Cervical root stimulation at C5/6 excites C8/T1 roots and minimizes pneumothorax risk.

Needle electrical cervical root stimulation may be performed lateral to the C5/C6 or C7/T1 spinous process interspaces. Pneumothorax has been reported following C7/T1 root stimulation. We evaluated the efficacy of a modified C5/C6 stimulation technique in exciting C8/T1 roots in 15 normal subjects and 36 patients with motor neuron disease (204 procedures).

Nongenital dermatologic disease in HIV-infected women.

Background: Dermatologic disease in HIV-infected women has not been adequately characterized.

Objective: The main purposes of this study were to characterize nongenital dermatologic disease in HIV-infected women and correlate these diagnoses with CD4 lymphocyte count to compare these findings with those in published reports of men.

Methods: This study was a retrospective chart review of female patients with dermatologic diagnoses followed up at an HIV clinic in New York City, seen by either a dermatologist (49 patients) and/or a primary care practitioner (114 patients).

Ossified intratesticular mucinous tumor.

We report a case of an ossified primary intratesticular mucinous tumor in a 69-year-old man, which was discovered incidentally during a consultation for erectile dysfunction. The 7.5 x 4.

Palliative care: pain and symptom management in persons with HIV/AIDS.

As patients with HIV/AIDS are living longer with the illness, pain and symptom management are increasingly important health issues. This article will discuss the assessment and management of such common problems as pain, fatigue and weakness, dyspnea and cough, anorexia and weight-loss, nausea and vomiting, sleep disorders, dry mouth, diarrhea, itching, and fever and night sweats.

Discordance between FDG uptake and technetium-99m-HMPAO brain perfusion in acute traumatic brain injury.

A 28-yr-old woman who sustained a mild traumatic brain injury had an 18F-fluorodeoxyglucose (FDG) PET brain study using coincidence imaging performed on a dual-head gamma camera (MCD version; ADAC, Milpitas, CA) followed 24 hr later by 99mTc-hexamethyl propyleneamine oxime SPECT brain perfusion imaging using a triple-head gamma camera (TRIONIX, Twinsburg, OH). The results of the SPECT brain perfusion study demonstrated decreased frontoparietal cortical brain perfusion, whereas 18F-FDG cerebral uptake was normal. Neuropsychological evaluation suggested frontal lobe involvement.

Clinical experience with adding delavirdine to combination therapy in patients in whom multiple antiretroviral treatment including protease inhibitors has failed.

Objective: To determine the effectiveness and safety of adding delavirdine mesylate to a treatment regimen that included indinavir and nucleoside analog reverse transcriptase inhibitors in patients in whom combination therapy had failed.

Design: Observational study.

Setting: Private practice.

The F(p) Infrequency-Psychopathology scale with chemically dependent inpatients.

This study examines characteristics of Arbisi and Ben-Porath's (1995) MMPI-2 Infrequency-Psychopathology scale, F(p), in a sample of individuals admitted for inpatient treatment of chemical dependency. The F(p) scale, designed to detect deviant response biases in settings characterized by high base rates of psychopathology, was found by Arbisi and Ben-Porath (1995) to have good construct and incremental validity with psychiatric inpatients. Comparisons of the F(p), Infrequency (F), and Infrequency-Back (Fb) scales' means and relationships to indices of psychopathology in the current study provide evidence supporting the F(p) scale's validity in populations of chemically dependent inpatients with and without concurrent psychiatric diagnoses.

Tumor and infection localization in AIDS patients: Ga-67 and Tl-201 findings.

Examples of Ga-67 and Tl-201 scans in AIDS patients performed at St. Vincent's Hospital and Medical Center of New York are presented. Use of these methods is the adopted approach at this institution in AIDS patients for localizing sites of tumor or infection involvement.

Microvascular cytomegalovirus endothelialitis of the lung: a possible cause of secondary pulmonary hypertension in a patient with AIDS.

Postmortem examination of the lungs of a patient with advanced AIDS who had developed pulmonary arterial hypertension late in the course of the illness demonstrated extensive cytomegalovirus (CMV) infection in endothelial cells of the lung microvasculature. Enlarged CMV-infected endothelial cells were present in virtually all histologic sections of the lungs, protruded into and compromised the lumens of the small vessels they lined, and were estimated by image cytometry of immunohistochemically stained sections to comprise 0.8% of the total lung tissue volume.

Surgical adjuvant active specific immunotherapy for patients with stage III melanoma: the final analysis of data from a phase III, randomized, double-blind, multicenter vaccinia melanoma oncolysate trial.

Background: A phase III, randomized, double-blind, multicenter trial of active specific immunotherapy (ASI) using vaccinia melanoma oncolysate (VMO) was performed in patients with stage III (American Joint Commission on Cancer) melanoma to determine the efficacy of VMO to increase the disease-free interval (DFI) or overall survival (OS) in these patients. Two interim analyses of data from this trial were performed in May 1994 and June 1995. Although the results from these analyses showed no statistically significant improvement in DFI or OS in all patients using VMO, two subsets-men aged 44-57 years with one to five positive nodes and all patients with clinical stage I and pathologic stage II disease-showed an overall survival advantage with VMO therapy.

Twenty-four-hour urinary free cortisol in patients with acquired immunodeficiency syndrome.

Many patients with acquired immune deficiency syndrome (AIDS) have symptoms consistent with adrenal insufficiency, but only a small subset of these patients meet criteria for adrenal insufficiency during a short corticotropin (ACTH) stimulation test. We hypothesized that patients with AIDS and symptoms of adrenal insufficiency who produce normal amounts of cortisol in response to administration of 0.25 mg cosyntropin may nevertheless produce lower amounts of cortisol in a course of 24 hours than comparably sick AIDS patients without symptoms of adrenal insufficiency or comparably sick patients without AIDS.

SPECT brain perfusion abnormalities in mild or moderate traumatic brain injury.

The purpose of this atlas is to present a review of the literature showing the advantages of SPECT brain perfusion imaging (BPI) in mild or moderate traumatic brain injury (TBI) over other morphologic imaging modalities such as x-ray CT or MRI. The authors also present the technical recommendations for SPECT brain perfusion currently practiced at their center. For the radiopharmaceutical of choice, a comparison between early and delayed images using Tc-99m HMPAO and Tc-99m ECD showed that Tc-99m HMPAO is more stable in the brain with no washout over time.

Acute cholecystitis in AIDS patients: correlation of Tc-99m hepatobiliary scintigraphy with histopathologic laboratory findings and CD4 counts.

Background: AIDS patients are susceptible to opportunistic gastrointestinal infections including ascending cholangitis and cholecystitis, especially if CD4 count is < 200. Incidence of acalculous cholecystitis has not been reported previously.

Purpose: We aim to evaluate the incidence of acalculous cholecystitis in AIDS patients and to identify causative organisms and mortality rate following cholecystectomy.