Abstract:
:A 66-year-old white male presented with jaundice, pruritus, and a 30-pound weight loss over two months. Physical examination revealed scleral icterus. Laboratory evaluation revealed ALT 161 U/L, AST 290 U/L, alkaline phosphatase 2004 U/L, GGT 2,552 U/L, total bilirubin 10.2 mg/dL, and a carbohydrate antigen 19-9 (CA 19-9) level of 4,374 U/mL. Initial endoscopic retrograde cholangiopancreatography (ERCP) was unsuccessful due to ulceration in the duodenum healed with esomeprazole therapy. Subsequent ERCP showed a possible filling defect in the common bile duct treated with sphincterotomy and balloon sweeping of the common bile duct. Symptoms and jaundice resolved five months after initial presentation with normal labs and studies. While elevated CA 19-9 levels occur in most patients with carcinoma of the pancreas, it can also be elevated in patients with extrapancreatic malignancies and acute cholangitis. This case illustrates the fact that a markedly elevated CA 19-9 can be secondary to causes other than carcinoma.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Lowe D,Lee J,Schade R,Chaudhary Adoi
10.1097/01.smj.0000202695.97123.2bsubject
Has Abstractpub_date
2006-03-01 00:00:00pages
306-8issue
3eissn
0038-4348issn
1541-8243journal_volume
99pub_type
杂志文章abstract:BACKGROUND:In this study, the clinical characteristics, survival, and prognostic factors of 200 patients diagnosed as having chronic lymphocytic leukemia (CLL) were analyzed. METHODS:The medical charts of 200 CLL patients registered to our center between 1984 and 2000 were retrospectively evaluated. RESULTS:Of all pa...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000053674.03385.B7
更新日期:2004-03-01 00:00:00
abstract::We have described a case of reversible acute renal failure caused by acute pyelonephritis. In this entity, the kidneys are swollen by an interstitial infiltrate and edema, and white cell tubular casts and microabscesses may be present. Fractional excretion of sodium is high, and nephrotic proteinuria may occur without...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198003000-00030
更新日期:1980-03-01 00:00:00
abstract::Chronic mucocutaneous candidiasis is a heterogeneous group of immunodeficiencies associated with persistent candidal infections. Patients with chronic mucocutaneous candidiasis are rarely associated with systemic infections caused by other fungi, but almost never by Candida. The authors report a case of a 16-year-old ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-200408000-00024
更新日期:2004-08-01 00:00:00
abstract::Swing beds contribute significantly to inpatient rehabilitation and skilled nursing care of the rural elderly, but little information is available in the general clinical literature regarding the types and outcomes of patients admitted to these programs. All swing bed admissions to a small rural hospital for the 1989 ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199212000-00008
更新日期:1992-12-01 00:00:00
abstract::The experience of the Southern Regional Trophoblastic Disease Center includes 222 patients who were referred from January 1972 to October 1977. The initial tissue diagnosis was hydatidiform mole in 212 patients and choriocarcinoma in ten. There was spontaneous remission of 142 (69%) of the moles and one of the chorioc...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197811000-00006
更新日期:1978-11-01 00:00:00
abstract::The objective of this study was to determine the effect(s) of pregnancy and of advancing gestation on maternal serum amylase and lipase levels. Thus, serum amylase and lipase concentrations were quantitated in three groups of women. Groups included (1) 118 pregnant women whose serum amylase and lipase levels were meas...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007611-199602000-00008
更新日期:1996-02-01 00:00:00
abstract::A 74-year-old man was admitted with rhabdomyolysis after undergoing initial treatment for gastrointestinal cancer with irinotecan. The syndrome partially resolved after the discontinuation of all of his usual medications, including his chronic selective serotonin reuptake inhibitor (SSRI). The rhabdomyolysis was exace...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000084311.35864.D6
更新日期:2003-10-01 00:00:00
abstract::Chordomas are tumors originating from remnants of the notochord, most commonly found in the cranial and caudal regions. This is a report of the seventh intrathoracic chordoma in the world literature and the second to be reported in a woman. Histologically the physalipherous (blister-bearing) cell is characteristic of ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197501000-00029
