Mayo Clinic proceedings
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Mayo Clinic proceedings · Dec 1984
Case ReportsDifferential mechanical ventilation in respiratory failure due to severe unilateral lung disease.
Severe unilateral lung disease that produces respiratory failure may necessitate mechanical ventilatory support to sustain gas exchange. This article describes the successful use of differential lung ventilation in the management of one patient with diffuse unilateral pneumonia and another with a postoperative bronchopleural fistula after standard methods of mechanical ventilation failed to provide adequate gas exchange for these patients.
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Mayo Clinic proceedings · Dec 1983
Occurrence of pheochromocytoma in Rochester, Minnesota, 1950 through 1979.
For the 30 years from 1950 through 1979, the population of Rochester, Minnesota, averaged 45,800, resulting in almost 1.4 million person-years of observation. During that time, 11 cases of pheochromocytoma were diagnosed in this population; thus, the average annual incidence rate was 0.8 per 100,000 person-years. With the inclusion of two additional diagnosed familial cases, the incidence rate would be 0.95 per 100,000 person-years. Five of the 11 cases were diagnosed initially at autopsy.
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Osteosarcomas of extragnathic craniofacial bones--those bones of the skull excepting the jaw bones--are rare lesions, constituting fewer than 2% of all osteosarcomas. In our series of 21 patients (12 male and 9 female), the ages ranged from 6 to 77 years, and 10 patients were in the third or fourth decade of life. At least six patients had predisposing conditions: Paget's disease of bone in three and prior regional irradiation in three. ⋯ Almost half of our patients died within 1 year after diagnosis. The one long-term survivor (12 years) underwent a radical surgical procedure when her tumor was small; this was the only patient in this series who had a low-grade lesion. Because of the characteristics described, osteosarcoma of extragnathic craniofacial bones must be considered a distinct disease.
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Staphylococcus aureus causes an acute endocarditis, often involving previously normal valves. The criteria used for diagnosis of subacute bacterial endocarditis are frequency absent, and distinguishing acute endocarditis from bacteremia without valvular involvement is difficult. ⋯ Use of two synergistic antibiotics has not been proved clinically superior to use one agent, and surgical intervention during treatment may be necessary in some cases. Despite prompt treatment recognition of complications, the morbidity and mortality associated with this infection remain high.