Vasculitis of the temporal arteries in the young.

Objective: Temporal artery vasculitis (TAV) in patients younger than 50 years is extremely rare. A case of TAV in an 18-year-old man is described here, followed by a literature review regarding cases of all types of vasculitic involvement of the temporal arteries in the young.

Methods: Review of the English literature on vasculitis involving the temporal arteries in young patients, based on a PubMed search.

Positive coeliac serology in irritable bowel syndrome patients with normal duodenal biopsies: Video capsule endoscopy findings and HLA-DQ typing may affect clinical management.

Objectives: To investigate a group of IBS patients (Rome criteria) with positive coeliac serology (EMA, TTG, IgG or IgA AGA) and normal small bowel biopsies. Video capsule endoscopy (VCE) findings of the small bowell were compared with DQ-typing.

Methods: Twenty-two patients with chronic abdominal pain (with or without diarrhea) and at least one positive result of any of the coeliac serological markers (AGA, TTG, EMA) and normal duodenal biopsy were enrolled and underwent VCE.

Chlorpromazine-induced liver and bone marrow granulomas associated with agranulocytosis.

Chlorpromazine-induced liver damage is usually manifested by intrahepatic cholestasis. Hypoplastic bone marrow associated with agranulocytosis is a well-known side effect of chlorpromazine treatment. A 35-year-old woman with liver and bone marrow granulomas associated with agranulocytosis induced by chlorpromazine treatment is described.

Metastatic maxillary sinus melanoma treated by local excision and brachytherapy.

Malignant melanoma has traditionally been considered a radioresistant tumor. A rare case of metastatic malignant melanoma into the nose and maxillary sinus is presented. Local control was achieved by a combination of local excision and teleradio and brachytherapy.

Isolated pulmonary blast injury in rats--a new model using the extracorporeal shock-wave lithotriptor.

Blast injury to the lungs is one of the most overwhelming threats to survival following exposure to powerful explosions. The pathophysiology of blast injuries differs significantly from other forms of trauma. Using the extracorporeal shock-wave lithotriptor, originally designed for the noninvasive treatment of nephrolithiasis, we were able to produce isolated, typical pulmonary blast effects in rats.

Interstitial pneumonitis in T cell-depleted bone marrow transplantation.

The incidence of interstitial pneumonitis (IP) was reviewed in 80 consecutive patients who received allogeneic T lymphocyte-depleted bone marrow transplantation (BMT) for malignant and non-malignant diseases. Pretransplant conditioning used in malignant disorders included total lymphoid irradiation (TLI) 150 cGy x 4, total body irradiation (TBI) 200 cGy x 6, and cyclophosphamide (CY) 120 mg/kg. In non-malignant diseases conditioning included no TBI, but adjusted doses of TLI in addition to CY (severe aplastic anemia) or CY and busulfan (severe beta-thalassemia major).

Sweet's syndrome.

Sweet's syndrome (acute neutrophilic dermatosis) is characterized by fever; polymorphonuclear neutrophilic leukocytosis; elevated ESR; and characteristic, raised, painful red plaques on the face and limbs. Since Sweet first described the syndrome in 1964, more than 150 cases have been reported, but it is assumed that the disorder is far more common than this number would indicate.

Growth of human mammary carcinoma cells from biopsy specimens in serum-free medium on extracellular matrix.

A method developed for the initiation and maintenance in primary culture of human normal mammary epithelial cells was adopted for the growth of epithelial cells from 45 primary human breast tumors. The cells were grown on a naturally produced extracellular matrix (ECM) or on regular tissue culture plastic in a serum-free medium containing growth supplements and high-density lipoprotein (HDL). Successful enzymatic dissociation of the tumor biopsy into organoid structures and cell aggregates was crucial for subsequent cell attachment and growth.

Esophageal involvement by pemphigus vulgaris.

