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Biomedical subjects

A E Pitchenik

Publications and source records attributed to A E Pitchenik.

51 records · Page 3Linked to original sources
PubMed1985

Kaposi's sarcoma of the tracheobronchial tree. Clinical, bronchoscopic, and pathologic features.

Two homosexual men with disseminated Kaposi's sarcoma presented with paroxysms of a nonproductive cough probably related to the presence of tumor in the airways. At bronchoscopy, multiple, flat, brightly red to violaceous lesions were seen throughout the tracheobronchial tree. In both patients the bronchial biopsies were nondiagnostic, and one patient had excessive bleeding after the procedure. Autopsies confirmed the presence of Kaposi's sarcoma in the trachea and bronchi. The bronchoscopic appearance of Kaposi's sarcoma of the tracheobronchial tree is characteristic, and bronchial biopsy is probably unnecessary when the diagnosis of Kaposi's sarcoma has already been made by biopsy of more accessible lesions. Furthermore, bronchial biopsy may be hazardous because of excessive bleeding.

Adult↗
PubMed1985

Bronchocentric granulomatosis with glomerulonephritis.

Bronchocentric granulomatosis is a chronic pulmonary disease treated with short-term therapy with corticosteroids, and the disease has an excellent prognosis. We describe a patient, and review an additional case from the literature, in whom bronchocentric granulomatosis was accompanied by glomerulonephritis. A misdiagnosis of Wegener's granulomatosis was made, and therapy with cyclophosphamide was either considered or given in each of these cases. We emphasize the need for careful histopathologic evaluation of open lung biopsies in patients suspected of having Wegener's granulomatosis in order to rule out the possibility of bronchocentric granulomatosis with concurrent renal disease, and thus avoid the unnecessary use of cytotoxic agents.

Diagnosis, Differential↗
PubMed1984

The acquired immunodeficiency syndrome in the wife of a hemophiliac.

A 71-year-old previously healthy woman developed unexplained thrush, onychomycosis, Pneumocystis carinii pneumonia, and a T-cell defect consistent with the acquired immunodeficiency syndrome. Her only apparent risk factor was infrequent, monogamous sexual contact with her husband, a 74-year-old hemophiliac who had received factor VIII concentrate and subsequently died due to P. carinii pneumonia. She first developed probable signs of the syndrome (recurrent thrush and onychomycosis) 1 year before her husband became ill. These findings suggest that the syndrome can be transmitted heterosexually by an asymptomatic person, and that the female sexual partners of hemophiliacs treated with factor VIII concentrate may be at risk of acquiring the syndrome; frequent sexual contact or several sexual partners are not necessary for transmission to occur; and the syndrome can occur in elderly people if exposed to risk factors. This case further supports the theory that the syndrome in hemophiliacs is due to an infectious agent that can be transmitted heterosexually as well as parenterally.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Tuberculosis, atypical mycobacteriosis, and the acquired immunodeficiency syndrome among Haitian and non-Haitian patients in south Florida.

To study the association between mycobacterial disease and the acquired immunodeficiency syndrome, we reviewed the records of all cases of tuberculosis and all cases of the syndrome reported in Dade County, Florida, from January 1980 through June 1983. Tuberculosis was diagnosed in 27 of 45 Haitians with the syndrome, but in only 1 of 37 non-Haitians with the syndrome (p less than 0.001). Among the 27 Haitians with the syndrome and tuberculosis, 19 had extrapulmonary tuberculosis, whereas among 286 Haitian patients with tuberculosis without the syndrome, only 56 had extrapulmonary tuberculosis (p less than 0.001). Tuberculosis preceded the syndrome by 1 to 17 months (mean, 6) in 22 patients. In 10 patients with the syndrome and positive sputum cultures who were treated with conventional antituberculosis drugs, the cultures became negative within 1 to 4 months and tuberculosis did not recur. The frequency of disseminated atypical mycobacteriosis or positive sputum cultures for atypical mycobacteria was not significantly different between Haitian (11.3%) and non-Haitian (8.3%) patients with the syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Acquired immune deficiency syndrome in low-risk patients. Evidence for possible transmission by an asymptomatic carrier.

Two patients who contracted acquired immune deficiency syndrome (AIDS) could not be included in any of the known high-risk groups for this syndrome (ie, they were not homosexual, intravenous [IV] drug abusers, Haitian, or hemophiliacs). Patient 1, however, had regular sexual contact with her husband, an IV drug abuser who is asymptomatic despite a severe T-cell defect (T-helper cells, 33/cu mm; T-helper/T-suppressor ratio, 0.32; and a depressed lymphoproliferative response to mitogens and antigens). We hypothesize that he may be an asymptomatic carrier of an AIDS agent that he transmitted to his wife through intimate heterosexual contact. This mode of sexual transmission may provide a vector for the spread of AIDS to low-risk populations.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Opportunistic infections and Kaposi's sarcoma among Haitians: evidence of a new acquired immunodeficiency state.

