Primary malignant lymphoma of the spleen in systemic lupus erythematosus

Malignant lymphoma has been infrequently reported in the course of systemic lupus erythematosus (SLE). We report a case of primary malignant lymphoma of the spleen, an unusual site of primary lymphoma, complicating the course of systemic lupus erythematosus (SLE). Our patient had been treated with low dose prednisone and hydroxychloroquine only, and her lupus was quiescent at the time of presentation with the lymphoma. Thus primary malignant lymphoma should be considered in the differential diagnosis of splenomegaly in SLE.     

The significance of microscopic invasive cancer in endoscopically removed polyps of the large bowel. A clinicopathologic study of 51 cases

A clinicopathologic study of 51 patients with endoscopically removed large bowel polyps showing histologic evidence of malignancy, either focally, to a massive extent, or comprising the entire polyp, revealed only one absolute finding capable of predicting residual disease, namely, the presence of cancer at the resection line. Of 23 radical resections, only one was justified. This case showed evidence of residual disease in the colectomy specimen that could have been predicted on the basis of involvement of the diathermy margin by carcinoma. Of 28 patients having polypectomy alone, 1 patient developed a Dukes' B carcinoma. The polyp, removed 9 months previously from the same site, had shown involvement of the margin by carcinoma. A conservative approach is thus advocated in the absence of this finding.     

A comparative study of steroid therapy in acute experimental spinal cord injury

Steroids are commonly used in the treatment of acute spinal cord injury patients although a review of the literature fails to define a consistent regimen for administration with regard to optimal preparation or dosage or schedule. This study was designed to evaluate the effect of exogenous steroids on the outcome of experimental spinal cord injury and the effect of experimental spinal cord injury on endogenous cortisol production. Thirty female rhesus monkeys received a 660 gm cm lesion to the T10 spinal cord. They were randomly placed into one of six groups of five animals each. Two groups were controls used to assess the endogenous cortisol response to spinal cord injury. These animals received no steroids. The other four groups received one of two commonly used steroid preparations. All animals were evaluated serially for neurological status using motor testing and for general physical status. Serial cortisol determinations were obtained for an eight-week post injury period. The steroid groups showed some benefit from treatment when compared to the untreated controls. There were no significant differences in physical condition between treated and control groups. Of special interest was the response of endogenous cortisol production to spinal cord injury. Early cortisol elevation following injury peaked by eight hours and then precipitously dropped to baseline levels before 24 hours following injury.     

The teaching of child psychiatry in U.S. medical schools: results of a survey.

The major results of this survey are that most schools have special programs in child psychiatry and that these are distinct from the adult psychiatry course. The course content involves clinical evaluation of children, information on child development and psychopathology, assigned reading, and liaison with pediatrics. Most schools have full-time psychiatrists on their faculty, and the child psychiatry course is taught by child psychiatrists; but less than 20 percent of the psychiatric faculty are child psychiatrists in a majority of the schools in the country. Finally, although evaluation by students and faculty is common in most of the schools, only slightly more than one-third of the institutions gave grades in child psychiatry and slightly fewer than one-third gave examinations in this subject.