1/34. chylothorax in hairy cell leukemia.A case of postoperative left chylothorax in a 43-year-old black woman with hairy cell leukemia is reported. First submitted to pleural drainage, she was successfully treated with a combination of chemotherapy and elemental enteral diet enriched with medium-chain triglycerides.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
2/34. Postoperative pressure-induced alopecia: report of a case and discussion of the role of apoptosis in non-scarring alopecia.We report a case of postoperative pressure induced alopecia in a 21-year-old black female after multiple intraoperative procedures. The histopathology is distinctive and demonstrated features in common with trichotillomania and alopecia areata, including the presence of pigment casts, catagen follicles, melanophages and apoptotic bodies. External hair manipulation is considered the primary event in the etiology of pigment casts, however, our present case demonstrated numerous pigment casts despite a complete lack of evidence of external hair manipulation. We performed pattern analysis and in situ end-labeling in 19 cases of non-scarring alopecia. Pigment casts were seen in postoperative alopecia (1 case), alopecia areata (1 case) and trichotillomania (5 cases). These forms of alopecia have in common the sudden termination of the anagen phase of the hair cycle. When the anagen portion of the hair cycle is prematurely disrupted hairs enter into catagen. Pigment casts may represent a non-specific reaction pattern of follicles that are suddenly transformed from anagen to catagen. We therefore propose that hair manipulation is not uniquely responsible for the formation of pigment casts. The primary pathophysiology resulting in the formation of pigment casts more correctly reflects the sudden termination of the anagen phase of the hair cycle.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
3/34. ochronosis: an unusual finding at aortic valve replacement.The condition known as ochronosis refers to the accumulation of oxidized homogentisic acid in the connective tissues of alkaptonuric patients. The diagnosis is usually made from the triad of degenerative arthritis, ochronotic connective tissue pigmentation and urine that turns dark brown or black on alkalinization. Cardiovascular disease is a less well appreciated aspect of this disorder. A patient with ochronosis of his stenotic aortic valve is reported. The role of the pigment in the genesis of the valve degeneration is discussed.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
4/34. Black esophagus: a view in the dark.A 73-year-old man had a low anterior resection for a villous adenoma in the rectosigmoid. On the 4th day after surgery, he suddenly developed severe interscapular pain. Aortic dissection was ruled out, but endoscopy showed black mucosa of the entire esophagus. With conservative treatment, including proton pump inhibition, he recovered completely. We hypothesize that a transient gastric outlet obstruction and massive gastroesophageal reflux played a significant role in the etiology of this rare and alarming, but, in this case, completely reversible, syndrome.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
5/34. Atypical presentation of madurella mycetomatis mycetoma in a renal transplant patient.A renal transplant patient presented with a swelling on his foot. Fungal hyphae were found in the abscess, and culture demonstrated madurella mycetomatis, an agent of mycetoma. There were no black grains in the pus and no overlying sinuses. This was an atypical presentation of maduromycosis in a renal transplant patient.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
6/34. Spread of a pharyngeal cancer to the abdominal wall after percutaneous endoscopic gastrostomy.Percutaneous endoscopic gastrostomy is frequently used in patients with head and neck cancer to establish enteral access for feeding. Spread of head and neck cancer to the gastrostomy site is a rare but increasingly reported complication after percutaneous endoscopic placement. We report the 13th such case in the literature, occurring in a 51-year-old black man with squamous cell carcinoma of the hypopharynx. The mode of tumor spread to the gastrostomy site remains debatable. Evidence exists for hematogenous dissemination and direct implantation. We think percutaneous endoscopic techniques for enteral access in this patient population are contraindicated, and we advocate a laparoscopic approach for gastrostomy placement.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
7/34. Acute scleral thinning after pterygium excision with intraoperative mitomycin C: a case report of scleral dellen after bare sclera technique and review of the literature.PURPOSE: To describe a patient with scleral dellen after pterygium excision with intraoperative mitomycin C. methods: Case report and medline review of the medical literature on scleral dellen after bare sclera technique. RESULTS: A 48-year-old man had a left nasal pterygium excised by the bare sclera technique with intraoperative mitomycin C. Eight days after surgery, the patient noticed a small black spot in the bare sclera area with mild irritation. Slit-lamp examination revealed a focal area of extreme thinning, centered on the nonepithelialized bare sclera, surrounded by edematous conjunctiva. The ciliary body was visible through the thin and dry scleral lesion. After topical lubricant therapy, the scleral lesion appeared normal thickness and white in color 3 days later. Therapy was continued until the sclera epithelialized. CONCLUSIONS: Scleral dellen is an early postoperative complication of bare sclera technique owing to delayed conjunctival wound closure. Hydration of the thinned sclera will rapidly thicken it. However, medical therapy should be continued until the surrounding conjunctiva has flattened and the sclera has epithelialized. Surgical wound closure is an alternative management and may be the way to prevent scleral dellen formation after bare sclera technique. All patients after bare sclera surgery should be followed up until the conjunctival wound has healed. If delayed healing is found, frequent artificial tears, patching, or surgical intervention is necessary.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
8/34. Black holes on MR images of the brain of patients with Bjork-Shiley heart valves: additional observation in three cases.We report the cases of three patients with Bjork-Shiley convexo-concave heart valves with unusual black holes shown on cerebral MR images. For two patients, these findings were associated with fracture of the Bjork-Shiley convexo-concave heart valve, and for the third, with worn surfaces on the heart valve. Susceptibility changes shown by MR imaging suggest the possibility that these black holes may be associated with microscopic metallic particles, although, the exact cause of these black holes remains undetermined.- - - - - - - - - - ranking = 3keywords = black (Clic here for more details about this article) |
9/34. keloid formation in a simple syndactyly release: a case report.keloid formation on the palms of the hands and soles of the feet is rare. A keloid developed 2 months after release of simple syndactyly in a young black child. The process of keloid formation is not completely understood, and surgical correction is not effective.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
10/34. renal artery false aneurysm. An unusual complication of prosthetic patch angioplasty.False aneurysm formation in a twenty-nine year old black woman treated for renovascular hypertension secondary to fibromuscular hyperplasia by knitted Dacron prosthetic patch angioplasty is reported. Etiologic mechanisms are discussed. The most likely factors leading to false aneurysm formation in this patient are disproportionate compliance between the arterial wall and the prosthesis and increased rigidity of the prosthesis, associated with increased shearing and vibratory stress. This patient was treated successfully by resection of the prosthetic path and involved artery with end-to-end reanastomosis of the artery.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
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