Thoracic and Cardiovascular Imaging Manifestations of Lupus.

Systemic lupus erythematosus (SLE), commonly referred to as lupus, is a widely prevalent chronic autoimmune disease that can affect any organ system in the body. Although the pathogenesis of this disease is rather complex and poorly understood, ultimately there is an overproduction of multiple self-reactive antinuclear antibodies. These autoantibodies are one of the laboratory hallmarks of the diagnosis and disease activity of SLE.

Primary aortogastric fistula after nissen fundoplication: a case report and review of pertinent literature.

Aortogastric fistulas are a rare but usually fatal entity that presents as an acute gastrointestinal bleeding. The authors present the case of a 65-year-old man who had undergone a Nissen fundoplication and presented in the emergency room with syncope secondary to massive upper gastrointestinal tract bleed. Despite aggressive resuscitation and prompt operative intervention with repair of the gastric ulcer and closure of the aortic side of the fistula, he succumbed to the complications of hypovolemic shock.

Type of affirmative action policy: a determinant of reactions to sex-based preferential selection?

In 3 studies, 150 undergraduates and 75 MBA students, men and women, were exposed to selection policies differing in the degree to which merit and group membership were weighted in selection decisions involving women. Results indicated that in self-views and self-assessments of beneficiaries (Study 1), competence perceptions on the part of others (Study 2), and work-related reactions of nonbeneficiaries (Study 3), many, but not all, negative reactions to sex-based preferential selection were alleviated when the policy made clear that merit considerations were central to the decision-making process. In the absence of information about policy type, participants acted as if merit had not been a factor in preferential selection decisions.

Increased colonic motility during exposure to a stressful situation.

Colonic smooth muscle spike potentials and contractility were recorded during the periods of stress by a bipolar electrode-perfused catheter apparatus placed in the rectosigmoid colon. Healthy subjects and patients with the irritable colon syndrome (ICS) were exposed to three standardized stressful conditions: (1) ice-water immersion, (2) Stroop stimulus differentiation test, and (3) ball sorting. In healthy controls, colonic motility increased after the first exposure to ice-water immersion (P less than 0.

Disorders of colonic motility in patients with diabetes mellitus.

Motility disturbances of the colon can give significant symptoms in patients with diabetes mellitus. Constipation is a common complaint in these patients. Diarrhea associated with a generalized autonomic neuropathy can be very troublesome.

Osteogenic sarcoma metastatic to the heart.

Of 20 patients with fatal osteogenic sarcoma who underwent postmortem examination, four had metastases to the heart. One had recurrent ventricular tachycardia, and one had anatomic evidence of aortic regurgitation due to massive periaortic neoplastic infiltration that prevented coaptation of the aortic cusps during ventricular diastole, one had massive invasion of the peri-superior vena caval syndrome, and one had neoplastic obstruction of the inferior vena cava as it entered the thorax. Among patients with either primary or secondary neoplasms to the heart, osteogenic sarcoma is unique because the metastases contain bone and, therefore, may be radiographically visible; they are usually large and often intracavitary.

Alpha-1-antitrypsin deficiency--a cause of cryptogenic liver disease in the elderly.

We report a 73-year-old woman with homozygous ZZ alpha-1-antitrypsin deficiency (AATD), micronodular cirrhosis, cholestatic jaundice, and emphysema. An elevated SGOT/SGPT ratio was noted in the absence of chronic alcoholism. ERCP demonstrated a normal extrahepatic biliary system and suggested obstruction of the intrahepatic ducts.

Metoclopramide to treat gastroparesis due to diabetes mellitus: a double-blind, controlled trial.

Ten patients with diabetic gastroparesis were selected for a randomized, double-blind, controlled trial of metoclopramide. Each patient had longstanding insulin-requiring diabetes mellitus and symptoms of gastric stasis. The patients were evaluated for the symptoms of gastric stasis and radionucleotide gastric emptying was measured before the patients entered the study and after they were given either metoclopramide or placebo treatment.

Abnormal colonic motility in progressive systemic sclerosis.

Progressive systemic sclerosis alters smooth muscle function throughout the gastrointestinal tract. In 10 consecutive patients with the disease, colonic spike activity and contractile activity were measured after a 1000-kcal meal, intramuscular injection of neostigmine, or intravenous injection of metoclopramide. The 1000-kcal meal stimulated a significant increase in spike and contractile activity in normal subjects.

Colonic dysfunction in diabetes mellitus.

