Diagnostic yield of renal biopsies: a retrospective single center review.

Background: Previous studies have examined the spectrum of diseases identified with a kidney biopsy and the complications of the procedure. However, few studies have examined the utility of the test to clarify the diagnosis and guide treatment of pediatric patients. This retrospective, single-center chart review was performed to test the hypothesis that at least 80% of native kidney biopsies provide clinically valuable information that rationally guides diagnosis and patient management.

Bisphosphonate complications including osteonecrosis of the jaw.

Bisphosphonate therapy has been incorporated in the standard management of patients with multiple myeloma-related bony disease. Although their efficacy in reducing skeletal related events is important in the supportive management of the myeloma patient, post-marketing experience with this class of agents, particularly the more potent intravenous agents pamidronate and zoledronic acid, have raised cautionary notes regarding the potential side effects of these agents. The focus of this session is to review the risk factors, incidence, prevention strategies and management of bisphosphonate-related osteonecrosis of the jaw.

111Indium pentetreotide imaging in the evaluation of head and neck tumors.

Objectives/hypothesis: Peptide receptor imaging with Indium pentetreotide is useful in the diagnosis of diffuse neuroendocrine system tumors (DNEST) of the head and neck. Uses of Indium pentetreotide scintigraphy include tumor and metastases detection, familial tumor screening, and surveillance for recurrence. Using target to background ratios (TBR) could generate a comparative scale for these tumors.

Ventilator strategy for status asthmaticus in pregnancy: a case-based review.

Asthma is a common and potentially serious condition complicating pregnancy. However, the literature available on the management of severe asthma in pregnancy is limited. We describe two episodes of respiratory failure due to asthma in pregnant women and discuss their management in the context of a review of the literature.

Laryngeal paraganglioma: an updated critical review.

Laryngeal paragangliomas are rare submucosal lesions that arise from paraganglion cells located in the false vocal fold and subglottic larynx. To date, 76 recognized cases have been reported in the world literature. Symptoms arise when the lesions become large enough to impair function.

Pediatric hemophilic pseudotumor of the paranasal sinus.

Objectives/hypothesis: Hemophilic pseudotumors are rare clinical entities in otolaryngology. An unusual case of a pediatric hemophilic pseudotumor of the paranasal sinus in a previously undiagnosed hemophiliac is presented.

Study Design: Case report.

Prenatal diagnosis of trisomy 3 mosaicism.

Objectives: To present the clinical, cytogenetic, and molecular cytogenetic findings of prenatally diagnosed trisomy 3 mosaicism.

Case And Methods: Trisomy 3 mosaicism is rare, and only two cases of prenatally diagnosed trisomy 3 mosaicism have been reported. Amniocentesis, performed for AMA, revealed a karyotype of 47,XX, + 3[8]/46,XX[27].

Prenatal diagnosis of a rare inherited heterochromatic variant chromosome 4.

Heterochromatic chromosome polymorphisms have been extensively reported. Most are associated with C-band positive regions located on chromosomes 1, 9, 16, and Y. We report a prenatal case of a rare heterochromatic variant on chromosome 4.

Recurrent laryngeal nerve paralysis: anatomy and etiology.

Etiologies of adult vocal paralysis are varied by the site of the lesion as well as the extent and cause of the damage. Most large series point to surgery and neoplastic causes for recurrent nerve paralysis. A detailed history is important when working up a patient with this voice disorder.

Total mediastinal traverse with isolated internal mammary artery transection.

Transmediastinal gunshot wounds are infrequent but life-threatening injuries. The course of the projectile and the bullet track often is unpredictable. Prompt and specific diagnostic and therapeutic interventions are necessary to quickly identify and repair potentially life-threatening injuries to the heart, great vessels, and the aerodigestive tract.

The clinical significance and anatomic distribution of parathyroid double adenomas.

Background: Parathyroid double adenomas are reported to occur in 3% to 12% of cases of primary hyperparathyroidism, but the very existence of double adenomas has been controversial. This study was undertaken to evaluate the clinical significance and anatomic distribution of parathyroid double adenomas.

Study Design: The medical records of 384 consecutive patients who underwent operation for primary hyperparathyroidism were reviewed.

