Histiocytic lymphoma and malignant angioendotheliomatosis: one disease or two?

The case history of a patient with diffuse histiocytic lymphoma and skin lesions characteristic of malignant angioendotheliomatosis is reported. The patient initially responded to aggressive chemotherapy but quickly had a relapse, CNS disease developed, and the patient died one year after diagnosis. Microscopic, ultrastructural, and surface membrane studies showed that the intravascular tumor cells were not of endothelial origin. The morphologic similarity of the malignant intravascular cells and peripheral blood cells, as well as the demonstration of surface membrane immunoglobulin on malignant blood cells suggested that, in some cases, unusual features of malignant lymphoma may be confused with malignant angioendotheliomatosis.

Cd branding studies in a homologous Robertsonian 13;13 translocation

A phenotypically normal female with a history of two miscarriages was found to have the karyotype 45,XX,t(13p:13p). C banding showed the translocation to have two regions of centromeric constitutive heterochromatin, silver staining showed an active NOR in 60% of the cells screened, and Cd banding studies showed a single Cd band with absence of the Cd band at the suppressed centromere.

Stress, symptom proneness, and general adaptational distress during pregnancy

Symptom proneness (SP), the 20 psychiatric items of the Cornell Medical Index, here called the Cornell Psychiatric Items (CPI), and a test developed partially from the Schedule of Recent Experiences called the Utah Stress Scales (STRESS) were used to predict general adaptational distress (GAD) symptoms during pregnancy on a sample of 1306 primigravidas. The causal model explored in seven path analyses developed for months 3-9 of pregnancy is that SP and STRESS affect CPI, and that SP, STRESS, and CPI directly affect GAD symptoms. Results suggest that CPI is most predictive of GAD symptoms until the ninth month when SP and STRESS become more predictive. It is suggested that GAD pregnancy symptoms are affected by situational stress, symptom proneness, and level of psychological upset and that this system of relations changes over the course of pregnancy. This information should have important implications for anticipating potential problems and improving the quality of nursing care of pregnant women.

Effects of high dose busulphan on leukaemic progenitor cells in chronic myeloid leukaemia

Six patients with Philadelphia positive chronic myeloid leukaemia (CML) were treated with single high doses of busulphan. The action of busulphan on the in vivo kinetics of circulating progenitor cells (colony forming cells) was measured using an agar culture system which involved scoring of total colonies and clusters at 7 days and of granulocyte, monocyte and eosinophil colonies at 14 days. High dose busulphan was found to be effective in suppressing circulating granulocyte, monocyte and eosinophil progenitor cells. The effect of busulphan on progenitor cells was rapid and their levels fell by at least 85% within five days. By contrast, the white blood cells fell by only 9% and the platelets fell by 10% over this time. Subsequently, the white cell count and platelet count fell to near normal levels. The progenitor cell levels began to rise again at a mean of 35 days following busulphan treatment and the white blood cells at a mean of 39 days in four patients. One patient remained in haematological remission for six months following 100 mg of busulphan with less than 1 progenitor per 5 x 10(5) peripheral blood nucleated cells. One patient in myeloblastic transformation had a previously not described culture pattern consisting of a high cluster to colony ratio at 7 days and of an increased number of predominantly eosinophilic colonies at 14 days. There was no significant fall in progenitor cell levels following busulphan and this patient died.

Evaluation of the relative effectiveness of methylphenidate and cognitive behavior modification in the treatment of kindergarten-aged hyperactive children

This study of kindergarten-aged hyperactive children evaluated the effects of three modes of treatment in relation to an untreated control group. The treatments were administered over a 3-month period and included cognitive behavior modification, methylphenidate, and the two treatments combined. A follow-up assessment was done approximately 1 year later at the end of the first grade. Analyses of psychological, rating scale observational, and interview data showed that hyperactive children became less symptomatic over time; the data did not provide evidence indicating that any of the treatments studied was more effective than any other or than no treatment at all.

Thiobarbituric acid reactive material in uremic blood

The thiobarbituric acid (TBA) assay was applied to uremic blood. Significant TBA-reactive material was found in patients with chronic renal failure compared to normal controls. The presence of TBA-reactive material correlated with the degree of renal failure, and was removed by hemodialysis. The reactive material is not 2-deoxyribose or sialic acid. In addition, the presence of TBA-reactive material in uremic blood is not abolished by prior aspirin ingestion, suggesting it is not related to active prostaglandin synthesis. The possible origin of the TBA-reactive material in uremic blood is discussed.

Isolation, stabilization, and characterization of a toxin from timber rattlesnake venom

A rapid and convenient method for the purification of a toxin from timber rattlesnake, Crotalus horridus horridus, venom using carboxymethyl cellulose ion-exchange chromatography has been devised. The toxicity of this venom component is labile, but it is stabilized by the addition of 20+ V/V glycerol to the buffer solution. This toxin has a molecular weight of 15,000 +/- 700 as determined by SDS gel electrophoresis. It is both heat and protease resistant. Treatment of this venom component with 2-mercaptoethanol followed by G-50 Sephadex chromatography causes no loss of toxicity although incubation of the toxin with 1% SDS and 1% 2-mercaptoethanol prior to electrophoresis does result in a faster migrating species. The toxin does not affect neuromuscular junctions but does appear to act on the nervous system. It causes no local responses in mice.

