Physical exam was notable for decreased breath sounds bilateral bases more prominent on the left lung fields, abdominal distension, pitting edema in scrotal and flank regions. CT chest and abdomen ...revealed large bilateral pleural effusions, small to moderate pericardial effusion, small volume intra-abdominal ascites, and diffuse anasarca(Fig 1).
Symptoms of diaphragmatic rupture and herniation of abdominal organs into the thoracic cavity can often be as vague and nonspecific as shortness of breath, chest discomfort, or abdominal pain, but ...can be clinically suspected due to history of traumatic event. In our young man with Becker's muscular dystrophy and previous instrumentation related to LVAD and heart transplant, there was no history of traumatic event apart from LVAD removal and he was relatively asymptomatic, so, the timeline for the progression of his herniation was unclear.
While rare, in patients with history of chronic pancreatitis or significant alcohol use presenting with chest pain, shortness of breath, and new pleural effusions it is important to entertain the ...possibility of PPF given that this will require intervention due to larger degree of effusion compared to small effusions seen commonly in pancreatitis. Case: A 45 year old man with history biopsy proven IgG4 positive plasma cell chronic autoimmune pancreatitis status post distal pancreatectomy and splenectomy, peripheral vascular disease, GERD, and tobacco abuse who presented for several days of epigastric and left upper quadrant abdominal pain and fevers.
The inspirational story of John Kizell celebrates the life of a West African enslaved as a boy and brought to South Carolina on the eve of the American Revolution. Fleeing his owner, Kizell served ...with the British military in the Revolutionary War, began a family in the Nova Scotian wilderness, then returned to his African homeland to help found a settlement for freed slaves in Sierra Leone. He spent decades battling European and African slave traders along the coast and urging his people to stop selling their own into foreign bondage. This in-depth biography—based in part on Kizell's own writings—illuminates the links between South Carolina and West Africa during the Atlantic slave trade's peak decades. Seized in an attack on his uncle's village, Kizell was thrown into the brutal world of chattel slavery at age thirteen and transported to Charleston, South Carolina. When Charleston fell to the British in 1780, Kizell joined them and was with the Loyalist force defeated in the pivotal battle of Kings Mountain. At the war's end, he was evacuated with other American Loyalists to Nova Scotia. In 1792 he joined a pilgrimage of nearly twelve hundred former slaves to the new British settlement for free blacks in Sierra Leone. Among the most prominent Africans in the antislavery movement of his time, Kizell believed that all people of African descent in America would, if given a way, return to Africa as he had. Back in his native land, he bravely confronted the forces that had led to his enslavement. Late in life he played a controversial role—freshly interpreted in this book—in the settlement of American blacks in what became Liberia. Kizell's remarkable story provides insight to the cultural and spiritual milieu from which West Africans were wrenched before being forced into slavery. Lowther sheds light on African complicity in the slave trade and examines how it may have contributed to Sierra Leone's latter-day struggles as an independent state. A foreword by Joseph Opala, a noted researcher on the "Gullah Connection" between Sierra Leone and coastal South Carolina and Georgia, highlights Kizell's continuing legacy on both sides of the Atlantic.
Various cardiac and pulmonary manifestations have been described in association with AOSD, including acute respiratory distress syndrome (ARDS) and pulmonary arterial hypertension (PAH). Physical ...examination was notable for hyperpigmented macules of the bilateral upper arms, lower extremity pitting edema, distended jugular venous pulse with accentuated hepatojugular reflex, and a loud P2 on cardiac auscultation.
To investigate effects of lacrimal drainage occlusion with intracanalicular silicone plugs in hydrogel lens wearers with the symptom of dryness. Effects of rewetting drops in combination with the ...plugs were also evaluated.
A 6-week, prospective, double masked, placebo-controlled study design was followed. Thirty-five patients (26 females and 9 males) were entered into the study based on specific symptoms and signs of dry eye with hydrogel lens wear. Baseline symptoms, noninvasive prelens tear film break-up time, lens water content, fluorescein, and rose bengal staining were recorded. Herrick Lacrimal Plugs were inserted into both canaliculi of one previously randomized eye by an independent investigator. The fellow eye was manipulated in a sham procedure. Symptoms and signs were followed over 4 weeks. Nonpreserved rewetting drops were used in both eyes during the 5th week. Symptoms and signs were again followed.
Symptoms improved more significantly in the plugged eye than the control eye after insertion of the plugs, and again after use of the drops. This improvement diminished in some of the patients. Prelens tear film break-up time was not significantly changed. Water content of all lenses combined increased only in the plugged eye with the use of drops. Fluorescein staining decreased significantly in the plugged eye. Rose bengal staining showed a slight decrease in the plugged eye.
Intracanalicular silicone plugs offer improvement of symptoms and signs of dryness in this population. There seems to be some decrease in improvement of symptoms with the plugs over time. Concurrent use of rewetting drops increases the benefits.
Over a period of 6 1/2 years between January 1986 and May 1992, 135 unselected primary breast cancers were cultured and of these 10 developed into cell lines. Six of the lines grew in defined ...serum-free medium, while the other four required supplementation with 0.5% fetal calf serum. Two of the lines are from the same breast, being derived from a local excision specimen and from a mastectomy specimen 12 months later. In addition, 12 lymph nodes containing metastatic breast cancer were cultured; one of these cultures became permanent in a defined serum-free medium. Oestrogen receptor (ER) status was negative in all but one of the tumours which grew successfully, and even in this case the derived cell line is ER negative. The epithelial nature of the lines has been confirmed by immunocytochemistry and by electron microscopy (EM), while their malignant nature is shown by morphology, unattached growth, chromosome analysis, and, in the case of the line from a lymph node metastasis, the absence of any benign source of epithelial cells.
