Biomedical subjects
Publications and source records attributed to S M Bloom.
Nine patients are reported who presented with severe weight loss of up to 13.6 kg (30 lb) as a result of chronic erosive gastritis. In many the cachexia was sufficient to prompt a search for malignancy but no other lesion was found. The importance of the radiological pursuit of this diagnosis is emphasised. Illustrative case histories are presented.
Chronic erosive gastritis has been regarded as an unusual, ill-defined condition of unknown etiology. We report a retrospective study of 40 patients in whom this diagnosis was made relating radiologic findings to patients' age, symptomatology and possible etiologic factors. The condition is more common than previously suspected and requires careful technique combining double contrast and graded compression to demonstrate fine mucosal abnormalities. The radiologic appearance is of mucosal mounds measuring 3-11 mm in diameter with central barium collections and numbering from 3-27 per examination. Antral involvement occurred in 90% of patients, with diffuse involvement of both antrum and body in 58%. Several linear erosions measuring up to 15 mm in length were also demonstrated. Chronic erosive gastritis is most severe and symptomatic between 40 and 60 years, becoming sub-clinical in the elderly. Symptoms mimic those of a peptic ulcer or gastric neoplasm and are more severe the more extensive the disease. Gastric irritants, virus infection and Crohn's disease were possible etiologic factors in some patients in this study.
A 71-year old woman initially presented with abdominal pain and an x-ray picture of ischemia of the terminal ileum. The ischemic changes were transient and reversed spontaneously. Six months later, she presented with the same complaint and an x-ray picture of ileocolic intussusception. At operation, a lipoma of the ileum was the leading point of the intussusception and ischemic changes of the ileum were evident.
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In more than 1,500 double contrast upper gastrointestinal examinations performed January through November 1974, 26 cases of multiple gastric ulcers were diagnosed. This represents 18.6% of the 140 patients who had a demonstrable gastric lesion, and 23.4% of the 111 patients who had either a single gastric ulcer or scar. This technique was developed in a country where gastric carcinoma is common, but in the United States its greatest usefulness will probably be in the detection of subtle mucosal defects such as multiple gastric ulcers, linear ulcers, and erosions. The sensitivity of the routine pharmacologically aided double contrast upper gastrointestinal examination is confirmed by the high incidence of multiple gastric ulcers found.
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PURPOSE: Our goal was to describe the CT findings in patients with an apparent mass at the thoracic inlet on barium swallow and to further explore its etiology by making appropriate measurements on CT. METHOD: Barium swallows and CT scans of five patients with esophageal pseudomass were reviewed and compared with CT scans of 65 controls. Anteroposterior (AP) diameters of the thoracic inlet were measured, and the relationships of the esophagus to the trachea were determined on CT. RESULTS: Absence of a demonstrable mass on CT in patients with an extrinsic impression on barium swallow was associated with narrowed AP diameter of the thoracic inlet (< 5 cm) and the esophagus to the left of the trachea. A significant correlation was observed between the AP diameter of the inlet and the position of the esophagus in relation to the trachea in control subjects (r = 0.52, p < 0.001); with diminished diameter, the esophagus is more frequently located to the left side of the trachea. CONCLUSION: An apparent mass is simulated by lateral deviation of the lower cervical esophagus, due to diminished available space between the trachea and the esophagus in subjects with a narrow (< 5 cm) AP diameter of the thoracic inlet.
Retinal detachment and retinal holes in two family members with retinitis pigmentosa sine pigmento are reported. We believe these are the first such cases reported in the literature. We describe the presenting symptoms and management, including cryotherapy, scleral buckling procedure, and sulfur hexafluoride injection (SF6), resulting in stable visual acuity in one case and retinal reattachment and improved visual acuity in the other case.
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1. Choroidal neovascular membranes (CNVM), the abnormal ingrowth of blood vessels from the choroid through Bruch's membrane, remain a major cause of treatable visual loss. 2. Laser photocoagulation is effective in destroying CNVM and preserving central vision in many affected patients. However, laser treatment of subfoveal CNVM irreversibly destroys foveal vision. 3. The utility of vitrectomy techniques for removal of subfoveal macular hemorrhage on CNVM remains unknown pending the results of a randomized, controlled prospective study. 4. Laser photocoagulation remains the treatment of choice for extra- and juxtafoveal CNVM caused by age-related macular degeneration (ARMD), ocular histoplasmosis and idiopathic causes, and for selected subfoveal CNVM caused by ARMD.