Approximately 30-40% of the patients have a history of previous attacks or acute intestinal obstruction with subsequent remission. Three patients were referred to the University of Mississip- pi Medical Center in Jackson within hours of injury for evaluation of multiple trauma and possible aortic injury. Rein- dollar et al, 3 in a single series of 252 patients with abnormal pubertal development, found vaginal agenesis to be the second-most common cause of primary amenorrhea. The AMA’s action reiterated the association’s long-standing policy of support for a physician-directed system of medical peer review rather than a federally-directed program. Rectal and vaginal palpation may help in locating the hernia sac which can be felt as a tender swelling in the area of the obturator foramen. Six have been selected to demonstrate different techniques of repair. Indeed, in 538 patients from nine case-series summarized by Ross and Vande Wiele, 2 congenital absence of the vagina ranked second only to gonadal dysgenesis as a cause of primary amenorrhea. Difficul- ties with the law increased and objections to the program grew, and in December 1980 the American Medical Association’s House of Delegates called for repeal of the program. It seldom causes a swelling in Scarpa’s triangle unless the limb on the ipsilateral side is flexed, abducted or rotated out- ward. Clinical Material Since 1978, numerous patients have been seen at the University of Mississippi Medical Center and the Medical University of South Carolina with acute tramatic injury to the thoracic aorta sustained in motor vehicle accidents. Jackson, Mississippi Congenital absence of the vagina occurs in ap- proximately 1 in 5000 female births, 1 but if consi- dered from the standpoint only of women presenting with primary amenorrhea, the disorder is fairly com- mon. The PSRO program, established under 1972 amendments to the Social Security Act, was beset by problems throughout its ten-year history.
The medical staff includes a large number of psychiatrists in private practice in the Jackson area. Effective closure may be obtained by the use of periosteal flaps, autogenous fascia, or prosthetic materials as necessary. One patient presented with a mild left hemiparesis. At age 14 years she noted cyclic abdominal bloating and breast full- ness. She was referred at age 17 years for further evaluation. The official statement noted that if those efforts at mod- ification fail, the association will seek repeal of the new program.
For more information about Kidney Care, Inc., contact Sam White. Or write our administrative offices, 3310 North State Street, R 0. The necessity for systemic heparinization can in itself cause excessive bleeding from the graft and repair as well as from other sites of injury (CNS, fractures, etc.). In the early attempts at surgical correction, the vaginal space between the urethra and rectum was opened and packed with a wool tampon dipped in vinegar. An UQCPRO may sanction a provider or practi- tioner from the Medicare program in cases of gross or flagrant violations of the obligation to furnish appropriate care.
Aor- tography is not only important for establishing a definitive diagnosis, but it can also provide knowl- edge as to site or sites of rupture, estimation as to the size of the false aneurysm, and it can also prevent unnecessary thoracotomy in an otherwise critically ill patient. One year after surgery she became sexually active and was able to achieve sexual intercourse. Regarding the question of cost containment or quality assurance, the new law is specific, as was the old law.
Riverside is licensed by the Mississippi Commis- sion on Hospital Care, and is fully accredited by the Joint Commission on Accreditation of Hospitals. The repair of the defect can be carried out after reduction of the con- tents, and the hernia sac should be inverted and ligated with the redundant portion excised. Similar associated injuries were present as was the radio- logic evidence for injury to the thoracic aorta. At age 1 1 years breast development began and was followed by pubic and axillary hair growth. D.: Congenital absence of the vagina: The Mayer-Rokitansky-Kuster-Hauser syndrome. The AMA will work to strengthen por- tions of the new program, but will continue to seek modification of those mandatory elements which are not consistent with current association policy.
Above all, care at Riverside is aimed at treating the patient with respect and dignity, fostering self- esteem, and returning the patient to independence and a satisfying, productive and happy life. Mississippi 39205 (601) 969 0666 State Medical Association January 1983, Volume XXIV, Number 1 EDITOR W. Should a mass be present, the thigh should be flexed and adducted, and a generous inci- sion made just above the mass. Three patients, all in their early thirties, were referred to the Medical University of South Carolina Hospital following motor vehicle accidents. They stress the need for early surgical correc- tion of vaginal agenesis to help these young women avoid psychologic com- plications and to establish healthy heter- osexual relationships. At age 6 she was noted to have severe scoliosis, but no ongoing treat- ment had been rendered for this condition. Following action taken by the AMA House of Dele- gates just last month, the association reported that it will expand assistance to physicians and medical societies in assuming a leadership role in medical peer review.