Abstract:
:We retrospectively studied 125 patients treated for carcinoma in situ of the vulva from 1961 through 1984, with follow-up ranging from one to 24 years. Patients' ages ranged from 24 to 90 years, with a mean age of 53 years. Multifocal disease was more common in women under age 40. Pruritus was the most common complaint, but 60% of the patients were asymptomatic. Twenty-five patients (20%) had other associated malignancies: carcinoma in situ of the cervix in ten patients, invasive carcinoma of the cervix in six, multifocal carcinoma in situ involving vulva, vagina, and cervix in five, vaginal carcinoma in situ in two, and endometrial carcinoma in two. Sixty-five patients were treated primarily with wide excision, 45 with total vulvectomy, seven with "subtotal" vulvectomy, three with skinning vulvectomy, and three with vulvectomy and bilateral groin node dissection; two patients refused treatment. Fifteen patients had a recurrence--recurrent carcinoma in situ in ten, and invasive carcinoma of the vulva in five. Whether the patient had had total vulvectomy or a lesser procedure appeared to make no difference in the recurrence rate. Thus a well planned excision of vulvar carcinoma in situ appears to be the treatment of choice. All recurrences were in patients over age 40, so although the lesion is histopathologically identical in the younger patients, its biologic behavior seems to be more benign. Since it is possible, however, that invasive disease will ultimately develop in some of the younger patients, careful follow-up is still required.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Fiorica JV,Cavanagh D,Marsden DE,Shepherd JH,Ruffolo EH,Songster CLdoi
10.1097/00007611-198805000-00012subject
Has Abstractpub_date
1988-05-01 00:00:00pages
589-93issue
5eissn
0038-4348issn
1541-8243journal_volume
81pub_type
杂志文章abstract::Despite recent pharmacologic advances in the prevention and treatment of osteoporosis, the disease remains incurable. Effective disease management ultimately lies in the hands of the individual patient, who must take responsibility for key health behaviors related to bone health. One behavior modification strategy tha...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-200406000-00007
更新日期:2004-06-01 00:00:00
abstract::While in most states information physicians obtain from the about patients is confidential and cannot be disclosed without the patient's permission, a recent California Supreme Court decision affirms that when the doctor reasonably believes his patient can cause violent harm to third persons, he had an overriding duty...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197903000-00030
更新日期:1979-03-01 00:00:00
abstract::We report a rare case of Candida glabrata liver abscess and fungemia complicating severe calculus cholecystitis in a 64-year-old female patient who had no history of immunosuppression or diabetes mellitus. The patient underwent cholecystectomy, resection of liver abscess, and systemic antifungal therapy using micafung...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181c9803b
更新日期:2010-03-01 00:00:00
abstract::The management of inflammatory carcinoma of the breast remains a therapeutic dilemma because of two basic conceptual problems: local control and systemic micrometastatic disease. Appropriate management requires a multidisciplinary approach involving radiation therapy, surgery, and medical oncology. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198102000-00020
更新日期:1981-02-01 00:00:00
abstract::Use of the needle-catheter feeding jejunostomy at Richland Memorial Hospital and the Dorn Veterans Administration Hospital, both clinical teaching institutions of the University of South Carolina School of Medicine, has been evaluated in 114 patients ranging from 20 to 90 years old. The results of this survey span a 3...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198611000-00018
更新日期:1986-11-01 00:00:00
abstract:OBJECTIVE:To determine vitamin D status in children with spina bifida (SB). METHODS:Charts of all patients with SB at the Shriners Hospital for Children in Houston, Texas, seen between July 2011 and June 2013 were retrospectively reviewed. Daily intake of milk, vitamins, amount of screen time, and time spent outdoors ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000397
更新日期:2016-01-01 00:00:00
abstract::We have described a 6-day-old male infant who presented with Neisseria gonorrhoeae conjunctivitis and a scalp abscess. Delivery was complicated by rupture of the membranes 24 hours before delivery and fetal monitoring for four hours. The rare scalp abscesses caused by gonococci cleared with penicillin therapy. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198003000-00042
更新日期:1980-03-01 00:00:00
