Biomedical subjects
Publications and source records attributed to R L Fletcher.
The case of a 57-year-old woman with no personal or family history of coagulopathy or blood dyscrasia who was found to be factor VII deficient by routine laboratory testing is reported. The patient was also found to have type 2 diabetes mellitus and adenocarcinoma of the uterus in the course of her hospitalization.
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Charts of 42 black patients with multiple malignant neoplasms were among 1,953 cancer patients selected for review during the period of 1959 through 1979. The incidence was 2.15 percent. Most patients were female and the breast was the most frequent initial primary carcinoma. With this relatively small number of cases, there was no consistent cluster of initial and second primaries about which to make inferences. In the absence of a regional registry of primary tumor incidence, no generalities could be obtained concerning a matched non-black population on the incidence of multiple primaries. However, comparison of this group could be made with data previously recorded.
Two patients with acute posterior multifocal placoid pigment epithelialopathy also had cerebrospinal fluid pleocytosis and elevated protein levels. A 24-year-old white women had visual acuity of counting fingers in each eye. The cerebrospinal fluid contained 56 lymphocytes per cubic millimeter and a protein level of 48 mg/100 ml. When the retinopathy resolved, visual acuity returned to R.E.: 6/60 (20/200), AND L.E.: 6/9 (20/30). A 22-year-old white man had visual acuity of counting fingers bilaterally. The initial lumbar puncture showed 70 lymphocytes and a protein level of 76 mg/100 ml. A second cerebrospinal tab showed 64 lymphocytes and a protein level of 86 mg/100 ml. Final visual acuity was R.E.: 6/15 (20/50), and L.E.: 6/6 (20/20). Neither patient received treatment for this disorder. The findings of cerebrospinal fluid cells and elevated protein levels in acute posterior multifocal placoid pigment epithelialopathy probably represent a mild viral meningitis as part of a systemic viral infection that also involves the retinal pigment epithelium or choriocapillaris.
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