Biomedical subjects
Publications and source records attributed to M Dollberg.
Intrathoracic amyloidosis affecting the lungs or mediastinum is rare, and mediastinal lymphadenopathy in the absence of pulmonary involvement is even more rare. The case history is presented of a previously healthy man who developed nodular mediastinal amyloidosis without pulmonary involvement. Diagnosis was made by percutaneous fine needle biopsy.
A 23-year-old Ethiopian new immigrant presented with a giant lymphangioma extending from the posterior mediastinum through the retroperitoneum, ending as a herniated fluid-filled sac in the inguinal region. Chylous fluid aspirated from within the lymphangioma was cultured positive for Mycobacterium tuberculosis. Considerable regression occurred following 6 months of antituberculous treatment.
We describe a case of pneumatosis cystoides intestinalis with unusual localization and radiologic features. Barium enema showed multiple, rounded, submucosal masses, which were polypoid and airless and were localized to a 20 cm segment of the splenic flexure. There was no extraluminal gas on X-ray. Puncture of these formations via colonoscopic biopsy did not result in deflation of air. Surgical resection was performed and the classical features of pneumatosis cystoides intestinalis were found. Isolated splenic flexure involvement in conjunction with atherosclerotic cardiovascular disease may suggest that pneumatosis cystoides intestinalis is a reparative process after ischemic injury.
A term infant was delivered uneventfully by repeat Cesarian section. At the age of 1 week there was clinical and radiographic evidence of fractures of the left tibia and right radius. The fractures most likely occurred during the cesarian section. Birth trauma should not be excluded on the basis of Cesarian section delivery.
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A 64-year-old white man was operated on for acute gastrointestinal bleeding. The patient was known to have a duodenal polyp for 15 years. Surgery revealed a small duodenal ulcer and a large cystic hamartoma of Brunner's glands. Incidence, aspects of pathogenesis, clinical features and treatment of this rare tumor are discussed.
Fetal pulmonary maturity based on visualization of one or both fetal knee secondary centers of ossification was assessed in 84 gravidas. Amniotic fluid lecithin/sphingomyelin ration of 2:1 or greater was the criterion of fetal lung maturity. It was concluded that when antenatal radiographs reveal the presence of both centers of ossification, fetal lung maturity can be assured in 100% of the fetuses. When the distal femoral center along is seen, only 60% of the fetuses will have mature lungs.
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A prospective, controlled, randomized study was done to compare the effect of early and late ambulation in hospitalized patients with acute myocardial infarction. All patients surviving longer than the first five days were studied; 64 patients were mobilized on day six and discharged on day 12, and 65 were mobilized on day 13 and discharged on day 19. Follow-up observation lasted from six to 52 weeks. Of patients without complications until day six, eight out of 32 in the early and 16 of 35 in the late groups manifested complications during the follow-up period (p smaller than 0.05). Of those who had complications before day six, seven of 32 and 26 of 30 still had or acquired new complications until last seen (p small than 0.0001). The number of serious complications in the two groups was eight and 24 respectively (p smaller than 0.001). We conclude that early ambulation is beneficial irrespective of complications on admission.