A brief history of the office of the Surgeon General and the 2 surgeons who have held the position.

Background: The Surgeon General oversees the Commissioned Corps of the U.S. Public Health Service (USPHS) and is viewed as the "Nation's Doctor," responsible for providing the public with information on living healthier and safer lives.

Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training.

Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care.

Emergent pancreaticoduodenectomy: a dual institution experience and review of the literature.

Background: Emergent pancreaticoduodenectomy (EPD) is an uncommon surgical procedure performed to treat patients with acute pancreaticoduodenal trauma, bleeding, or perforation. This study presents the experience of two university hospitals with EPD.

Methods: Clinical data on EPD in trauma and nontrauma patients from 2002-2012 were extracted from the hepatopancreatobiliary surgery databases at Thomas Jefferson University and Kaunas Medical University Hospitals.

Nonoperative management of blunt traumatic cardiac rupture: considerations of a novel approach.

Blunt traumatic cardiac rupture carries a dismal prognosis. Patients who survive to presentation are treated with prompt surgical repair. Operative intervention carries significant morbidity and mortality, as these patients present in extremis.

Are roadside pedestrian injury patterns predictable in a densely populated, urban setting?

Background: Roadside pedestrian injuries represent a significant portion of trauma team activations, especially at urban trauma centers. Patient demographics and severity of injury vary greatly in this patient population. Herein, we hypothesize that injury patterns may be predictable, especially with respect to age.

Port site metastasis of B-cell lymphoma: a first occurrence or an underreported complication?

Minimally invasive techniques have been accepted as safe and reliable in the work-up of patients with lymphoproliferative disorders. As the oncologic indications of laparoscopy expand, many authors have raised concerns regarding the occurrence of port site metastases after minimally invasive procedures for a multiform array of neoplastic diseases. A review of the existing literature demonstrates no mention of port site occurrence following staging laparoscopy for malignant hematologic disorders.

Delayed leiomyoma degeneration after microwave endometrial ablation.

Background: Microwave endometrial ablation is an effective treatment for dysfunctional uterine bleeding. Patients with leiomyomata, including submucosal leiomyomata up to 3 cm, may also be treated with microwave endometrial ablation.

Cases: A 46-year-old woman with multiple leiomyomata and menometrorrhagia underwent microwave endometrial ablation.

Treatment of Mycobacterium avium complex immune reconstitution disease in HIV-1-infected individuals.

Immune reconstitution disease caused by Mycobacterium avium complex (MAC) infection presenting shortly after the introduction of highly active antiretroviral therapy (HAART) has been reported with increasing frequency in persons with HIV-1 infection during the past several years. Several therapeutic modalities have been utilized for this entity, but the optimal means of treating MAC immune reconstitution disease remains unclear. We now describe a patient who underwent some of these therapies.

Surgical management of adrenal cysts.

Adrenal cysts are rare and are often found incidentally during abdominal imaging for another reason. We describe two cases of adrenal cysts, one of which was found to be a cystic pheochromocytoma. Most cystic pheochromocytomas are not diagnosed by urinary screening studies, and the first indication of a pheochromocytoma may be hemodynamic instability during resection.