bluuebunny/crossref_metadata_2025 huggingface dataset:
Cutaneous Rosai‐Dorfman Disease
Authors: Lin L. , Bergfeld W. F.
Published: August 2010

Rosai‐Dorfman disease, or sinus histiocytosis with massive lymphadenopathy (SHML), is a rare benign disease of unknown etiology that involves the cervical lymph nodes. Histologic findings include emperiopolesis of lymphocytes and S‐100 protein positivity. Extranodal involvement occurs in 30–40% of cases, often involving skin. However, cutaneous Rosai‐Dorfman disease without lymph node involvement is uncommon. We describe a case of cutaneous Rosai‐Dorfman disease and discuss its clinical and histopathologic findings. A 69‐year‐old Caucasian male presented with a two‐year history of a slowly enlarging violaceous mass on the mid‐upper abdomen. He had a history of renal cell carcinoma two‐year ago and was asymptomatic without any systemic symptoms. Physical examination revealed a large, violaceous mass of mid‐upper abdomen with several violaceous nodules surrounding the periphery. There was no palpable lymphadenopathy. Punch biopsy showed diffuse dermal infiltrates composed of central xanthomatous cells surrounded by lymphoplasmacytic cells. Focal germinal center was noted. Immunostaining revealed strong S‐100 and CD68 reactivity of central xanthomatous cells and kappa and lambda polyclonal lymphoplasmacytic cells. Special stains for infectious disorder were negative. Cutaneous Rosai‐Dorfman disease is a benign reactive process, often under‐recognized due to lack of systemic symptoms and lymphadenopathy. A high index of diagnostic awareness is required for its recognition.
Multiple Sclerotic Fibromas in an HIV‐Positive Patient Without Evidence of Cowden’s Disease
Authors: Olivere Joseph W. , Monahan Timothy P. , Barrett Terry L.
Published: August 2010

Sclerotic fibroma is an uncommon benign neoplasm of the skin which may occur sporadically in a solitary form or as multiple lesions as a component of Cowden’s disease. Sclerotic fibromas have a distinctive histologic appearance characterized by well‐circumscribed, hypocellular dermal nodules of thick, hyalinized collagen bundles arranged in a whorled or storiform pattern with prominent clefts. We present the case of a 52‐year‐old HIV‐positive, African‐American female who presented with multiple firm flesh‐colored nodules of several year duration on bilateral lower extremities. Biopsies of the lesions demonstrated characteristic features of sclerotic fibroma. Detailed physical examination and extensive systemic work‐up failed to reveal evidence of Cowden’s disease. To our knowledge, multiple sclerotic fibromas have not been reported in the absence of Cowden’s disease, and this is the first reported case of multiple sclerotic fibromas occurring in an HIV‐positive patient without evidence of Cowden’s disease.
Primary Cutaneous Carcinosarcoma (PCCS0 Aka Metaplastic Carcinoma)
Authors: Ram Ramin , Saadat Payam , Vadmal Manju
Published: August 2010

We describe a case of PCCS in a 73 year‐old male who presented with a rapidly growing tumor of 6 months duration on the right ear. Clinical examination revealed a 5 × 4 × 4‐cm ulcerated, crusted, exophytic tumor on the superior aspect of the helix. Histologically, the mass revealed a biphasic tumor with malignant epithelial and mesenchymal components. The epithelial component consisted of a few foci of basal cell carcinoma (BCC). The majority of the tumor was composed of osteogenic sarcoma and malignant fibrous histiocytoma (MFH). An intricate transition of BCC into sarcoma was noted in a few foci. Atypical mitosis and necrosis were common. The BCC and tumor giant cells in the MFH area showed positive immunoreaction for cytokeratin and CD68 respectively. The tumor was negative for S‐100 protein, HMB‐45, muscle actins, chromogranin, and synaptophysin. In conclusion, a PCCS growing predominantly as osteosarcoma and MFH is reported. Although the exact histogenesis of PCCS is unknown, primitive mesenchymal cells of the dermis, surrounding the follicular units, are capable of pluripotent differentiation and are likely the source of origin of the sarcoma. The known aggressive biological behavior warrants wide excision and given the rare reports of metastasis and death, regular follow‐up is required
Cutaneous Rhizopus in an Immunosuppressed Patient
Authors: Ravis S. , Frankel S. , Elgart G.
Published: August 2010

The patient is an eight‐year‐old white male with a prior history of a small bowel transplant secondary to gastroschisis and a history of chronic rejection. He was admitted to the hospital to rule out rejection of his second small bowel transplant. During the admission he developed painful erythematous plaques with necrosis and hemorrhagic bullae on his left knee and left neck. Dermatology was consulted and biopsies and tissue cultures were obtained. On H&E there were multiple thick walled non‐septate hyphae and the GMS stain showed right angle irregular branching hyphae with an affinity for blood vessels. A further work‐up for disseminated disease was negative. The patient was diagnosed with cutaneous mucormycosis. The patient underwent extensive surgical debridement and was started on Ambisone and treated for six months with resolution. Primary cutaneous mucormycosis is a rare opportunistic deep fungal infection. It is the most acute and fatal of all fungal infections. There are multiple associated conditions including immunosuppression. This disease can be controlled with early diagnosis and a combination treatment plan. There are only a few reported cases in the pediatric population.
Chordoma Cutis: An Unusual Malignant Tumor Metastatic to Skin
Authors: Rubin A. , Bagel J. , Niedt G.
Published: August 2010