Demonstration of eosinophil degranulation on the surface of opsonized schistosomules by phase-contrast cinemicrography

Phase-contrast cinephotomicrography was used to examine eosinophil-schistosomule interaction. Eosinophil degranulation against the surface of schistosomules was observed in the presence of immune serum.

Gender identity problems of children and adolescents: the establishment of a special clinic

Theoretical accounts of the origins of gender identity disturbance are reviewed and then followed by a description of the establishment of a child and adolescent gender identity clinic. Clinical impressions of 16 gender disturbed patients are presented and the position is taken that most patients manifested a confused, as opposed to fixed, core gender identity.

Platelet MAO activity in schizophrenia and other psychiatric illnesses

Previous reports have indicated that platelet MAO activity is low in some schizophrenic and other psychiatric patients. However, other studies have not been able to replicate this phenomenon. This study supportsthe previous observations of low enzyme activity in some chronic schizophrenic patients. The authors discuss the thesis that low platelet MAO activity may be a biochemical marker for vulnerability to psychiatric illness.

Magnesium and other electrolytes in bovine eyeballs immersed in sea water and other fluids

Bovine eyeballs were immersed in fluids including sea water for variable intervals of time, and magnesium concentrations and those of other electrolytes were determined in the aqueous and vitreous humor. Magnesium values increased with time, but no final saturation was reached nor were the levels obtained as high as those previously reported. In human immersion fatalities, Mg++ increased comparably to the most closely stimulating experimental situation, that is, corneal exposure in an unstirred medium. At best, vitreous Mg++ appears to be an imperfect marker in estimating the length of immersion, and then only if the sample remains unhemolyzed and the total post-mortem interval is considered. Establishing or excluding the diagnosis of drowning solely by this technique seems unlikely because of ion diffusion into the eye fluids.

The use of steroids in Bell's palsy: a prospective controlled study

A prospective, controlled, double-blind study was designed to evaluate the effect of steroid treatment on the natural history of Bell's palsy. Fifty-one patients were included in the study between 1972 and 1974. The patients were evaluated and started on treatment within two days of onset of Bell's palsy and followed for six months. Treatment was given in randomized double-blind fashion and consisted of either vitamins or a total of 410 mg of prednisone plus vitamins in descending doses over 10 days. The recovery of facial motor function was determined by three physicians who had no knowledge of the treatment received by the patients. They examined photographs of the patients taken six months after onset of paralysis in eight positions of facial function and categorized them as to complete fair, or poor recovery of facial function. These results of this evaluation were submitted to the biostatistician who broke the treatment code. The results of this study demonstrate no statistically significant beneficial effect of steroid therapy upon recovery from Bell's palsy. Factors considered included the patients' age, sex, the presence of pain, ageusia, hyperacusis, diabetes, hypertension, the progression and degree of palsy, the results of nerve excitability and salivary flow tests, and the time at which recovery was first noted or became complete. Bell's palsy remains without a proven efficacious treatment.

Natural history of bell's palsy: the salivary flow test and other prognostic indicators

Fifty-one patients with Bell's palsy were evaluated within two days of onset and followed for six months without surgical intervention or effective medical treatment in order to observe the natural history of the disease. Sixty-three percent had a complete return while 37 percent had incomplete return. Age, the presence of pain, and taste alterations had no prognostic value. The progression of the palsy, response to maximal stimulation and salivary flow testing were approximately 80 percent accurate in predicting outcome. The salivary flow test was the most useful prognostic indicator since salivary flow became reduced within two days of onset in the patients likely to develop denervation while the other tests did not become altered until 3 to 14 days after onset. In patients with Bell's palsy, the salivation test seems to be the only method capable of predicting denervation before it begins; therefore, it should be ideal for selecting patients for appropriate treatment.

The predictive accuracy of renal vein renin activity in the surgery of renovascular hypertension

In a consecutive group of 38 patients undergoing operations for renovascular hypertension, there were 24 arterial reconstructions and 16 nephrectomies. Thirty-two patients were available for late observation, and 25 (78 percent) had a successful result. The renal vein renin ratio (RVRR) correctly predicted successful results in 76 percent of the patients with a RVRR of 1.5 or more but was correct in predicting an unsuccessful result in only one of the six patients with an RVRR less than 1.5. This high incidence of "false-negative" results has appeared in several other reports but has received insufficient emphasis. The presumed causes include inadequate sodium depletion prior to the renal blood vein samplings or, less likely, the effects of renin-suppressing drugs such as alpha methyldopa, propranolol, or reserpine. Because five of the six patients with RVRR less than 1.5 enjoyed a successful result from operation, it is apparent the clinical factors and the aortogram should be determinant when the RVRR, performed under the conditions described, is not diagnostic of renovascular hypertension. Nonetheless, when all diagnostic factors, i.e., the aortogram, the rapid-sequence intravenous pyelogram, and the RVRR, support such a diagnosis, a successful surgical result is nearly certain.