Support for the lunar cataclysm hypothesis from lunar meteorite impact melt ages.

Lunar meteorites represent a more random sampling of lunar material than the Apollo or Luna collections and, as such, lunar meteorite impact melt ages are the most important data in nearly 30 years with which to reexamine the lunar cataclysm hypothesis. Within the lunar meteorite breccias MAC 88105, QUE 93069, DaG 262, and DaG 400, seven to nine different impact events are represented with 40Ar-39Ar ages between 2.76 and 3.

Urticarial eruption associated with rheumatic fever in a child.

The classic description of erythema marginatum is of a few asymptomatic erythematous patches or plaques with a characteristic central clearing which may coalesce and develop a polycyclic configuration. We report a boy with a urticarial eruption without the classic lesions of erythema marginatum in whom the diagnosis of rheumatic fever was subsequently made. Histology of the urticarial lesions revealed a mixed, superficial, perivascular infiltrate with prominent eosinophils.

Generalized lupus panniculitis and antiphospholipid syndrome in a patient without complement deficiency.

Generalized chronic cutaneous lupus including lupus panniculitis in childhood is rare and usually occurs in the setting of genetic complement deficiencies. The association with antiphospholipid syndrome is even more rare. We report a 13-year-old girl with extensive lupus panniculitis since the age of 8 months and no evidence of complement deficiency.

Plasma viral load and CD4 lymphocytes predict HIV-associated dementia and sensory neuropathy.

Objective: To determine the predictive value of plasma HIV RNA and CD4 lymphocytes for HIV-associated dementia and sensory neuropathy.

Methods: A total of 1,604 AIDS-free HIV seropositive men from the Multicenter AIDS Cohort Study were followed over a 10-year period (1985 to 1995). HIV-associated dementia and sensory neuropathy were diagnosed according to standard definitions.

An artificial cell-cycle inhibitor isolated from a combinatorial library.

Understanding the genetic networks that operate inside cells will require the dissection of interactions among network members. Here we describe a peptide aptamer isolated from a combinatorial library that distinguishes among such interactions. This aptamer binds to cyclin-dependent kinase 2 (Cdk2) and inhibits its kinase activity.

Spontaneous intracranial hypotension: spinal MR findings.

We report three patients with spontaneous intracranial hypotension in whom spinal MR imaging revealed ventral extradural fluid collections that were centered at the cervicothoracic junction in two patients and extended throughout the entire spine in the third patient. These spinal fluid collections most likely resulted from the accumulation of CSF at the site of dural leakage. Knowledge of this association can be helpful in the selection of imaging studies to facilitate diagnosis and treatment.

Delayed occurrence of a severe cutaneous reaction in a multiple sclerosis patient taking interferon beta-1b.

We report a case of a patient treated for relapsing multiple sclerosis (MS) with interferon beta-1b who developed a severe vasculitic-like skin reaction 9 months after initiation of interferon therapy. Prompt discontinuation of interferon beta-1b and institution of corticosteroid therapy was associated with complete resolution of the cutaneous lesions. Other potential causative agents were excluded by penicillin skin sensitivity testing or continuing use in the absence of adverse reactions.

Prevalence of IgE-mediated food allergy among children with atopic dermatitis.

Objective: There is a growing body of clinical and laboratory evidence to support the notion that food allergy plays a role in the pathogenesis of atopic dermatitis (AD). However, the incidence of IgE-mediated food allergy in children with AD is not well established.

Design: A prospective study to determine the prevalence of IgE-mediated food hypersensitivity among patients referred to a university-based dermatologist for evaluation of AD.

Neurologic complications of HIV infection.

Neurologic symptoms are common in HIV-infected individuals, and they result from a wide range of etiologic agents, including HIV itself and opportunistic pathogens. Neurologic syndromes may be presenting features or may occur at any stage of infection, and they affect all levels of the neuraxis. The physician who cares for patients with AIDS must be prepared to recognize these neurologic complications to pursue aggressive diagnosis and, where possible, therapeutic interventions.

The determination of ice composition with instruments on cometary landers.

