Characterization of erythrocyte carbonic anhydrase in an ancient fish, the longnose gar ( Lepisosteus osseus).

This study investigates the evolutionary history of vertebrate red blood cell carbonic anhydrase (CA) by characterizing the isozyme properties and nucleotide sequence of an ancient fish, the longnose gar ( Lepisosteus osseus). The inhibitor sensitivities of gar rbc CA closely resembled those for mammalian CA II, as well as those for CAs from more recently evolved fishes. The kinetic properties of gar rbc CA were not closely aligned with either mammalian CA I and CA II, but fit well into an emerging phylogenetic pattern for early vertebrates.

Human Papillomavirus Infection.

Condyloma acuminata, the anogenital expression of human papillomavirus commonly called genital warts, is the focus here. Of particular emphasis is HPV's association with genital cancer. The use of androscopy for the examination and treatment with cryotherapy, podophyllin, trichloroacetic acid, and 5-fluorouracil also are assessed.

Molluscum Contagiosum.

Molluscum contagiosum is described as an easily treated benign viral disease of the skin. Treatments detailed include cryosurgery and curettage-the treatments of choice-and podophyllotoxin and tretinoin. History and virology also are outlined.

Increasing use of "Ecstasy" (MDMA) and other hallucinogens on a college campus.

We conducted a random survey of illicit drug use by undergraduate students at a private southern university in 1990 and compared the results with results from a similar 1986 survey of that college's student population. During the 4 years since the first study, the prevalence of cocaine use declined from 39% to 21%, and use of traditional amphetamines declined from 22% to 12%. No significant differences were found in the use of marijuana--68% in 1986, 64% in 1990--or in use of LSD (lysergic acid diethylamide)--14% in 1986, 17% in 1990.

Frustrated by Chronic Fatigue?

In brief When active patients relate brief chronic fatigue, three basic questions must be answered: Is there an underlying medical or psychiatric disorder? Could the fatigue be from overtraining or a sleep disturbance? Does the patient have chronic fatigue syndrome or the far more common idiopathic chronic fatigue? Answers may come from sensitive history-taking and targeted physical and laboratory exams. And the patient must play an active role in treatment, which includes reassurance, stress relief, and regular exercise.

The Sports Physical.

This chapter discusses the preparticipation examination and outlines its components. Sports participation history and physical forms recently published by the Sports Medicine Committee of the American Academy of Pediatrics are provided. The author stresses the importance of performing a musculoskeletal assessment as part of the sports physical, and describes the "two-minute orthopedic examination.

Forum.

A Forum for Our Readers Jim Blankenship, MD Danville, Pennsylvania Forum is intended to provide a sounding board for our readers. Perhaps you have a special way to treat a common medical problem, or you may want to air your views on a controversial topic. You may object to an article that we have published, or you may want to support one.

Phase I trial of indicine-N-oxide in children with leukemia and solid tumors: a Pediatric Oncology Group study.

A phase I trial of indicine-N-oxide was carried out in 12 children with solid tumors and in 16 with leukemia. Doses of 5, 6, and 7.5 g/m2 were given parenterally as a 15-min infusion every 3 weeks.

Controversies in Pediatric Sports Medicine.

In brief: Primary care physicians often need to advise pediatric patients and their parents on medical issues in children's sports, but for many areas of sports medicine, data are inconclusive, recent, or nonexistent. For instance, infant exercise programs seem to be increasing in popularity with parents, but the passive exercises have little or no effect on an infant's development. And on another front, some schools still do not allow high school girls to try out for sports like football and wrestling, yet this position has been challenged in court by a few girls.

The adolescent athlete and ergogenic aids.

Amphetamines and anabolic/androgenic steroids are the ergogenic aids with the most serious side effects that adolescents are likely to misuse, although adolescents are more frequently lured into taking expensive and worthless vitamin and protein supplements. Physicians performing preparticipation physical examinations should address the issue of ergogenic aids when they offer anticipatory guidance to adolescent athletes.

Management of minor soft tissue trauma in adolescent athletes.

Rest, ice therapy, compression, and elevation (RICE) are important components of the initial management of acute soft-tissue injuries such as contusions, strains, and sprains. Cryotherapy should be used, in the form of an ice pack, as soon as possible after the injury, and then several times a day for 20 minutes for several days. The use of ice has a theoretical, clinical, and experimental basis.

Another look at the sports preparticipation examination of the adolescent athlete.

The sports preparticipation examination can be worthwhile if the musculoskeletal system is examined carefully, with particular regard for the residual disabilities from previous injuries; this can be accomplished in a two-minute orthopedic examination done in addition to the usual physical examination. As many as 10% of young people may have abnormalities such as patellofemoral syndrome, incompletely rehabilitated ankle sprains, or tight hamstring muscles, which may result in further injury unless a rehabilitation exercise program is instituted.

Drugs and the adolescent athlete.

The pediatrician performing a preparticipation physical examination on an adolescent athlete should discuss the use of ergogenic aids. This could be with all of the athletes present in the case of the mass screening examination, or in private during the preferred office-based physical examination, whether preparticipation or health maintenance. Knowing which sport the youth is active in can lead to the drugs most likely being misused being emphasized by the physician; ie, androgens in the case of weightlifting and football, and amphetamines in competitive events like swimming, football, and track.

Impact of the timing of triple intrathecal therapy on remission induction in childhood acute lymphoblastic leukemia: a Pediatric Oncology Group study.

Five weekly doses of triple intrathecal (IT) chemotherapy (methotrexate, hydrocortisone, cytosine arabinoside) starting on day 1 of treatment were added to systemic induction therapy in a regimen (Arm 3) that was compared to three other regimens (Arms 1, 2, and 4) in which central nervous system (CNS) prophylaxis was initiated after complete marrow remission (CR) was attained. The CR rate for Arm 3 was only 83% as compared to 91-92% for other Arms. The lower CR rate was the result of a significantly higher death rate during induction for patients receiving early CNS prophylaxis (10.