A seventy‐year‐old woman developed back pain associated with a sacral mass seven years prior to presentation. Biopsy of the sacral mass showed chordoma. The patient underwent two surgical resections because of recurrent disease. She presented after developing a firm, non‐tender skin nodule on the left back. Biopsy of the lesion showed a dermal neoplasm composed of nests of cells in a mucinous stroma. There was moderate cytologic atypia of the cells, and occasional mitotic figures were seen. Physaliphorous cells were present. The immunostains S‐100, cytokeratin, and EMA were all positive. A diagnosis of metastatic chordoma to the skin or chordoma cutis was made. The patient died 15 months later from complications of metastatic disease. Chordomas are rare, representing only 1–4% of malignant bone tumors, which most often occur in the sacral area. Metastasis to the skin is unusual. In one study, 207 cases of chordoma were evaluated, and only 19 had skin involvement. Chordoma cutis has been described as nodules which are firm, blue domed, cystic‐appearing, erythematous, translucent, flesh‐colored, and reddish brown. Cutaneous metastasis of chordoma has been reported to the nose, chest, back, thigh, shoulders, left arm, face, neck, and scalp.
Septic Vasculitis from Femoral Artery Catheterization
Authors: Saporito F. , Stetson C. , Hope R.
Published: August 2010

A 77‐year‐old white male presented to an outpatient clinic with painful, purpuric macules and papules on his right foot. The patient had recently undergone cardiac catheterization via his right femoral artery. The patient had no other complaints, was afebrile, and generally felt well. The clinical impression was either cholesterol emboli versus vasculitis. A 4 mm punch biopsy was obtained. Histopathology showed a vasculitis with many basophilic organisms consistent with bacteria present within the vascular spaces. There was a perivascular infiltrate consisting of lymphocytes and neutrophils. A gram stain revealed gram‐positive cocci. The clinician was immediately notified and blood cultures were drawn and echocardiogram performed. The cultures grew staphylococcus aureus. While no evidence of endocarditis was found, a psuedoaneurysm of the right femoral artery was noted. Despite rapid admission and treatment, the patient subsequently expired.
Aquagenic Syringeal Acrokeratoderma
Authors: Scalf L.A. , Baldwin B. , Messina J.
Published: August 2010

A 24 year‐old man with a 3‐year history of hyperhidrosis presented with intermittent bilateral, burning, whitish translucent patches with excessive wrinkling of the palms. These symptoms occurred within minutes of exposure to water or sweat. He complained of pain with hand flexion during flares. Symptoms usually resolved within an hour of drying. Soles were spared. No relationship to pressure or trauma existed. He had no history of atopy, other skin disease, or family history of a similar disorder. Physical examination revealed several macerated patches in the center of the palms. After immersion in water for several minutes, the palms and lateral fingers became whitish, translucent, edematous, thickened, intensely wrinkled, and painful. There was no response to topical emollients and aluminum chloride. Biopsy revealed hyperkeratosis; the epidermis was otherwise unremarkable. Eccrine ostia were unremarkable. No significant inflammation was present. The eccrine epithelium was distinctively hyperplastic and papillated, with focal stratification. Glandular cells were enlarged with abundant, granular cytoplasm. To our knowledge, this is the first reported case of aquagenic syringeal acrokeratoderma in a male patient. All other reported cases have been in women from 9 to 33 years old. The histologic features of the present case are also unique.
Verrucous Malignant Melanoma with Lentigo Maligna Masquerading as Invasive Squamous Cell Carcinoma
Authors: Scalf L.A. , Messina J.L. , Glass L.F.
Published: August 2010

An 85 year‐old woman presented with two pearly papules on her left cheek. The clinical impression was BCC. Biopsy revealed a proliferation of atypical keratinocytes emanating from the epidermis and extending beyond the papillary dermis. A diagnosis of invasive squamous cell carcinoma was rendered. Excison with frozen section margin control was performed. Permanent sections revealed melanoma, at least 2.06 mm in depth, with melanoma in situ extending to all peripheral margins. Upon re‐examination of the initial biopsies, pseudoepitheliomatous epidermal hyperplasia (PEH) with marked squamous atypia was noted. Intimately admixed with the squamous proliferation was a growth of large malignant epithelioid cells. The epitheliod cells lacked pigment production and extended to the shave biopsy margins. This second population of cells was strongly S‐100 positive, diagnostic for amelanotic verrucous melanoma. A revised diagnosis of verrucous malignant melanoma, Clark level III, 0.82 mm in depth was rendered. The patient’s course was complicated by multiple positive surgical margins and she ultimately received XRT. This case spotlights the rare occurrence of PEH in conjunction with melanoma. PEH can mask the underlying melanoma and lead to a diagnosis of squamous cell carcinoma. As demonstrated, immunostaining is essential in diagnosis of this difficult tumor.
Mast Cell Tryptase and Microphthalmia Transcription Factor Effectively Discriminate Between Cutaneous Mast Cell Disorders and Leukemia Cutis: A Comparative Cytochemical and Immunohistochemical Study
Authors: Sundram U. , Natkunam Y.
Published: August 2010

