[Fever and transient leukopenia due to hypersensitivity to quinidine sulfate].
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Biomedical subjects
Publications and source records attributed to S Weiss.
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Echocardiography was used in 30 women and 2 men with systemic lupus erythematosus (SLE) in order to determine the incidence and severity of pericardial effusion and mitral valve involvement. 31 patients showed normal thickness of the mitral valve leaflets, only one patient showed irregular thickening of the leaflets suggesting the presence of vegetations. Mitral valve motions were normal in all patients. These results indicate that myocardial and valvular involvement in SLE is usually not severe enough to result in haemodynamic abnormalities. Pericardial effusion was found in 2 patients who were symptom free, whereas 4 of the patients with a past history suggestive of pericarditis showed no echocardiographic evidence of pericardial effusion. These suggest the transient nature of pericarditis in SLE, and the value of echocardiography as a diagnostic tool in detecting clinically inapparent lupus pericarditis.
A patient with multiple myeloma (MM) who developed Kaposi sarcoma (KS) is described. The KS appeared 18 months after the diagnosis of MM and 1 month after the treatment was changed from cyclophosphamide to melphalan. The treatment with melphalan was discontinued and the spread of the KS was arrested by irradiation and bleomycin. One month after the melphalan was restarted, the KS advanced. The patient died 28 months after the diagnosis of MM and 10 months after KS had developed. The association of KS and MM is discussed and the previously reported cases are reviewed. A possible connection between the treatment with melphalan and the development of KS is proposed.
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In five patients having primary autonomic dysfunction with clinical manifestations including postural hypotension, the mean plasma norepinephrine concentrations were significantly lower than those of normal subjects after two and five minutes in the standing position. The mean (+/-SE) increment in the plasma norepinephrine concentration after two minutes standing were 123 +/- 19 pg/ml in the normal subjects and 13 +/- 4 pg/ml (P less than .001) in the patients with primary autonomic dysfunction. After five minutes standing, the mean increment in plasma norepinephrine concentration was 244 +/- 36 pg/ml in the normal subjects and 99 +/- 51 pg/ml (P less than .05) in the patients. There were no statistically significant differences in plasma epinephrine between the two groups.
A case of congenital Pelger-Hüet anomaly of the peripheral blood cells is described. Electronmicroscopic examination of the blood cells revealed nuclear bridges and appendices in the polymorphonuclear leukocytes. The number of cytoplasmic granules was diminished, but the size of the secondary granules was markedly increased. The eosinophils showed pronounced polymorphism of the granules, and the platelets showed a decrease in the alpha-granulomere number.
A 51-year-old male with acute lymphoblastic leukemia whose course was complicated by primary fibrinolysis and spontaneous rupture of the spleen is described. The patient was treated with various drug combinations: vincristine and prednisone, later by cytosine arabinoside and finally by prednisone, methotrexate and 6-mercaptopurine. Four months after the diagnosis he developed epistaxis and petechiae. The coagulation tests were compatible with primary fibrinolysis and he responded to treatment with epsilon-aminocaproic acid (EACA). One month and a half later he developed again epistaxis, ecchymoses, splenomegaly and an acute abdomen. The coagulation tests revealed primary fibrinolysis. The operation revealed a ruptured spleen. After splenectomy the treatment with EACA was continued and, despite an improvement in the coagulation tests, the patient died.
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A patient with clinical and haematological findings compatible with congenital dyserythropoietic anaemia (CDA) most porbably type II is described. In contradistinction to previous observations, electron microscope examination of the erythroid cells in the bone marrow showed the concomitant appearance of nuclei at different maturation stages in a single cell. In addition, a marked tendency toward multinuclearity of the megakaryocytes was found. The mature erythroblasts showed an increased uptake of 3H-thymidine less than is normally found in these cells. Thes findings suggest an impairment in RNA and DNA synthesis.
In the review of 117 patients hospitalized for herpes zoster (HZ) during the 10-year-period of 1960-1969, six patients with motor paralysis of the limbs were found. The incidence of motor paralysis in HZ which ranges in the literature between 0.5 and 31%, was 18% in our series. Reasons for these differences are discussed. An uncommon feature, local recurrence of HZ with motor deficit pertaining to the same segments is reported, and joint subluxation, a rare complication of motor HZ, is also described. The importance of looking for diaphragmatic paralysis and motor deficit in the thoracoabdominal segments, not readily revealed in routine examination, is stressed.
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Hearing was studied audiometrically in 20 diabetic patients with peripheral neuropathy, and the results were compared with those from a group of normal, age-matched subjects. Although the patients gave no history of hearing loss or ear disease, 11 (55%) had symmetrical sensorineural hearing loss involving at least one frequency. Regression analysis demonstrated significantly higher hearing thresholds for the diabetic group at nine of 11 frequencies tested. Decreased hearing acuity in diabetes mellitus may be related to neuropathy of the auditory nerve.
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