Twenty Haitian patients, hospitalized from 1 April 1980 to 20 June 1982, had Pneumocystis carinii pneumonia, central nervous system toxoplasmosis, esophageal candidiasis, cryptococcosis, disseminated cytomegalovirus, progressive herpes simplex virus, chronic enteric coccidiosis, or invasive Kaposi's sarcoma. Ten patients died. Opportunistic infections were frequently multiple and were recurrent in three patients. In seven patients disseminated tuberculosis preceded the other infections by 2 to 15 months. There was no evidence of an underlying immunosuppressive disease, and no history of homosexuality or intravenous drug abuse. At least three patients probably acquired the syndrome in Haiti. Lymphadenopathy was common. Seventeen patients tested had anergy, and 18 had lymphopenia. Monoclonal antibody analysis of peripheral-blood T-cell subsets done on 11 patients showed a marked decrease in T-helper cells and an inversion of the normal ratio of T-helper cells to T-suppressor cells. This syndrome among heterosexual Haitians is strikingly similar to the syndrome of immunodeficiency described recently among American homosexuals.

Acquired Immunodeficiency Syndrome↗
PubMed1978

PPD-tuberculin and PPD-Battey dual skin testing of hospital employees and medical students.

Tuberculin PPD and PPD-Battey skin tests were simultaneously applied to 3,882 employees of Charity Hospital and 408 medical students at Louisiana State University. The PPD was doubtful (5 to 9 mm induration) in 253 of the total 4,290 persons tested (5.9%). In 86 of these 253 persons, the reaction to PDD-Battey was greater than the reaction to PPD, presumably identifying a subpopulation with a falsely positive PPD and therefore at considerably lower risk of developing future tuberculous disease. Of the 408 medical students (average age 24 years), 80 (19.6%) were classified by the skin tests as having atypical mycobacterial sensitization as compared to six (1.45%) who were classified positive or probably positive to Mycobacterium tuberculosis (P less than .001). In the Southeastern United States, where the incidence of atypical mycobacterial infection is relatively high and occurs at a young age, dual skin testing may have its greatest applicability in identifying tuberculous infection when the PPD falls in the "doubtful" 5 to 9 mm range.

Adult↗
PubMed1978

Lingual thyroid.

After 15 years of being asymptomatic, this patient with documented lingual thyroid developed a lump in the throat, with dysphagia. Routine thyroid function tests were within normal limits, but serum TSH concentration was increased to twice normal. On thyroxine therapy TSH levels returned to normal and the symptoms were relieved. TSH determinations and suppressive thyroid hormone administration play an important role in the management of a patient with lingual thyroid.

Adult↗
PubMed1978

Superior vena cava syndrome caused by Nocardia asteroides.

A patient developed the superior vena cava syndrome from Nocardia asteroides pneumonia with mediastinitis. Specific treatment was dangerously delayed because malignancy was primarily suspected, and nocardial infection was not initially considered. The correct diagnosis was eventually made by appropriate stains and culture of a lung aspirate. Specific therapy with sulfonamide resulted in a cure of the infection, disappearance of facial swelling, and a long-term state of clinical well-being. Active nocardial pneumonia with mediastinitis is a treatable cause of the superior vena cava syndrome and should be considered in the differential diagnosis.

Adult↗
PubMedDate not supplied

Spontaneous lymphokine activated killer (LAK) activity in bronchoalveolar lavage cells from patients with bronchogenic carcinoma.

Bronchoalveolar lavage cells (BAC) are considered to be representative of cells that are in the interstitium and in patients with lung cancer, may represent, in part, cells that infiltrate cancerous tissue. We used bronchoalveolar lavage (BAL) specimens to test the hypothesis that cells within this region might be regulated locally by factors and show activities that are dependent on these growth and activation mediators. We showed previously that Natural Killer (NK) activity and IL2 titers were proportional. As compared to normal subjects, patients with all stages of bronchogenic carcinoma consistently had very high levels of IL2 in their bronchoalveolar lavage (BAL) fluid and this titer correlated with an increase in NK activity in the BAC both in absolute level and in relative level to the blood. Now, we report results that show that spontaneous lymphokine activated killer (LAK) activity also can be measured in most patients, but not all patients, that express IL2 titers. These findings support the hypotheses that different types of nonspecific cytotoxic cells are present and active in cancerous lung specimens secondary to the secretion of lymphokines from activated T lymphocytes in that region and that LAK activity is a physiological phenomenon that may be expressed in regional rather than systemic areas of the body.

Bronchoalveolar Lavage Fluid↗