1/68. The cystic fibrosis conductance regulator gene exon sequence is normal in a patient with edematous eosinophilic nasal polyps.nasal polyps are the most common mass lesions found in the nose and their etiology is unknown. nasal polyps from cystic fibrosis (CF) patients are histologically distinct from nasal polyps from patients without CF. It has been suggested that a mutation (G551D) of the cystic fibrosis transmembrane conductance regulator (CFTR) gene may play a role in nasal polyp formation in patients without CF. To investigate the possibility that this or other CFTR gene exon mutations are required for nasal polyp formation, the CFTR gene exons were sequenced from peripheral blood dna derived from an adult patient with edematous eosinophilic nasal polyps and no personal or family history of CF. No mutations or deletions were identified in any of the CFTR exons. A single polymorphism (A or G) was found in exon 10, base pair 1540, amino acid 470. This polymorphism was detected in 11 of 16 subjects (69%) with edematous eosinophilic nasal polyps and 10 of 21 normal subjects (48%) without nasal polyps and was not statistically significant (p = 0.316). These results demonstrate that mutations of the CFTR coding region are not a prerequisite for the formation of edematous eosinophilic nasal polyps.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/68. Gingival telangiectases: an underappreciated physical sign of juvenile dermatomyositis.BACKGROUND: medline searches (1966-June 1969) failed to identify references that give detailed descriptions of the oral manifestations of dermatomyositis (DM). However, several reports predating medline provided more complete descriptions of oral lesions associated with DM. OBSERVATIONS: We describe 5 cases of juvenile DM with oral manifestations, primarily in the form of gingival telangiectases. These findings are compared with those descriptions found in earlier reports. CONCLUSIONS: Oral lesions in juvenile DM have rarely been reported. mucous membrane involvement associated with DM may include telangiectases, edema, erosions, ulcers, and leukoplakia-like areas. In cases of DM, gingival telangiectases likely represent an underappreciated diagnostic finding analogous to nail-fold telangiectases.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
3/68. Conjunctival edema and alopecia of the external third of the eyebrows in a patient with meige syndrome.PURPOSE: To describe a patient with meige syndrome in whom we observed the coexistence of hereditary lymphedema of the lower legs, conjunctival edema and alopecia of the lateral third of the eyebrows. methods: Case report. RESULTS: Histological examination of the conjunctival and skin specimens showed dermal edema and a slight reduction in the number of severely ectatic lymphatics in the reticular dermis. The vessel were identified as lymphatics on the basis of immunohistochemical evidence of discontinuity and/or absence of basement membrane. CONCLUSIONS: Clinical and histological findings suggest that the etiopathogenesis of the edema in meige syndrome is related to a structural ectatic defect of lymphatics. This anomaly seems to involve both skin and other sites, such as conjunctival mucosa.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
4/68. vibrio vulnificus infection complicated by acute respiratory distress syndrome in a child with nephrotic syndrome.A 9-year-old girl with nephrotic syndrome visited a local hospital after developing fever, chills, and edematous changes and multiple hemorrhagic bullae on both legs over 2 days. Cultures of blood and an aspirate from the bullae yielded vibrio vulnificus. The patient was transferred to our hospital because of persistent fever, generalized edema, acute renal failure, and disseminated intravascular coagulopathy. We treated this patient as a V. vulnificus infection complicated with necrotizing fasciitis. With minocycline and ceftazidime combination therapy was instituted. Emergency fasciotomy and continuous peritoneal dialysis were performed. The patient developed acute respiratory distress syndrome (ARDS) during the hospitalization, requiring intubation and mechanical ventilation. She eventually died. The histopathological findings showed diffuse alveolar damage with lobular pneumonitis. Hyaline membranes, composed of proteinaceous exudate and cellular debris, covered the alveolar surfaces. Microscopic examinations of lung could not distinguish the effects of cytolysin from other insults to lungs that occur in ARDS. This report highlights the postmortem pathological findings in V. vulnificus infection in a child with nephrotic syndrome complicated by ARDS.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
5/68. Remitting asymmetrical pitting oedema in systemic lupus erythematosus: two cases studied with magnetic resonance imaging.To our knowledge, only three cases of remitting symmetrical pitting oedema in systemic lupus erythematosus have been reported so far. This is the first report of two patients with asymmetrical pitting oedema and systemic lupus erythematosus. The first patient presented two consecutive episodes of unilateral oedema. The first episode involved the distal part of the right lower extremity and remitted spontaneously while the second involved the volar region of the left wrist and distal half of the forearm and promptly responded to steroids. magnetic resonance imaging of the left wrist and forearm showed tenosynovitis of the flexor tendons and subcutaneous oedema. The second patient instead developed a single episode of pitting oedema of the distal part of the right lower extremity that resolved spontaneously. magnetic resonance imaging of the right ankle and foot showed subcutaneous oedema without involvement of the tendon sheaths or osteoarticular and ligamental structures. These two cases suggest that pitting oedema in systemic lupus erythematosus may occasionally be asymmetric and associated or not with tenosynovitis.- - - - - - - - - - ranking = 3.1672061409273keywords = ligament (Clic here for more details about this article) |