The determination of the composition of materials that make up comets is essential in trying to understand the origin of these primitive objects. The ices especially could be made in several different astrophysical settings including the solar nebula, protosatellite nebulae of the giant planets, and giant molecular clouds that predate the formation of the solar system. Each of these environments makes different ices with different composition.

The development of an outcomes management system for acute medical rehabilitation.

In 1993, Continental Medical Systems, Inc. (CMS), a provider of comprehensive medical rehabilitation, developed the Total Outcomes and Prediction Program (TOPP) to measure and evaluate key medical rehabilitation outcomes, quality indicators, and patient satisfaction at its 37 acute rehabilitation hospitals. The broad purposes of TOPP are to manage patient treatment, improve the cost-effectiveness of care, and provide outcomes reporting for managed care and other interested parties.

Granuloma annulare. A clinical review.

Granuloma annulare is a self-limiting disorder occurring primarily in children. The clinician must recognize clinical variants, including localized, subcutaneous, disseminated, and perforating granuloma annulare. Although granuloma annulare can rarely be associated with underlying systemic disease, in most patients the eruption resolves without treatment in several months to several years.

Prognosis and response to therapy of cytomegalovirus encephalitis and meningomyelitis in AIDS.

Effective diagnosis and treatment of cytomegalovirus infection of the nervous system in AIDS patients has been limited by a lack of sensitive diagnostic measures. Retrospective series suggest a poor prognosis for cytomegalovirus encephalitis with rapid mortality. Polymerase chain reaction amplification of cytomegalovirus DNA allows detection in CSF that appears specific for CNS infection.

Panglobal distribution of a single clonal lineage of the Irish potato famine fungus.

More than 300 isolates of the Irish potato famine fungus, Phytophthora infestans, collected in 20 countries on five continents, were analyzed for genetic variation at the mating type and two allozyme loci. A subset of more than 200 isolates was also analyzed for DNA "fingerprint" variation. A surprising result was that a single clonal lineage dominated most populations worldwide.

Temporal trends in the incidence of HIV-1-related neurologic diseases: Multicenter AIDS Cohort Study, 1985-1992.

Objective: To describe temporal trends in the incidence of human immunodeficiency virus (HIV)-related neurologic diseases in the Multicenter AIDS Cohort Study from 1985 to 1992.

Methods: The incidence rates of six neurologic disorders were examined: toxoplasmosis, cryptococcal meningitis, primary CNS lymphoma, progressive multifocal leukoencephalopathy, HIV dementia, and sensory neuropathy. Poisson modeling was used to test linear trends over time and the effects of progressive immunosuppression, antimicrobial prophylaxis, and antiretroviral drug therapy.

Cutaneous polyarteritis nodosa. Reports of two cases in children and review of the literature.

Background: Polyarteritis nodosa (PAN) is a necrotizing vasculitis of small- and medium-sized arteries that most often affects the kidneys, heart, and liver but can affect any organ system. A cutaneous form of PAN without visceral involvement, which follows a benign but often chronic course, has also been described. Both forms are rare in children.

Sweet's syndrome in children.

Acute febrile neutrophilic dermatosis (Sweet's syndrome) is a rare inflammatory disease of unknown cause characterized by painful, erythematous plaques and a dermal infiltrate of mature neutrophils. Associated systemic disease is a common finding in patients with Sweet's syndrome, and in fact determines the prognosis; therefore, the diagnosis of Sweet's syndrome warrants a thorough medical evaluation. We found only 17 reported cases of Sweet's syndrome in children.

Herpes simplex type 2 in a patient with Mollaret's meningitis: demonstration by polymerase chain reaction.

We describe a patient with recurrent self-limited aseptic meningitis meeting the criteria for Mollaret's syndrome, in whom extensive serological investigation and cerebrospinal fluid analysis failed to reveal a specific cause. Using polymerase chain reaction techniques to amplify herpes simplex viral DNA, we were able to identify the presence of herpes simplex virus type 2 in the cerebrospinal fluid. The duration of clinical illness may have been shortened by treatment with intravenous acyclovir.