Index by author

July 01, 1993; Volume 60,Issue 4

  1. Schuster, Marvin M.

    1. Irritable bowel syndrome: new perspectives on management
      Marvin M. Schuster, MD
      Cleveland Clinic Journal of Medicine July 1993, 60 (4) 270-272;

      Long classified as psychosomatic, irritable bowel syndrome is now considered a motor disorder in which a number of factors are at play.

  2. Steiner, Charles P.

    1. Stereotactically guided thrombolysis of deep cerebral hemorrhage: preliminary results
      David W. Miller, MD, Gene H. Barnett, MD, Donald W. Kormos, PhD and Charles P. Steiner, BS
      Cleveland Clinic Journal of Medicine July 1993, 60 (4) 321-324;

      BACKGROUND The neurologic outcome from conventional medical or surgical therapy of intracerebral hemorrhage (ICH) is poor; however, stereotactically guided instillation of thrombolytic agents to dissolve parenchymal clots due to hypertensive hemorrhage has recently produced results equal to or better than those obtained with conventional therapies.

      OBJECTIVE To determine whether stereotactic thrombolysis of deep ICH is safe and effective.

      METHODS We administered urokinase to clots in four patients with hypertensive ICH. After the hemorrhage was localized using angiography and computed tomography-assisted stereotactic technique, a ventricular catheter was used to administer urokinase to the clot.

      RESULTS Preliminary results showed dramatic reduction in clot volume within 48 hours of initiating treatment and modest clinical improvement in all four patients. No further hemorrhages were seen after treatment. Three patients ultimately died of non-neurologic causes.

      CONCLUSIONS With careful patient selection, stereotaxy-assisted thrombolytic therapy may be an advance in the treatment of certain cases of ICH.

  3. Stillwell, Paul

    1. Lung transplantation: the Cleveland Clinic experience
      Sunit R. Patel, MD, Thomas J. Kirby, MD, Patrick M. McCarthy, MD, David P. Meeker, MD, Paul Stillwell, MD, Thomas W. Rice, MD, Mani S. Kavuru, MD and Atul C. Mehta, MD
      Cleveland Clinic Journal of Medicine July 1993, 60 (4) 303-319;

      BACKGROUND Lung transplantation has been steadily developing as a therapeutic option for end-stage lung disease.

      METHODS Retrospective analysis of all 26 patients who underwent lung transplantation at the Cleveland Clinic Foundation between February 1990 and February 1992.

      RESULTS Nineteen single-lung transplantations and seven bilateral lung transplantations were performed. The 1-year actuarial survival for all recipients was 65%. A trend was noted towards better survival in recipients with emphysema (100%) and poorer survival in those with pulmonary hypertension (37.5%). Fungal sepsis and reimplantation lung injury were the most common causes of death, and most deaths (8 of 9) occurred within the first 4 weeks. Of 119 pulmonary complications, 82% occurred in the first 3 months, with infection (39%) and acute rejection (29%) being the most common. Bacterial and fungal infections occurred mainly in the first month, and cytomegalovirus infections occurred mainly in the second and third months. The majority of survivors have shown improvement in functional status.

      CONCLUSIONS The early perioperative and 1-month post-transplantation period appears critical to long-term survival. Even though the complications are numerous, they are usually manageable and, in general, do not result in long-term morbidity.

  4. Stoller, James K.

    1. The elevated peripheral white blood count
      Brian J. Bolwell, MD
      Cleveland Clinic Journal of Medicine July 1993, 60 (4) 267-268;

  5. Sweeney, Patrick J.

    1. Parkinson’s disease: where do westand?
      Patrick J. Sweeney, MD
      Cleveland Clinic Journal of Medicine July 1993, 60 (4) 269-270;

      Although a cure has not been found, certain drugs can relieve symptoms and may actually slow disease progression.

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