Acute Presentation of Simultaneous Liver Abscesses Caused by Streptococcus constellatus.

Simultaneous liver abscesses are rarely seen and reported. We are reporting a case of two simultaneous, complex liver abscesses in a patient who had no evidence of liver abscess on cross-sectional imaging close to three months prior to this presentation. These abscesses were 7-8 cm in size, large, and septated.

Ischemic Gastropathy Treated with Celiac Artery Revascularization.

Ischemic gastropathy is an uncommon diagnosis due to extensive arterial collaterals that supply the stomach. The mucosal integrity of the stomach is dependent upon this redundant circulation. Hence, its diagnosis is infrequently entertained in patients presenting with an upper gastrointestinal (GI) bleed.

Surgical Duodenotomy Following Untreated Bouveret Syndrome.

Bouveret syndrome is caused by the impaction of a gallstone into the duodenum through a cholecystoduodenal fistula. This is typically followed by pyloric obstruction via retrograde migration of the stone, as opposed to anterograde migration, which can result in gallstone ileus. Bouveret syndrome usually presents with nausea, vomiting, and abdominal pain.

Hernioscopy in Incarcerated Inguinal Hernia Spontaneously Reduced after General Anesthesia Induction.

Hernioscopy is essentially hernia sac laparoscopy. Hernia repair has evolved over the years with better outcomes; however, strangulated inguinal hernias are acute surgical emergencies which require emergent operative intervention. During anesthesia induction and/or after incision, hernia self-reduction is possible, with or without compromised bowel, back into the abdominal cavity.

Inverted Meckel's Diverticulum: Rare Etiology of an Intestinal Obstruction.

Acute gastrointestinal obstruction can have a varied spectrum of clinical presentation and etiologies. It has been studied in detail and the management criteria have been well defined for the most part in our era. The etiologies are usually well defined.

Retroperitoneal Pseudoaneurysm Mimicking Ureteral Calculus: Pitfalls in Diagnosis.

Arterial aneurysms (AA) can be classified as true aneurysms, characterized by the persistence of all three layers of the arterial wall with progressive dilation and wall thinning; arterial pseudoaneurysms (APAs) are characterized by a tear in the vessel wall and a periarterial hematoma formation. They could occur due to a visceral, retroperitoneal, or peripheral origin. Most AA/APA are usually found incidentally, and it is imperative to be vigilant in order to diagnose and manage them due to their potentially life-threatening complications.

Abdominal Drains Retrieved Laparoscopically 15 Years Post Laparotomy.

A retained intra-abdominal foreign body is a common occurrence that is frequently underreported due to its medicolegal implications. Sponges, gauzes, surgical instruments, abdominal drains, etc. have been reported in the literature.

Low prevalence of Pneumocystis pneumonia in hospitalized patients with systemic lupus erythematosus: review of a clinical data warehouse.

Objective In the era of powerful immunosuppression, opportunistic infections are an increasing concern in systemic lupus erythematosus. One of the best-studied opportunistic infections is Pneumocystis pneumonia; however, the prevalence of Pneumocystis pneumonia in systemic lupus erythematosus is not clearly defined. This study evaluates the prevalence of Pneumocystis pneumonia in hospitalized systemic lupus erythematosus patients, with a focus on validating the Pneumocystis pneumonia and systemic lupus erythematosus diagnoses with clinical information.

Prenatal and postnatal bisphenol A exposure and asthma development among inner-city children.

Background: Bisphenol A (BPA) is used widely to manufacture food container linings. Mouse models suggest exposure to BPA might increase allergic inflammation.

Objectives: We hypothesized that BPA exposure, as assessed based on urinary BPA concentrations, would be associated with increased odds of wheeze and asthma and increased fraction of exhaled nitric oxide (Feno) values in children.

Merkel cell carcinoma arising in a patient with a history of multiple malignancies.

Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroendocrine carcinoma of the skin. Although the association between MCC and other primary malignancies has been documented, the mechanism of this association has not been elucidated. We report a case of MCC in a man with a history of multiple primary malignancies and treatment with immunomodulators.

Pheochromocytoma-induced aggression?

Objective: To document a case of pheochromocytoma with an unusually high plasma ratio of norepinephrine to epinephrine concentrations (NE:E), and a history of violent and aggressive behavior (which has been reported to be associated with increased NE:E ratios).

Methods: We present the history of present illness, history of aggressive behavior, and the clinical course of a man who was found to have pheochromocytoma with a remarkable catecholamine profile. We also review the literature on the relationship of catecholamine ratios to behavior.

Design as dream and self-representation: Philip Johnson and the Glass House of Atreus.

Philip Johnson's masterpiece--the Glass House--is compared to a dream and conceptualized as containing encrypted and embedded representations of the self. Freud's masterpiece--The Interpretation of Dreams--is the theoretical and methodological model for this approach to design-as-dream. Drawing on Johnson's words and forms set in biographical, historical, and cultural context, interpretive paths are traced from manifest design elements of the Glass House to overdetermined latent meanings, yielding new and surprising insights into the Glass House, its elusive architect, and the process of its design.

Romantic fantasies of madness and objections to psychotropic medication.

Many patients object to, and often refuse, psychotropic medications. The exploration-a "defense analysis"-of their objections brings attention to ubiquitous fantasies of madness, which may be feared and concealed as a source of shame, destruction, and loss, and also cherished and revered as a source of power, inspiration, and mystery. They are commonly illuminated when the prospect of taking medication threatens to expose, confirm, and defuse the fantasized hidden or latent madness.

Medication as object.

People experience and treat medication as though it were a person: in other words, as an object. Among the many symbolic meanings attributed to medication, this sort of personification, or object representation, is a meaning that medication is uniquely positioned to contain and convey: imbued with intentionality and influence, medication moves beyond the sphere of static, iconic representation and enters the changeable, dynamic object world of action, aim, and agency. Unlike more generic or stereotypic meanings, object representations attributed to medication may reflect the patient's specific dynamics and object relations.

The surgical management of primary invasive breast cancer.

The treatment of operable primary breast cancer has evolved dramatically in the past few decades. The standard operative procedure has changed from the radical mastectomy to the modified radical mastectomy, and the use of breast-conserving treatment is increasing. This article reviews trends in treatment of early-stage breast cancer, factors associated with increased risk for local recurrence after breast-conserving treatment, and the use of axillary lymph node dissection.

Sensitivity of lod scores to changes in diagnostic status.

This paper investigates effects on lod scores when one individual in a data set changes diagnostic or recombinant status. First we examine the situation in which a single offspring in a nuclear family changes status. The nuclear-family situation, in addition to being of interest in its own right, also has general theoretical importance, since nuclear families are "transparent"; that is, one can track genetic events more precisely in nuclear families than in complex pedigrees.