Fibroepithelial polyps of the pelviureteric junction in childhood.
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Child↗
Biomedical subjects
P Kleinman
Publications and source records attributed to P Kleinman.
[Early treatment of biliary lithiasis in biliary pancreatitis].
Since 1982, 38 consecutive patients with biliary pancreatitis were treated prospectively in order to prevent recurrent migration of gallstones. Removal of the stones was achieved by "early surgery" i. e. within the first week after admission or by endoscopic sphincterotomy in patients with severe pancreatitis. Gallstones were visualized by ultrasonography in 31 patients (82 p. 100). Microlithiasis was present in 14 (37 p. 100) and was missed at ultrasonography in 7 patients. According to Ranson's prognostic signs, only 4 patients had 4 or more signs. These 4 patients and 2 additional patients aged more than 85 underwent urgent retrograde cholangiography and endoscopic sphincterotomy. No complications could be attributed to this technique. Among the 4 patients with severe pancreatitis, 3 developed an abscess which required delayed surgery without further complications. The 32 other patients underwent a biliary operation within the first week after admission. Common bile duct calculi were present in 14 patients being discovered by cholangioscopy in 6. One patient died after operation and one was reoperated on for a pseudocyst on day 40. No recurrent attack of pancreatitis was observed in either group. Our study suggests that slightly delayed biliary operation with cholangioscopy during the same hospitalization can be performed safety in patients with mild pancreatitis. In patients with severe attack and/or poor general condition, endoscopic sphincterotomy is a safe technique and deserves wider consideration in the management of severe acute pancreatitis for which delayed drainage of pancreatic necrosis may occasionally be required.
Acute Disease↗
The AIDS epidemic among blacks and Hispanics.
Social researchers and epidemiologists, as well as their major institutions and the general public, have been slow to address the racial and ethnic aspects of the AIDS epidemic. Whether measured by categories associated with major routes of infection, age level, gender, or by diminished length of survival, blacks and Hispanics are disproportionately affected by AIDS. Education, care, and outreach efforts based upon stereotypes of gay white males will have to yield to greater attention to cultural differences--and potential strengths--within each of the special "communities at risk." Evidence indicates areas of social resistance along with unique possibilities for change.
Acquired Immunodeficiency Syndrome↗
The anatomical basis for retrorenal extensions of pancreatic effusions: the role of the renal fasciae.
Retrorenal extension of pancreatic inflammatory processes are considered to involve invasion of the posterior pararenal space. Analysis of computed tomographic (CT) images demonstrates preservation of posterior pararenal fat in most patients, implicating some other mechanism. We have examined the anatomical basis for these retrorenal extensions in static and functional studies of 12 cadavers using CT imaging, dissection and histological techniques. We observed that the posterior renal fascia was thicker than the anterior, that it could be easily separated into two layers by manual dissection and injections of liquid latex, that the inner (anterior) layer of the posterior fascia was continuous with the anterior fascia and the outer layer continuous with the lateroconal fascia. The point at which the two layers of the posterior fascia separated laterally and the medial extent of the posterior fascia varied considerably in CT scans of 100 patients. These data are interpreted to mean that pancreatic effusions extend posterior to the kidney by separating the two layers of the posterior renal fascia.
Fascia↗
Juvenile ankylosing spondylitis.
The clinical histories and radiographs of 28 patients with ankylosing spondylitis were reviewed. Symptoms developed before the age of 17 in all cases. Juvenile ankylosing spondylitis affected youths in their early teens, who presented most commonly with appendicular joint complaints rather than low back pain. The disease was progressive, with the characteristic changes of ankylosing spondylitis eventually occurring in the spine and sacroiliac joints, frequently accompanied by widespread and severe changes in the appendolar joints. HLA B 27 antigen was present in 8 of the 9 patients tested. Thorough clinical, radiographic, and laboratory examination should prevent confusion with juvenile rheumatoid arthritis.
Adolescent↗
Sulfatide cholecystosis.
Polypoid masses metachromatic sulfatides have been found at autopsy in the gallbladder of patients with metachromatic leucodystrophy. In a 10-year-old girl with this disease oral cholecystrography demonstrated a filling defect, which was felt to represent a polyp. In the proper clinical setting, sulfatide cholecystosis should be considered in the differential diagnosis of polypoid lesions of the gallbladder.
Autopsy↗
Necroqizing enterocolitis with pneumatosis intestinalis in systemic lupus erythematosus and polyarteritis.
Pneumatosis intestinalis was encountered in association with fatal necrotizing enterocolitis in systemic lupus erythematosus (SLE) and polyarteritis nodosa. The radiologic identification of mottled, bubbly, and linear collections of intramural intestinal gas distinguish this ominous complication from benign pneumatosis cystoides intestinalis. In the setting of intestinal vasculitis due to SLE or polyarteritis nodosa, these characteristic radiologic features indicate necrotizing enterocolitis. Since corticosteroids may mask clinical progression of the intestinal lesion, radiologic evaluation is essential in the overall management of the patient with intestinal vasculitis.
Adult↗
Pseudotumor of the nasal fossa secondary to mucoid impaction in choanal atresia.
An intranasal mass was discovered during evaluation of unilateral choanal atresia. Radiologic investigation of the lobulated cystic mass showed no communication with the central nervous system or any other bony abnormalities. During surgery for the choanal atresia, the mass proved to be a mucous impaction. The case illustrates the need to utilize decongestants and aspiration prior to instillation of contrast agent.
Female↗