Inflammatory pseudotumor of the skull base.

Introduction: Inflammatory pseudotumor is an idiopathic, non-neoplastic mass lesion with few cases reported in the literature involving only the skull base and related structures. Imaging of skull-base pseudotumors shows characteristics similar to that of nasopharyngeal carcinoma and lymphoma, thereby requiring a biopsy to exclude malignancy. Surgical versus medical management relates to the location of the mass, the extent of bony invasion, and the involvement of corresponding anatomic structures.

Tuberculosis and trimethoprim-sulfamethoxazole.

The sulfonamides were the first drugs with antituberculous effects. Their use was abandoned and basically forgotten with the advent of streptomycin and isoniazid combination treatment. There is a widespread belief, apparently based on testing a single isolate on questionable media, that Mycobacterium tuberculosis is resistant to trimethoprim-sulfamethoxazole (TMP-SMX).

Samuel A. Levine and the history of grading systolic murmurs.

Murmurs were described first by Laennec in 1819, after which the significance of a murmur became a matter of debate. By the late 19th century, many physicians regarded systolic murmurs as "organic," whereas others believed that they were often "functional." Samuel Levine became a central figure in separating functional from organic systolic murmurs.

Comparing the Gleason prostate biopsy and Gleason prostatectomy grading system: the Lahey Clinic Medical Center experience and an international meta-analysis.

Background: The accuracy of the prostate biopsy Gleason grade to predict the prostatectomy Gleason grade varies tremendously in the literature.

Objectives: Determine the accuracy and distribution of the prostate biopsy Gleason grade and prostatectomy Gleason grade at LCMC (Lahey Clinic Medical Center) and worldwide.

Design, Setting, And Participants: Participants included 2890 patients who had not received preoperative hormones, and for whom preoperative and postoperative Gleason sums were available.

Electrocardiographic-clinical-pathologic sleuthing (by Dr. J. Willis Hurst).

An unusual electrocardiogram was sent to Dr. J. Willis Hurst, who had no knowledge of the clinical details.

Extracardiac manifestations of infective endocarditis and their historical descriptions.

In his landmark "Gulstonian Lectures on Malignant Endocarditis," published in 1885, William Osler commented, "Few diseases present greater difficulties in the way of diagnosis than malignant endocarditis, difficulties which in many cases are practically insurmountable." At that time, the fields of microbiology and blood cultures were in their infancy, and the diagnosis was made premortem in just half the patients with the condition. After Osler's report, extracardiac physical findings became essential clues to earlier diagnosis.

Correlation of bone SPECT scintigraphy with histopathology of the ethmoid bulla: preliminary investigation.

Objectives: Reports in the rhinology literature suggest that osteitis of the ethmoid bone may be responsible for refractory and/or recurrent sinusitis. If so, bone scanning technologies capable of detecting osteitis may be useful in diagnosing this condition and its response to treatment. The objective of this prospective cohort study was to determine the correlation of single photon emission computed tomography (SPECT) bone scintigraphy with the histopathology of the ethmoid bulla.

Discovery of the sinus node by Keith and Flack: on the centennial of their 1907 publication.

In 1839, Jan Evangelista Purkinje discovered a net of gelatinous fibres in the subendocardium of the heart. Walter Gaskell in the 1880s observed that the impulse of the heart began in the sinus venosus, and that this region had the most rhythmic ability. A conducting bundle between the atrium and the ventricle was found by Wilhelm His, Jr in 1893.

A unique case of pulmonary artery leiomyosarcoma.

Primary pulmonary artery leiomyosarcomas are rare, and the diagnosis is usually confused with other, more common, diseases, especially pulmonary embolism. A 52-year-old male, previously healthy, sustained a cardiac arrest. Chest CT-angiography diagnosed a "saddle embolus".

Progression of laparoscopic radical prostatectomy: improved outcomes with the extraperitoneal approach and a running anastomosis.

Purpose: To compare the operative and perioperative outcomes of patients undergoing either a transperitoneal or an extraperitoneal laparoscopic radical prostatectomy (TLRP or ELRP) with either an interrupted or a running urethrovesical anastomosis (IUVA or RUVA).

Patients And Methods: From January 2003 through December 2004, 265 patients underwent LRP by one surgeon at the Lahey Clinic Medical Center. They were divided into three groups according to the operative approach (TLRP or ELRP) and the suture anastomosis (IUVA or RUVA): group 1 = TLRP and IUVA (N = 58; 21.

Why does the heart beat? The discovery of the electrical system of the heart.

Why does the heart beat? This question--known as the myogenic versus neurogenic theory--dominated cardiac research in the 19th century. In 1839, Jan Evangelista Purkinje discovered gelatinous fibers in the ventricular subendocardium that he thought were muscular. Walter Gaskell, in 1886, demonstrated specialized muscle fibers joining the atria and ventricles that caused "block" when cut and found that the sinus venosus was the area of first excitation of the heart.

History and personal observations of electrical cardioversion of atrial fibrillation.

Electrical cardioversion of atrial fibrillation was initially very controversial. The procedure was carefully developed by Bernard Lown and his associates who experimented first on animals and then on postoperative patients using a direct-current technique designed to avoid the vulnerable period. Their results, published in 1963, were soon accepted, and the procedure became a major therapeutic advance in the treatment of heart disease.