Colonic myoelectrical and motor activity were measured in 12 patients with diabetes mellitus. Diabetic patients with severe constipation were compared to diabetics with mild or no constipation. Gastric emptying and peripheral nerve conduction studies were performed in all patients.

Inhibition of postprandial colonic motility after ingestion of an amino acid mixture.

Previous studies suggested that the ingestion of a mixture of amino acids inhibited the fat-stimulated increase in colonic motility. This study determine the effect of the ingestion of an amino acid mixture on the postprandial distal colonic spike potential (SP) response to a standard 1000-calorie meal in normal subjects and in patients with the irritable bowel syndrome. The distal colonic response was measured following a standard meal with and without the preadministration of a protein hydrolysate solution.

Echocardiographic practice in a large metropolitan area.

A survey performed concerning echocardiography in a metropolitan area. Of 110 hospitals in the area, 62 reported having echocardiographic facilities. Echocardiographic physicians and/or technicians from 41 of these hospitals responded to questionnaires designed to determine the following: (1) educational background and credentials of technicians, (2) average salaries of technicians, (3) role of the physician and technician in the performance and reporting of echocardiograms, (4) volume, cost, and method of storage of echocardiograms, and (5) number and type of echocardiographic units in use.

The gastrocolic response: evidence for a neural mechanism.

The aim of this study is to determine the effect of anticholinergic therapy on the gastrocolonic response to a standard meal or its major constituent fat. A rapid increase in rectosigmoidal spike activity occurs after ingesting the standard meal or the fat meal (P less than 0.01).

Value and limitations of technetium-99m stannous pyrophosphate in the detection of acute myocardial infarction.

Technetium-99m stannous pyrophosphate (99mTc-PYP) myocardial imaging was performed in 436 consecutive patients for the evaluation of chest pain and suspected acute myocardial infarction (AMI). Scintigrams were assessed independently by three observers with a 90% interobserver agreement. In 134 patients with documented AMI (97 TRANSMURAL, 37 NONTRANSMURAL), THE SENSITIVITY OF 99MTc-PYP imaging was significantly lower in patients with nontransmural AMI (41%) than in patients with transmural AMI (78%), 99mTc-PYP imaging correctly localized the site of transmural infarction in 53 patients (70%).

Amplitude of the oral temperature circadian rhythm and the tolerance to shift-work.

The aim of the study was to test the hypothesis of a relationship between the tolerance to shift-work and the amplitude of the oral temperature circadian rhythm. Forty eight shift-workers (Rhône-Alpes Region) volunteered for this chronophysiological investigation: a) 23 steel-industry workers (SI); shift-duration: 7 days (weekly rotation); b) 25 chemical-industry workers (CI); shift-duration 2 days. The subjects' ages were roughly similar with regard to groups (SI and CI) as well as sub-groups (good and poor tolerance of shift-work).

Adenocarcinoma of the stomach with common variable immunodeficiency syndrome.

Two patients had adenocarcinoma of the stomach in association with common variable immunodeficiency syndrome. There has been an increased prevalence of malignancy in this late-onset immunodeficient state. Similar to five previously reported cases, our patients had gastric carcinoma as a late complication.

The predictive value of myocardial perfusion scintigraphy after stress in patients without previous myocardial infarction.

Seventy-five patients who had chest pain but no history or ECG evidence of myocardial infarction (MI) underwent myocardial-stress perfusion scintigraphy (MSPS) with thallium-201, treadmill-stress testing (TST), and coronary cineangiography (CA). The sensitivities of MSPS and TST for coronary stenosis greater than or equal to 75% were 68% and 71%, respectively; their specificities were 97% and 79%, respectively (0.1 greater than p greater than 0.

Intravenous injection of talc-containing drugs intended for oral use. A cause of pulmonary granulomatosis and pulmonary hypertension.

Clinical and morphologic features are described in two patients known to have repeatedly injected intravenously talc-containing drugs intended for oral use. In one patient severe pulmonary hypertension developed; the talc granulomas in him were located predominantly within the pulmonary arteries. The second patient had normal pulmonary arterial pressures, and the talc granulomas in him were located predominantly in the pulmonary interstitium.

Umbilical portogram in a case of Schistosomiasis japonicum.

The life cycle of shistosomes in their human host contributes to protean pathologic changes in many organs. One of these, pre-sinusoidal hepatic fibrosis in the case of S. Japonicum, was studied by an umbilical portogram during the work-up before haemofiltration.