Cutaneous mast cell disorders are uncommon but a subset of these disorders, especially mastocytoma, can histologically mimic leukemia cutis. Our objective was to employ a panel of cytochemical and immunohistolochemical markers to determine which markers would be most useful in distinguishing these entities. We studied 17 cases of cutaneous mast cell disorders (UP, TMEP, and mastocytoma) and 12 cases of leukemia cutis (myeloid, myelomonocytic and monocytic) with toluidine blue, Giemsa, pinacyanol erythrocyanate (PE), mast cell tryptase, microphthalmia transcription factor (MITF), CD117, myeloperoxidase, CD43 and CD68. We found that PE stained the majority of cases of mast cell disorders (11/15) but did not stain leukemia cutis. Tryptase and MITF stained all cases of mast cell disorders but not leukemia cutis. Although CD117 showed strong staining in all cases of mast cell disorders, it also stained up to 25% of cases of leukemia cutis (2/8). Staining for myeloperoxidase was specific to leukemia cutis but detected only leukemias with myeloid differentiation (6/12). Our results show that mast cell tryptase and microphthalmia transcription factor are equally effective in distinguishing mast cell disorders from leukemia cutis. Interestingly, pinacyanol erythrocyanate appears to be specific for mast cell disease, as no staining was seen in leukemia cutis.
CD30‐Positive Large Cell Transformation of Mycosis Fungoides
Authors: Susa JS , High WA , Yegappan S , Hoang MP
Published: August 2010

Large cell transformation of mycosis fungoides (MF) is an uncommon phenomenon. We present a case of CD30‐positive large cell transformation and discuss its possible pathophysiology. A 74 year‐old male with a 36‐year history of patch stage MF presented with a 3‐month history of right chest cellulitis that was refractory to IV antibiotic treatment. Skin biopsies from his thigh demonstrated a patchy dermal infiltrate of irregular and hyperchromatic lymphocytes and epidermotropism. The majority of the infiltrate was positive for CD4, CD3, CD2, and negative for CD7. Only 10% were positive for CD25 and CD8. Biopsies obtained from the ulcerated chest nodules showed a dermal infiltrate of large and pleomorphic lymphoid cells with prominent nucleoli. These large lymphoid cells were strongly positive for CD3, CD30, CD25, CD2 and UCHL‐1. Occasional cells were positive for CD4 and CD20. They were negative for ALK‐1, TIA‐1, CD7, CD8, and CD15. T‐gamma receptor gene rearrangement analyses by polymerase chain reaction demonstrated a clonal process with similar rearrangement patterns identified in the patch stage MF as well as in large cell transformation areas. Examinations of his peripheral blood and bone marrow were negative. The patient had tolerated one cycle of CHOP chemotherapy.
Use of Screen Recording Software to Create Video Tutorials for Dermatopathology Education
Authors: Woosley J.
Published: August 2010

Texts and atlases have limitations when used to teach dermatopathology to trainees: they can be tedious and time‐consuming to use, image detail is limited, text and figure legends can be ambiguous, and only a minor degree of image annotation (letters, arrows, lines outlining important features) is possible. A video screen recording software program (Camtasia Studio) has been used to create high quality digital audio and video dermatopathology tutorials. The screen recording program is started with the image window being recorded. Audio narration (USB digital microphone) is recorded along with live drawings of annotating lines outlining important histologic features, creating the effect of a “digital chalkboard” being used by the instructor. Separate clips of each “chalkboard annotation” with accompanying narration can be combined to create a seamless movie detailing each of the important histopathologic features leading to a specific dermatopathologic diagnosis. Video dermatopathology tutorials are extremely effective because they closely mimic instruction at the microscope. However, they offer the significant advantage of allowing remote teaching at any time or place convenient for the learner. Tutorials can be compressed into a variety of multimedia formats and streamed for web delivery or can be provided on CD for distribution.
Cutaneous and Systemic Plasmacytosis
Authors: Wyatt AJ , Salob S , Klimek V , Busam KJ
Published: August 2010

Background: Plasmacytosis is a rare entity, which may manifest with cutaneous patches and plaques and may subsequently progress to involve extracutaneous sites. First described in Japan by Kimura K et al in 1983, most cases have been reported in patients of Asian descent. Observation: We report a case of plasmacytosis in a 52‐year‐old Hispanic woman, who presented ten years ago with cutaneous infiltrates of plasma cells and polyclonal hypergammaglobulinemia. Numerous (immunohistochemical, molecular, serologic) studies failed to demonstrate a clonal lymphoplasmacellular neoplasm, collagen vascular disease or chronic infection. Her course has been slowly progressive with new plaques developing on the integument. Plasma cells have since infiltrated gastric and esophageal mucosa, the left temporal artery and lymph nodes. The disease has been resistant to various therapeutic approaches. Conclusions: Our case provides long‐term follow‐up of a patient with plasmacytosis and illustrates the chronic progressive course of this disease over a 10‐year course with unique involvement of the temporal artery and gastrointestinal mucosa.
Myointimoma of the Glans Penis
Authors: Thurber S. , Robbins J. , Kohler S.
Published: August 2010

A 54‐year‐old man presented with a 2‐month history of a firm, non‐tender, non‐mobile 0.4 cm nodule of his coronal sulcus. An incisional biopsy was performed and histopathology revealed a multinodular proliferation of cytologically bland spindled cells embedded in a fibromyxoid matrix. The lesional cells were immunoreactive for smooth‐muscle actin but not S‐100 protein. A Verhoeff van Gieson stain demonstrated a meshwork of elastic fibers surrounding individual tumor nodules. The clinical and histologic findings were diagnostic of a myointimoma. The lesion has not recurred one month after the initial partial biopsy. Myointimomas are a recently described, myointimal proliferation affecting the corpus spongiosum. Clinical experience with this type of lesion is limited. Reports in the literature thus far suggest this neoplasm is benign with persistence of incompletely excised lesions but no recurrences or metastases following complete excision. Myointimomas represent a strictly intravascular proliferation of intimal cells of blood vessels.
La lécithine et son action sur la résistance des globules rouges du sang
Authors: GRÖNBERG ALBERT , LUNDBERG ÁKE , EKECRANTZ THOR
Published: August 2010

La lécithine empruntée à la substance cérébrale des bovidés (cérébrolécithinepréparée par le prof. Ekecrantz) n'agit pas sur la résistance des globules rouges du sang à l'égard d'une solution do sel marin hypotonique.

