1/397. Chronic motor axonal neuropathy: pathological evidence of inflammatory polyradiculoneuropathy.Chronic immune and inflammatory motor neuropathies may resemble motor neuron disease, and the distinction may be particularly difficult if conduction block or GM1 antibodies are absent. The pathology of this axonal type of chronic motor neuropathy has not been characterized except in a few cases associated with paraproteinemia. We describe the clinical, electrophysiological, and pathological findings in a patient with a chronic motor axonal neuropathy, normal immunoelectrophoresis, and no GM1 antibodies. At autopsy the spinal cord was normal with the exception of chromatolytic motor neurons. All the ventral roots were greatly thinned. Of 10 mixed nerves and numerous spinal roots sampled, five showed areas of perineurial, perivascular lymphocytic infiltration. There was severe axonal loss in the motor roots that was not as evident in mixed nerves, and the sensory nerves and roots were virtually unaffected. Our findings suggest that a chronic motor axonal neuropathy without paraproteinemia or GM1 antibodies may, in some cases, result from an inflammatory process.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
2/397. Nodular fasciitis of the lower eyelid in a pediatric patient.PURPOSE: To describe a 14-year-old boy with a 1-month history of a rapidly growing, nontender, lower eyelid mass. methods: The specimen was studied using light microscopy. RESULTS: Although magnetic resonance imaging suggested a chronic vascular lesion, histopathologic analysis after excisional biopsy was consistent with nodular fasciitis. CONCLUSIONS: Nodular fasciitis is a relatively common soft-tissue lesion and represents a benign, reactive process. Lesions in the head and neck develop more frequently in children and adolescents than in adults, but periorbital lesions are uncommon. This is the first reported case of nodular fasciitis of the lower eyelid in a pediatric patient.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
3/397. Chronic toxic encephalopathy in a painter exposed to mixed solvents.This paper describes symptoms and findings in a 57-year-old painter who had been exposed to various organic solvents for over 30 years. He began to work as a painter at 16 years of age, frequently working in poorly ventilated areas; he used solvents to remove paint from the skin of his arms and hands at the end of each work shift. The patient and his family noticed impaired short-term memory function and changes in affect in his early forties, which progressed until after he stopped working and was thus no longer exposed to paints and solvents. After the patient's exposures had ended, serial neuropsychological testing revealed persistent cognitive deficits without evidence of further progression, and improvement in some domains. magnetic resonance imaging revealed global and symmetrical volume loss, involving more white than gray matter. The findings in this patient are consistent with chronic toxic encephalopathy and are differentiated from other dementing processes such as Alzheimer's disease, multi-infarct (vascular) dementia, and alcoholic dementia. Previous descriptions in the literature of persistent neurobehavioral effects associated with chronic exposure to organic solvents corroborate the findings in this case.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
4/397. Implantation of patients with prelingual long-term deafness.The purpose of this paper is to provide performance data on long-term congenitally and prelingually deafened children and adults who are implanted with the CLARION Multi-Strategy Cochlear Implant and who use the Continuous Interleaved Sampler (CIS) speech processing strategy. Open-set speech perception was assessed preoperatively and postoperatively with word and sentence recognition tests. Results indicate that a majority of subjects showed improvement from preoperative performance to the last available postoperative evaluation. These results represent a change from previously reported data on a similar population who used earlier speech processing strategies.- - - - - - - - - - ranking = 2keywords = process (Clic here for more details about this article) |
5/397. Ultrasonic characteristics of chronic atrophic pyelonephritis.Six cases of chronic atrophic pyelonephritis were studied with gray scale ultrasound. The findings are analogous to those seen pathologically, namely a focal or multifocal process with loss of renal parenchyma, retraction of one or more calyces, decrease in renal size, and increased echoes from fibrosis. In the proper clinical setting, the diagnosis of chronic atrophic pyelonephritis can be made using ultrasound technique.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
