Defective medical interviews.
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Biomedical subjects
Publications and source records attributed to G G Winzelberg.
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The diagnostic value of a strikingly elevated serum lactate dehydrogenase (LDH) level in association with only small or no increases in SGOT and alkaline phosphatase levels was noted in five patients with proved renal infarction. Four had renal artery embolism and infarction in association with atrial arrhythmias; one had an acute extension of an abdominal aortic aneurysm occluding the renal artery. Other causes of a considerable isolated increase in the serum LDH level such as hemolysis and myocardial infarction can usually be easily excluded.
To determine the effectiveness of abdominal imaging with RBCs labeled in vivo with Tc-99m, for the detection of gastrointestinal (GI) bleeding, 28 control subjects and ten patients with suspected bleeding underwent scintigraphy at 0-24 hr after tracer injection. Colonic activity was noted in one of the controls within 3 hr of injection, and in five of ten controls at 24 hr, all of whom had initial gastric activity. Of the ten patients with suspected GI bleeding, eight had documented active bleeding; seven of these had positive scintigrams. Nasogastric (NG) suction markedly decreased the presence of initial gastric activity in the patients with active bleeding. With this blood-pool radiopharmaceutical, frequent imaging of the abdomen over 24 hr can be done to test active bleeding. Continuous NG suction is recommended to reduce accumulation of gastric activity. These results suggest that red blood cells labeled in vivo with Tc-99m provide a sensitive method of detecting active GI bleeding.
Disseminated aspergillosis is a major complication in immunosuprressed patients. Infiltration of the thyroid with Aspergillus organisms occurs in approximately 20% of autopsies in patients dying with disseminated disease. The present report describes Aspergillus thyroiditis, Hashimoto's thyroiditis, and possible hypothyroidism in a patient with disseminated aspergillosis.
An aid for prehospital cervical immobilization was studied radiographically. We applied the Vertebrace Extrication Collar to ten volunteers and measured cervical movement in the sagittal plane. Results of mean degrees of flexion-extension and mean percentage of restricted motion at each level compared favorably with results of earlier studies using rigid orthoses (the four-poster brace, Cervicothoracic, Somi Brace, and Yale collar). A second method of analysis, measuring relative motion of vertebral segments by level, found no flexion displacement in 70% and no extension displacement in 60% at C5-C6. The Vertebrace Collar proved to be effective in restricting movement of the cervical vertebrae most often injured following serious trauma.
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