ISSN:0038-4348    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

In a retrospective evaluation of chest roentgenograms and medical records of 40 patients with non-Mtuberculosis (atypical) mycobacterial pulmonary disease, 34 hadM avium-intracellulare,five hadM kansasii,and one hadMfortuitum. The roentgenologic spectrum of disease closely resembled that ofMtuberculosis. One third of the patients had predisposing factors, and the disease predominated in middle-aged and elderly men. Two thirds of the patients had slow progression of the disease, with an average of 6.4 years before roentgenographic changes occurred. The diagnosis was frequently missed, and in most of the patients it was delayed from one to 16 years. Only after chronic, slow disease progression was atypical mycobacteriosis suspected clinically. The more widespread application of multiple simultaneous skin tests for atypical mycobacteria may improve the diagnosis and prognosis of this disease.

ISSN:0038-4348    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The hospital now known as the Gillis W. Long Hansen's Disease Center is the only hospital in the United States solely treating Hansen's disease (leprosy). From the time of its establishment in 1894 until 1923, the psychiatric patients presented treatment and management problems that remained unaddressed. Since 1923, however, psychiatric consultants have provided care and treatment for this segment of the Carville population. This paper presents the findings of three of these consultants for the period 1923 to 1985, and outlines similarities and differences in the diagnoses, treatments, and disposition of patients, as well as indications for future investigations.

ISSN:0038-4348    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

We studied both the clinical features and CT findings in 24 children who had acute head trauma as a result of child abuse. Twenty-three of them were less than 1 year of age. The diagnosis of whiplash shaken infant syndrome was made in 17. Serial CT, done in 50% of the cases, was useful in managing the medical, legal, and social aspects of the cases and in predicting the neurologic outcome. Three children died and 12 others suffered serious neurologic sequelae. The other five children has lesser degrees of deficit; one was lost to follow-up. Three were neurologically normal on follow-up visits. Two siblings of these children died of child abuse, indicating the necessity for continuing intervention in the abused child's family to prevent further abuse.

ISSN:0038-4348    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The use of intraperitoneal radioisotopes in the management of women with ovarian cancer is controversial. We analyzed the experience with intraperitoneal chromic phosphate P 32 at our institution, from October 1979 to February 1983, in 22 patients with various stages and grades of ovarian malignancy. Survival in stage I is 87.5% and in stage II, 50%. Survival is 88.9% among patients with grade 1 tumors and 33.3% for those with grade 3 lesions. Morbidity related to chromic phosphate P 32 was minimal; small bowel obstruction occurred in only one patient who had also received external pelvic irradiation. Our results suggest that chromic phosphate P 32 is a safe, well tolerated, inexpensive, and effective adjuvant to surgery in the management of selected patients with ovarian malignancy.

ISSN:0038-4348    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

In an attempt to identify clinical features of prognostic value in patients with limited stage small cell lung cancer, we retrospectively reviewed the records and chest roentgenograms of 101 such patients seen at Vanderbilt University Hospital. All patients were treated with combination chemotherapy regimens of comparable efficacy with or without chest radiotherapy and/or surgical resection. Median survival for the 101 patients was 16 months; the three-year actuarial survival was 14%. Elevated serum LDH level at the time of diagnosis was predictive of improved survival by both univariate and multivariate analyses (P< .01). Initial tumor volume (calculated from tumor measurements) on chest roentgenogram and clinical TNM stage were unrelated to survival. Until the prognostic significance of an elevated serum LDH level is confirmed by other investigators, we cannot recommend any modification in the current system for staging small cell lung cancer. Although patients with limited stage small cell lung cancer form a clinically heterogeneous group, they should continue to be treated uniformly.

ISSN:0038-4348    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

A notion has prevailed that carinal bronchogenic cyst and other congenital mediastinal cystic lesions, particularly those occurring in older children and adults, are usually asymptomatic, innocuous, and frequently only an incidental finding on routine chest roentgenogram or postmortem examination. Some physicians, therefore, have adopted a policy of observation for these patients. Our experience, however, as demonstrated in three cases reported herein, and the experience of others, clearly shows that carinal bronchogenic cyst is far from being usually asymptomatic and innocuous, but in fact often produces a broad spectrum of clinical manifestations, some of which are life-threatening. Mere observation not only places these patients at serious risk, but also increases the possibility of missed diagnosis and delayed treatment of those lymphoproliferative malignancies involving mediastinal lymph nodes that can mimic a carinal bronchogenic cyst. Computerized tomography (CT) is the single most important method of making a diagnosis of carinal bronchogenic cyst. We believe strongly that the mere presence of a mediastinal carinal bronchogenic cyst is an indication for surgical excision.

ISSN:0038-4348    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Some authors have reported that the erythrocyte sedimentation rate (ESR) is elevated in almost all patients with biopsy-proven temporal arteritis, while others believe it may be normal in up to 30% of such patients. We studied 62 patients with biopsyproven temporal arteritis, and found that all of the 54 untreated patients and six of the eight treated patients had an elevated ESR; thus, when the ESR is normal, a diagnosis of temporal arteritis must be suspect.

ISSN:0038-4348    

出版商:OVID    

年代:1987

数据来源: OVID