- Email: [email protected]
Have Problem — Will Travel
526
EDITORIALS
can be made, The intriguing possibility of studying the refractoriness of the bypass pathways themselves and constructing a drug which can alter its conduction now seems feasible, QUinidine, of course, is said to depress conduction through the Kent bundle, The mechanism of this has not yet been shown, Other drugs must also be studied in the hope that pharmacologic block of all the known bypass tracts could be achieved in the future, The precision and imagination demonstrated by such studies as those of Rosen et al will surely stimulate progress in this difficult area of ventricular preexcitation. AI. Irene Ferrer. M.D." New York City "Professor of Clinical Medicine, College of Physicians and Surgeons, Columbia University; Director, Electrocardiographic Laboratory, Columbia-Presbyterian Medical Center.
Have Problem - Will Travel One's approach to diagnosis and management of most diseases is far from a mechanical exercise. Quite obviously, clinical judgment is an individual matter, being influenced by such things as previous training, specialty and even the area of the country in which one practices. The availability and efficacy of various diagnostic and therapeutic tools are also important determinants of this approach, \Vith rapidly advancing techniques for both diagnosis and treatment, indications for various manipulations may change rapidly: How soon do we consider using "invasive" techniques for diagnosis? Has our surgical treatment of a condition advanced to such a state that we can consider earlier operation? Have \'-"C learned enough about natural history of a condition to warrant more or less vigorous managcment? Because of these considerations, we all
wonder from time to time how certain problems should he approached and what clinicians from a different part of the country or world possessing a different background or persuasion may think about a given problem. In our new section "Clinical Problems in Cardiopulmonary Disease" (see page 605), \ve are attempting to help fill this gap by presenting brief case summaries which lead up to specific problems. These summaries are sent to two or more authorities from around the world for their views on the solutions of these problems. These views arc then published together with the problem. We plan to present both the common "garden varietv" conditions and the more unusual or complicated diseases. In this fashion we hope to cover a broad range of problems which the clinician can use to sharpen his skills and to keep abreast of current advances. The editors would also welcome any brief casc summaries that readers would like to submit for this type of discussion, If such summaries are provocative and of sufficient general interest, they will be handled in the method described above. We not only welcome-but invite-controversy! Our first "Clinical Problem" is one of the more complicated problems, namely, the combination of congenital (anomalous pulmonary venous drainage) plus acquired (coronary ) heart disease. The editors are particularly pleased to inaugurate this section with discussions by Dr. Joseph K. Perloff and Dr. Dwight E. Harken, two distinguished consultants. We hope the readers wiII find these and subsequent discussions useful. We welcome comments or suggestions regarding ways in which this department may be improved. Morton E. Tavel, M.D., rccr: I ndianapolis
"Indiana University Medical Center.
First Alaska Case Conference on Chest Diseases A series of case presentations and discussions for physicians, nurses and allied health personnel will be held at Mt. Alyeska Resort, Girdwood, Alaska, December 2-3. The conference is sponsored by the Alaska Academy of Family Physicians, National Tuberculosis and Respiratory Disease Association, Alaska Tu berculosis and Respiratory Disease
Association, Inc., Alaska State Medical Association, and the American College of Chest Physicians. For further information, please write Mr. Leo C. Kaye, Executive Director, Alaska TB and Respiratory Disease Association, 406 G Street, Anchorage, Alaska 99501.
CHEST, VOL. 62, NO.5, NOVEMBER, 1972
EDITORIALS
can be made, The intriguing possibility of studying the refractoriness of the bypass pathways themselves and constructing a drug which can alter its conduction now seems feasible, QUinidine, of course, is said to depress conduction through the Kent bundle, The mechanism of this has not yet been shown, Other drugs must also be studied in the hope that pharmacologic block of all the known bypass tracts could be achieved in the future, The precision and imagination demonstrated by such studies as those of Rosen et al will surely stimulate progress in this difficult area of ventricular preexcitation. AI. Irene Ferrer. M.D." New York City "Professor of Clinical Medicine, College of Physicians and Surgeons, Columbia University; Director, Electrocardiographic Laboratory, Columbia-Presbyterian Medical Center.
Have Problem - Will Travel One's approach to diagnosis and management of most diseases is far from a mechanical exercise. Quite obviously, clinical judgment is an individual matter, being influenced by such things as previous training, specialty and even the area of the country in which one practices. The availability and efficacy of various diagnostic and therapeutic tools are also important determinants of this approach, \Vith rapidly advancing techniques for both diagnosis and treatment, indications for various manipulations may change rapidly: How soon do we consider using "invasive" techniques for diagnosis? Has our surgical treatment of a condition advanced to such a state that we can consider earlier operation? Have \'-"C learned enough about natural history of a condition to warrant more or less vigorous managcment? Because of these considerations, we all
wonder from time to time how certain problems should he approached and what clinicians from a different part of the country or world possessing a different background or persuasion may think about a given problem. In our new section "Clinical Problems in Cardiopulmonary Disease" (see page 605), \ve are attempting to help fill this gap by presenting brief case summaries which lead up to specific problems. These summaries are sent to two or more authorities from around the world for their views on the solutions of these problems. These views arc then published together with the problem. We plan to present both the common "garden varietv" conditions and the more unusual or complicated diseases. In this fashion we hope to cover a broad range of problems which the clinician can use to sharpen his skills and to keep abreast of current advances. The editors would also welcome any brief casc summaries that readers would like to submit for this type of discussion, If such summaries are provocative and of sufficient general interest, they will be handled in the method described above. We not only welcome-but invite-controversy! Our first "Clinical Problem" is one of the more complicated problems, namely, the combination of congenital (anomalous pulmonary venous drainage) plus acquired (coronary ) heart disease. The editors are particularly pleased to inaugurate this section with discussions by Dr. Joseph K. Perloff and Dr. Dwight E. Harken, two distinguished consultants. We hope the readers wiII find these and subsequent discussions useful. We welcome comments or suggestions regarding ways in which this department may be improved. Morton E. Tavel, M.D., rccr: I ndianapolis
"Indiana University Medical Center.
First Alaska Case Conference on Chest Diseases A series of case presentations and discussions for physicians, nurses and allied health personnel will be held at Mt. Alyeska Resort, Girdwood, Alaska, December 2-3. The conference is sponsored by the Alaska Academy of Family Physicians, National Tuberculosis and Respiratory Disease Association, Alaska Tu berculosis and Respiratory Disease
Association, Inc., Alaska State Medical Association, and the American College of Chest Physicians. For further information, please write Mr. Leo C. Kaye, Executive Director, Alaska TB and Respiratory Disease Association, 406 G Street, Anchorage, Alaska 99501.
CHEST, VOL. 62, NO.5, NOVEMBER, 1972