Showing papers by "LAC+USC Medical Center published in 1992"

Polysaccharide encapsulated bacterial infection in sickle cell anemia: a thirty year epidemiologic experience.

Abstract: Annual age-specific incidence rates of Streptococcus pneumoniae or Haemophilus influenzae bacterial septicemia in sickle cell anemia (SS) were determined for the years of 1957 through 1989. Forty-nine patients had 64 episodes of septicemia among a population of 786 SS patients observed for 8,138 person-years. Peak frequency of infection occurred between 1968-1971 and 1975-1981 with a conspicuous absence of episodes in 1972, 1973, 1982-1984, and 1986-1987, thus demonstrating cycles of high and low attack rates. The annual age-specific incidence rate of septicemia varied from 64.5 (1965) to 421.1 (1980) per 1,000 person-years for those under 2 years of age and never exceeded 10.2 per 1,000 in those over 4 years of age. Following the introduction of pneumococcal polyvalent vaccine in 1978, incidence of infection decreased in SS children greater than 2 years of age. No modification of the risk of infection was observed in immunized children less than 2 years of age. During these three decades, there has been a ten-fold increase in the number of SS adults over 20 years of age. The relative risk of chronic sickle complications comparing the survivors of septicemia to the non-infected patients was: subsequent death 1.76, retinopathy 4.06, avascular necrosis 1.95, symptomatic cholelithiasis 1.33, stroke 1.30, and priapsim 1.26. These data suggest that prognosis for lifetime severe SS is initially manifested as an increased risk of septicemia during childhood.

Dynamic digitized cerebral parenchymography

Abstract: Aortic arch injections centred on the head have been performed routinely in patients with cerebral ischaemia. Digital angiograms with modified windowing (low and narrow) have been used. This "cerebral" arch injection allows much improved analysis of the cerebral parenchymal vascularization, giving better understanding of hemispheric ischaemia and making the decision about revascularization more rational.

Pleomorphic adenoma of the palate in a child.

Abstract: Pleomorphic adenoma of the palate is a rare entity in childhood. Only 4 cases of this lesion are documented in detail in the literature. We present a patient with this lesion and discuss the usefulness of magnetic resonance imaging (MRI) in the preoperative evaluation. A review of the previously reported cases is provided along with a discussion of the treatment of this lesion.

Case report 749

Abstract: We report a case of primary intraosseous glomus tumor in a 30-year-old man who was found to have an expanding, lytic lesion in the distal phalanx of his left thumb The histological appearance was atypical in that areas of myxoid stroma resembled chondroid material The unusual location and microscopic appearance caused diagnostic problems Immunohistochemical studies, including strong positive staining for MSA and negative staining for keratin and S-100 protein, were helpful in establishing the correct diagnosis

Pathology of pentamidine-induced pancreatitis.

Abstract: Extensive acute necrotizing pancreatitis occurred in three patients with the acquired immunodeficiency syndrome who had received both aerosolized pentamidine as prophylaxis and intravenous pentamidine for Pneumocystis carinii pneumonia. The clinical manifestations along with gross and microscopic pathologic findings at autopsy are presented.

Double-blind comparison of the clinical, hemodynamic, and electrocardiographic effects of sodium meglumine ioxaglate or iohexol during diagnostic cardiac catheterization.

Abstract: The clinical effects and the maximal hemodynamic and electrocardiographic effects of two low-osmolality radiographic contrast media (ioxaglate and iohexol) were directly compared during diagnostic cardiac catheterization in a double-blind, randomized study in 80 patients. Because small changes were expected after injection of both of these agents, sensitive ECG and intracardiac-pressure-monitoring methods were used, and maximal changes, as well as mean changes in variables, were analyzed. Symptoms were absent, mild, or moderate in 67-77% of patients after left ventriculography and in 97-100% of patients after coronary arteriography. After left ventriculography, maximum and minimum left ventricular systolic pressure and end-diastolic pressure, the first derivative of left ventricular pressure (dp/dt), heart rate, were significantly altered over the two-minute observation period but were not different from the preinjection values at two minutes after both agents. Small but significant increases in mean aortic pressure, cardiac output, and pulmonary arterial wedge pressures were seen at two minutes after both agents.

Umbilical inflammatory conditions: case report and differential diagnosis.

Abstract: Umbilical inflammatory conditions may result from a variety of congenital and acquired abnormalities, some of which may be life threatening. An understanding of the developmental anatomy of the umbilicus provides a basis for formulating an approach to both evaluation and treatment of these conditions. A case report is presented.

Hepatoerythropoietic porphyria in a woman with short stature and deformed hands.

Abstract: A 23-year-old woman from Honduras was diagnosed to have hepatoerythropoietic porphyria. She had photosensitive skin of early onset, hypertrichosis, and severe scleroderma-like lesions of the hands. Erythrocyte uropor-phyrinogen decarboxylase activity was reduced to about 10% of the normal activity. © Wiley-Liss, Inc.

Contrast injection around mandril wire of an Accustick system using an extension tubing: technical note.

Abstract: We describe a technique for injecting contrast material around a mandril wire of an Accustick™ access system through the outer 6 French sheath of this system, thus identifying the position of the wire. This is accomplished by using an extension tubing.