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Biomedical subjects

M J Shortsleeve

Publications and source records attributed to M J Shortsleeve.

11 recordsLinked to original sources

Herpes esophagitis in otherwise healthy patients: clinical and radiographic findings.

The authors report the clinical and radiographic findings in five otherwise healthy male patients with herpes esophagitis who had no underlying immunologic problems. The patients all presented with onset of acute odynophagia after a flulike prodrome of fever, sore throat, or myalgias. In all five patients, double-contrast esophagograms revealed innumerable punctate or linear areas of ulceration, predominantly located in the midesophagus near the level of the left main bronchus. Four patients received viscous lidocaine and antacids, and one patient, intravenously administered acyclovir. All five patients had an acute, self-limited illness with complete resolution of symptoms 10-12 days from the time of presentation. It is concluded that, if the characteristic clinical prodrome is present in patients with typical findings on double-contrast esophagograms, such patients can receive conservative treatment without need for endoscopic intervention.

Adolescent

Small bowel stricture caused by rheumatoid vasculitis.

Small bowel involvement in rheumatoid arthritis is rare and is caused by vasculitis, which results in ulceration, perforation, and necrosis of the small bowel. The authors present a case of rheumatoid vasculitis associated with a small bowel stricture. The patient had a 3-week history of daily postprandial bloating, abdominal cramping, and vomiting. Barium study demonstrated partial small bowel obstruction. Pathologic examination of a resected segment of the small bowel proved that the stricture was caused by rheumatoid vasculitis. To the authors' knowledge, this is the first reported case of such an association in the radiology literature.

Aged

Renal US findings in sulfadiazine-induced crystalluria.

The authors report two cases of sulfadiazine-induced obstructive nephropathy that were diagnosed with ultrasound (US). Renal US demonstrated layered clusters of echogenic shadowing material--presumed to be sulfa crystals--which cleared when the crystalluria resolved. The authors conclude that renal US is helpful in diagnosing sulfa calculi and subsequent obstructive nephropathy.

AIDS-Related Opportunistic Infections

Radiologic findings in hemorrhagic colitis due to Escherichia coli O157:H7.

Hemorrhagic colitis due to Escherichia coli O157:H7 is a distinct clinical entity characterized by abdominal pain, watery diarrhea progressing to bloody diarrhea, and little or no fever. It has been reported to have a mortality as high as 31%. This form of colitis is not described in the radiologic literature. This paper describes the radiographic findings, and stresses the need for radiologists to be familiar with the disease in order to assist in early diagnosis. Key clinical and epidemiological features are reviewed.

Adult

Large colonic neoplasms missed by endoscopy.

Endoscopy is commonly accepted as the gold standard in the evaluation of neoplastic colonic disease. The procedure is used to confirm or exclude lesions detected on barium enemas, with the assumption that the endoscopist was successful in reaching the appropriate segment of the colon. We collected 18 cases, all with proved colonic neoplasm 2-8 cm in diameter that were detected by barium enema but overlooked on initial endoscopy. All of the lesions were relatively flat with little intraluminal protuberance. Histologic examination showed malignant foci in six of 11 tumors that were resected. In two of the other seven patients, unresected lesions progressed to advanced carcinomas. This experience suggests that a repeat barium enema is indicated when endoscopy fails to detect a colonic tumor suspected on barium enema examination.

Barium Sulfate

Herpetic esophagitis.

Four patients with herpetic esophagitis were examined. In three of them, the presenting symptom was odynophagia. Early in the course of herpetic esophagitis, shallow round and oval ulcers were seen on barium esophagograms. Later, the ulcers filled with fibrinous exudate, forming nodular plaques that projected into the esophageal lumen. Although these findings are diagnostic of esophagitis, they are not specific for a herpes virus infection. The definitive diagnosis must be established by histologic examination, which demonstrates the cytopathic effect of the herpes virus infection within the squamous epithelium.

Adult

Pulmonary pseudonodule.

A nodular density seen at the posterior lung base on lateral chest radiographs proved to be normal bone in the spine. This nodule results from slight thickening of the bone at the superior aspect of the area where the two laminae join to form the spinous process.

Diagnosis, Differential