La lécithine de l'œuf de poule (ovolécithinepréparée par le prof. Ekecrantz) agit par contre en augmentant la résistance des globules rouges du sang.

Pour que cette action apparaisse, la concentration de l'ovolécithine doit être pour le moins de 1/20000.

En vue de cette même action il faut que la lécithine soit à l'état de fine emulsion, après avoir été secouée dans un appareil à succussion pendant une heure au moins.

La stérilisation par le procédé indiqué plus haut ne trouble pas cette action.

La différence des résultats obtenus dans nos expériences avec l'»ovolécithine», d'une part, et la »cérébrolécithine», d'autre part, s'explique peut‐être par le fait que ces deux lécithines, en dépit de la ressemblance de leur dénomination, représentent deux composés ou groupes de composés essentiellement différents. L'ovolécithine a une composition répondant à un monoamino‐phosphatide et, par suite, doit être rangée parmi les phosphatides non saturés. Par contre, la cérébrolécithine dont la partie principale serait, à ce qu'on pense, la sphingomyéline offre une composition répondant aux diaminomonophosphatides. Ces derniers sont à ranger parmi les phosphatides saturés. La céphaline est considérée par Thudichum comme un monoaminomonophos‐phatide, mais dans nos expériences elle s'est comportée comme la cérébrolécithine.

(Des expériences qui continuent les précédentes sont déjà en cours.)
Sur la bilharziose pulmonaire, maladie des poumons simulant la tuberculose
Authors: MAINZER FRITZ
Published: August 2010

On décrit cinq observations d'une maladie chronique infiltrative des poumons simulant la tuberculose, mais combinée avec un agrandissement de la rate et une éosinophilie excessive et réagissant a un traitement par l'antimoine.

L'éosinophilie, le traitement, la présence d'une bilharziose intestinale et urinaire simultanées dans un cas (et une observation analogue de la littérature), les données cliniques et expérimentales sur l'infection des poumons pendant le développement des différentes formes de la Schistosomiasis présentent des forts arguments qu'il s'agit d'une Schistosornasis pulrnonaire.

On distingue:

l'asthme bronchique provoqué par la Bilharziose;

la Bilharziose pulmonaire (en sens strict) aiguë, dont les foyers peuverit complétement disparaïtre par le traitement.

la Bilharziose pulmonaire (en sens strict) chronique, lais‐ sant aprks le traitement un cirrhose pulmonaire.

Deux observations relevées dam la littérature sous le titre de »Eosinophilie familiale» (Armand‐Delille c. s.) et »Eosinophilie persistante avec agrandissement de la rate» (H. Brugsch) apparaissent comme des cas de cette maladie.

La Bilharziose pulmonaire doit être distinguée des Phénoménes pulmonaires bien connus accompagnant la Bilharziose d'autres organes.
Zur Kenntnis der Hervorrufung des akuten Porphyrieanfalls
Authors: NILSSON FRIED
Published: August 2010

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SPLENECTOMY IN HEMATOLOGIC DISEASES
Authors: Nordøy Arne , Neset Gunnar
Published: August 2010

Abstract The effect of splenectomy in a variety of hematological disorders has been evaluated by a follow‐up study of 179 patients 3–15 years after surgery. A lasting remission was obtained in about 75% of patients with idiopathic thrombocytopenic purpura. All patients with hereditary spherocytosis had a complete remission, whereas hereditary non‐spherocytic hemolytic anemia was not influenced by splenectomy. More than 50% of patients with acquired hemolytic anemia showed no symptoms of hemolytic disease when examined ten years after surgery. Twenty‐five % of the patients with pancytopenia were in good condition ten years after splenectomy. Normal or increased bone marrow cellularity in this condition strengthens the indication for surgery. The proliferative diseases including chronic lymphatic leukemia, lymphosarcoma and myelofibrosis may represent indications for surgery whereas chronic myelogenous leukemia seemed to be a contraindication for splenectomy. The hematological disturbances associated with congestive splenomegaly usually can be corrected by splenectomy.
PULMONARY HAEMOSIDEROSIS AND GLOMERULONEPHRITIS
Authors: Bergdahl U. , Berge T. , Johansson S.
Published: August 2010

Abstract Three cases with the combination pulmonary haemosiderosis and glomerulonephritis (Goodpasture's syndrome) are described. All the patients died. A temporary improvement was seen in two cases with steroid treatment. In one of the patients the disease appeared in two distinct bouts. In the first she had a localized lung process and microscopic haematuria. After lobectomy the state was normalized, but one year later she had a rapid deterioration with pulmonary haemorrhages and glomerulonephritis.
RENAL FAILURE ASSOCIATED WITH GENTAMICIN THERAPY
Authors: Milman Nils
Published: August 2010

Abstract. A report is given on 6 cases of impaired renal function possibly caused by treatment with gentamicin. All patients had normal renal function before initiation of treatment. Two patients underwent peritoneal dialysis before recovery. In all patients renal function returned to almost normal level within 150 days after withdrawal of gentamicin. The importance of an individualized dosage of gentamicin related to body weight and renal function as well as frequent control of renal parameters and antibiotic serum concentration during treatment is emphasized.
THE EFFECT OF ALPRENOLOL AND ALPRENOLOL IN COMBINATION WITH SALURETICS IN HYPERTENSION
Authors: Angervall Gunnar , Bystedt Ulla
Published: August 2010

Abstract The effects of saluretic diuretics, alprenolol and these agents combined have been investigated in 23 patients with mild or moderately severe hypertension. Mean age was 60 years (range 43–75 years).

