ABSTRACTAcademic tenure is the guarantee that a faculty member cannot be arbitrarily dismissed. The tenure system developed to maintain academics free of external pressure and coercion, and in dramatic instances tenure has been used to defend academic freedom. With the development of the research-oriented medical school staffed by full-time faculty,…
ABSTRACTAlthough sickle cell disease (SCD) and systemic lupus erythematosus (SLE) are two distinct chronic diseases, many clinical features are common to both conditions. We describe a young patient who had a mild clinical course of SCD until SLE developed when he was 15 years old. His initial manifestations of SLE…
ABSTRACTCervical spinal cord injury compromises the ventilatory muscles and is associated with respiratory complications. Patients who are quadriplegics are also at increased risk of Charcot's arthropathy of the spine. The development of a large pleural effusion in quadriplegia further increases respiratory compromise. I present a case of Charcot's arthropathy of…
ABSTRACTData from asbestos workers were used to devise a cutpoint classifier to identify subjects as Nonuser (non-tobacco user), Smokeless (exclusive smokeless tobacco user), and Smoker (ignited tobacco user). In some clinical trials and smoking cessation programs, Smokeless should be separated from Smoker. One therefore needs a marker for smoke exposure,…
ABSTRACTEvery health care worker should be aware of the quality and deficiencies of gloves in the health care setting. Since the introduction of the human immunodeficiency virus into the health care setting, the medical community's compliance with universal precautions and the standards mandated by the Food and Drug Administration have…
ABSTRACTGranular cell tumors are benign neoplasms of putative Schwann cell origin that most commonly occur in the tongue. While granular cell tumors in the breast are uncommon, the occurrence of this tumor at this site warrants special consideration, since the mammographic, gross, and microscopic appearance can mimic carcinoma. We describe…
ABSTRACTHepatobiliary cystadenomas are rare, truly benign cystic epithelial tumors with the potential to become cystadenocarcinoma. The initial symptom is vague, nonspecific abdominal pain, frequently in middle-aged women, but patients may be asymptomatic. Abdominal ultrasonography may be diagnostic. Intracystic fluid, obtained by sonographically guided fine-needle aspiration, may contain elevated levels of…
ABSTRACTHerpes zoster (HZ) often occurs concomitantly with various internal malignancies, most commonly hematologic in origin. Authors in the past proposed that HZ was a marker for internal malignancy, since it is often found in association with a malignancy. A critical review of the literature revealed that when HZ and malignancy…
ABSTRACTIn this case, a distinctive amyloid tumor of the breast clinically simulated carcinoma, although the patient related onset to trauma. Hepatosplenomegaly, elevated globulins, and anemia led to identification of large amounts of monoclonal IgG-κ production. The patient died of renal failure within several months despite chemotherapy. The matrix of the…
ABSTRACTMassive ovarian edema is a rare tumor-like condition of the ovary characterized by marked enlargement of one or both ovaries due to marked accumulation of edema fluid in the ovarian stroma. This paper reviews the literature on massive ovarian edema and presents a case associated with androgenic manifestations.
ABSTRACTMid-ileal conduit stenosis is an unusual yet morbid complication following ileal conduit urinary diversion. We report the cases of four patients who developed mid-ileal stenosis at an average interval of 19.5 years after urinary diversion, with the longest interval being 25 years. This series emphasizes the importance of life-long follow-up…
ABSTRACTOur purpose was to determine the discovery method and stage of newly discovered breast cancers at two different medical centers. To do this, we conducted a retrospective chart review at our urban and suburban teaching hospitals during 1991 through 1992 and 1992, respectively. Only 29 (26%) of 112 cancers at…
ABSTRACTPrevious publications have described thrombotic events with unclear causes in individuals infected with the human immunodeficiency virus (HIV). We stratified the cases of 52 individuals infected with HIV by degree of immunosuppression and the presence of complicating illnesses. Plasma from these individuals was screened for abnormalities that might predispose to…
ABSTRACTSeabather's eruption is an unusual rash that develops in individuals who have been swimming in the ocean. We report the case of a 25-year-old woman who had the rash in a typical bathing suit distribution. Several species of cnidarian larvae have been implicated in causing the disease. Symptomatic treatment is…
ABSTRACTSince its introduction in 1989, laparoscopic cholecystectomy has rapidly become the preferred alternative to open cholecystectomy for symptomatic cholelithiasis. Although possible complications of laparoscopic cholecystectomy are essentially the same as for open cholecystectomy, we report a case of an inadvertent subtotal cholecystectomy, a complication that we believe has not been…
ABSTRACTThe Zygomycetes are uncommon human pathogens. They cause illness in some patients who are immunosuppressed and can present as any of several syndromes, including rhino cerebral, pulmonary, gastrointestinal, or cutaneous disease, or as disseminated infection. Pulmonary zygomycosis can occur in any of several patterns and can mimic more common pneumonic…
ABSTRACTTo facilitate access to care for HIV-infected women, a maternal-child program was started at an HIV outpatient clinic in New Orleans. The program consisted of free child care and transportation, separate waiting and examination rooms, female care providers, merged visits for mother and child, and on-site colposcopy services. This study…
ABSTRACTTriploidy, though unusual in advanced gestations, may be associated with preeclampsia. The increase in paternal genetic material associated with the triploid diandric placenta may support the role of immunologic factors in the development of preeclampsia.
ABSTRACTWe compared the efficacy of very-low-intensity oral anticoagulation (OA) with that of the recommended standard low-intensity oral anticoagulation, using international normalized ratios (INRs). We enrolled 101 patients into a pilot study—51 patients in the very-low-intensity anticoagulation arm (INR 1.4 to 2.0) and 50 in the standard low-intensity anticoagulation arm (INR…
ABSTRACTWe describe the case of a woman who had cannulation of the internal jugular vein for the placement of a hemodialysis catheter. The procedure was unsuccessful and resulted in a retropharyngeal hematoma, which in turn caused severe compression on a carotid artery that was already severely narrowed by atherosclerosis. This…
ABSTRACTWe encountered an unusually severe case of intra-abdominal lymphangiomatosis associated with protein-losing enteropathy and intestinal bleeding. A low-fat diet effectively raised the patient's serum levels of hemoglobin and the total serum protein, perhaps by inducing a reduction in intestinal lymph flow and pressure.
ABSTRACTWe report a case of basal cell carcinoma arising in a previously radiated field after treatment of cervical cancer. Our search of the literature yielded no other case of basal cell carcinoma due to irradiation for cervical carcinoma.
ABSTRACTWe report a case of unilateral polycystic disease of the parotid gland. Only eight cases of this disease have previously been published in the English language literature, and seven of them were bilateral. Thus, we are reporting the second case of unilateral involvement. The disease is apparently limited to the…
ABSTRACTWe reviewed the medical records of 17 patients with sickle hemoglobinopathy-associated cholelithiasis who were candidates for laparoscopic cholecystectomy (LG) between 1991 and 1994. Eight patients with suspected choledocholithiasis (CDL) were identified, all of whom had preoperative endoscopic retrograde cholangiopancreatography (ERCP), which revealed CDL in 3 patients (18%), all of whom…
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