Extramedullary plasmacytoma: simulating a soft tissue sarcoma of the chest wall

Extramedullary plasmacytoma occurs infrequently as compared to osseous myoloma. A single case of extramedullary plasmacytoma was seen during the last 10 years whose initial presentation was that of a soft tissue sarcoma of the chest wall. Clinical data along with relevent investigation and treatment results are discussed with a review of the literature.

Use of salivary concentrations in the prediction of serum caffeine and theophylline concentrations in premature infants

Simultaneous blood and saliva samples were drawn for determination of caffeine and theophylline concentrations in 17 infants receiving caffeine or theophylline therapy for apnea of prematurity. The relationship between serum and saliva concentrations in each drug treatment group was explored using (1) regression analysis and (2) serum:saliva ratio. Significant correlations were observed between serum and salivary concentrations. Salivary concentrations approximated 76 to 80% of the serum concentrations based on the derived serum:saliva ratios. When salivary concentrations were less than 8 microgram/ml, the serum concentrations did not exceed therapeutic range and no clinical toxicity was noted. Monitoring of salivary drug concentrations as an alternative to serum drug concentrations may be useful in preterm infants on methylxanthine therapy. When salivary concentrations exceed 8 microgram/ml, serum concentrations should be determined.

The use of a microcomputer in the evaluation of echocardiograms

A low-cost microcomputer system is used to calculate cardiac parameters from echocardiographic (Echo) measurements and produce a chartable report. The system is simple, uses Basic language, and provides for data storage.

Primary tumors of the jaws in children

Reports on primary tumors of the jaw in children are infrequent. This article reports 24 cases of primary tumors and tumor-like conditions of the jaws in children. All varieties of odontogenic and nonodontogenic tumors are seen in the jaw; fibro-osseous lesions are the most common. A possible explanation for the high incidence of mesenchymal lesions in children may be related to the shedding and eruption of teeth. The differences between childhood and adult types of ameloblastomas are highlighted.

Hemangiopericytoma: report of three cases regarding role of radiation therapy

The experience in treating three patients with hemangiopericytoma is reviewed. One patient was given irradiation alone, and the others were both treated with surgery and irradiation. Our experience reinforces reports of the usefulness of irradiation in treating this neoplasm and its metastases.

Blood coagulation studies in children with surface hemangiomas

Thirty patients with surface hemangiomas were investigated for any latent coagulopathy. Whole blood clotting time, kaolin cephalin clotting time, prothrombin time, thrombin time and platelet counts did not differ significantly from the control group values. The values of plasma fibrinogen, euglobulin lysis time and serum levels of fibrinogen degradation products remained within the normal ranges but their mean values were significantly different from those of healthy children. The findings may be attributed to a chronic incipient type of "consumption coagulopathy" occurring locally in the hemangiomas.

Pharmacokinetics of acetaminophen in the human neonate: formation of acetaminophen glucuronide and sulfate in relation to plasma bilirubin concentration and D-glucaric acid excretion

The purpose of this study was to determine if certain physiologic parameters (plasma bilirubin concentration and urinary excretion rate of D-glucaric acid) can be used to predict a newborn infant's ability to eliminate a phenolic drug, and particularly to predict the ability to conjugate that drug with glucuronic acid. Tweleve healthy 2- to 3-day-old full-term infants with plasma bilirubin concentrations of 1.0 to 11.6 mg/100 ml and D-glucaric acid excretion rates of 0.131 to 0.345 mg/kg/day received a single oral dose of acetaminophen, 12 mg/kg. Urine was collected serially for 48 hours and analyzed for acetaminophen, acetaminophen glucuronide, acetaminophen sulfate, and D-glucaric acid. The biologic half-life of acetaminophen was 3.5 plus or minus 0.85 hours (average plus or minus SD) as compared to average values of 1.9 to 2.2 hours observed in five reported studies on a total of 39 adults. The rate constant for acetaminophen glucuronide formation in neonates was considerably smaller, on the average, than in adults but the average rate constant for acetaminophen sulfate formation was somewhat larger than in adults. There is not statistically significant colucaric acid excretion. The results of this study suggest that the limited ability of neonates to conjugate phenolic drugs with glucuronic acid is compensated to a degree by a well-developed capability for sulfate conjugation.

Xeroderma Pigmentosum

Five cases of xeroderma pigmentosum have been presented, three of the patients belonging to one family. There was no history of consanguineous marriages in this series. All five patients had advanced ocular complications. Three presented with multiple basal cell carcinomata, which were treated by radiotherapy in two cases and surgery in one. One patient presented with a dermatofibroma, which does not seem to have been reported earlier in association with this disease. Reconstructive techniques such as the use of flaps and grafts arc safe, and the healing response is quite satisfactory.