The results of the study show that:

Alprenolol in a dose of 426 mg daily gave the same reduction of diastolic pressure as previous treatment with diuretics. In order to achieve the same reduction of systolic pressure a mean dose of 700 mg alprenolol daily was required. The combination saluretic diuretics and alprenolol appears to give re‐inforcement of the antihypertensive effect as combination of 1/4 of the dose of each agent gave equally good control of the blood pressure as the full dose of either agent alone. Some increase of serum uric acid was observed during the treatment with the higher dose of alprenolol. Slight weight gain was observed during all alprenolol periods.

Potassium substitution was given only during diuretic periods but despite this the serum potassium levels were higher during treatment with alprenolol. The combination provides a good alternative for the treatment of raised blood pressure.
INHIBITORY EFFECT OF L‐DOPA ON COLLAGEN BIOSYNTHESIS
Authors: Blumenkrantz Nelly , Asboe‐Hansen Gustav
Published: August 2010

Abstract.The effect of L‐dopa on connective tissue biosynthesis by 10‐day‐old chicken embryos has been studied. Inhibited collagen formation as expressed by a reduced hydroxylation of (14C)proline and (14C)lysine, and a similarly reduced glycosylation of (14C)hydroxylysine was found. No influence on the biosynthesis of glyco‐and/or mucoproteins was observed.
Pre‐β1‐lipoprotein and Lp(a) Antigen in Relation to Triglyceride Levels and Insulin Release Following an Oral Glucose Load in Middle‐aged Males
Authors: Dahlén Gösta , Berg Kåre
Published: August 2010

ABSTRACT A series of 30 previously investigated and presumably healthy middle‐aged males have been studied, following an oral glucose tolerance test (OGTT). The insulin mean value 120 min after the start of the OGTT was found to be significantly lower in persons possessing the pre‐β1‐lipoprotein (preβ1 +) and Lp(a) antigen, than in those who were pre‐β1 ‐/Lp(a—). At 60 min during the OGTT, triglyceride and insulin correlated significantly in pre‐β1 ‐/Lp(a—) individuals, but not in pre‐β1 + or Lp (a+) individuals; on the other hand, insulin correlated significantly with blood glucose at this time in the pre‐ β1 + and Lp(a+) individuals, but not in the pre‐ β1 —/Lp(a—). These findings may reflect an important biochemical difference between the two sub‐populations.
Different Composition of the Eosinophilic Bone Marrow Pool in Reactive Eosinophilia and Eosinophilic Leukaemia
Authors: Brandt L. , Mitelman F. , Beckman G. , Laurell H. , Nordenson I.
Published: August 2010

ABSTRACTThe composition of the eosinophilic cell series in the bone marrow has been analysed in 10 patients with a pronounced reactive eosinophilia (RE) and in 2 with eosinophilic leukaemia (EL). An impaired differentiation of the eosinophils was found in the EL patients compared with the RE group. Thus the ratio of eosinophilic promyelocytes+myelocytes: segmented eosinophils was 9.2 and 9.1, respectively, in the patients with EL and 0.1–3.1 (average 1.3) in the RE patients. It is suggested that EL is characterized by an impaired differentiation of the eosinophilic bone marrow cells and that the recognition of this abnormality is of value in the differential diagnosis between EL and RE.
Neutrophil Kinetics in Acute Bacterial Infection
Authors: Hansen Niels Ebbe , Karle Hans , Valerius Niels Henrik
Published: August 2010

ABSTRACT. Neutrophil kinetics in peripheral blood were studied with DF32P‐labeled cells in eight patients during severe acute bacterial infection. Contrary to previous studies in man, the blood transit time of labeled neutrophils was short and the neutrophil turnover rate increased, up to ten times the normal, during the early phases of infection. This early phase was followed by a period in which the specific neutrophil radioactivity in the blood remained constant for up to 50 hours, probably indicating that in early convalescence neutrophil egress from the bone marrow to the blood is almost stopped. The demonstration of increased neutrophil turnover may seem to illustrate what might be considered an obvious fact, but is in contrast to previous findings and seems to obviate the prevailing theory of quantitatively unchanged but redistributed neutrophil kinetics during bacterial infection in man. The mechanism which apparently abruptly stops neutrophil egress from the bone marrow to the blood during early convalescence is unknown.
Plasma Free Fatty Acids and the Incidence of Arrhythmias in Acute Myocardial Infarction during Treatment with Small Doses of Subcutaneous Heparin or Warfarin
Authors: Arnesen H. , Skjæggestad Ø. , Wik B.
Published: August 2010

ABSTRACT. In a prospective trial, 99 patients with a history of AMI of less than 12 hours were allocated at random to treatment with subcutaneous heparin, 5000 IU twice daily, (51 patients) or warfarin (48 patients). In a subsample of 21 patients, 11 in the warfarin group and 10 in the heparin group, fasting FFA analyses were performed before and 2 hours after administration of anticoagulants on days 1 and 2. No measurable increase in FFA concentrations was demonstrated in the heparin‐treated patients, in spite of a significant influence on the thrombin clotting time. The frequency of ventricular arrhythmias as detected by continuous tape recordings was equal in the two groups. It is concluded that subcutaneous heparin, 5000 IU every 12 hours, can be administered to patients with AMI without increasing the risk of arrhythmias as compared with warfarin.

