Through thick and thin

Article Abstract:

Two recent papers on quite different diseases of the kidney have focused attention on the importance of obtaining biopsies for microscopic analysis of the nature of the pathology. In a study of membranous glomerulonephritis, the membrane that supports the microscopic structures which are responsible for filtration of the blood (the glomerulus) was found to be thickened. The other study dealt with idiopathic hematuria, the presence of blood in the urine for no apparent reason. In this case, biopsy samples of patients' kidneys examined by both light and electron microscopes led to the discovery that a significant number of patients had a extraordinary reduction of the thickness of the glomerulus basement membrane. The use of biopsies was also an effective way of getting at the prognosis of each case. Similarly, since many urologic and renal problems have a common symptom in hematuria, obtaining kidney biopsy material to clearly document the condition, determine the proper treatment, and project the prognosis is essential to the management of the patient.

Research, Glomerulonephritis, editorial, Ponticelli, Claudio, Tiebosch, Anton T.M.G.

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Through thick and thin

Article Abstract:

The case of a 58-year-old woman illustrates the difficulty in diagnosing pulmonary embolism. This condition is caused by a blood clot in the lungs. She was admitted to a hospital with chest pain similar to the pain she experienced a few months before, when she had a heart attack. However, her ECG was normal. Abnormalities in her blood gases caused her doctors to suspect pulmonary embolism even though she had very few of the normal symptoms. An x-ray technique to image the blood vessels in her lungs confirmed that she had a pulmonary embolism.

Pulmonary embolism

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Vestibular neuritis, or driving dizzily through Donegal

Article Abstract:

A neurologist experienced vertigo ten years ago while driving up the coast of Donegal in Ireland. He wonders whether the self-diagnosis he did then according to what was in the textbooks is relevant to the new findings in vestibular neuritis.

Personal narratives, Ear diseases, Neurologists, Vestibular diseases

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