Staphylococcal toxin-mediated syndromes in childhood.

Staphylococcal toxic shock syndrome (TSS) and staphylococcal scalded skin syndrome (SSSS) are two distinct toxin-mediated syndromes with prominent cutaneous features. The exanthematous presentation of these syndromes places them in the broad category of childhood exanthems, and the ability to recognize these potentially devastating illnesses is essential for pediatricians and dermatologists who may encounter children with fever and rash. Recent advances in the understanding of the pathogenesis of these entities has helped to explain the distinctive clinical presentations of TSS and SSSS.

Childhood exanthems. Old and new.

Exanthems are a common cause of rashes in children. Several recent developments have sparked a renewed interest in this group of diseases, including the identification of parvovirus B19 and human herpesvirus 6 as the causative agents of erythema infectiosum and roseola infantum. The resurgence of measles as a childhood exanthem has caused a re-examination of current immunization practices.

Neuropsychological function in schizophrenia. Selective impairment in memory and learning.

Unmedicated schizophrenic patients (according to DSM-III-R criteria) (n = 36) and age-matched normal controls (n = 36), balanced for parental socioeconomic status, were administered a battery of standardized neuropsychological tests. Patients showed generalized impairment relative to controls and a selective deficit in memory and learning compared with other functions. Selective impairment was not found on tests related to frontal system function (abstraction, verbal fluency, and motor).

Magnetic resonance imaging in schizophrenia. I. Volumetric analysis of brain and cerebrospinal fluid.

The study reports magnetic resonance imaging data for 42 patients with schizophrenia and 43 normal controls. Volumetric measures were obtained with a validated computerized algorithm for segmentation of cranial volume into brain tissue and central and peripheral cerebrospinal fluid (CSF), with high inter-operator reliability. Patients did not differ significantly in whole-brain volume, but had higher whole-brain CSF volume and higher ratios of ventricular and sulcal CSF to cranial volume.

Gender differences in age effect on brain atrophy measured by magnetic resonance imaging.

A prospective sample of 69 healthy adults, age range 18-80 years, was studied with magnetic resonance imaging scans (T2 weighted, 5 mm thick) of the entire cranium. Volumes were obtained by a segmentation algorithm that uses proton density and T2 pixel values to correct field inhomogeneities ("shading"). Average (+/- SD) brain volume, excluding cerebellum, was 1090.

Relations among clinical scales in schizophrenia.

Objective: Clinical scales have become established as tools to quantify phenomenological features of schizophrenia. The goal of this study was to examine relations among the following: the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the deficit-nondeficit classification.

Method: Forty-seven patients with schizophrenia were recruited according to specific inclusion and exclusion criteria.

Tissue plasminogen activator treatment of experimental subretinal hemorrhage.

To determine if tissue plasminogen activator, a clot-specific fibrinolytic agent, could eventually be used to assist in the clearance or removal of subretinal hemorrhage, we studied the effect of subretinal injections of tissue plasminogen activator, autologous blood, balanced salt solution, and the combination of either tissue plasminogen activator or balanced salt solution after subretinal injection of autologous blood on retinal morphologic characteristics and clearance of subretinal hemorrhage in the albino rabbit. No morphologic evidence of tissue plasminogen activator toxicity was found in the rabbit retina at a dose of 25 to 50 micrograms/0.1 ml.

Dermatophytosis mimicking Kaposi's sarcoma in human immunodeficiency virus disease.

Kaposi's sarcoma (KS) is an important finding in patients infected with human immunodeficiency virus (HIV), with a distinctive spectrum of clinical presentations. Three cases of dermatophytosis in HIV-infected patients are presented which clinically mimic the appearance of KS. This new observation underscores the importance of histopathologic examination in the evaluation of skin lesions suspicious for the diagnosis of KS.

Conjunctival synthetic and nonsynthetic fiber granulomas.

Synthetic and nonsynthetic fiber granulomas can be easily diagnosed and treated. This is a case of a child who had a granulomatous inflammation surrounding a filamentous foreign body that was removed and identified by simple histopathologic techniques. The pathologic findings are remarkably similar to the few case reports in the literature.

Analysis of brain and cerebrospinal fluid volumes with MR imaging. Part I. Methods, reliability, and validation.

A computerized system was developed to process standard spin-echo magnetic resonance (MR) imaging data for estimation of brain parenchyma and cerebrospinal fluid (CSF) volumes. In phantom experiments, the estimated volumes corresponded closely to the true volumes (r = .998), with a mean error less than 1.