AMI= acute myocardial infarction,
Characteristics of Atrioventricular Conduction Disturbances in Ankylosing Spondylitis (Mb. Bechterew)
Authors: Nitter‐Hauge Sigurd , Otterstad Jan Erik
Published: August 2010

ABSTRACT. Atrioventricular (AV) conduction disturbances in 30 patients with ankylosing spondylitis (Mb. Bechterew) have been examined. Nine patients had AV block I with intermittent AV block II (Wenchebach block), 3 had complete heart block, 1 patient had atrial fibrillation and another had intermittent sinoatrial (SA) block. Thus, 14 (48%) patients had conduction defects. Electrophysiological investigations in 5 patients with AV block and in 1 patient with SA block revealed that the site of the block was proximal to the bundle of His. Two additional patients had prolonged sinus node recovery time implying dysfunction of the sinus node. An association between aortic valvular insufficiency and conduction disturbances was found, but AV block occurred also in patients without signs of valvular regurgitation. Four patients were treated with a permanent pacemaker and 5 with a temporary pacemaker in connection with aortic valvular surgery.
Hemolytic Anemia during Cyclofenil Treatment of Scleroderma
Authors: Wollheim Frank A. , Ljunggren Håkan O. M. , Blom‐Bülow Berith
Published: August 2010

ABSTRACT. During the course of a placebo‐controlled double‐blind crossover study of cyclofenil treatment in scleroderma (PSS), Coombs‐positive hemolytic anemia (HA) occurred in one of 30 patients. The anemia was mild and responded promptly to low‐dose steroid therapy and/or reduction of cyclofenil dosage. Coombs' test and observance for signs of HA are indicated in cyclofenil treatment of PSS.
Intravenous Naphazoline Intoxication
Authors: van Montfrans G. A. , van Steenwijk R. P. , Vyth A. , Borst C.
Published: August 2010

ABSTRACT.Nine pale perspiring drug addicts with drowsiness, nausea, headache, normal blood pressure and marked sinus bradycardia with premature ventricular beats were seen at the Casualty Department soon after alleged i.v. cocaine administration. Eight were treated with atropine, as the bradycardia suggested intoxication with a parasympathomimetic compound. Seven were discharged in good condition after a few hours' observation. One patient developed a blood pressure of 150/120 mmHg after atropine. Subsequently, a hemiparesis was found and an intracerebral haematoma was evacuated at surgery. Another patient was admitted forthwith to the CCU. He did not receive any medication and recovered within two days. Urinalysis of these two patients disclosed contents of naphazoline, a powerful α‐adrenergic agent. Samples of the alleged cocaine contained 97 % naphazoline HCl. A conscious rabbit was injected with naphazoline and thereafter with atropine. I.v. naphazoline doubled mean arterial pressure (MAP) and reduced heart rate (HR) from 167 to 30 beats/min. Atropine doubled HR, but caused a marked rise in MAP, too, stressing the adverse effects of atropine in these cases. When confronted with patients after alleged cocaine abuse, the role of substitute drugs, especially α‐adrenergic compounds, should be considered as this should influence the therapeutic approach.
Insulin Pumps
Authors: Ege Henrik
Published: August 2010

ABSTRACT. The technique employed in open‐loop insulin infusion pumps is reviewed. Most commonly used syringe as well as peristaltic pumps are exemplified. Their weights and prices are compared. Possibilities of development are discussed.
Thermography in the Diagnosis of Deep Venous Thrombosis
Authors: WALLIN LENA , ALBRECHTSSON U. , FAGHER B. , LAGERSTEDT C. , LARUSDOTTIR HILDUR , OLSSON C.‐G. , WESTLING H. , ÖQUIST B.
Published: August 2010

ABSTRACT. Thermography, clinical examination and 99Tcm‐plasmin test were performed in 112 patients and compared with phlebography. The study population consists of consecutive outpatients with symptoms compatible with deep venous thrombosis, who presented during regular clinic hours. Scoring systems were constructed for the clinical and thermographic evaluation. Both thermography and clinical diagnosis were insufficiently sensitive and specific for screening purposes. Plasmin test had a high sensitivity, 95%, but a low specificity. It is possible that a combination of thermography and clinical diagnostic criteria can provide an acceptable screening procedure. Combining thermography wiht a routine examination by the physician on duty yielded less favourable results.
Drug Utilization Data in Risk/Benefit Analyses of Drugs–Benefit Analysis
Authors: Gross Franz H.
Published: August 2010

ABSTRACT. For a benefit analysis of drug utilization data little reliable information is available. Benefit criteria have to be established for individual classes of drugs as well as for various types of diseases submitted to drug treatment. Antihypertensive therapy is taken as an example of how drug preferences vary from country to country and how prescribing patterns are affected by the appearance of new drugs. In the Federal Republic of Germany, fixed‐ratio combinations of reserpine and diuretics are still the leading group of drugs in this field, whereas they have virtually disappeared in Great Britain and Sweden. In the latter two countries, β‐blockers are the most widely prescribed antihypertensives, and also in Germany they rank quite high in sales, but less so in the number of prescriptions. Extreme differences are found in the utilization of cardiac glycosides between Germany and Great Britain, but little is known about the consequences of risk/benefit analyses of either over‐ or underpre‐scribing of these drugs. It is highly recommended to make further efforts in analyzing drug utilization data and developing studies in drug epidemiology.
Autonomic Neuropathy and Toe Circulation
Authors: SUNDKVIST GÖRAN , ALMÉR LARS‐OLOF , LILJA BO
Published: August 2010

