Malignant pleural mesothelioma: difficulties in diagnosis.
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Biomedical subjects
Publications and source records attributed to D A Albertson.
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A case of hypercalcemic crisis secondary to a large functioning parathyroid cyst is presented. Because none of the theories about the origin of parathyroid cysts are well substantiated or accepted, these cysts should be referred to simply as parathyroid cysts, functional or nonfunctional.
To explore the possibility that the half-life of insulin changes after trauma, five control subjects and 19 severe trauma patients received intravenous glucose (0.5 gm/kg) in 5 minutes to raise rapidly the insulin levels, followed immediately by 300 mg of intravenous diazoxide over 5 minutes to inhibit any further insulin secretion. Serial blood samples were analyzed for immunoreactive insulin, and insulin half-life was calculated. The baseline insulin level was 13.4 +/- 3.8 microU/ml in the trauma group 10.4 +/- 3.1 microU/ml in the control group. During the glucose infusion, insulin levels rose to 177.0 +/- 56.0 microU/ml in the controls and to 127.0 +/- 27.0 microU/ml in the trauma group. The rise in the control subjects was greater (P less than 0.03) than the rise in the trauma patients. After diazoxide, insulin levels fell to 25.0 +/- 6.2 microU/ml and 25.0 +/- 6.6 microU/ml, respectively. Insulin half-life in the control subjects was 5.2 +/- 0.3 min and 3.9 +/- 0.2 min in the trauma group (P less than 0.019).
A case of Crohn's colitis is described in a patient who demonstrated multiple extraintestinal complications, including erythema nodosum, pyoderma gangrenosum, and aphthous oral ulcerations. Our patient simultaneously developed an unusual vasculitis in muscle. Small vessels were affected by necrosis, and polymorphonuclear leukocyte infiltration was appreciated. Leukocytoclastic was suggested by these features and the additional finding of small amounts of nuclear debris. A strong immunofluorescence to antihuman C3 was demonstrated in the affected vessel walls. We did not find circulating IgG immune complexes in serum with the Raji cell assay. The implication of the finding of leukocytoclastic vasculitis in muscle, associated with Crohn's colitis, is discussed.
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