11/13. Surgical treatment of lung cancer in patients with human immunodeficiency virus.BACKGROUND. Since January 1986, more than 20 patients have been seen at the University of Miami/Jackson Memorial Medical Center and the Miami veterans Administration Medical Center with concurrent human immunodeficiency virus infection and bronchogenic carcinoma. Four of these patients were treated surgically with curative intent. methods. The histories, records, operative reports, and pathology reports of the 4 patients were reviewed. RESULTS. The 4 surgically treated patients had stage I T1 N0 M0 lung cancer. Three patients had T4 cell counts of less than 200/microL and were managed by lobectomy. These patients died 5, 3 1/2, and 5 months postoperatively. More recently, a fourth patient had a T4 cell count of 963/microL and was treated with wedge resection. He is currently alive 12 months postoperatively. CONCLUSIONS. It is concluded that surgically treated patients with lung cancer, human immunodeficiency virus infection, and T4 cell counts lower than 200/microL have high mortality and morbidity. Although it may be best to base surgical intervention on the stage of the patient's human immunodeficiency virus infection, further analysis is essential to determine which subgroup of human immunodeficiency virus-positive patients, if any, would benefit from surgical treatment of lung cancer.- - - - - - - - - - ranking = 1keywords = deficiency (Clic here for more details about this article) |
12/13. Small bowel intussusception and brown bowel syndrome in association with severe malnutrition.Brown bowel syndrome is a rare condition characterized by deposition of lipofuscin in the smooth muscle cells of the gastrointestinal tract. The number of reported cases is small, but all are associated with malabsorptive states. Despite these small numbers, there is considerable evidence that vitamin e deficiency is important etiologically. We report here the case of a severely malnourished [body mass index 11.7 kg/m (2): normal range 20-25 kg/m (2)] 31-yr-old black male with a longstanding history of alcohol abuse, who was on anti-tuberculosis therapy. The patient presented with an acute abdomen and was found, at operation, to have a mid-ileal intussusception. Histological examination of the resected specimen demonstrated lipofuscin accumulation consistent with brown bowel syndrome, but no tumor. Subsequent investigations revealed no significant quantities of vitamin E in the blood and pancreatic steatorrhea. However, deficiency of other fat-soluble (vitamin a and D) and water-soluble vitamins (vitamin C and thiamine) also were detected. This report supports the association of brown bowel syndrome with vitamin e deficiency but cannot exclude the compounding effects of protein calorie malnutrition, multiple vitamin deficiencies, and chronic alcohol toxicity.- - - - - - - - - - ranking = 0.375keywords = deficiency (Clic here for more details about this article) |
13/13. Perforation of the jejunum secondary to AIDS-related gastrointestinal Kaposi's sarcoma.intestinal perforation in human immunodeficiency virus-positive patients due solely to Kaposi's sarcoma (KS) has rarely been described. A homosexual man with acquired immunodeficiency syndrome-related KS who presented with an acute abdomen is presented. He was found to have a jejunal perforation through a small KS lesion. There were no infectious organisms identified at the site of perforation.- - - - - - - - - - ranking = 0.25keywords = deficiency (Clic here for more details about this article) |
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