Prolonged remission of lymphangitis carcinomatosis from breast cancer

Lymphangitis carcinomatosis has a grave prognosis. We report a case from carcinoma of the breast that responded completely and durably to chemotherapy.     

Effect of thiamine on auditory evoked potentials of the guinea pig

Application of thiamine (1 X 10(-11)-1 X 10(-3) mol/l) on the membrane of cochlear round window increased the amplitude and decreased the latency of the auditory nerve action potential, waves I and II of brainstem auditory-evoked electrical potentials in response to acoustic clicks of different intensity. The mechanism of thiamine action on auditory-evoked electric potentials is discussed.     

The care of burned upper extremities

Two sets of factors will ultimately influence the outcome of the burned upper extremity. The first set of factors is the depth and severity of the burn. The second set is the group of complications of the burn injury attributable to edema, inflammation, immobility, and malposition. An awareness of the potential pitfalls that follow burn injury has resulted in improved primary care and a lessening of deformity. Progressive acute care with topical chemotherapy, early motion, thoughtful splinting, and timely burn wound closure are essential to reduce the need for secondary operations. Reconstructive efforts should be tailored to the individual needs of the patient. These procedures should be carefully planned with a view toward balancing aesthetic and functional considerations and minimizing the time required for rehabilitation.     

Choice of general practice for postgraduate training among medical graduates and undergraduates in Nigeria

A questionnaire survey of career choices was carried out among 112 medical graduates, after one year's internship (group I), during their National Youth Corps programme in Kaduna, Lagos, Cross River and Oyo states of Nigeria, and 365 final-year medical undergraduates (group 2) in the colleges of medicine in the corresponding states. A total of 13% in group I and 40% in group 2 were undecided as regards their first choice. Obstetrics and gynaecology was the most popular first choice in both groups. General practice ranked fifth among group I, but displaced surgery to rank second among group 2. The differences were statistically significant. A total of 41% of group I and 46% of group 2 preferred to work in a teaching hospital, reflecting the high preference for surgical specialties. Twenty-six per cent and 33.7% of respondents in groups 1 and 2 respectively wished to own their own practice or work in the private sector. General practice is a new specialty and its growth is supported by a national postgraduate training programme. A shift towards general practice is seen compared with previous studies of career preference among Nigerian medical graduates and students. This may be due to a changing balance of supply and demand in the medical work-force, or a better assessment of the nation's health problems and manpower needs.