Biomedical subjects
Publications and source records attributed to D H Wright.
Granulocytic sarcoma is a rare, solid tumor composed of immature granulocytes usually found in association with systemic leukemia in younger patients. We present a case of granulocytic sarcoma occurring in an elderly female with no evidence of systemic leukemia. Computed tomography, MR (with and without Gd-DTPA), and angiography showed features commonly found in meningiomas.
BACKGROUND: The purpose of this study was to determine if mixing of fluoroquinolones with a common enteral feeding formulation, Ensure (Ross Products Division, Abbott Laboratories, Columbus, OH), would alter the measured in vitro quinolone concentrations over a 24-hour period. METHODS: Tablets of ciprofloxacin (500 mg), levofloxacin (500 mg), and ofloxacin (300 mg) were crushed and mixed with 240 mL of Ensure, water and calcium chloride (500 mg/L), water and magnesium chloride (200 mg/L), water and calcium chloride and magnesium chloride, and water alone. Fluoroquinolone concentrations of the mixtures were measured, via high-performance liquid chromatography, at baseline and serially over 24 hours. Experiments were performed in duplicate, at three temperatures (5 degrees C, 25 degrees C, and 37 degrees C). RESULTS: Average decreases of 82.5% +/- 1.5% for ciprofloxacin, 61.3% +/- 5.2% for levofloxacin, and 45.7% +/- 10.1% for ofloxacin (mean +/- 95% CI) were observed in vitro for Ensure over the two experimental sets at baseline. Serial analysis revealed no further significant change in any of the quinolone concentrations over the remaining 24-hour period. No significant decrease was noted with the quinolones when mixed in water and calcium, water and magnesium, water and calcium and magnesium, or water alone. This phenomenon appears to be unaffected by time and temperature. CONCLUSIONS: These data suggest there is an immediate and significant loss of fluoroquinolone when mixed with Ensure. An explanation for the loss of fluoroquinolone remains unclear.
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Two further cases of the so-called intravascular bronchioloalveolar tumour of lung are reported. Electron microscopic demonstration of Weibel-Palade bodies and immunocytochemical demonstration of factor VIII in the cytoplasm of the tumour cells indicate the vascular nature of these lesions. One patient presented with an enlarged liver and the tumour was found to be involving the liver and parietal pleura as well as the lung. The characteristic micropolypoid structure was not seen in the pleural or hepatic deposits and it is evident that this feature is a consequence of the alveolar architecture of the lung and is not an inherent property of the tumour.
Two cases of axillary lymphadenopathy induced by foreign body reaction to silicone particles are presented. Both were patients with longstanding arthritis who had silastic metacarpophalangeal joint implants; one patient also had concomitant lymphoma. The material was conclusively identified as silicone by electron microprobe analysis. With currently increasing numbers of silastic finger joint arthroplasties performed for rheumatoid arthritis, silicone lymphadenopathy should be considered in the differential diagnosis of axillary node enlargement in these patients. A history of previous silastic arthroplasty may not always be made available to the pathologist but the histological appearances are sufficiently characteristic, in our opinion, to warrant this history being sought.
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This case report describes clinical, surgical, MR, and pathologic findings of an intraventricular fibroma, a rare, benign mesenchymal neoplasm. Relatively isointense with normal brain parenchyma on T1-weighted images, the tumor exhibited hyperintense signal on T2-weighted pulse sequences and enhanced intensely and homogeneously after intravenous administration of gadopentetate dimeglumine. Choroid plexus papilloma/carcinoma, meningioma, ependymoma, and subependymal giant cell astrocytoma should be included in the differential diagnosis.
Human bites should be considered dangerous injuries with potentially serious complications. Their characteristics vary from an uninfected abrasion to a serious infection such as cellulitis or osteomyelitis. An estimated 10% of the injuries become infected; suspected pathogens include oral and skin flora. Management consists of history and examination, wound care, surgical intervention if necessary, assessment of risk of disease transmission, and appropriate antibiotic prophylaxis or treatment. The best choice for oral or intravenous antibiotic therapy remains the combination of a beta-lactam antibiotic with a beta-lactamase inhibitor. Among the most serious human bites are clenched fist injuries, which often require surgical intervention and intravenous antibiotic therapy.