Biomedical subjects
Publications and source records attributed to E Edelstein.
A case report and review of the literature of a primary peritoneal borderline tumor is presented. A patient with primary peritoneal borderline tumor diagnosed by elevated of serum CA-125 and asymptomatic pelvic cysts, two years after laparotomy due to mullerian cysts, is discussed.
Malignant transformation of benign cystic teratoma of the ovary is rare, with an incidence of 1.8%. The commonest malignant neoplasm to develop is squamous carcinoma (80%). Adenocarcinoma occurs with less frequency, and only one of which has ever been cited to be of gastrointestinal origin. A 38-year-old female underwent TAH-BSO due to a large right ovarian tumor. Microscopically and immunohistochemically, the tumor was defined as mucinous adenocarcinoma originating from gastrointestinal epithelium in benign cystic teratoma.
OBJECTIVE: The purpose of the study is to report the clinical outcome of acute Bacillus endophthalmitis after cataract surgery. DESIGN: The study design is a cohort study. PARTICIPANTS: Fourteen eyes of 14 patients with epidemic acute postoperative inflammation after exposure to bacteria-contaminated viscoelastic material were studied. INTERVENTION: Three patients with milder clinical presentations were treated without vitrectomy or antibiotics. Eleven patients with more severe infection were treated with vitrectomy as well as intravitreous and topical fortified antibiotics. MAIN OUTCOME MEASURES: Final visual acuities were obtained in all 14 study patients. Results of microbiologic studies of aqueous and vitreous specimens from 11 vitrectomized eyes also were analyzed. RESULTS: One patient with late presentation had severe inflammation and had phthisis bulbi develop with no light perception. The remaining 13 patients had successful resolution of inflammation after treatment by 1 month of follow-up. Twelve of these 13 patients, including 1 nonvitrectomized patient, had final visual acuities of 20/100 or better at 6 months' follow-up. Six patients, including two patients with nonvitrectomized eyes, had outcomes of 20/40 or better visual acuity. Bacillus species were grown from all 11 (100%) vitreous and 7 (88%) of 8 aqueous specimens obtained from vitrectomized patients, as well as from the contaminated viscoelastic material remaining in the operating room. CONCLUSIONS: Postoperative Bacillus endophthalmitis need not result in poor outcome. Results depend on factors including bacterial load, specific bacterial species, timing of treatment, and immune status of the patient.
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This article explores the idea that symptoms in certain functional and organic disorders may be precipitated by a patient's anxiety in anticipation of that symptom's recurrence (symptom anticipation). Furthermore, through a process of learning from earlier experience, the induction of symptoms may be a highly directed process mediated by the nervous system and driven by the patient's apprehension or anxiety. In some patients this anticipation may be a major factor in causing a seemingly deteriorating clinical situation, which is often poorly responsive or unresponsive to conventional and perhaps previously effective medication. This situation tends to evoke a response from the treating physician that may lead to a course of action potentially dangerous to the patient through the use of more invasive diagnostic procedures, second-line drugs with more hazardous side effects, or even surgery. This article attempts to demonstrate that psychosomatic processes may be of considerable importance in mediating suffering through a defined mechanism in patients with established organic disease states.
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With the techniques used in this study, the nucleoid of Streptococcus faecalis could not be seen in freeze-etch preparations unless glutaraldehyde had been added to cultures of cells before they were frozen. With time, the nucleoid became visible as a network of fibers, apparently as a result of the aggregation of individual chromosomal elements in the presence of glutaraldehyde. When glutaraldehyde was added to undisturbed cultures, the fibers that became visible were observed in small patches that were seemingly scattered throughout the cytoplasm. However, if cells were chilled or placed on filters before glutaraldehyde was added, the fibers which then developed were seen in large central areas. The appearance of centralized nucleoids in freeze fractures of cells that had been chilled or filtered could be correlated with a decrease in the central density of the cytoplasm, as seen by light microscopy, in cells embedded in gelatin or bovine serum albumin. These observations are discussed in relation to a model for the normal structure of the nucleoid which suggests that the treatments routinely used to study the morphology-physiology of cells (chilling, filtration, and fixation) result in a reorganization of the cytoplasm, leading to an increase in the centralization of nuclear material.
