Proteus syndrome: a case report.

Proteus syndrome is a rare, sporadically occurring hamartomatous disorder with complex multisystem involvement and wide clinical variability. Clinical characteristics include craniofacial abnormalities; asymmetrical overgrowth of the trunk, limbs, and digits; lipomas; and vascular malformations. Cystic lung disease is noted in approximately 10 per cent of patients. These cystic malformations may lead to cystic pulmonary emphysema, which may cause significant morbidity for the patient. We describe the case of a 27-year-old woman with known Proteus syndrome who developed acute on chronic respiratory failure. Subsequent CT scan of the chest was significant for extensive bullous disease with nearly complete replacement of the right lung tissue. Our operative management and the patient's clinical course are described.

Mentorship in a community-based residency program.

The concept of mentorship has become a timely issue in surgical residency education. Traditionally, surgical training programs contained resident teams consisting of chiefs, seniors, juniors, and interns on 4- to 8-week blocks. With the new hour regulations, many programs have had to make changes in the format of their teaching programs to accommodate the new hour restrictions and yet still strive to maintain excellence in residency education. We examined a rotation with a mentor or a small group of surgeons in an apprenticeship model. This consists of one resident following one to three surgeons in a practice, in essence being their apprentice. One of the strongest advantages of this is the exposure the resident has to the true lifestyle of a practicing general surgeon. There is also strong continuity of care, because that one resident goes to office with their mentor, scrubs all their cases, rounds with them, and sees the patients in follow up. This continuity concept ultimately results in better outcomes for the patients.