ABSTRACT. Ankle and toe pressure ratios and toe temperature reactions to cold followed by indirect heating were evaluated in 23 diabetic patients with and without autonomic neuropathy (AN) in a first and in a second follow‐up study after 5–7 years. In the first study, despite normal blood pressure ratios, AN patients, all with parasympathetic neuropathy, showed a markedly delayed increase in toe temperature after cooling followed by indirect heating. In the second study, most AN patients showed sympathetic neuropathy and had higher toe temperatures before cooling than those without AN. Parasympathetic neuropathy leads to increased sensitivity to cold in toe vessels and sympathetic neuropathy to vasodilation and increased toe temperatures.
Individual growth trajectories of sibling Brycon moorei raised in isolation since egg stage, and their relationship with aggressive behaviour
Authors: Baras E. , Lucas M. C.
Published: August 2010

The growth of sibling dorada Brycon moorei (Characidae) housed individually in small enclosures (0·25 l; 27·0° C, range ±0·5° C; 12L:12D) from the egg stage was examined at regular intervals until 36 days after hatching (dah) and compared with their behaviour. From 1 to 8 dah, when cannibalism is intense among B. moorei raised in groups, there was no significant increase of size heterogeneity among isolated fish (c.v. of total length of 3·1 and 3·6%, at 1 and 8 dah, respectively) and no primacy of early size differences either. These results suggest that cannibals of B. moorei raised in groups are not natural‐born killers with greater growth capacities than others. Size heterogeneity among isolated fish increased significantly first when B. moorei were weaned on formulated feed (8–15 dah), then again from 24 to 36 dah when the average growth rate was half as fast as before (c. 0·5 v. 1·0 mm day−1), despite fish consistently feeding. During both periods, there was a significant, positive relationship between individual growth and aggression or boldness. These results suggest that (1) boldness can favour the transition to a new food type and (2) fish exhibited a variable responsiveness to spatial restriction in small enclosures, which may have been alleviated in some individuals by establishment of territorial behaviour, as suggested by their enhanced aggression.
Recombinant human prolactin for the treatment of lactation insufficiency
Authors: Powe Camille E. , Allen Maureen , Puopolo Karen M. , Merewood Anne , Worden Susan , Johnson Lise C. , Fleischman Amy , Welt Corrine K.
Published: August 2010

Context  Lactation insufficiency has many aetiologies including complete or relative prolactin deficiency. Exogenous prolactin may increase breast milk volume in this subset. We hypothesized that recombinant human prolactin (r‐hPRL) would increase milk volume in mothers with prolactin deficiency and mothers of preterm infants with lactation insufficiency.

Design  Study 1: R‐hPRL was administered in an open‐label trial to mothers with prolactin deficiency. Study 2: R‐hPRL was administered in a randomized, double‐blind, placebo‐controlled trial to mothers with lactation insufficiency that developed while pumping breast milk for their preterm infants.

Patients  Study 1: Mothers with prolactin deficiency (n = 5). Study 2: Mothers of premature infants exclusively pumping breast milk (n = 11).

Design  Study 1: R‐hPRL (60 μg/kg) was administered subcutaneously every 12 h for 28 days. Study 2: Mothers of preterm infants were randomized to receive r‐hPRL (60 μg/kg), placebo or r‐hPRL alternating with placebo every 12 h for 7 days.

Measurements  Change in milk volume.

Results  Study 1: Peak prolactin (27·9 ± 17·3 to 194·6 ± 19·5 μg/l; P < 0·003) and milk volume (3·4 ± 1·6 to 66·1 ± 8·3 ml/day; P < 0·001) increased with r‐hPRL administration. Study 2: Peak prolactin increased in mothers treated with r‐hPRL every 12 h (n = 3; 79·3 ± 55·4 to 271·3 ± 36·7 μg/l; P < 0·05) and daily (101·4 ± 61·5 vs 178·9 ± 45·9 μg/l; P < 0·04), but milk volume increased only in the group treated with r‐hPRL every 12 h (53·5 ± 48·5 to 235·0 ± 135·7 ml/day; P < 0·02).

Conclusion  Twice daily r‐hPRL increases milk volume in mothers with prolactin deficiency and in preterm mothers with lactation insufficiency.
An overhaul of the species–area approach for predicting biodiversity loss: incorporating matrix and edge effects
Authors: Koh Lian Pin , Lee Tien Ming , Sodhi Navjot S. , Ghazoul Jaboury
Published: August 2010

1.  Species–area (SA) models have often been used to predict biodiversity loss resulting from habitat loss. This application of SA models hinges on two fundamental assumptions: the resultant landscape matrix is inhospitable to the taxa of interest; and edge effects do not factor into extinction risks. Despite growing consensus that these assumptions are unrealistic, the SA approach continues to be used in assessments of biodiversity decline and conservation planning.

2.  We propose an overhaul of the SA approach by accounting for taxon‐specific responses to landscape‐specific matrix quality and deleterious effects of habitat edges. We pitted nine variants of an improved SA model (calibrated for edge and/or matrix) against two variants of the conventional model (calibrated with island or continental z values) to predict species extinction and endangerment in 15 tropical biodiversity hotspots.

3.  The matrix‐calibrated SA model received the highest Akaike’s Information Criterion weight (birds: 66·8%; mammals: 63·3%), which reflects the weight of evidence in support of it being the most parsimonious model given the set of candidate models and data considered. Additionally, the matrix‐calibrated (MC) model produced species extinction predictions that were the most accurate and least biased.

4.  The second best model (for both birds and mammals) was one that simultaneously corrected for matrix and edge effects.

5.  The conventional SA model (particularly when calibrated with an island z value) performed worse than the matrix‐calibrated and/or edge‐corrected models.