6/68. chondrocalcinosis in an isolated suprapatellar pouch with recurrent effusion.We report the case of a 45-year-old man with a long history of chondrocalcinosis and recurrent painless suprapatellar swelling. Over the 3 months before his admission, the swelling had become persistent and extended 10 cm proximal to the patella on the anterior aspect of the thigh. magnetic resonance imaging revealed an enlarged suprapatellar pouch that was completely separated from the knee joint cavity by a suprapatellar membrane. Arthroscopic treatment consisted of complete removal of the membrane, creating a passage to the articular cavity, and debridement of the synovial calcifications. The patient was followed-up postoperatively for 2 years and no recurrence of the swelling was reported during this period of time. Two potential mechanisms might have been responsible for the persistent swelling: (1) chondrocalcinosis led to effusion of a suprapatellar pouch that was originally isolated from the knee joint cavity, or (2) the suprapatellar pouch was separated from the knee joint cavity as a result of an incomplete involuted suprapatellar plica that became adherent during recurrent inflammation due to chondrocalcinosis.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
7/68. Lamellar macular hole: a complication of cystoid macular edema after cataract extraction.A woman developed an inner lamellar macular hole and cellophane maculopathy as a complication of chronic cystoid macular edema following cataract extraction. fluorescein angiography revealed a cystoid pattern of fluorescence in the paracentral area but no evidence of staining in the region of the hole. Following death, histopathologic examination of both eyes confirmed the clinical observations. Biomicroscopic examination and fluorescein angiography are of value in differentiating an inner lamellar macular hole from a full-thickness macular hole and from a pseudomacular hole caused by spontaneous contraction of an epiretinal membrane.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
8/68. corneal edema resolution after "descemetorhexis".A 79-year-old woman had left eye phacoemulsification complicated by inadvertent excision of Descemet's membrane (DM). One day postoperatively, the visual acuity was counting fingers with diffuse corneal edema. The patient was treated medically, with gradual resolution of the corneal edema over a 6-month period. The torn edge of DM could be visualized as the edema cleared, and no endothelial cell count could be obtained centrally. Approximately 1 year postoperatively, the central endothelial cell count was 2114 cells/mm(2) in the right eye and 827 cells/mm(2) in the left eye. The decreased cell count, increased polymegethism, and pleomorphism suggested that endothelial cells migrated to cover the stromal surface area in the absence of DM.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
9/68. 99mTc-HDP pinhole SPECT findings of foot reflex sympathetic dystrophy: radiographic and MRI correlation and a speculation about subperiosteal bone resorption.reflex sympathetic dystrophy (RSD) is a common rheumatic disorder manifesting painful swelling, discoloration, stiffening and atrophy of the skin. Radiographic alterations include small, spotty subperiosteal bone resorption (SBR) and diffuse porosis, and MR imaging shows bone and soft-tissue edema. The purposes of current investigation were to assess 99mTc HDP pinhole SPECT (pSPECT) findings of RSD, to correlate them with those of radiography and MRI and to speculate about causative mechanism of SBR which characterizes RSD. pSPECT was performed in five patients with RSD of the foot. pSPECT showed small, discrete, spotty hot areas in the subperiosteal zones of ankle bones in all five patients. Diffusely increased tracer uptake was seen in the retrocalcaneal surface where the calcaneal tendon inserts in two patients with atrophic RSD. pSPECT and radiographic correlation showed spotty hot areas, that reflect focally activated bone turnover, to closely match with SBR. Further correlation with MRI showed both spotty hot areas and SBR to coincide in location with the insertions of ligaments and tendons, onto which pulling strain is constantly exerted. In contrast, the disuse osteoporosis in unstrained bones did not show any more significantly increased tracer uptake than normal cancellous bones.- - - - - - - - - - ranking = 3.1672061409273keywords = ligament (Clic here for more details about this article) |
10/68. gastric outlet obstruction by an antral mucosal diaphragm: a case of a congenital anomaly revealed by an acquired disease.Congenital antral membrane may become symptomatic early in life or late in childhood. A gastric outlet obstruction was revealed in a 14-month-old girl, previously developing well until 3 days ago, by melaena and recurrent non-bilious vomiting, after administration of a non-steroidal anti-inflammatory drug for fever. Plain X-ray performed during the neonatal period was normal. Despite ultrasonography, contrast radiography and endoscopy, the correct diagnosis was made at surgery; the obstruction was due to an inflammatory, thickened membrane with mucosal oedema reducing the central aperture of the diaphragm. This case emphasizes that if antral membrane diaphragm is congenital, the onset of symptoms may result from an additional acquired lesion.- - - - - - - - - - ranking = 3keywords = membrane (Clic here for more details about this article) |
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