Biomedical subjects
Publications and source records attributed to A Elguezabal.
A 15-year-old girl had massive watery and protein-losing diarrhea. She was found to have a pancreatic islet cell tumor secreting high levels of vasoactive intestinal polypeptide. Eighty-five percent pancreatic resection was needed to remove the tumor. She has normal serum VIP levels and no tumor recurrence 6 years later.
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A rare lung tumor composed of contiguous foci of classical blastoma and carcinosarcoma with transitional features is described. Based on these observations and a review of the literature, we propose that pulmonary carcinosarcomas are composed of a heterogeneous population of tumors. This case supports the concept that blastomas are a distinctive subtype of carcinosarcomas. An unusual feature in the clinical presentation was the expectoration of an endobronchial portion of tumor.
An unusual case of granulocytic sarcoma (chloroma) of the parenchyma of the brain occurring in a patient with acute myelocytic leukemia in remission is described and the literature reviewed. The patient presented with an intracranial mass without clinical evidence of meningeal involvement. The value of 99mTc scan in CNS leukemia is shown.
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Lung metastases evolved into large thin-walled cysts in two children with Wilms' tumor. Histologic examination of one lesion suggested that invasion of a small bronchus or bronchiole, leading to ball-valve obstruction, was responsible. One patient also experienced recurrent pneumothorax, probably on the same basis. The formation of thin-walled cysts has not previously been observed with metastatic Wilms' tumor. Pneumothorax is a rare complication of metastatic Wilms' tumor.
A case is presented of incontinentia pigmenti with severe neurological handicaps and unusual features such as single umbilical artery, pigmented lesion at birth, and biochemical changes including elevated alkaline phosphatase and immunoglobulin M.
Pulmonary blastoma is a rare primary malignancy of the lung originating from multipotential pulmonary blastema. Two cases of this tumor are reported emphasizing lack of correlation between the microscopic appearance and the clinical course. There are no specific clinical features that differentiate this tumor from the more common lung neoplasms. Surgical resection is the preferred treatment; the merits of radiotherapy and chemotherapy have not yet been established. Prognosis after adequate resection appears no better than for other pulmonary malignancies.
Gastric atrophy in the elderly may cause problems in the interpretation of gastrointestinal studies. Seventeen such cases are reported: 8 patients showed limited distensibility and irregularity of the distal stomach simulating scirrhous carcinoma; 6 patients showed gastric retention of food; and 2 patients showed gastric retention of oral cholecystographic medium. Awareness of these phenomena may prevent serious errors in roentgen diagnosis.
A series of 10 instances of genital actinomycosis infection complicating the use of intrauterine contraceptive devices is recorded and its pathogenesis described. The likelihood is suggested that this complication is more frequent than is generally appreciated. A pathway of infection extending upward from the patient's anus, across the perineum, and up the vagina and cervix is suggested as the route of infection. The traumatizing effect of the device and a previously existing or intercurrent infection as additional contributing factors to the development of actinomycotic infection in the female genitalia is also postulated.
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Human umbilical cord vein allografts (HUCVAG) were modified by sequential treatment with 95% ethanol and 1.3% dialdehyde starch and stored in 70% ethanol. Tensile strength measurements of HUCVAG were found to range between canine aorta and bovine heterograft. Surface clotting was prolonged to 4 times that of pre-clotted dacron velour and 2 times that of bovine carotid heterograft. Inferior vena cava implants of HUCVAG remained patent for a period of 10 to 14 days while 4 of 5 bovine carotid heterografts clotted in 2 hrs ans one within 3 days. Micrpscopic examination showed a smooth intimal surface with no fibrin deposition and no evidence of rejection, providing excellent basic qualities as a vascular substitute. Using "14 gauge cannula, 180 repetitive percutaneous punctures were made in 10 heparinized dogs with HUCVAG fistulas between the carotid artery and external jugular vein. With exception of one instance in any preparation over a 4 month period. These results suggest the valueless. unbranched modified umbilical cord vein in unlimited supply is suitable as an arteriovenous fistula for blood access in maintenance hemodialysis.
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