation of the uterus, although the precise causes of infertility have not been elucidated. We suggest that in young men, fear of infertility have not been elucidated. We suggest that in young men, fear of injuring sexuality should not impede selection of appropriate surgical modality. However, we also suggest that the woman's risk of post-operative impairment of sexual function is greater than the man's.


Journal ArticleDOI
TL;DR: The epidemiologic characteristics of 119 cases and the clinical features of 75 serologically confirmed cases are summarized in this communication and compared with other published reviews of RMSF.
Abstract: During the period 1933–1973, 169 cases of Rocky Mountain spotted fever (RMSF) were either reported by physicians or detected in a retrospective survey of hospitals and practicing physicians in Mississippi. The epidemiologic characteristics of 119 cases and the clinical features of 75 serologically c

Journal ArticleDOI
TL;DR: Twenty years' experience with the surgical treatment of Zenker's diverticulum is discussed, with emphasis on 25 patients treated by the Dohlman endoscopic method since 1959, in which the sac was not removed, but the wall between the esophagus and pouch was divided endoscopically.
Abstract: Twenty years' experience with the surgical treatment of Zenker's diverticulum is discussed, with emphasis on 25 patients treated by the Dohlman endoscopic method since 1959. In these patients, mostly elderly, the sac was not removed, but the wall between the esophagus and pouch was divided endoscopically. There were no deaths and no instances of mediastinitis or hemorrhage. Twenty-four of the 25 patients were able to eat with much greater ease. The chief advantages of the endoscopic approach are its extreme brevity of two to five minutes, lack of morbidity, and lack of threat to the recurrent laryngeal nerve. Reoperations are as simple as the original.

Journal Article
TL;DR: Scalded skin syndrome in children has increased in frequency recently, is usually due to S aureus infection with potential epidemic aspects, can be recognized easily by its unusual clinical features, and has an excellent prognosis with appropriate management.
Abstract: The bacteriologic, epidemiologic, clinical, and diagnostic findings and management of the scalded skin syndrome (SSS) in 42 children are reported SSS may present in one of three ways: (1) Ritter's disease in infants, characterized by an acute, generalized bullous dermatitis simulating the appearance of scalded skin, followed by exfoliation; (2) Lyell's disease, or toxic epidermal necrolysis (TEN), in children or adults, with scalded skin and bullae followed by extensive exfoliation; or (3) a nonstreptococcal scarlatiniform eruption, or staphylococcal scarlet fever, manifested by a generalized scarlatiniform erythema ans subsequent minimal to moderate fine desquamation. Staphylococcus aureus was isolated and implicated as the causative agent in 32 of the 42 children; nine of the other ten children had received a drug or vaccine preceding their rash. SSS in children has increased in frequency recently, is usually due to S aureus infection with potential epidemic aspects, can be recognized easily by its unusual clinical features, and has an excellent prognosis with appropriate management.

Journal ArticleDOI
TL;DR: This method of treatment in eight cases of high-voltage, electrical injury has preserved viable tissue, decreased the incidence of fatal sepsis and renal shutdown, decreased patient morbidity, and generally facilitated patient rehabilitation.
Abstract: Based on a knowledge of electropathophysiology, a recommended treatment has been proposed for the management of extensive high-voltage electrical burns. Early, aggressive, surgical intervention consisting of adequate decompression fasciotomy and wound debridement has been emphasized as the f

Journal ArticleDOI
TL;DR: Patients with chronic snuff-induced keratosis associated with mucosal ulcerations were treated with topically applied vitamin A acid and there was distinct involution of the oral lesions with complete healing and restoration of a normal-appearing mucosa within five weeks after beginning of treatment.
Abstract: Patients with chronic snuff-induced keratosis associated with mucosal ulcerations were treated with topically applied vitamin A acid. In each case, after a marked, local inflammatory response initially, topical vitamin A acid showed a definite beneficial effect in promoting healing and involution of the precancerous snuff-induced leukoplakic keratosis. In one patient there was distinct involution of the oral lesions with complete healing and restoration of a normal-appearing mucosa within five weeks after beginning of treatment. In four patients there was healing of superficial ulcerations and regression in the size of the luekoplakic lesions.

Journal ArticleDOI
TL;DR: Electrocardiographic criteria for left atrial enlargement (LAE) were evaluated in a group of 100 patients with a wide spectrum of cardiovascular diseases and compared with the echocardiographic measurement ofleft atrial dimension (LAD), showing a high degree of correlation.
Abstract: Electrocardiographic criteria for left atrial enlargement (LAE) were evaluated in a group of 100 patients with a wide spectrum of cardiovascular diseases and compared with the echocardiographic measurement of left atrial dimension (LAD). Data analysis showed a high degree of correlation between the echocardiographic measurement of LAD and the EKG criteria for LAE. The magnitude of the P terminal force in lead V1 was the most specific of the EKG criteria evaluated, while the P/P-R segment ratio was least specific. Concordance between the two methods of measuring left atrial size increased when multiple positive EKG criteria were present.