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A pilot study on the time sense of ten depressed patients was performed before and during, as well as after, antidepressant therapy with tricyclic compounds. Short time spans were measured by two methods, giving then two different tasks. Measurements were performed in the morning as well as evening hours, in order to take into account diuranl variations. Accuracy of time estimation was considerably deviant. All except one patient overestimated time. With improvement, time sense also improved. Errors were still greater in the morning. The value of the results are discussed.
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BACKGROUND: To present the computed tomographic (CT) findings of synchronous mucinous tumors of the ovary and the appendix associated with pseudomyxoma peritonei (PMP). METHODS: Imaging studies, mainly abdominal CT scans, of three women aged 49-75 years were reviewed. Attention was directed to the ovarian masses, peritoneal seeding, and the presence of an appendiceal mucocele. RESULTS: The ovarian tumors and the appendiceal mucocele were clearly demonstrated in two cases, and they were part of the extensive PMP in the third patient. Ascites was found in all cases, with internal septation in one. Associated scalloping of the liver margins and hypodense peritoneal implants, with extensive bowel involvement, were seen in another one. Pathologically, there was one case of right ovarian mucinous cystadenoma and villous adenoma of the appendix, one case of right ovarian and appendiceal mucinous cystadenocarcinoma, and one case of bilateral metastatic ovarian implants of appendiceal mucinous cystadenocarcinoma. PMP was found in all. In the case with benign tumors of the ovary and the appendix, the PMP was classified as a benign mucinous spillage. This patient returned 33 months after surgery with PMP, in which epithelial cells were found. CONCLUSIONS: Radiologists should be familiar with the clinical occurrence of synchronous mucinous tumors of the ovary and the appendix associated with PMP and with the typical CT findings of the latter two entities. Alternatively, when the imaging findings suggest ovarian cystic tumor with PMP, the radiologist should be alerted to the probability of a clinically unsuspected appendiceal mucocele and should search for it.
Thirty-nine patients with acute low back pain were treated with amitriptyline (150 mg/d) or acetaminophen (2,000 mg/d) in a controlled double-blind design for 5 weeks. Both groups revealed mild depression, normal coping, and increased anxiety at the beginning, with significant improvement in anxiety state and pain at the end of treatment. A repeated measures analysis of variance demonstrated that amitriptyline was more effective than acetaminophen in reducing pain intensity from the second week of treatment. Age and depression were the only significant pretreatment predictors of posttreatment pain. The study evaluates the significance of these findings.
After complete but inconclusive audiometric evaluation, 30 suspected cases of nonorganic hearing loss (NOHL) were referred to this laboratory for a complete battery of electric response audiometry tests (recording of cochlear, brain stem and cortical evoked responses). The chief advantages of these tests lie in their ability to more objectively confirm the presence of NOHL and to elicit the true threshold of the subject. Such tests along with psychiatric evaluation, indicate that NOHL can be subdivided into categories, examples of which are presented and discussed: malingering or conscious simulation of deafness for obvious personal gain, and psychogenic deafness in which an emotional problem (e.g., combat stress, anxiety) is unconsciously converted into a hearing problem in an escape mechanism. The basis of NOHL in some cases may be a mixture of both conscious components (malingering) and unconscious components (psychogenic). Several cases of NOHL are really nonorganic overlays or exaggeration on a small to moderate organic hearing loss. The psychogenic hearing loss seen in soldiers with combat neurosis may have originally developed as a psychogenic exaggeration of a temporary threshold shift induced by the noise of battle. Thus objective electrophysiological hearing tests and psychiatric evaluation have contributed to a better understanding of NOHL.