ABSTRACT: A case of a stage IB gastric cancer associated with spontaneous muscle atrophy of both hands is reported. The cause of this atrophy was not apparent with current neurologic diagnostic modalities. Although the association of gastric cancer with muscle atrophy may be coincidental, it may be part of a…
ABSTRACT: Advances in the treatment of obstructive sleep apnea have evolved rapidly over the past two decades. Nasal continuous positive airway pressure (CPAP) devices are effective, but are neither curative nor universally well tolerated. Uvulopalatopharyngoplasty (UPPP) has been reported to have widely varying success rates; many studies of this procedure…
ABSTRACT: Although body temperature has been monitored for more than a century as a means of distinguishing health from disease, physicians' perceptions of concepts of clinical thermometry are largely unknown. To characterize such perceptions, we did a descriptive analysis of responses to a survey questionnaire dealing with body temperature. Seventy-five…
ABSTRACT: Bacillus cereus, a ubiquitous, endospore-forming, aerobic gram-positive bacillus, is primarily associated with toxin-mediated food poisoning. Frequently, isolates of Bacillus species from clinical specimens are dismissed as contaminants. We report a rapidly fatal case of disseminated infection due to B cereus in a patient receiving induction chemotherapy for MO acute…
ABSTRACT: Bronchiolitis obliterans organizing pneumonia (BOOP) is characterized clinically by progressive cough, fever, and dyspnea and pathologically by plugging of the bronchiolar and alveolar lumen with buds of loose connective tissue containing fibroblasts and inflammatory cells. The radiographic appearance of the disease varies. Definitive diagnosis requires the histologic identification of…
ABSTRACT: Computed tomography (CT) is increasingly used to evaluate abdominal diseases, including those of the colon. Recent CT studies have documented colonic abnormalities in patients with pseudomembranous colitis; however, these, findings are not widely appreciated by primary care physicians. Over a 25-month period, we prospectively identified 13 patients who had…
ABSTRACT: Idiopathic pulmonary hemosiderosis (IPH), a rare clinical entity, is characterized by bleeding into the alveoli and progressive pulmonary fibrosis. It is usually treated with systemic corticosteroids during acute bleeding episodes and with prolonged courses of oral corticosteroids and/or other immunosuppressant drugs for maintenance therapy. Because prolonged treatment with these…
ABSTRACT: In this case-series analysis, of 34 patients originally identified with eosinophiliamyalgia syndrome (EMS), 31 survivors were followed-up by yearly telephone interviews. We ascertained type, duration, and severity of symptoms and whether certain patient characteristics were associated with illness improvement. At a median of 3.6 years after onset, 3 patients…
ABSTRACT: Inadequate therapeutic response to parenteral corticosteroids in patients with acute bronchial asthma is infrequent. We report four patients whose bronchial asthma symptoms worsened after treatment with parenteral corticosteroids. All had larvae of Strongyloides stercoralis in the stool. The new attack or the exacerbation of asthma appeared to be precipitated…
ABSTRACT: Obesity is a major contributor to chronic and costly diseases and disabilities. More than 30% of American adults are obese, and the percentage has been rising for 20 years. A recent estimate placed the direct economic costs of obesity at more than $39.3 billion, or 5.5% of all medical…
ABSTRACT: Our goal was to determine if evidence of cerebrospinal fluid (CSF) leakage on routine postmyelogram computed tomography (CT) of the lumbar spine was useful in predicting subsequent development of moderate or severe headaches in patients having outpatient myelography. We reviewed postmyelogram CT studies of the lower lumbar region of…
ABSTRACT: Patients with tragic diseases such as AIDS (acquired immunodeficiency syndrome) may be at risk for using herbal remedies and other alternative medical therapies. To ascertain what products may be available for use among AIDS patients in our community, we surveyed 20 local health food stores. Store employees were asked…
ABSTRACT: Perineurioma is a rare, probably benign peripheral nerve sheath neoplasm. Perineurial cell origin is most efficiently demonstrated immunohis to chemically by positivity for epithelial membrane antigen and negativity for S-100 protein and Leu 7.
ABSTRACT: Subdural hematomas are among the most common forms of intracranial hemorrhage encountered in clinical practice and are a surgically remediable cause of dementia. When the symptom presentation is subtle or diffuse, a subdural hematoma can be overlooked. This is especially true among elderly people who may exhibit unrelated, preexisting…
ABSTRACT: The objective of this study was to examine the relative sensitivity of femoral and lumbar bone mineral density (BMD) measurements in patients with ankylosing spondylitis (AS) and to identify the most appropriate test site for detection of osteopenia in these patients. Fourteen patients with ankylosing spondylitis had femoral and…
ABSTRACT: The purpose of this study was to determine whether use of a 24-hour personal emergency response system (PERS) might be associated with selected hospital utilization rates among community-residing users. Utilization rates of 106 patients were reviewed for 1 year before and 1 year after enrollment in the PERS. Self-paired…
ABSTRACT: This article will review the embryology, clinical presentation, diagnosis, treatment, and clinical significance of ectopic breast tissue, supernumerary breasts, and supernumerary nipples. These structures most commonly develop along the embryonic “milk line.” Supernumerary nipples can be identified at birth, whereas ectopic breast tissue becomes noticeable only after hormonal stimulation,…
ABSTRACT: This retrospective study determines risks, outcomes, and cost savings in microscopic tubal sterilization reversal done by minilaparotomy. From January 1992 to December 1993, 40 women, as outpatients, had combined laparoscopy and minilaparotomy for tubal anastomosis. The mean operating time was 1.7 hours, mean blood loss was 20 mL, and…
ABSTRACT: This study compares the recanalization characteristics of intracoronary streptokinase (IC-SK) with those of intravenous tissue plasminogen activator (t-PA) in patients with acute myocardial infarction (AMI) treated in the first 6 hours after onset of symptoms. We studied 263 patients with AMI. Among these, 160 were treated with IC-SK; in…
ABSTRACT: This study to compare single-dose and multiple-dose antithyroid therapy was prompted by a perceived lack of compliance in our University Medical Clinics by those patients using multidose regimens. Twenty-two hyperthyroid patients were randomly assigned to two therapy groups. Twelve received methimazole (Tapazole) 30 mg once daily in the morning;…
ABSTRACT: Urinary bladder distention is a rarely reported cause of iliac vein compression. We report a case of bilateral lower extremity and scrotal edema resulting from marked bladder distention. The bladder was readily palpable and a 4,100 cm3 postvoid residual urine volume was found. No other cause of lower extremity…
ABSTRACT: We report a case of a pregnant patient with Guillain-Barré syndrome. Her symptoms, including weakness, vague numbness, urinary incontinence, and unsteady gait, were initially mild and mimicked many of the changes seen in pregnancy. Her progressive weakness was not preceded by any known illness. Evaluation of symptoms revealed an…
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