Biomedical subjects
J M Embil
Publications and source records attributed to J M Embil.
Salmonella urinary tract infections associated with exposure to pet iguanas.
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Primary cerebellar T-cell lymphoma with acquired immunodeficiency syndrome.
We report a 33-year-old man with the acquired immunodeficiency syndrome (AIDS) and a solitary T-cell lymphoma. Systemic sites of lymphomatous involvement could not be identified. Subtotal resection of the lesion with cranial irradiation resulted in a marked neurologic improvement. Our case suggests that T-cell lymphomas should be considered in the differential diagnosis of a solitary mass of the cerebellum in patients with AIDS and that aggressive therapy may be warranted.
Photo quiz. Symmetric peripheral gangrene.
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More on patients with implantable cardioverter-defibrillators.
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Late recurrence of testicular cancer.
Late recurrence of nonseminomatous germ cell tumours of the testis is rare. The authors report on a 35-year-old man treated initially for embryonal cell carcinoma of the testis with metastases, who presented 12 years later with an increasing serum alpha-fetoprotein level and a biopsy-proven embryonal cell cancer in the hilus of the left lung. Because the tumour was highly resistant to two separate courses of cis-platinum-based chemotherapy and one course of radiotherapy, surgical resection for salvage was carried out. The patient was free of disease 3.5 years after the second operation. The possible reasons for the occurrence of this highly resistant metastatic testicular cancer are discussed. They include a second primary tumour and malignant degeneration of the original tumour. In this patient the latter cause was the most plausible.
Return to arc welding following defibrillator implantation.
A male arc welder who was fitted with an implantable defibrillator wished to return to his former employment. Device testing and ambient magnetic field measurements were performed at his place of work. During welding, artifacts were seen on the intracardiac electrogram but there was no resulting disturbance of sensing function. Measured field strengths were too low to result in device inactivation. The patient resumed his work without incident. This appears to be the first reported case of a patient with an implantable defibrillator returning to this "electrically hostile" environment following thorough screening.
Recombinant human platelet-derived growth factor-BB (becaplermin) for healing chronic lower extremity diabetic ulcers: an open-label clinical evaluation of efficacy.
Topically applied recombinant human platelet-derived growth factor-BB (becaplermin) is a new pharmacologically active therapy for chronic, neuropathic, lower extremity diabetic ulcers. In previous studies, becaplermin gel was administered once daily but dressings were changed twice daily. In the present study of 134 patients with diabetes mellitus and full thickness lower extremity ulcers, dressings were changed only once per day, simplifying the treatment regimen. Efficacy criteria included the percentage of patients achieving complete healing within the 20-week treatment period, the time to achieve complete healing, the rate of ulcer recurrence during the 6-month period following healing, and treatment compliance. Complete healing of ulcers was achieved in 57. 5% of patients, with a mean time to closure of 63 days and a recurrence rate of 21% at 6 months. Of the potential factors affecting ulcer healing, only drug compliance (p < 0.001), dressing compliance (p < 0.01), the presence of infection (p < 0.01), baseline ulcer area (p < 0.05), and baseline total wound evaluation score (p < 0.05) were significantly associated with healing. Results of this study further confirm the efficacy and safety of becaplermin gel for the treatment of lower extremity diabetic ulcers.