IMAGES IN CLINICAL MEDICINE: Spontaneous Pneumothorax in Tuberous Sclerosis

A 28-year-old woman with tuberous sclerosis presented with sudden onset of dyspnea and discomfort in the right chest and back. On examination she had tachycardia, tachypnea, and hypoxia, with an...

ORIGINAL ARTICLE: Sirolimus for Angiomyolipoma in Tuberous Sclerosis Complex or Lymphangioleiomyomatosis

Background: Angiomyolipomas in patients with the tuberous sclerosis complex or sporadic lymphangioleiomyomatosis are associated with mutations in tuberous sclerosis genes resulting in constitutive activation of the mammalian target of rapamycin...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 7-2007 — A 59-Year-Old Woman with Diabetic Renal Disease and Nonhealing Skin Ulcers

Dr. Maha R. Farhat (Medicine): A 59-year-old woman was admitted to the hospital because of a nonhealing ulcer on the right heel and painful ulcers on the right thigh and...

REVIEW ARTICLE: Management of Crush-Related Injuries after Disasters

Disasters can rarely be anticipated, much less prevented. After both natural disasters (e.g., earthquakes, hurricanes, tornadoes, and landslides) and man-made catastrophes (e.g., wars, mining accidents, and terrorist attacks), injuries to...

IMAGES IN CLINICAL MEDICINE: Urinary Calcium Oxalate Crystals in Ethylene Glycol Intoxication

A 73-year-old man presented with a self-inflicted stab wound to the abdomen. A plasma ethanol level of 27 mg per deciliter was found on preliminary toxicologic screening; the results of...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 31-2005 — A 60-Year-Old Man with Skin Lesions and Renal Insufficiency

A 60-year-old man was evaluated in the rheumatology clinic because of a rash and worsening renal function.

He had been well until three months earlier, when he began to have fatigue...

IMAGES IN CLINICAL MEDICINE: Improvement in Hypertensive Retinopathy after Treatment of Hypertension

A 34-year-old woman presented with a short history of headache and blurred vision. Her corrected visual acuity was 20/30 and N24 in the left eye and 20/20 and N5 in...

ORIGINAL ARTICLE: Nephrogenic Syndrome of Inappropriate Antidiuresis

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common cause of hyponatremia. We describe two infants whose clinical and laboratory evaluations were consistent with the presence of SIADH,...

REVIEW ARTICLE: Renal Dysfunction Complicating the Treatment of Hypertension

Treatment of hypertension in patients with normal renal function does not generally cause renal dysfunction. By contrast, in patients with hypertension and chronic renal insufficiency, it is not uncommon for...

ORIGINAL ARTICLE: Prospective Study of Polyomavirus Type BK Replication and Nephropathy in Renal-Transplant Recipients

Background: Nephropathy associated with the polyomavirus type BK (BKV) nephropathy has emerged as a cause of allograft failure linked to immunosuppressive regimens containing tacrolimus or mycophenolate mofetil. The presence of...

ORIGINAL ARTICLE: BK-Related Polyomavirus Vasculopathy in a Renal-Transplant Recipient

Polyomaviruses typically infect a single species and limited types of tissue. Examples include the human BK and JC viruses and simian virus 40 (SV40). These three viruses are approximately 70...

ORIGINAL ARTICLE: A Comparison of the Survival of Shipped and Locally Transplanted Cadaveric Renal Allografts

Background: The effect on allograft survival of the shipment of cadaveric renal allografts from one organ-procurement organization to another is uncertain.

Methods: Using data from the Organ Procurement and Transplantation Network...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 32-2001 — A 77-Year-Old Man with Rheumatoid Arthritis and Acute Dyspnea and Renal Failure

A 77-year-old man was transferred to this hospital because of worsening bilateral air-space disease and acute renal failure.

He had stopped smoking 30 years before admission. He had mild chronic obstructive...

EDITORIAL: Is Liver Fibrosis Reversible?

Cirrhosis represents a late stage of progressive scarring in chronic liver disease. It begins with subendothelial or pericentral fibrosis (hepatic fibrosis) and progresses to panlobular fibrosis with nodule formation (cirrhosis)....

EDITORIAL: Hemodialysis as an Artificial Lung in Sleep Apnea

In 1959, O'Brien, Baxter, and Teschan, with the help of medical corpsmen at Brooke Army Medical Center, demonstrated that daily hemodialysis for up to 22 days promoted survival in 13...

ORIGINAL ARTICLE: Transmission of by Organ Transplantation

Histoplasmosis may occur either after primary infection or after reactivation of latent infection, and its incidence among immunocompromised persons, including recipients of organ transplants, is increasing.123 A variety of infectious...

EDITORIAL: A Survival Advantage for Renal Transplantation

There is virtual unanimity that the optimal treatment for most patients with end-stage renal disease is renal transplantation. However, unlike the case for liver, heart, and lung transplantation, for which...

ORIGINAL ARTICLE: Subcutaneous Compared with Intravenous Epoetin in Patients Receiving Hemodialysis

Background: Several studies have suggested that if recombinant human erythropoietin (epoetin) is administered subcutaneously rather than intravenously, a lower dose may be sufficient to maintain the hematocrit at a given...

IMAGES IN CLINICAL MEDICINE: Calcified Mass in a Patient on Long-Term Hemodialysis

Figure 1. A 46-year-old man with end-stage renal disease due to diabetic nephropathy had been undergoing hemodialysis for almost two years. Fourteen months after beginning dialysis, he reported pain below...

ORIGINAL ARTICLE: Treatment of Ostial Renal-Artery Stenoses with Vascular Endoprostheses after Unsuccessful Balloon Angioplasty

Background: Percutaneous transluminal renal angioplasty is a safe and effective treatment for nonostial stenoses of the renal arteries, but it has proved to be disappointing for ostial stenoses. Therefore, we...

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