Pemphigus vulgaris is a well-known disease that involves the skin and the mucous membranes. The disease can start in the oral or pharyngeal mucosa and the skin lesions may appear later. Esophageal involvement seems to be very rare.

Pilar tumor of the nose.

We report a case of pilar tumor of the nose and review the literature. No such tumor in a similar location has been reported previously.

Transient global amnesia associated with a single metastasis in the non-dominant hemisphere. Case report.

A patient in whom transient global amnesia (TGA) led to the diagnosis of a metastasis of a transition-cell carcinoma of the bladder to the non-dominant hemisphere is described. In previously reported cases of TGA associated with brain tumors, the tumors involved either the dominant or both hemispheres. The etiology of TGA associated with a brain tumor is most likely vascular, as suggested by the sudden development and the transitory character of the event.

Persistent neonatal hypoglycemia due to hyperinsulinism: medical aspects.

Eight neonates with persistent hypoglycemia were seen over a four-year period and a ninth infant with neonatal onset was treated from 9 months of age. Seven infants had high absolute insulin levels (range 12 to 50 microunits/ml) during hypoglycemia whereas two patients had normal levels which were, however, inappropriate for the low blood glucose levels. Six patients with severe intractable hypoglycemia resistant to intensive medical therapy (including high dose diazoxide) had partial or total pancreatectomy, whereas three with relatively controllable hypoglycemia eventually had spontaneous remissions.

Platelet studies in patients with hypertrophic cardiomyopathy.

Because of a shared abnormality of platelet and muscle in some neuromuscular diseases, platelets were investigated in five cases of hypertrophic cardiomyopathy, a disease likely to be primarily myogenic. Morphometric and chemical differences from normal were found consisting of increased cell size, decreased phosphorus concentrations and increased permeability to cations. The findings suggest membrane and energy metabolism aberrations.

The clinical use of CO2 laser beam in the surgery of kidney parenchyma.

Encouraged by the experimental work done on 40 kidneys in 20 dogs using the CO2 laser beam for partial nephrectomies, we decided to use the laser in four patients. Three of them underwent lower partial nephrectomy, and the fourth underwent bivalving of kidney through the anatrophic line. The use of this new instrument was very helpful in reducing blood loss, shortening the time of hemostasis, and minimizing parenchymal damage.

Comparative experimental study on the use of the carbon dioxide laser beam in partial nephrectomy.

A report is given on an experimental study in 20 dogs designed to compare the use of the CO2 laser beam as a cutting instrument in resection of the kidney parenchyma, with the simple scalpel and the cutting diathermy current. It was found that the laser can be used with impunity. It shortens the time of operation by facilitating hemostasis, diminishes blood loss, and does not interfere with the final kidney function.

Studies of platelets with heavy metal impregnation techniques.

Various methods of heavy metal impregnations were performed on human platelets. The optimal technique consisted of glutaraldehyde fixation, incubation in warm uranyl acetate at a pH of 3.5, followed by a double solution of lead and copper, and finally overnight immersion in cold osmium tetroxide.

Platelet heterogeneity and dense tubular system changes on activation.

Platelets impregnated with heavy metals appeared as 3 distinct morphological types: 'reticular' cells with a polygonal dense tubular network and stained granules, dark metallophilic cells, and pale metallophobic cells with microvesicles and non-staining granules. On stimulation, type 1 cells decreased while type 3 cells increased, suggesting that with activation dense tubules break up into microvesicles and granules become metallophobic. In the type 2 cells a different functional mechanism may exist.

Neonatal hyperinsulinism--surgical and pathologic considerations.

Hyperinsulinism in infancy is most often associated with a diffuse pancreatic lesion designated islet-cell dysmaturation syndrome. This disease is commonly associated with persistent hypoglycemia which usually results from inappropriate secretion of insulin. Urgent medical therapy consisting of hypertonic glucose infusion, frequent feeding, and diazoxide is mandatory in order to prevent central nervous system damage.