更新日期:1975-01-01 00:00:00
abstract::We retrospectively reviewed medical records and computerized critical care data for 40 consecutive critically ill surgical patients receiving "standard" doses (1.5 to 2.0 mg/kg loading dose and 3 to 5 mg/kg/day) of gentamicin or tobramycin for gram-negative infections. End points measured were serum drug levels and cl...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199701000-00007
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVES:To determine the prevalence of overweight in a cardiac stress testing population, and the percentage of subjects who indicate a history of overweight. METHODS:A total of 251 consecutive subjects presenting for cardiac stress testing in a 450-bed community hospital from June to September 2010 were asked to c...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31821e9359
更新日期:2011-07-01 00:00:00
abstract::Several treatment regimens of trimethoprim-sulfamethoxazole (TMP-SMZ) were compared to the USPHS-recommended schedules for treatment of uncomplicated gonorrhea with ampicillin plus probenecid, tetracycline, or aqueous procaine penicillin G in both men and women. TMP-SMZ, six tablets as a single oral dose daily for 3 d...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197509000-00020
更新日期:1975-09-01 00:00:00
abstract::Two cases of recurrent psychotic depression are reported in which ECT (electroconvulsive therapy) was administered with good results for previous episodes of depression, but treatment of the current episode with combined drug therapy (antidepressant and antipsychotic drugs) in one case and antidepressant chemotherapy ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197812000-00021
更新日期:1978-12-01 00:00:00
abstract::We report two cases of lymphangiomyomatosis with pleural and peritoneal chylous effusions, one without pulmonary involvement. The first patient died after seven years. The second received external irradiation to control the chylous ascites and remains alive 12 years later. The disease appears to be estrogen-dependent,...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198408000-00024
更新日期:1984-08-01 00:00:00
abstract:OBJECTIVES:Accurate and consistent documentation of pain management, including patient responses regarding improvement in pain scores, is essential for improving patient care. The objective of the project was to evaluate the current prescribing patterns and to review the current documentation for opioid-managed, chroni...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3182296f20
更新日期:2011-09-01 00:00:00
abstract::Prognosis of angiosarcoma, the most common primary malignant cardiac tumor, is very poor. An early detection and treatment may extend survival beyond one year. Newer imaging modalities, including magnetic resonance imaging (MRI), play an important role in the evaluation of cardiac masses. The case of a man admitted to...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181ecfb64
更新日期:2010-10-01 00:00:00
abstract::We evaluated the indices of arterial distensibility in a group (N = 40) of normotensive subjects and patients with borderline or established hypertension by measuring intra-arterial pressure, pulse wave velocity, and a mathematical modification of MOEN's formula to calculate arterial distensibility. Multiple linear re...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198401000-00015
更新日期:1984-01-01 00:00:00
abstract::While opioids are regarded as the mainstay of chronic pain management, their use is controversial in the minds of many primary care physicians due to clinical concerns about dependence, abuse, and addiction and medicolegal concerns regarding state and federal regulatory authorities. For patients with moderate to moder...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e3180f626ff
更新日期:2007-10-01 00:00:00
abstract::Phantom sensation and phantom limb pain are two recognized sequelae of limb amputation. In most previous surveys, amputations were done for arteriosclerotic or trauma related conditions. We studied 25 patients who had lower extremity amputation for neoplasia. In studying the features of pain before and after amputatio...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198501000-00009
更新日期:1985-01-01 00:00:00
abstract::Chemotherapy with radiation has become more popular than radiotherapy alone for patients with locally advanced head and neck cancer because of the successful results associated with it. We report the case of a 67-year-old man with hypopharyngeal cancer invading the prevertebral fascia who became free of disease after ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000125170.34916.FB