6. Synthesis and applications. Our results suggest that accounting for the landscape matrix per se is a sufficient and significant improvement to the SA approach in terms of assessing species extinction risks from land‐use change. More importantly, given that the MC model was also the most parsimonious model (in that it requires only one additional model parameter than the conventional SA model), it could prove to be a cost‐effective heuristic tool for conservation scientists and decision makers to accurately evaluate extinction risks resulting from land‐use decisions. We argue that, henceforth, the MC model, which takes account of both the extent of deforestation and quality of the resultant matrix, should replace the conventional SA model for predicting biodiversity loss.
Standard care and telecare services: comparing the effectiveness of two service systems with consumers with intellectual disabilities
Authors: Taber‐Doughty T. , Shurr J. , Brewer J. , Kubik S.
Published: August 2010

Background  Onsite standard care and remote telecare supports were provided to adults with intellectual disabilities living in integrated community settings and evaluated in terms of effectiveness as consumers completed a series of novel household activities.

Methods  Using an alternating treatment design with baseline and follow‐up conditions in this single‐case study, investigators compared the prompting effectiveness provided by onsite standard care staff and a remote telecare provider.

Results  While both types of supports resulted in consumers completing tasks, results indicated consumers achieved slightly more independence when prompted by the telecare support provider. Additionally, telecare supports resulted in greater duration for task completion per consumer.

Conclusions  Although consumers completed tasks with greater independence using telecare supports, caution should be used when interpreting results due to the small number of participants. The potential for this technology certainly exists in supporting consumers in their own homes thus, suggestions for future investigations are provided.
Effect of microwave irradiation on the flexural strength and residual monomer levels of an acrylic resin repair material
Authors: YUNUS N. , HARRISON A. , HUGGETT R.
Published: August 2010

The degree of polymerization of an acrylic resin repair material, as established by residual monomer estimation, was compared using three different polymerization methods, i.e. bench‐cure, hydroflask‐cure and microwave irradiation cure. The repair strength of a conventional heat‐polymerized resin was then assessed following repairs using each of these three methods. The lowest level of residual monomer was achieved with the microwave irradiation cure. It was also demonstrated that of the three methods, polymerization using microwave energy resulted in the strongest repair.
Adaptation to the cavity floor of the light‐cured glass ionomer cement base under a composite restoration
Authors: HOTTA M. , AONO M.
Published: August 2010

The study attempted to assess methods of prevention of the formation of a contraction gap in a cylindrical enamel and dentine cavity. The influence has been investigated of the tensile bond strength of cement/dentine and cement/composite resin and the direct tensile strength during setting of light‐cured glass‐ionomer cements. The interface between composite resin/cement and cement/dentine were viewed and photographed by replica techniques under an SEM (Scanning Electron Microscope). The most noticeable finding was that an enamel and dentine cavity applicated with light‐ and auto‐cured glass‐ionomer cement generally presented with a small construction gap at the tooth restoration interface. However, the light‐cured glass‐ionomer base (Vitrabond) exhibited significantly better tensile bond strength to dentine and resin performance than the conventional glass‐ionomer tested. This study revealed that there was no clear relationship between the adhesion to dentine and the adaptation to the dentine cavity floor.
Complete dentures in the prosthetic rehabilitation of elderly persons: five different criteria to evaluate the need for replacement
Authors: NEVALAINEN M.J. , RANTANEN T. , NÄRHI T. , AINAMO A.
Published: August 2010

summary
The purpose of this study was to examine the condition and functional properties, as well as adjustment and replacement needs, of 288 complete dentures worn by 144 inhabitants of Helsinki over 75 years old. Five different criteria to evaluate the need for replacement were used: (I) criteria based on Oral Health Surveys – Basic Methods (WHO, 1987); (II) criteria based only on the clinical data collected during the examination; (III) criteria based only on examiners' subjective opinion of the condition of the dentures; (IV) criteria based on clinical data as well as examiners' experience and consultation with the patient; (V) criteria based only on patients' subjective opinion. Depending on the evaluation method used, 10–84% of the dentures were judged to be in need of replacement. Strict objective evaluation methods produced the highest figures for replacement need, and method (I) (WHO, 1987) the lowest. The most justifiable replacement percentage (26%) was achieved when the dentist assessed treatment need together with the patient. This study documents the multiple subjective and objective difficulties related to the wearing of complete dentures. The study also highlights the well‐recognized importance of regular annual re‐examinations for those wearing complete dentures and the assessment of need for adjustment of the dentures. It also demonstrates that successful treatment decisions cannot be made solely on the basis of clinical examination or a dentist's subjective opinion, but should be formulated in close consultation with the patient.
Characteristics of masticatory movement in relation to inclination of occlusal plane
Authors: OGAWA T. , KOYANO K. , SUETSUGU T.
Published: August 2010

summary
The relationship between masticatory movement and the inclination of the occlusal plane in sagittal plane was analysed in 41 young adults. It was found that the occlusal plane and the masticatory closing path were consistent in maintaining an almost perpendicular relationship with each other, regardless of the variation in inclination of the occlusal plane. This finding can be explained by the observation that the timing of the balancing‐side condylar translation during closure correlated with the inclination of the occlusal plane. The inclination of the occlusal plane also influenced the masticatory closing pattern in the sagittal plane. Anterior convex closure patterns dominated when the occlusal plane inclined in the anterior direction. In contrast, the majority of posterior convex closure patterns were induced by the posteriorly inclined occlusal plane. The appearance of these types seems to reflect a harmonious relationship between the inclination of the occlusal plane, tooth guidance, and other central and peripheral control. The correlation between the inclination of the occlusal plane and masticatory closing movement could serve as the functional background for the significance of the occlusal plane.