Sage advice. Experienced physician executives share the secrets of their success. Interview by David O. Weber.

Seven successful physician executives, now retired from distinguished careers, look back over their experiences and offer advice for those who follow. Be a good doctor first, and never let business interests undermine the ethics of the health care profession. Prepare for management responsibilities with business training. Seek out mentors and develop a network of knowledgeable colleagues and advisors. Exert leadership rather than authority. Expect disappointments and arm yourself for them.

Tuberculous cervical lymphadenitis.

Atypical mycobacterial cervical lymphadenitis is predominantly a disease of childhood, presenting with lesions high in the neck. The incidence of this disease is apparently on the increase. There is rarely concurrent pulmonary involvement. Although management is controversial, the case reported demonstrates an instance in which surgery was combined with chemotherapy. Coincidently, surgery provides the best opportunity for definitive bacteriologic identification. Diagnosis should be based on histologic studies combined with tuberculin skin testing, bacteriologic identification, and cultures from the affected glands. Although it is uncommon, tuberculous cervical lymphadenitis should definitely be entertained in the differential diagnosis of neck masses, especially in young children.

Heparin lock: a cost-effective method of increasing safety of intravenous therapy.

A cost-effective method of intravenously administering medication and maintaining patent intravenous access via a heparin lock has been proposed. Although this technique is by no means new, it has not received enough recognition for safety, convenience, and adaptability in the oral and maxillofacial surgery office. The increased cost over direct venipuncture is only about $.70 to $1.00, which is considerably less expensive than the use of a continuous infusion for each patient.

Gingival involvement in mycosis fungoides: report of case.

A case of mycosis fungoides of the gingiva is reported. Mycosis fungoides is a lymphoproliferative disease that primarily affects the skin. Systemic dissemination is a distinct aspect of the natural course of mycosis fungoides and usually involves the lymph nodes, spleen, and liver. The diagnosis of mycosis fungoides depends on the presence of a variety of atypical cells, including small and large variants of the mycosis cell with an infiltrate of polymorphous inflammatory cells in both the dermis and epidermis. Various modes of treatment have been used. In the current case, remission was achieved with radiation therapy.

A ganglion associated with the temporomandibular joint.

A ganglion that occurred as a preauricular mass was reported. A review of the literature disclosed no previous report of a ganglion in this area. Although a ganglion is an innocuous lesion, its presence in the preauricular region must be considered a remote possibility in the differential diagnoses of masses in this area.