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Biomedical subjects

T M Roy

Publications and source records attributed to T M Roy.

At least 91 records · Page 5Linked to original sources
PubMed1993

Patterns of chronic granulomatous disease.

We report the clinical course of an adult patient with chronic granulomatous disease, an inherited disorder of neutrophil function that is generally limited to the pediatric population. The biochemical and functional disorders of the neutrophil in chronic granulomatous disease are examined. The mode of inheritance and expression of this disease is profiled to aid the clinician who must consider this diagnosis in the adult patient with recurrent infections.

Adult↗
PubMed1993

Invasive aspergillosis of the central nervous system.

Advancing technology permits aggressive medical interventions that are often lifesaving, yet place the patient's immune system in temporary jeopardy. During the interval of immunocompromise, physicians must maintain vigilance for opportunistic infection by saprophytic organisms such as Aspergillus. Although the lung is the most common site of infection by this fungus, subsequent hematogenous dissemination with central nervous system involvement may occur. Currently, the majority of Aspergillus infections of the central nervous system remain unrecognized until the patient's demise. The clinical and pathological features of aspergillosis of the central nervous system are reviewed in order to promote earlier diagnosis and treatment.

Adult↗
PubMed1993

False pregnancy: an unusual paraneoplastic syndrome associated with bronchogenic neoplasm.

Human chorionic gonadotropin (HCG) is typically associated with pregnancy or germ cell tumors. Although it may be detected within the tissue of a variety of malignant tumors by immunohistochemical methods, including primary lung cancers, serum levels are rarely elevated in non-germ cell malignancies. We describe a young lady who presented with chest discomfort and dyspnea. Clinically, she was thought to have deep venous thrombosis. She presumed that she was pregnant since her last menses was 3 months before admission. She also had breast tenderness similar to that which she had experienced during a previous pregnancy. A serum value for B-HCG suggested that she was 4 to 6 weeks pregnant. Further investigation confirmed that this patient was not pregnant, but had developed a gonadotropin secreting adenocarcinoma of the lung.

Adenocarcinoma↗
PubMed1993

Re-expansion pulmonary edema: a preventable complication.

Ipsilateral pulmonary edema may occur in a lung that has been rapidly reinflated after a variable period of collapse resulting from pleural effusion or pneumothorax. The syndrome of re-expansion pulmonary edema is associated with variable degrees of hypotension and hypoxemia with some patients experiencing cardiac arrest and death. Although the number of cases reported in the medical literature is small, the actual incidence of this potentially avoidable complication is unknown. It may go unrecognized by the clinician as a primary contributor to an adverse outcome.

Acute Disease↗
PubMed1993

Dissecting aortic aneurysm mimicking massive pulmonary embolism.

The finding of a massive unilateral segmental defect with normal ventilation upon lung scanning does not always secure the diagnosis of acute pulmonary embolus. We present a patient whose ventilation-perfusion lung scan suggested a significant embolic phenomenon, but who was subsequently found to have compression of her right pulmonary artery by a dissecting aortic aneurysm. Conditions that present with a unilateral perfusion defect merit further evaluation with pulmonary arteriography.

Adult↗
PubMed1993

The value and limitation of pleural fluid pH measurement.

Analysis of an aliquot of fluid from a pleural effusion will often provide the clinician with the information needed to establish a presumptive or definitive diagnosis of the patient's illness. A properly performed pleural fluid pH can maximize the diagnostic yield and provide guidelines for further clinical interventions.

Carcinoma, Squamous Cell↗
PubMed1993

Primary thrombosis in the upper extremity.

Deep vein thrombosis may occur in the axillary or subclavian veins in the upper extremities, sometimes in young patients without the typical risk factors for thrombus development. This unusual clinical situation usually follows strenuous activity and is often referred to as "effort" thrombosis. Since some cases have occurred with mild exertion and there is a lack of obvious predisposing vessel trauma, a more correct term might be "primary" thrombosis. Early recognition of this condition is necessary to prevent potentially fatal acute effects and minimize chronic sequelae.

Adult↗
PubMed1993

Bronchogenic carcinoma in young adults.

