Mycobacterium marinum arthritis

Mycobacterium marinum is an atypical acid-fast organism that is rarelyassociated with septic arthritis. Most often this is seen in patients with monarticular synovitis of the hands or wrists, especially in association with a history of periarticular trauma or exposure to marine environments. From tissue obtained by aspiration or synovectomy, Mycobacterium marinum can be identified by Ziehl-Nielson stain and has optimal growth in Lowenstein-Jenson medium. Therapy should consist of at least two anti mycobacterial agents for a minimum 6 months. Surgical debridement also may be beneficial. The clinician must have a high index of suspicion that exposure to Mycobacterium marinum has occurred so appropriate stains and cultures can be obtained and antimycobacterial therapy initiated.     

Leiomyosarcoma of the rectum

A case of leiomyosarcoma of the rectum is presented and followed by a review of 135 cases from the literature. The five- and ten-year survival figures were the same whether the patient was treated by radical or local excision; however, local excision was followed by 67.5 percent recurrence. Abdominoperineal resection is still the procedure of choice. Local excision might be considered for small tumors of low-grade malignancy in a poor-risk patient.     

The relationship of serum IgA concentration to human immunodeficiency virus (HIV) infection: A cross-sectional study of HIV-seropositive individuals detected by screening in the United States Air Force

Serum immunoglobulins were measured in 107 patients with human immunodeficiency virus seropositivity. Each patient was categorized by the Walter Reed staging classification and serum concentrations of immunoglobulins were compared with patient staging. Serum IgM concentrations were normal in all but nine patients. Serum IgG concentrations were elevated in 74 of 107 patients, with no significant differences noted between different stages of disease severity. Serum IgA concentrations were elevated in 38 of 107 patients, with a significant relationship noted between increasing staging category and increasing serum IgA concentration (p = 0.0001). Serum IgA concentrations in patients with human immunodeficiency virus seropositivity may be a useful marker of immunologic progression of disease.     

Effect of a nonlactose diet on human intestinal disaccharidase activity

Summary Total lactose abstinence for 42 days in 7 subjects failed to induce a deficiency in intestinal lactase or clinical lactose intolerance. Therefore, dietary lactose content does not appear to be an important factor in determining the level of intestinal lactase in humans for this period of time.Further reproduction is authorized to satisfy the needs of the U. S. Government.Supported in part by Training Grant T1 AM-5179 from the National Institutes of Health, U. S. Public Health Service.The authors wish to acknowledge the technical assistance of Anthony Walker, who did the enzyme assays.     

Peripheral venous aneurysms with recurrent pulmonary embolism: Report of a case and review of the literature

This clinical report deals with a femoral venous aneurysm as a source of recurrent pulmonary embolism. The literature concerning venous aneurysms is reviewed with emphasis on those cases which were complicated by venous thrombosis and pulmonary embolism. This case demonstrates that lower leg venous aneurysms can occur in either sex and in different age groups. Venography was shown to be important in diagnosing these lesions. Surgical resection may be necessary to prevent potential thrombosis and life-threatening pulmonary embolism. Statement. The views expressed in this paper are those of the authors and do not necessarily reflect the views of the United States Air Force or the Department of Defense.—Lee H. Greenwood. M.D.     

Stone basket rescue

A case report is presented in which a Dormia stone basket tip was broken off and retained during a stone manipulation. It was successfully retrieved from the distal ureter with an alligator forceps under fluoroscopic guidance.