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Biomedical subjects

W R Sundstrom

Publications and source records attributed to W R Sundstrom.

11 recordsLinked to original sources
PubMed1992

Neuropathologic findings in multi-infarct dementia associated with anticardiolipin antibody. Evidence for endothelial injury as the primary event.

OBJECTIVE: There are few reports describing histopathologic changes associated with the antiphospholipid antibody syndrome. We describe a patient with multi-infarct dementia and antiphospholipid antibody syndrome, in whom a brain biopsy was performed. METHODS: Biopsy material from the left frontal cortex, including meninges, cortex, and underlying subcortical white matter, was investigated. Microscopic examination and special staining were performed. RESULTS: Microscopic examination showed lumenal occlusion by thrombi, and marked endothelial hyperplasia of small meningeal and cortical arterioles. CONCLUSION: These findings suggest that the pathogenesis of this cerebral vasculopathy is noninflammatory and is associated with reactive endothelial hyperplasia and thrombosis of small arterioles.

Antibodies, Anticardiolipin↗
PubMed1991

Prosthesis-induced synovitis simulating villonodular synovitis.

Prosthetic arthroplasties are performed frequently in arthritic patients. The usual causes of prosthetic failures are loosening, infection, subluxation, or fracture. A 65-year-old man with total knee arthroplasty illustrates the complication of prosthetic synovitis developing 5 years after metal-polyethylene arthroplasty. Double contrast arthrography revealed nodular synovial filling defects. Arthrotomy and hematoxylin-and-eosin-stained histological sections of the synovium showed nonpigmented villonodular synovitis (VS). Giant cells and polyethylene particles were observed by polarized light within the synovium.

Aged↗
PubMed1991

Pneumocystis carinii pneumonia following corticosteroid therapy for giant cell arteritis.

Pneumocystic carinii pneumonia (PCP) is a well-recognized complication of immunodeficiency disorders. PCP has been reported in patients with connective tissue diseases, but most were on cytotoxic drugs. We report a case of PCP occurring in a patient with giant cell arteritis who was receiving high dose prednisone. To our knowledge this complication has not been previously reported.

Aged↗
PubMed1986

Low-dose weekly oral methotrexate therapy for inflammatory arthritis.

The efficacy and toxicity of low-dose, weekly oral methotrexate (MTX) therapy for inflammatory arthritis was evaluated. Fifty-nine patients with a diagnosis of inflammatory arthritis who had failed to respond to or developed toxicity to gold, penicillamine, or hydroxychloroquine therapy were treated with MTX 10-20 mg administered orally or intravenously once a week in divided doses. Various tests to assess arthritis were performed upon each patient's entrance into the study and at specified intervals throughout the 24-month study period. The mean duration of methotrexate therapy was 15.5 months. Patients showed significant improvement in number of swollen joints, duration of morning stiffness, amount of pain, and amount of activity during the study period. Of the 35 patients who had had roentgenographic studies of their hands performed initially and after one year of MTX therapy, 23 had no evidence of new joint erosions after one year. Biopsies of hepatic tissue from 20 patients showed no progressive changes when compared with pretreatment biopsies. Gastrointestinal symptoms, mucocutaneous lesions, or small increases in liver enzyme concentrations were observed in 31 patients; three patients developed pulmonary toxicity and had to be withdrawn from the study. MTX is an effective agent for the treatment of inflammatory arthritis in patients who do not respond to therapy with nonsteroidal anti-inflammatory drugs or slow-acting antirheumatic drugs. Short-term weekly oral MTX therapy does not appear to result in clinically important liver disease.

Administration, Oral↗
PubMed1985

Streptococcal myositis.

Two patients had streptococcal myositis. Both patients developed extensive muscle necrosis and overwhelming sepsis after trivial skin trauma. Death occurred within 48 hours of hospital admission despite aggressive surgical and medical treatment. Review of the literature is included to highlight the fulminant nature of this unusual infection and to contrast streptococcal myositis with other soft-tissue streptococcal infections.

Adult↗
PubMed1985

Use of biofeedback training in treatment of Raynaud's disease and phenomenon.

To assess biofeedback training in Raynaud's, we retrospectively reviewed 23 patients' records. Eleven had Raynaud's disease and 12 had Raynaud's phenomenon; 9 had recurrent digital ulcers. Patients demonstrated lower baseline digital temperatures than controls (p less than or equal to 0.001), patients with Raynaud's and scleroderma manifesting the lowest. After biofeedback training all patients elevated baseline temperatures. Patients with scleroderma and systemic lupus erythematosus had the greatest elevations. Improvement, both subjective (57%) and ulcers (44%), persisted one year after treatment. Four of 7 patients were capable of elevating digital temperatures within 5 min, 18 months after their last training session. These findings support biofeedback training as beneficial therapy in Raynaud's.

Arthritis, Rheumatoid↗
PubMedDate not supplied

A review of selected investigational nonsteroidal antiinflammatory drugs of the 1980s.

We reviewed the literature on 7 investigational nonsteroidal antiinflammatory drugs (NSAIDs): fenbufen, flurbiprofen, tiaprofenic acid, diclofenac, fenclofenac, etodolac and proquazone. These drugs all appear to be at least as effective as currently marketed NSAIDs. Toxicity reported with these newer agents is similar to that seen with other drugs in this class, with gastrointestinal complaints being most commonly reported. The frequency of gastritis and the extent of gastrointestinal microbleeding are less than what occur with aspirin therapy. Fenclofenac may affect thyroid function tests, an effect not noted with other NSAIDs. Proquazone and fenclofenac may have some effect on immunologic function similar to those of slow-acting antirheumatic drugs. These drugs decrease immunoglobulins, rheumatoid factor and C-reactive protein. The place for these drugs in the management of rheumatic diseases has yet to be defined. They may prove to be more beneficial than currently marketed drugs for some patients.

Acetates↗