Lung cancer occurs most frequently in the sixth decade of life. It has been suggested that the incidence of bronchogenic neoplasm is increasing in the population under the age of 40. While this observation may simply reflect the general increase in lung cancer in both sexes, there is a distinct difference in the pathology and behavior of lung tumors that occur in the young.

Adult↗
PubMed1993

Clinical theophylline toxicity: acute and chronic.

Reliable methods for measuring serum theophylline levels have provided the clinician with a range of serum theophylline concentrations to maximize therapeutic results while minimizing potential adverse effects. Although serum theophylline levels are often quoted for diagnosing theophylline toxicity, intolerance of this agent is closely associated with clinical features that are more important than an absolute serum value. This report contrasts the two most common settings of theophylline toxicity and presents an approach to the treatment of each type.

Adult↗
PubMed1992

Variable vocal cord dysfunction: an asthma variant.

Vocal cord dysfunction is a little recognized cause of dyspnea and wheezing. Its lack of recognition has often led to the institution of inappropriate therapeutic methods, including intubation and tracheostomy. Awareness of this possible cause of respiratory distress should allow early institution of appropriate psychotherapy, rather than unnecessary medical intervention.

Adult↗
PubMed1992

Thrombosed pulmonary artery aneurysm. A rare cause of a high-probability lung scan.

The high-probability ventilation-perfusion lung scan is accepted as supportive of pulmonary embolism and often negates further diagnostic evaluation; however, there are processes that mimic the clinical presentation and radiographic findings of pulmonary emboli, including a unilateral segmental or greater perfusion defect. We present the findings in a patient whose presentation and ventilation-perfusion scans over a three-month course were suggestive of pulmonary embolism, yet pulmonary angiography revealed a thrombosed pulmonary artery aneurysm. The interpretation of a unilateral segmental perfusion defect as high probability does not secure the diagnosis of pulmonary embolism and should not preclude further evaluation for alternative etiologies.

Adult↗
PubMed1992

Cushing's syndrome associated with lung tumors.

The production of corticotropin or corticotropin-releasing factor by non-pituitary, non-adrenal tumors may rarely be associated with an overt clinical expression of hypercortisolism. Recent studies have emphasized the importance of careful thoracic evaluation when such ectopic hormone secretion is suspected.

ACTH Syndrome, Ectopic↗
PubMed1992

Bronchoscopy for pulmonary hygiene in the intensive care unit.

The safety and ease of fiberoptic bronchoscopy recommends its use in the intensive care unit. In critically ill patients, the procedure may be a valuable diagnostic or therapeutic tool. In most instances, the diagnostic indications are well defined. The therapeutic indications for bronchoscopy, however, are more controversial. They center around using the bronchoscope for removal of secretions, mucus plugs and reversing atelectasis in mechanically ventilated patients. This report examines the small but definite risk of therapeutic bronchoscopy in mechanically ventilated patients.

Adult↗
PubMed1992

Solitary fibrous tumor of the pleura with hypoglycemia: the Doege-Potter syndrome.

The occurrence of hypoglycemia with an intrathoracic tumor was reported in 1930 independently by Doege and Potter. Since then, the presence of a nonpancreatic tumor associated with low blood sugars has often been referred to as the Doege-Potter syndrome. We report a patient with a recurrent solitary fibrous tumor of the pleura who experienced symptomatic hypoglycemia attributable to his tumor.

Aged↗
PubMed1992

Blastomycosis: a reminder of Kentucky's other fungus.

Although not as common as Histoplasmosis, the disease caused by Blastomyces dermatitidis is also endemic in the Commonwealth of Kentucky. Greater clinical awareness of this systemic mycosis and the newer effective forms of treatment may lessen the significant morbidity and mortality of this potentially serious infection. To illustrate the varied manifestations of this illness, we contrast the presentation of an urban female with blastomycosis and atypical chest radiographic changes to the more classic features of blastomycosis described in the literature.

Adult↗
PubMed1992

Pulmonary emphysema in a nonsmoker with normal alpha-1-antitrypsin.

Premature and rapidly progressing emphysema of the lung is unique in the absence of cigarette smoking or an inherited homozygous alpha-1-antitrypsin deficiency. We describe a young man with radiographic evidence of early onset bullous emphysema without the usual risk factors and provide a review of the alternative explanations proposed for this form of lung damage.

Adult↗