Journal ArticleDOI
TL;DR: Colestipol hydrochloride is an insoluble, nonabsorbable copolymer with bile-acid-binding capacity that prevents reabsorption of cholates from the intestinal tract into the enterohepatic circulation causing a net loss of bile acids, and therefore of cholesterol.
Abstract: Colestipol hydrochloride is an insoluble, nonabsorbable copolymer with bile-acid-binding capacity. It prevents reabsorption of cholates from the intestinal tract into the enterohepatic circulation causing a net loss of bile acids, and therefore of cholesterol. Sixty subjects with cholesterol levels over 250 mg/100 ml were studied for 104 weeks. Patients with normal phenotypes, types 2,3, and 4, were given 5 gm three times daily and experienced an average drop of 40 mg/100 ml (14%). While patients with types 2,3, and 4 hyperlipidemia responded effectively, cholesterol levels in type 2 patients dropped earliest and most consistently with an average decrease of 58 mg/100 ml (19%). A comparable group of patients with hyperlipidemia taking placebo showed on average no change in serum cholesterol. Serum triglyceride values were not altered significantly. The resin is not absorbed from the gastrointestinal tract and produces a slight increase in fecal volume. Results of chemistries, enzyme assays, prothrombin times, hematology, and urinalysis and body weights wer unaltered. There was no evidence of lithogenic bile production. Colestipol is a tasteless and ordorless copolymer with high acceptability. Side effects were limited to occasional bloating, gas, and constipation. The drug is a safe, effective, palatable hypolipedmic agent.

Journal ArticleDOI
TL;DR: Two patients are presented who had malignant fibrous histiocytomas of the skin and soft tissue that characteristically consist of a solitary mass, 0.5 cm to 12.0 cm, which has skin fixation, is circumscribed and firm.
Abstract: Two patients are presented who had malignant fibrous histiocytomas of the skin and soft tissue These tumors characteristically consist of a solitary mass, 05 cm to 120 cm, which has skin fixation, is circumscribed and firm Microscopically, there is a pattern of histiocytes and bizarre histiocytic giant cells intermingled in a fibrous stroma with fibroblasts arranged in a whirling pattern The lesion is treated with wide excision and skin grafting Local recurrence is common Metastasis is less common, but with metastasis the prognosis is poor

Journal Article
TL;DR: Experiences in managing patients suffering cardiac stab wounds and coming to the University of Alabama Hospital in Birmingham from January 1964 to July 1972 are reviewed and the advisability of primary operative management for these patients is convinced.
Abstract: Experiences in managing patients suffering cardiac stab wounds and coming to the University of Alabama Hospital in Birmingham from January 1964 to July 1972 are reviewed. From 1964 through July 1971, conservative management was used primarily, but most patients ultimately required operation. Analysis of our experiences during this period convinced us of the advisability of primary operative management for these patients, and since July 1971, primary operative management has been used. In the years from January 1964 to July 1972, 34 patients with cardiac stab wounds were treated at our hospital. Ten were managed conservatively with three deaths among this group. The remaining 24 received operative management either primarily or secondarily, and all of these patients survived. A patient managment program is outlined.


Journal ArticleDOI
TL;DR: Infection within the peritoneal cavity without an identifiable source of contamination is rare and can be made with certainty only after a thorough laparotomy.
Abstract: Infection within the peritoneal cavity without an identifiable source of contamination is rare. The diagnosis is one of exclusion, and can be made with certainty only after a thorough laparotomy. The response to antibiotic therapy is usually prompt and gratifying.

Journal ArticleDOI
TL;DR: It is concluded that lead nephropathy should be recognized early and treated energetically, as this may stabilize or improve renal function and the dosage must be reduced proportionately in response to elevated serum creatinine levels in the patient with renal failure.
Abstract: Although treatment has been well defined for childhood lead poisoning and for industrial lead exposure, the treatment of lead nephropathy has been poorly studied. The available chelating agents are reviewed and the results of treatment in 17 cases of lead nephropathy are shown. It is concluded that lead nephropathy should be recognized early and treated energetically, as this may stabilize or improve renal function. Since EDTA is excreted much like creatinine, the dosage must be reduced proportionately in response to elevated serum creatinine levels in the patient with renal failure.