6/397. Care of the patient with interstitial cystitis: current theories and management.Interstitial cystitis is a disease process that has only come into focus over recent years. Researchers are looking for a cause of this painful and frustrating disorder of the bladder, but currently, only theories exist. nurses must understand the pathophysiology of the disease and the dysfunction of the bladder to educate and assist the patient in the management of this chronic process. This report provides the nurse with information and education on the symptoms, pathophysiology, nursing diagnoses, and potential treatment modalities.- - - - - - - - - - ranking = 2keywords = process (Clic here for more details about this article) |
7/397. Osteoid osteoma of the lateral talar process presenting as a chronic sprained ankle.Pathologic conditions of the lateral talar process may be difficult to diagnose using physical examination and roentgenographs. A computed tomography scan of the hindfoot is often useful to define lesions of the lateral process. We report a case of osteoid osteoma of the lateral talar process that defied diagnosis for 4 years. The patient had an antecedent history of an inversion injury, which had been treated as a chronically painful sprained ankle without resolution of symptoms. The tumor was ultimately identified on a computed tomography scan, best seen on a coronal section through the talus. The patient had complete relief of pain after excisional biopsy of the tumor.- - - - - - - - - - ranking = 7keywords = process (Clic here for more details about this article) |
8/397. Hyperaeration of the sphenoid sinus: cause for concern?A case of exuberant pneumatization of the left sphenoid sinus into the pterygoid process and floor of the middle cranial fossa is presented. The fact that pneumatization of the sphenoid sinus is frequently atypical is of clinical import because there is an intimate relationship between the contents of a hyperaerated sinus and adjacent vital facial and cranial structures. It is imperative that clinicians determine the location and extent of the walls of the sphenoid sinus and its relationship to adjacent vital structures whenever endoscopic sinus surgery is contemplated to avoid morbid consequences during surgery.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
9/397. Corneal stromal calcification after topical steroid-phosphate therapy.Secondary corneal calcification involving the full thickness of the stroma is a rare potential complication of severe dry eye conditions, recurrent corneal ulcerations, chronic ocular inflammation, or multiple surgical procedures. We describe on a patient with unusual, hitherto unreported calcareous degeneration of the corneal stroma after topical steroid-phosphate therapy for chronic keratoconjunctivitis after stevens-johnson syndrome. The patient's serum levels of calcium and phosphorus were normal. Histopathologic and electron microscopic examination of the corneal button revealed mainly intracellularly located crystalline calcium deposits throughout all layers of the corneal stroma but sparing the Bowman layer. Energy-dispersive x-ray analysis confirmed the presence of calcium phosphate. The calcium deposits were closely associated with intracellular and pericellular accumulations of glycosaminoglycans. Our findings indicate that corneal stromal calcification may develop after topical steroid-phosphate medication, and suggest a possible role of alterations in the glycosaminoglycan metabolism of stromal keratocytes in the calcification process.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
10/397. Maxillofacial osteonecrosis in a patient with multiple "idiopathic" facial pains.Previous investigations have identified focal areas of alveolar bone tenderness, increased mucosal temperature, abnormal anesthetic response, radiographic abnormality, increased radioisotope uptake on bone scans, and abnormal marrow within the quadrant of pain in patients with chronic, idiopathic facial pain. The present case reports a 53-year-old man with multiple debilitating, "idiopathic" chronic facial pains, including trigeminal neuralgia and atypical facial neuralgia. At necropsy he was found to have numerous separate and distinct areas of ischemic osteonecrosis on the side affected by the pains, one immediately beneath the major trigger point for the lancinating pain of the trigeminal neuralgia. This disease, called NICO (neuralgia-inducing cavitational osteonecrosis) when the jaws are involved, is a variation of the osteonecrosis that occurs in other bones, especially the femur. The underlying problem is vascular insufficiency, with intramedullary hypertension and multiple intraosseous infarctions occurring over time. The present case report illustrates the extreme difficulties involved in the diagnosis and treatment of this disease.- - - - - - - - - - ranking = 3.4838311780388keywords = alveolar (Clic here for more details about this article) |
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