1/103. Treatment of protein-losing gastropathy with atropine.Protein loss from the gastric mucosa with hypertrophic gastric folds and hypoalbuminemia has been associated with low, normal and elevated gastric acid output. A case of protein-losing gastropathy with slightly elevated gastric acid output is described. Associated findings were hypertrophic gastric folds, hypoalbuminemia, hyperlipidemia, lymphadenopathy, edema, ascites and venous thrombosis. Oral administration of atropine resulted in a cessation of gastrointestinal protein loss and correction of hypoalbuminemia.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
2/103. 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 = 0.75381821889636keywords = membrane (Clic here for more details about this article) |
3/103. 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 = 0.75381821889636keywords = membrane (Clic here for more details about this article) |
4/103. 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 = 1.7538182188964keywords = mucosa, membrane (Clic here for more details about this article) |
5/103. 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 = 0.75381821889636keywords = membrane (Clic here for more details about this article) |
6/103. granular cell tumor of the hypopharynx treated by endoscopic CO(2) laser excision: report of two cases.BACKGROUND: granular cell tumor (GCT), or Abrikossoff's tumor, is an unusual lesion probably arising from schwann cells. It is frequently found in the head and neck region, where the tongue is the most commonly affected site. Involvement of the hypopharynx is exceedingly rare because, to the best of our knowledge, only four cases have been reported in the literature. methods: We describe hypopharyngeal GCT in two women aged 29 and 52 years, respectively. RESULTS: In the first patient, preoperative diagnostic examination, including endoscopy, CT, and MRI scan, was suggestive of a benign lesion arising from the posterior wall of the hypopharynx. In the second patient, a previous biopsy of the postcricoid area performed elsewhere suggested a diagnosis of well-differentiated squamous cell carcinoma, and CT scan staged the lesion as T1 N0. In both cases, treatment included surgical excision under microlaryngoscopy with CO(2) laser. The histopathologic study of the specimens, supported by immunohistochemical techniques, determined the lesions to be a GCT. The postoperative course was uneventful, and the patients were discharged 12 and 2 days after surgery, respectively. Both patients were asymptomatic without evidence of recurrence when last seen 2 years and 4 months after surgery, respectively. CONCLUSIONS: GCT should be included in the differential diagnosis of submucosal hypopharyngeal lesions. endoscopy and radiologic imaging do not display any typical finding suggestive of the diagnosis, which can be based only on histologic findings. Resection of the tumor, when technically feasible, should be performed under microlaryngoscopy with the CO(2) laser, which makes it possible to work in a bloodless field with minimal thermal damage and reduction of scarring and postoperative edema.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
7/103. Orofacial granulomatosis with gingival onset.BACKGROUND, AIMS: Orofacial granulomatosis (OFG) is a descriptive term used for granulomatous disorders of the face and oral cavity that may occur for a variety of reasons, some of which result in significant morbidity and mortality. Although rarely, a granular enlargements of the gingiva may be the first clinical manifestation of OFG, preceding other local or systemic manifestations. METHOD: We will report a case of OFG that showed an atypical and monosymptomatic onset with a generalized hyperplastic gingivitis that preceded other facial and mucosal features by several weeks. RESULT: Considering the variable clinical onset of OFG and its apparent increase in incidence, we emphasize that in some cases, the periodontologist, as first consulted health care professional, plays an important role to detect this disorder. early diagnosis of OFG is a crucial step to prevent and cure its unsightly sequelae and sometimes avoid progression of systemic potentially life-threatening OFG-related diseases. CONCLUSION: Thus, when none of the common causes of gingival enlargement can be detected, OFG diagnosis should be suspected.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
8/103. Dissolving foreign bodies in the trachea and bronchus.Two young children inhaled sweets which dissolved in the tracheobronchial secretions and caused severe respiratory obstruction. The viscid fluid produced as the sweet dissolved was not expectorated and bronchoscopy was necessary. The oedema of the mucosa caused by the presence of a hyperosmolar sugar solution took up to 48 hours to resolve; antibiotics and steroid cover were considered necessary. The similarity of presentation with acute tracheobronchitis and the lack of reports in the literature suggest that such cases may be misdiagnosed.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
9/103. 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 = 1.5076364377927keywords = membrane (Clic here for more details about this article) |
10/103. Edema due to protein-losing enteropathy--a disorder rarely considered by nephrologists.In the differential diagnosis, protein-losing enteropathy (PLE) is a rarely considered explanation of edema. Three such cases are reported in this article. Clinical presentations varied from severe generalized anasarca and respiratory distress to mild pitting edema on the pretibial surface. hypoalbuminemia (< 35 g/l) was another common finding in addition to edema. The patients were carefully examined to exclude other causes of hypoalbuminemia. Two patients experienced diarrhea. Endoscopic studies (plus biopsies) for any mucosal lesion in the stomach and colon were also performed. PLE was confirmed by the positive radionuclide scanning results after infusing intravenous 99mTc human serum albumin (USA). Investigation for the etiologies showed intestinal lymphangiectasia in 1 patient, Menetrier's disease in another, and no recognizable cause in the third. The severe anasarca of the patient with intestinal lymphangiectasia didn't respond to corticosteroids and albumin supplement plus large doses of furosemide. She died of overwhelming pulmonary infection despite the use of powerful antibiotics (ceftriaxone and amikacin). We planned to treat the Menetrier's disease patient with somatostatin to decrease the exocrine activities of the intestinal tract. The patient with presumable idiopathic PLE had the least severe edema and was not treated with any medication. In addition to the above patients, another 3 patients with hypoalbuminemia and edema were also noted to have positive HSA scan results. However, 2 of these patients had systemic lupus erythromatosus and the third pulmonary tuberculosis and biopsy-proven membranous nephropathy. Treatment of their underlying diseases showed satisfactory remission of edema.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
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