摘要:

Glioblastoma multiforme is the most common primary brain tumor of adults, as well as the most malignant. Its etiology is unknown, but the tumor is thought to arise through dedifferentiation of adult astrocytes. It occurs most frequently between the ages of 40 and 60, in men more often than in women (1.5:1). Important early symptoms include subtle personality change, headache, weakness, and intellectual impairment; specific complaints and physical findings depend on the location of the lesion. The initial diagnostic test should be a CT-scan; it will detect more than 90% of malignant astrocytomas. Surgery remains the cornerstone of treatment; patients receiving radical debulking have a median survival of 8 months compared to the 3 month survival of unoperated cases. Modern neurosurgical technique, neuroanesthesia, mannitol, and corticosteroids have reduced the surgical mortality to 3%. Most patients also receive 4500 rads of whole-brain irradiation and 1800 rads to the operative site; radiotherapy increases the median survival of operated patients by 2 to 3 months. An additional small increment in survival time and some improvement in quality of survival can be achieved by nitrosourea chemotherapy; the latter is usually given as 100 mg/m2/day × 3 days of BCNU every eight to ten weeks. Experimental treatments under study include the use of radiosensitizers, the role of immunotherapy and the application of microwave-induced hyperthermia. Two-year survival remains 10% to 20%, and there are virtually no five-year survivors. An optimal combined modality treatment plan, one in which each cellular compartment of this truly multiforme tumor is effectively addressed, remains to be designated.

ISSN:0002-9629    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The responses of seronegative adults to two live attenuated rubella virus vaccines were compared. Of 50 women who received the HPV-77-DE5 strain, 49 (98%) had an antibody response; the geometric mean antibody titer(GMT) was 1:38 at two to five months and 1:59 at six to 14 months. Of 66 women and three men who received the RA 27/3 strain all (100%) had an antibody response; the GMT was 1:55 at two to five months and 1:75 at six to 14 months. The incidence of mild to moderate transient clinical reactions, occurring in approximately one-fourth of those vaccinated, was similar for both groups. The serologic response to both vaccines was excellent.

ISSN:0002-9629    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Two cases of septicemia withStreptococcus equinus, a group D streptococcus, are reported, and the literature pertaining to infections with this organism is reviewed. Both of our patients presented with obvious signs of infection, hadS equinusisolated from multiple blood cultures, and had a good clinical response to penicillin therapy, alone or in combination with streptomycin.In vitrotesting of the isolates confirmed susceptibility to penicillin.S equinusshould now be recognized as a human pathogen as are the other group D streptococci,S bovisand the enterococci.

ISSN:0002-9629    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A patient withAspergillus fumigatusinfection involving an aortotomy site with multiple peripheral emboli following implantation of an aortic valve prosthesis for rheumatic heart disease is described. Eleven aortotomy site infections are reviewed from the literature. Eight cases were caused by fungi withAspergillussp accounting for four cases. Presenting symptoms were nondiag-nostic and multiple. However, the diagnosis of aortotomy site infection should be entertained in patients who have had aortic valve surgery who develop fever and embolic phenomena with or without positive blood cultures coupled with no evidence of valve dysfunction, and who respond inappropriately to antibiotic therapy. Ten of the 11 patients reviewed from the literature died. Therapy should be directed at early recognition followed by prompt early surgery combined with the use of proper antimicrobial agents directed against the isolated microorganism.

ISSN:0002-9629    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The coexistence of Philadelphia negative chronic granulocytic leukemia (CGL) of the neutrophilic type and IgA monoclonal gammopathy is reported in a patient. The possible relation between the two proliferative processes is discussed in the light of current knowledge on the pluripotent stem cell and the clonal origin of CGL.

ISSN:0002-9629    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A patient with a clinical course consistent with Legionnaires' disease rapidly developed acute respiratory failure. Sputa and bronchoscopic washings revealed many polymorphonuclear leukocytes but no organisms on gram stain and culture. The diagnosis of Legionnaires' disease was strengthened when the transthoracic aspirate revealed weakly staining gram-negative bacilli with no growth noted on culture. Serologic titers confirmed the diagnosis of Legionnaires' disease. This patient's course was complicated by cavitation which responded to medical therapy with erythromycin. This is the second reported case of Legionnaires' lung abscess.

ISSN:0002-9629    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Three patients with serious infections due to beta hemolytic streptococci, Lancefield group G are presented. The clinical syndromes are septicemia with possible endocarditis in a patient with laryngeal carcinoma, septic arthritis in a healthy boy and endocarditis in an adult with no previous underlying valvular disease. All were treated with intravenous penicillin and recovered. The clinical and microbiologic significance of recognizing the organism is emphasized.

ISSN:0002-9629    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A patient with pseudothrombocytopenia due to the anticoagulant EDTA is described. The thrombocytopenia was secondary to platelet agglutination and required the presence of EDTA in a critical concentration and the patient's plasma. Both homologous and autologous platelets were affected by this plasma factor in the presence of EDTA. The platelet agglutination was temperature independent and could be prevented by divalent cationsa. The agglutination phenomenon was irreversible. The platelet count in oxalate, not heparin, and citrate anticoagulated blood was normal. The patient's clinical course was benign and no hemorrhagic complications occurred. We believe this is the first reported case of pseudo- thrombocytopenia associated with a vasculitis. The diagnosis of this disorder, its implications and the pertinent literature is discussed.

ISSN:0002-9629    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1980

数据来源: OVID