Diffuse pulmonary hemorrhage after streptokinase administration for acute myocardial infarction.

Fibrinolytic drug therapy has markedly reduced morbidity and mortality from acute myocardial infarction. As with any other drug therapy, however, benefits are maximal when patients at higher risk for complications can be identified and treatment decisions modified to reduce the chance of adverse events. Streptokinase, a commonly used and inexpensive thrombolytic, is known to cause both bleeding and immunologic complications, and coexistent conditions predisposing to either are considered relative or absolute contraindications to its use. We report an unusual case of immune-mediated diffuse pulmonary hemorrhage following streptokinase administration for acute myocardial infarction in a patient with pulmonary infection and concurrent cutaneous infection. We propose that these infections constitute additional risk factors and may be used to identify patients at higher risk of this complication from streptokinase.

Comparison of electromyographic response patterns during posture and stress tasks in chronic low back pain patterns and control.

Activity of the paraspinals, abdominals, and hip extensor muscles, heart rate, and skin conductance were measured in 13 chronic low back pain patients (CLBP) and 13 controls during static postures and psychological stress. After 10 min of baseline-rest, a subject was tested during standing, 45 degrees bend, maximum bend, posterior and anterior pelvic tilts, sitting, and supine with knees up, followed by mental arithmetic and the cold pressor. The postures were grouped into supported, balanced, and unbalanced categories. Multivariate analyses of variance revealed differences due to posture categories, but not due to group membership. It was concluded that while work is needed to understand normal muscle function during common movements, there is no compelling evidence that back muscle functioning in CLBP patients differs significantly from control subjects.

Myeloblastoma (granulocytic sarcoma) of the ovary.

Myeloblastic neoplasms occur in patients with leukemia. In women, the ovary is a common site. The cells of the tumor are identical histochemically to those in the peripheral blood. The Giemsa stain, PAS stain, and Leder stain assist in the diagnosis. The tumors are responsive to radiation therapy, chemotherapy, and operative removal, but tend to be associated with decreased survival. This report describes a case of myeloblastoma of the ovary in an 18-year-old woman. The clinical and pathologic features of these tumors are described. The literature is reviewed briefly.