abstract::The transition of care between pediatric and adult medicine is a challenging time for patients and physicians. This longitudinal process encompasses much more than the physical transfer of a patient between providers. Established transition of care processes and literature exist for many chronic disease populations, b...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.14423/SMJ.0000000000001017
更新日期:2019-09-01 00:00:00
abstract::We have described a 38-year-old woman with a lesion of the cervix found on routine physical examination. The lesion proved to be a primary leiomyosarcoma of the cervix. Despite radiation therapy, surgery, and chemotherapy, the tumor recurred and grew relentlessly. She is alive with disease at two years seven months af...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198104000-00042
更新日期:1981-04-01 00:00:00
abstract::Lymphoid interstitial pneumonitis (LIP) is a rare complication of AIDS in adults. Patients with AIDS and LIP are at high risk for bacterial pneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. We have described an HIV-positive patient with LIP complicated by recurrent pneumo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199210000-00022
更新日期:1992-10-01 00:00:00
abstract::A new era in the treatment of immune-mediated inflammatory disorders has begun with the clinical availability of anticytokine therapy. Biological agents that are currently available include 3 agents that decrease the activity of tumor necrosis factor-alpha (infliximab, adalimumab, etanercept) and an interleukin-1 rece...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000153119.37032.8B
更新日期:2005-02-01 00:00:00
abstract::While opioids are regarded as the mainstay of chronic pain management, their use is controversial in the minds of many primary care physicians due to clinical concerns about dependence, abuse, and addiction and medicolegal concerns regarding state and federal regulatory authorities. For patients with moderate to moder...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e3180f626ff
更新日期:2007-10-01 00:00:00
abstract::We report a case of recurrent Merkel cell carcinoma (MCC) of the upper extremity, treated aggressively with wide local excision, regional lymphadenectomy, and immediate reconstruction. Five years after surgery, there is no clinical or diagnostic evidence of locoregional recurrence or distant disease. The patient's upp...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract::Axillary and palmar hyperhidrosis are featured prominently in the literature, but no previous studies have detailed a treatment regimen for specific excessive localized sweating of the face and scalp. In this report, a patient was treated for this condition with a combination of clonidine hydrochloride (0.3 mg to 0.4 ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::Pain is a tax levied on man for the privilege of life upon this planet. Some are taxed lightly and others are taxed heavily, but all are taxed. To relieve this stress, from time immemorial man has taken analgesics. In modern times, if home medication fails, professional consultation is available. The important questio...
journal_title:Southern medical journal
pub_type: 历史文章,杂志文章
doi:
更新日期:1980-12-01 00:00:00
abstract::Two cases of postoperative death due to unsuspected pheochromocytoma are presented. Both patients exhibited signs and symptoms preoperatively which might have been attributable to a pheochromocytoma. These reports serve as a reminder of the potentially fatal consequences of inadequate evaluation of hypertensive patien...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197711000-00023
更新日期:1977-11-01 00:00:00
abstract::The importance of considering organic diseases when evaluating catatonic patients is illustrated by two cases of akinetic parkinsonism in which the patients became catatonic, with waxy flexibility. The catatonic syndrome occurs in association with a variety of lesions that may affect any level of the central nervous s...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198606000-00008
更新日期:1986-06-01 00:00:00
abstract::Although skin testing with ubiquitous antigens is widely employed to assess delayed hypersensitivity, little is known about the effect of geographic location on the frequency of skin test reactions to given antigens. To assess skin test reactivity in the mid-South, 82 hospitalized patients and 68 normal controls had s...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197604000-00013
更新日期:1976-04-01 00:00:00
abstract:OBJECTIVE:The literature shows that food insecurity (FI) can negatively affect the trajectory of many chronic illnesses. FI can be acutely severe for older adults, but screening for FI is not regularly performed in the hospital setting. Our goal was to develop a tool to screen for FI upon hospital discharge to identify...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001007