更新日期:2004-11-01 00:00:00
abstract::Gabapentin, an antiepileptic agent, is a safe and versatile medication also used in the adjunctive treatment of painful disorders. These include neuropathic pain, such as postherpetic neuralgia, diabetic neuropathy, and the pain of reflex sympathetic dystrophy. Interstitial cystitis, a painful disease entity, shares m...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVES:To determine whether prolonged length of stay (pLOS) in ischemic stroke is related to delays in discharge disposition arrangement. METHODS:We designed a retrospective study to compare patients with acute ischemic stroke who experienced pLOS to those who did not experience pLOS. Patients who have had acute i...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0000000000000036
更新日期:2013-12-01 00:00:00
abstract::Extraskeletal dedifferentiated chondrosarcomas (DC) are uncommon tumors that predominantly occur in the head and neck. Herein, we describe a case of pulmonary DC detected in a patient with systemic sclerosis and presenting with a symptomatic large pleural effusion and a pulmonary lobar consolidation on chest imaging. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181ad6236
更新日期:2009-08-01 00:00:00
abstract::Computed tomography (CT) is increasingly used to evaluate abdominal diseases, including those of the colon. Recent CT studies have documented colonic abnormalities in patients with pseudomembranous colitis; however, these findings are not widely appreciated by primary care physicians. Over a 25-month period, we prospe...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199509000-00008
更新日期:1995-09-01 00:00:00
abstract::In three patients with SIADH, mannitol or glycerol promoted a rapid free water diuresis. Use of osmotic agents requires less laboratory and clinical monitoring than use of furosemide, is appropriate treatment, and in fact may be the treatment of choice in some patients with symptomatic hyponatremia from SIADH. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198503000-00028
更新日期:1985-03-01 00:00:00
abstract::Reported is the association of condyloma acuminatum and squamous carcinoma of the vulva in three cases and condyloma followed by squamous dysplasia in a fourth case. This association has previously been reported in both male and female genitalia and in the perianal area. In our four cases, cancer or squamous dysplasia...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197705000-00029
更新日期:1977-05-01 00:00:00
abstract::The comparative value of palpation, light percussion, and auscultatory percussion for detecting the liver below costal margin was studied in 45 normal subjects and 20 patients. The presence of the liver 2 cm or more below the costal margin was considered abnormal, since this organ was found no more than 1 cm below in ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199402000-00006
更新日期:1994-02-01 00:00:00
abstract::Seven patients with diabetes of ten to 24 years' duration and renal insufficiency were treated with fluphenazine and amitriptyline in an attempt to control severe pain in the extremities. Six patients had relief of pain within five days of initiation of therapy. One patient had no pain relief despite mood alteration. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1983-04-01 00:00:00
abstract::The gene for sickle cell disease is carried by 8% of the African-American population in the United States. The primary care physician is often called upon to recognize and treat one of the major sequelae of sickle cell disease--vaso-occlusive pain crisis. An injectable nonsteroidal anti-inflammatory drug has recently ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199208000-00005
更新日期:1992-08-01 00:00:00
abstract::Nonspherocytic hemolytic anemia was diagnosed in a 34-year-old man with jaundice since childhood. Splenectomy at the age of 8 had no influence on the anemia. Bronze diabetes was diagnosed at age 31, presumably due to hemosiderosis and secondary hemochromatosis. Iron chelation was unsuccessful in controlling iron overl...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198505000-00027
更新日期:1985-05-01 00:00:00
abstract:OBJECTIVE:We sought to determine predictors of coronary events (cardiac death, acute myocardial infarction, and urgent revascularization) within 30 days after admission. METHODS:We prospectively collected data on 400 patients admitted through our emergency room for unstable angina and acute coronary syndromes. Patient...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000053481.49309.58
更新日期:2003-11-01 00:00:00