1/9. Giant uterine tumors: two cases with different clinical presentations.BACKGROUND: Giant uterine tumors are uncommon. However, they may be life threatening because of pressure effects on the lungs and other adjacent organs. Proper surgical management and careful perioperative care are essential to assure a good outcome after excision. CASE: Two women with giant uterine leiomyomata (weighing more then 40 kg [88 lb]) are discussed. In one case the leiomyoma led to severe pulmonary hypertension and respiratory failure necessitating an emergency operation. Abdominal hysterectomy and bilateral salpingo-oophorectomy were successfully carried out in both cases, which are among the largest tumors ever removed with survival of the patient. CONCLUSION: Different clinical manifestations can be expected in cases of giant uterine tumors according to which other organs are secondarily affected. Numerous difficulties may be encountered in the evaluation and removal of these tumors. A combined team consisting of gynecologic, general, and plastic surgeons is necessary for a successful outcome.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
2/9. poems syndrome caused refractory ascites in a polycystic disease patient undergoing hemodialysis.A 60-year-old man with polycystic disease (PCD) undergoing hemodialysis was admitted to our hospital because of refractory ascites in September 2000. He had been diagnosed with probable chronic inflammatory demyelinating polyradiculopathy 6 months before admission. Though the ascites was bloody and exudative, the cytology was normal and cultures of bacteria and acid-fast bacillus were both negative. Hepatic venous outflow obstruction was excluded by several radiological examinations. Because of the presence of polyneuropathy, organomegaly, endocrine abnormality, M-protein, plasma cell dyscrasia, and skin lesions, POEMS, syndrome was diagnosed; this had caused the refractory ascites. Initial prednisolone therapy was effective for the refractory ascites, but it was not effective in preventing recurrence. He died due to cachexia in December 2000. This is a very rare case of the presence of both PCD and poems syndrome in a patient.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
3/9. Anomalous coronary artery in a transplanted heart: a technical modification.We report the case of a 47-year-old man who underwent orthotopic heart transplantation for valvular cardiomyopathy. At the time of cardiac catheterization we identified an anomalous origin of the donor left main coronary artery from the right coronary sinus of valsalva. To decrease the risk of left main coronary artery compression during re-implantation of the transplanted heart, we performed a careful geometric arrangement of the aortopulmonary artery angle. This simple technical modification suggests that a heart with an anomalous left coronary artery may be safely used for organ donation.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
4/9. An atypical case of poems syndrome with IgG kappa M protein and end stage renal failure.poems syndrome is a rare plasma cell dyscrasia which is characterized by small amounts of monoclonal protein, and a multisystem complex manifested by various combinations of polyneuropathy, organomegaly, endocrinopathy and skin changes. Here, we presented an atypical case of poems syndrome with IgG kappa monoclonal protein, chronic demyelinating polyneuropathy, hepatosplenomegaly, hypothyroidism, gynecomastia and severe renal impairment. The finding of IgG kappa type of monoclonal protein in our patient was interesting because the majority of cases were reported to have lambda light chain. Also, the absence of typical skin and bone lesions were atypical. Though speculative, these atypical features may account for the unusual presentation of this case. Our patient rapidly progressed to end-stage renal failure and died of cachexia. Renal involvement in poems syndrome is rare but may show substantial clinical and pathological variations. proteinuria, hematuria, renal dysfunction and renal failure requiring hemodialysis can be seen. The pathogenesis of renal dysfunction is unclear. As a conclusion, poems syndrome may present with diverse clinicopathologic manifestations. In this syndrome, renal involvement may lead to end stage renal failure and the course may be fatal due to severe polyneuropathy and wasting.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
5/9. High concentrations of organochlorines in a patient with kidney cancer and anorexia-cachexia syndrome.PURPOSE: To determine persistent organic pollutants in adipose tissue in a patient with kidney cancer. methods: adipose tissue was sampled from the abdominal wall during autopsy of a 75-year old man who had died from a kidney cancer. The concentrations of polychlorinated biphenyls (PCBs), p,p'-dichlorodiphenyltrichloroethane (DDE), hexachlorobenzene (HCB), chlordanes and tetrabromodiphenyl ether (TeBDE) were determined on lipid basis. For comparison results from 29 male population based subjects aged 70-80 years were used. RESULTS: All concentrations except for TeBDE were very high in the patient; sum of PCBs 18 808 ng/g fat (median for controls 997), DDE 14 183 (median for controls 751), HCB 424 (median for controls 46), and sum of chlordanes 2 389 (median for controls 62). The patient lost weight from 80 kg to 48 kg when he died, which may have contributed wholly or partly to the very high concentrations of organochlorines. CONCLUSION: Changes in weight must be recorded in cancer patients and the concentrations of persistent organic pollutants should be normalized to weight. The concentrations in this patient were 10- to almost 40-times higher than in the controls. Such very high concentrations may give clinical symptoms in the final stage of a wasting cancer patient.- - - - - - - - - - ranking = 3.5keywords = organ (Clic here for more details about this article) |
6/9. Clinical experiences with beta adrenergic blocking therapy on burned patients.The cachexy which appears in the toxicoseptic phase of burn injuries can be prevented by the regular use of beta-adrenergic blocking drugs. This therapy is based upon data which maintain that the burned organism passes through a beta-modulated adrenergic receptor state as a result of the endocrine changes taking place between the 3rd and the 5th post-burn day. The author describes his own positive experiences of beta-adrenergic blocking therapy. The possible contra-indications (obstructive lung diseases, shock) to this therapy are discussed. Finally he draws attention to some of the side effects which were observed (E.C.G. conduction disturbances).- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
7/9. The Groll-Hirschowitz syndrome.Two sisters showed a similar disorder with cachexia, sensory deafness, and upper gastrointestinal abnormalities. The family pedigree suggests autosomal recessive inheritance of the disorder. Demyelinization demonstrated by a peripheral nerve biopsy may explain the basis for the manifestations. Only one family with this unique syndrome has been reported in the literature. The term "The Groll-Hirschowitz Syndrome" has been suggested, named after the two physicians who first described this condition.- - - - - - - - - - ranking = 2.5871554492857keywords = nerve (Clic here for more details about this article) |
8/9. Latrogenic lipidosis following prolonged intravenous hyperalimentation.Intralipid was used as the main source of calories in the long-term therapy of a patient with severe nutritional failure and cachexia. The treatment was tolerated well for 64 days. The patient died of sepsis after a second therapeutic course which lasted 16 days adn was preceded by an impairment in liver function apparently related to starvation. At autopsy, free fat droplets and extreme foamy swelling of the cytoplasm of the reticuloendothelial cells were found in all examined organs. These findings constitute an unusual example of iatrogenic lipidosis. It is suggested that caution be exerted in the administration of Intralipid to patients with impaired liver function and that serum lipids be maintained regularly during therapy.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
9/9. Delayed radiation-induced bulbar palsy.We report a man with a slowly progressive bulbar palsy 14 years after radiation therapy for nasopharyngeal carcinoma. electromyography demonstrated prominent myokymic and neuromyotonic discharges in muscles innervated by the lower cranial nerves. Late effects of radiation therapy can occur in the cranial nerve musculature that are similar to well-recognized syndromes affecting the brachial plexus and spinal cord.- - - - - - - - - - ranking = 5.1743108985715keywords = nerve (Clic here for more details about this article) |