更新日期:2019-08-01 00:00:00
abstract::With the advent of ultrasonography, perinephric fluid collection can be easily diagnosed and confirmed by fine needle aspiration. In the past these cases sometimes went undiagnosed for several months. We did fine needle aspiration under the guidance of ultrasonography in 16 patients without complications. The aspirant...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198506000-00018
更新日期:1985-06-01 00:00:00
abstract::Brown recluse spider bites are usually self-limited skin lesions that infrequently progress to bullae, ulceration, and scarring. We treated a patient with a documented brown recluse bite who had recurring lesions resembling pyoderma gangrenosum (PG) that persisted for months. Three other patients referred to Vanderbil...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198503000-00012
更新日期:1985-03-01 00:00:00
abstract::Although the accurate assessment of blood loss at vaginal delivery is clinically important in terms of maternal morbidity and mortality, the quantity is usually underestimated. We present a simple, practical, and convenient method of quantitating blood loss at vaginal delivery. The method of vaginal delivery (spontane...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198602000-00013
更新日期:1986-02-01 00:00:00
abstract::We have described a patient with vaccinia necrosum after smallpox vaccination for persistent herpes labialis. The patient eventually recovered after surgical resection of the lesion and multiple courses of vaccinia immune globulin and methisazone. This report emphasizes the needless risks of vaccinating patients with ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198103000-00044
更新日期:1981-03-01 00:00:00
abstract::Pectus excavatum is relatively uncommon. Our experience with 177 children during a 15-year period produced changes in our surgical technique, which now includes a small transverse incision, minimal subcutaneous flap elevation, a muscle-relaxing incision over the fifth costal cartilage, complete resection of involved c...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199109000-00010
更新日期:1991-09-01 00:00:00
abstract::Appendicovesical fistula is an uncommon condition usually occurring in boys and young men and associated with chronic urinary tract infection. Diagnosis is based on cystoscopic findings that may be confirmed by a retrograde study. Treatment by appendectomy is usually successful. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198004000-00037
更新日期:1980-04-01 00:00:00
abstract::The gene for sickle cell disease is carried by 8% of the African-American population in the United States. The primary care physician is often called upon to recognize and treat one of the major sequelae of sickle cell disease--vaso-occlusive pain crisis. An injectable nonsteroidal anti-inflammatory drug has recently ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199208000-00005
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVE:Decreased bone mineral density has been found in the advanced stages of various lung diseases. Limited data are available about prevalence and risk factors for osteoporosis/osteopenia (OP) in pulmonary arterial hypertension (PAH). METHODS:Patients with PAH (either idiopathic or secondary to scleroderma [SSC-...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31825b8117
更新日期:2012-07-01 00:00:00
abstract::In children, intramural duodenal hematomas resulting from blunt abdominal trauma are generally managed nonoperatively with nasogastric suction and parenteral nutrition. Experience with three cases in which this form of treatment failed caused us to reappraise its benefits and results. Consequently, we now recommend su...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198808000-00011
更新日期:1988-08-01 00:00:00
abstract::From our retrospective review of 30 patients having hepatic resection, we have made the following conclusions: (1) Hepatic resection is an uncommon procedure. (2) The majority of liver injuries require only drainage or suture ligation and drainage. (3) Midline incision, early arterial occlusion, and resectional debrid...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198106000-00006
更新日期:1981-06-01 00:00:00
abstract:OBJECTIVES:The authors sought to explore patients' views about discussing spiritual issues with primary care physicians, including perceived barriers to and facilitators of discussions. METHODS:The study was a qualitative, semistructured interview of 10 chronically or terminally ill patients who were deliberately sele...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000146486.69217.EE
更新日期:2004-12-01 00:00:00