Incidence of metastatic well-differentiated thyroid cancer in cervical lymph nodes.

Objective: To determine the incidence of clinically positive lateral cervical nodes at presentation and after initial treatment in patients with well-differentiated thyroid cancer.

Design: Retrospective chart review.

Setting: University-affiliated teaching hospitals.

Sestamibi scans and intraoperative parathyroid hormone measurement in the treatment of primary hyperparathyroidism.

Objective: To assess the value of preoperative sestamibi scanning and intraoperative parathyroid hormone (IOPTH) measurement in the treatment of patients with primary hyperparathyroidism due to multiple gland disease (MGD).

Design: Retrospective medical record review.

Setting: Tertiary care academic medical center.

Facial nerve stimulation and postparotidectomy facial paresis.

Objective: We sought to evaluate the association of intraoperative facial nerve stimulation and postoperative facial nerve paresis/paralysis.

Study Design And Setting: Eighty-nine consecutive patients who underwent parotidectomy by a single surgeon were retrospectively analyzed for age, gender, size of tumor, tumor histology, and intraoperative use of a facial nerve stimulator.

Results: Facial paresis developed in 22% (10 of 46) of the patients who were stimulated and 22% (5 of 23) of the nonstimulated patients.

Development and implementation of a curriculum in communication skills and psycho-oncology for medical oncology fellows.

Background: Over a ten-year period, the authors developed and implemented a disease-trajectory-based curriculum in communication skills and psycho-oncology for oncology fellows.

Methods: The basic format is a weekly ward round centered on a patient interview and subsequent discussion. More recently, this has been supplemented by a written curriculum.

Hurthle cell neoplasms of the thyroid.

Objectives/hypothesis: Hurthle cell tumors are a variant of follicular cell neoplasms. The purpose of the study was to determine the reliability of intraoperative frozen-section analysis for diagnosing Hurthle cell carcinoma and Hurthle cell neoplasm and to evaluate age, gender, and tumor size differences in the incidence of Hurthle cell carcinoma.

Study Design: Retrospective chart review.

Reduced protease inhibitory capacity in patients with abdominal aortic aneurysms is reversed with surgical repair.

Background: Abdominal aortic aneurysm (AAA) disease is a complex degenerative process that is associated with elevated proteolytic activity. This increased proteolytic activity may be linked to an imbalance in the protease regulatory mechanisms. We hypothesize that reduced AAA plasma inhibitory capacity is related to increased elastolytic activity observed in patients with AAA, which promotes matrix degradation in the aortic wall and AAA expansion.

Recurrent attacks of facial nerve palsy as the presenting sign of leukemic relapse.

Objective: To present an unusual case of recurrent facial palsy resulting from acute leukemic infiltration of the parotid gland.

Study Design: Case report.

Methods: An 11-year-old boy who had been treated for acute lymphoblastic leukemia (ALL) from 3 to 6 years of age presented with intermittent left facial nerve palsy with concurrent ipsilateral parotid fullness.

Significance of a prenatally diagnosed del(10)(q23).

Structural chromosome mosaicism is rare. We report a case of prenatal mosaicism for a deletion of chromosome 10(q23). To our knowledge, there are only three reports of prenatally diagnosed cases of del(10)(q23).

Adult Still's disease and respiratory failure in a 74 year old woman.

A case of adult onset Still's disease in an elderly woman, that was associated with severe respiratory failure and multiorgan dysfunction, is reported. Histopathology was confirmed on open lung biopsy.

The incidence of carcinoma in cytologically benign thyroid cysts.

Background: The management of cytologically benign thyroid cysts is controversial. Treatment options include observation, chemical sclerosis, and surgery. This study was undertaken to determine the incidence of carcinoma in cytologically benign thyroid cysts that recur after complete aspiration and to determine the indications for surgery in these patients.

Possible levofloxacin-induced acute hepatocellular injury in a patient with chronic obstructive lung disease.

Levofloxacin is one of the most commonly prescribed antibiotics for both inpatient and outpatient care of respiratory tract infection. It is generally well tolerated, and it has an excellent safety profile. We report a case of severe acute liver toxicity that apparently complicated intravenous administration of levofloxacin, which resolved after discontinuation of the drug.