The clinical course of a 50-year-old woman with oral lichen ruber planus (Irp) and prolonged dysphagia is described. The swallowing problems of this patient were related to an inflammatory lesion of the middle third of the esophagus, leading to stenosis. Distal to this area, the esophagus was covered with mucosa of the cardia type, as seen in endobrachyesophagus. Apart from reflux disease, the Irp may have accounted for the stenosis of the mid-esophagus. The mucosal lesions disappeared after administration of etretinate (Tigason). After endoscopic dilatation the patient was able to swallow normally again.
Tangier disease is a rare familial metabolic disorder due to the absence of normal plasma HDL. Cholesteryl esters are stored in various tissues, mostly in reticulo-endothelial foam-cells; enlarged tonsils, (hepato) splenomegaly and polyneuropathy are the principal clinical manifestations. The very unusual endoscopical findings in a recently observed patient might contribute to the detection of this disease: the uneven surface of the liver has a salmon-bright red, strawberry-like color; the enlarged spleen is covered by numerous minute, yellowish, subcapsular "stipples" and some isolated, irregular, yolk-yellow patches; the rectal, and even more the colonic mucosa, presents itself with round, brownish-red spots, diffusely scattered on a yellow-orange background ("cheetah fur-like").
ERCP was performed in 57 patients who had undergone Billroth II resection. Cannulation of the papilla of Vater was successfully accomplished in 31 cases (55%). The success rate of ERCP was clearly dependent on the type of Billroth II resection presenting.
We report on six cases of sepsis caused by Serratia marcescens in patients with neutropenia. Four cases showed an additional involvement of the upper respiratory and digestive tract with oral and pharyngeal mucositis, haemorrhagic laryngo-tracheo-bronchitis, and oedematous swelling of the face. One patient showed a Serratia marcescens carrier state in the pharynx over a period of months without neutropenia. The isolated strains showed a broad spectrum of resistance against antibiotics; only aztreonam and amikacin were effective in vitro against all isolates.
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