Biomedical subjects
Publications and source records attributed to S A Chillag.
The unusual soft tissue tumor we have described may be the largest yet reported. The tumor was considered benign, and its histologic features were most consistent with fibromatosis arising in a region that had been previously traumatized. Although the patient is doing well, it is premature (2 years later) to conclude that the tumor will not recur.
This study shows that conduction abnormalities may occur frequently in Reiter's syndrome of new onset or short duration. Since these conduction defects may be initially life threatening or may progress to life-threatening abnormalities, anyone with RS should be followed up. Because of the strong association between RS and HIV infection, we suggest HIV testing for all patients with RS. Anyone with RS should have an electrocardiogram, either to study symptoms or as a baseline if no symptoms exist.
Left atrial enlargement is a significant finding, usually indicating elevated left ventricular end-diastolic pressure. An increased tracheal carinal angle has been reported as one indicator on chest radiography of left atrial enlargement. This study retrospectively compared echocardiographically determined left atrial size with carinal angle on plain films. Enlarged left atria and paired, age-matched normal left atria by echocardiography were selected. The carinal angle was measured on roentgenogram (standard and portable films) by goniometer. The left atrium could be accurately predicted to be larger than 5.0 cm in diameter if the carinal angle was 100 degrees or greater. A carinal angle greater than 100 degrees is an easy, inexpensive, reliable method of predicting left atrial enlargement.
The current increased participation in long distance running and endurance events brings new challenges to the physician. Adaptive changes of exercise must be differentiated from disease states. Left ventricular hypertrophy, Wenckebach rhythm, elevated creatine kinase (myocardial fraction), gastrointestinal bleeding, hematuria, hemoglobinuria, amenorrhea, and apparent anemia may all be exercise related. New syndromes have arisen--from "runner's high" to athletic amenorrhea. These dedicated athletes can be difficult patients. They are highly motivated and will continue training despite significant pain and danger of permanent damage. Speaking their language--carbohydrate loading, "the bonk," "slow twitch," "the wall"--is helpful in their treatment. Traditional health problems are less likely to bring the fitness addict to the physician than some new and peculiar disorders.
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