doi: 10.1093/oxfordjournals.qjmed.a068204pmid: N/A
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RUTHERFORD, JOHN, D.;BRAUNWALD,, EUGENE
doi: 10.1093/oxfordjournals.qjmed.a068205pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © Oxford University Press
DORREEN, M., S.;IRONSIDE, J., W.;BRADSHAW, J., D.;JAKUBOWSKI,, J.;TIMPERLEY, W., R.;HANCOCK, B., W.
doi: 10.1093/oxfordjournals.qjmed.a068206pmid: N/A
Abstract SUMMARY Intracerebral disease was diagnosed in 14 out of 450 patients who presented with non-Hodgkin's lymphoma between January 1976 and January 1987. Twelve of the 14 presented after June 1980. Age ranged from 31 to 73 years and eight patients were male. Two patients had other tumours, and three had relevant associated immunosuppressive disorders. Radiological assessment of one further patient showed a cavitating bronchial carcinoma. Five patients were untreated, and one died before radiotherapy was complete. Eight patients completed courses of whole-brain irradiation; four of these received higher doses. All entered remission. Three patients are alive, between eight months and seven years after treatment. Of the remaining five, one never recovered intellectual function and died of bronchopneumonia; three died between eight and 30 months after treatment and autopsy showed severe radionecrosis of the brain with no residual tumour. All three had received higher does of radiation and had undergone burrhole aspiration before treatment. Autopsy was refused on one patient who also appeared to have died from radionecrosis of the brain. Immunohistologica examination in eight cases confirms that cerebral non-Hodgkin's lymphoma is a B-cell tumour. As other groups have found, its incidence appears to be rising. Survival rate is poor, and at least some deaths are related to both radiation necrosis and the bulk of residual tumour after diagnostic surgery. This content is only available as a PDF. Author notes ‡Present address: Department of Pathology, University of Leeds, Leeds LS2 9JT. © Oxford University Press
GREENSTONE,, M.;RUTMAN,, A.;DEWAR,, A.;MACKAY,, I.;COLE, P., J.
doi: 10.1093/oxfordjournals.qjmed.a068207pmid: N/A
Abstract SUMMARY Thirty patients with functional and/or morphological abnormalities of respiratory tract cilia were identified. The diagnosis of primary ciliary dyskinesia was based on observed abnormalities of ciliary ultrastnicture or beating in vitro (beat pattern, beat frequency or percentage of motile cilia). Beat frequency and motility indices approached the normal range in some cases and suggests that the term ‘immotile cilia syndrome’ is not appropriate. Morphological abnormalities were most commonly due to deficiency of dynein arms, affecting the outer arms (n=7), inner arms (n=3) or both (n=10). Examples of radial spoke and microtubular defects were also identified but in seven subjects ciliary ultrastructure was normal. In six patients paired samples of nasal and bronchial cilia were obtained and showed consistent abnormalities of motility and ultrastnicture. Adenosine triphosphate and adenosine triphosphatase did not restore in vitro motility when added to dynein deficient cilia. The clinical picture was of life-long sinusitis and recurrent bronchial infection but the spectrum was broader than that encompassed by Kar-tagener's triad (dextrocardia, sinusitis and bronchiectasis). Fourteen patients had normal cardiac situs and definite or highly suggestive evidence of bronchiectasis was present in only 17 patients. Radiological evidence of sinusitis was common but absence of frontal sinuses was not universal. Chronic serous otitis media was a frequent finding but deafness was rarely profound. Fertility problems were common but were not universal in female subjects. Lung function testing revealed evidence of airflow obstruction but this was mild in most cases. This content is only available as a PDF. © Oxford University Press 1988
HART, I., K.;KENNEDY, P. G., E.
doi: 10.1093/oxfordjournals.qjmed.a068208pmid: N/A
Abstract SUMMARY Three cases of Guillain–Barré syndrome associated with serological evidence of active cyto-megalovirus (CMV) infection are described. There are a variety of problems in establishing a causal role for cytomegalovirus in the development of the Guillain-Barré syndrome, the most important of which relates to the unequivocal demonstration of a primary infection preceding the condition. It is postulated that an immune–mediated mechanism probably plays an important role in pathogenesis whether it is associated with cytomegalovirus or other human herpesviruses. This content is only available as a PDF. © Oxford University Press
READING, NICHOLAS, G.;ROBES,, ALASTAIR;NUNNERLEY, HEATHER, B.;WILLIAMS,, ROGER
doi: 10.1093/oxfordjournals.qjmed.a068209pmid: N/A
Abstract SUMMARY Twenty-four adults (10 male; age 27-65 years, median 43.5) with hepatic haemangioma are reviewed. Fifteen had right hypochondrial pain (lesions 8 cm or more in diameter in nine). Six lesions were found incidentally, at ultrasound examination or elective cholecystectomy. Diagnosis, from ultrasonic and angiographic appearances, was confirmed in 12 by percutaneous biopsy without complication. Eleven patients were followed untreated for up to 60 months (median 24 months): lesion size (median 2.5 cm) did not change and all remained well. Surgical resection succeeded in two of three patients; the third and eight other patients (seven with symptoms) with lesions 3 to 30 cm in diameter were selected for Gelfoam embolization. Transient minor side effects preceded improvement in most, but two patients (with lesions of 20 cm or greater in diameter) developed multiple liver abscesses: recovery was protracted. Embolization failed in three; two remain well, untreated, to 24 and 51 months. Two patients had hepatic artery ligation, one with radiotherapy. Further imaging at from eight to 60 months (median 24) showed little change in lesion size or vascularity with any non-resectional technique. Expectant management of small asymptomatic haemangiomas appears appropriate. Embolization may reduce pain but the risk of abscess formation is high for large tumours, and reduction in size or vascularity of lesions is unlikely whatever their initial diameter. This content is only available as a PDF. © Oxford University Press
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