Sudden nocturnal death in Southeast Asian refugees.
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Biomedical subjects
Publications and source records attributed to M F Colman.
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Arytenoid cartilage dislocations and avulsions are often seen as a part of severe laryngeal injuries due to blunt trauma. An uncommon type of injury is the unilateral degloving of an arytenoid cartilage following laterally directed trauma to the thyroid cartilage. It may occur without additional cartilaginous or mucosal damage. The arytenoid cartilage is squeezed between the thyroid ala and the cervical spine and stripped of its mucosal covering. It may retain mobility and be exposed only on adduction, or it may lose mobility due to dislocation and be tipped into the laryngeal lumen. Prognosis for vocal cord mobility and voice production is good for the degloving injury alone, but poor if the arytenoid cartilage is also dislocated. Cases are discussed to illustrate the mechanism, treatment, and outcome of such injuries.
Kaposi's sarcoma and Hodgkin's disease have each been associated with abnormalities in T lymphocyte function and occur with increased frequency in the immunosuppressed host. Although the association of Kaposi's sarcoma with lymphoreticular disorders has long been recognized, only sporadic cases of Hodgkin's disease have been described in patients with the acquired immune deficiency syndrome (AIDS) in contrast to the frequent occurrence of non-Hodgkin's lymphoma in these patients. The simultaneous occurrence of Kaposi's sarcoma and Hodgkin's disease in the same lymph node is described in a patient with AIDS. This case suggests an association of AIDS with both Kaposi's sarcoma and malignant lymphomas and raises the question of a common pathogenetic mechanism.
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Malignant external otitis (MEO) is a progressive necrotizing infection which spreads to the skull base. The causative organism is usually Pseudomonas aeruginosa and 90% of the patients are diabetic. The infection gains access to the skull base at the temporal bone. Cranial nerve involvement is common. We present a case of malignant external otitis causing blindness due to optic neuritis. Progressive vascular involvement along the skull base is the pathogenic mechanism that best explains spread from the temporal bone to the orbital apex.
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Invasive fungal infections of the head and neck are uncommon. The most common organism is Mucor which is classically seen in diabetic individuals in or immediately after a bout of ketoacidosis. This report outlines our experience of four cases of invasive fungal disease caused by the Aspergillus species. All four patients in this series were profoundly granulocytopenic. Three of the four patients remained profoundly immunocompromised and succumbed to infections. One patient recovered immune competence and became a long term survivor after antifungal chemotherapy and debridement of necrotic tissue. The literature on invasive Aspergillus of the head and neck is reviewed. Some recent insights in the medicine literature concerning the epidemiology of the more common pulmonary form of this invasive disease are also discussed.
Verrucous carcinoma is an unusual variant of squamous cell carcinoma; it comprises approximately 5% of all oral malignancies. The buccal mucosa, gingiva, and tongue are the most commonly involved areas within the oral cavity. Histologically, verrucous carcinoma can present a diagnostic dilemma. The basement membrane is often intact, which may cause the pathologist to misinterpret these carcinomas as hyperkeratosis and severe dysplasia. The preferred treatment for this lesion is wide local excision. Regional lymph node dissection is usually not necessary and radiation therapy appears to be contraindicated. Close follow-up is recommended.
The adenomatoid odontogenic tumor is an uncommon, extremely benign odontogenic lesion that should be differentiated from the other osseous lesions. The surgical management should be conservative without expectation of recurrence.
An additional case of rare, benign osteoblastoma occurring in the right maxilla of a 27-year-old female is reported. The differential diagnosis is discussed and the important distinction between osteoblastoma and low-grade osteosarcoma is stressed.
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