UAF radiorespirometric protocol for assessing hydrocarbon mineralization potential in environmental samples.

Following the EXXON Valdez oil spill, a radiorespirometric protocol was developed at the University of Alaska Fairbanks (UAF) to assess the potential for microorganisms in coastal waters and sediments to degrade hydrocarbons. The use of bioremediation to assist in oil spill cleanup operations required microbial bioassays to establish that addition of nitrogen and phosphorus would enhance biodegradation. A technique assessing 1-14C-n-hexadecane mineralization in seawater or nutrient rich sediment suspensions was used for both of these measurements.

Giant juvenile xanthogranuloma: exophytic and endophytic variants.

Xanthogranulomas larger than 2 cm are rarely reported variants of this otherwise common, benign lesion usually measuring 1 mm to 1 cm in diameter. The natural history of such macronodular xanthogranulomas is uncertain, but appears to parallel the generally predictable course toward involution seen in micronodular lesions. Two patients with macronodular xanthogranuloma illustrate exophytic and endophytic variants, as well as the problems of managing this unusual tumor.

Dermatologic Manifestations of Sexually Transmitted Diseases.

Cutaneous signs and symptoms are important because they may represent the most prominent, earliest, or only evidence of sexually transmitted disease. AIDS and HIV infection are increasingly serious problems of adolescence, and the recognition of non-AIDS STDs in adolescents now has the added importance of identifying a population at high risk for HIV infection.

Livedo reticularis.

A wide variety of internal diseases may be associated with livedo reticularis. In adults, the most frequently encountered associated diseases are characterized by vessel wall disease or intravascular obstruction. In the former group, lupus erythematosus is particularly important, since LR along with anticardiolipin antibodies appears to be a marker of serious cerebrovascular and renal disease.

Subcortical metabolic alterations in partial epilepsy.

The function of subcortical nuclei in partial epilepsy was investigated using positron emission tomography (PET) to measure metabolism in the basal ganglia and thalamus. Sixteen patients undergoing surgical evaluation were studied with 18F-fluorodeoxyglucose (FDG) interictally and had intensive extracranial and intracranial electrophysiologic evaluations. Eight patients had left temporal lobe seizure foci, six had right temporal lobe foci, and two had right posterotemporal or parietal foci.

Purification and amino-terminal sequence analysis of the complement-fixing and precipitin antigens from Coccidioides immitis.

Two proteins (21 and 48 kilodaltons) purified from endospore-spherule culture filtrates of Coccidioides immitis are identified as precipitin and complement-fixing antigens, respectively. To allow specific structural comparison to antigens identified by other investigators and as a first step to eventual serodiagnostic antigen production by recombinant DNA technology, amino-terminal amino acid sequences were determined for these antigens.

The effect of focal cerebral atrophy in positron emission tomographic studies of aging and dementia.

We used x-ray computed tomographic (XCT) scans to measure the degree of cerebral atrophy in brain regions defined by a region of interest (ROI) anatomy atlas. The same atlas was employed for quantitation of local cerebral glucose metabolic rates (LCMRglc) by PET. PET data were obtained from 9 young controls, 7 healthy elderly controls, and 10 patients with dementia.

Autoinoculated palmar pustules in neonatal candidiasis.

A 2-week-old infant had grouped pustules on the right hand, wrist, and antecubital flexure that appeared after the first week of life. The infant was seen repeatedly to suck the involved areas of the hand and wrist. Clinically typical candidiasis was noted in the oral cavity and the diaper area.

Laterality and frontality of cerebral blood flow and metabolism in schizophrenia: relationship to symptom specificity.

Two of the hypotheses on regional brain dysfunction in schizophrenia that have received some support in studies of cerebral blood flow (CBF) and cerebral metabolic rate (CMR) are: (1) left hemispheric dysfunction and overactivation (laterality) and (2) frontal lobe deactivation or failure to activate (frontality). Although these hypotheses are not mutually exclusive, their relative importance for providing clues to neural underpinnings of symptoms specific to schizophrenia depends on their ability to predict variation in symptomatology. A potentially efficient strategy for such study is to start with physiological parameters of laterality and frontality, and correlate them with measures of severity of clinical symptoms specific to schizophrenia.

Health maintenance issues of the elderly. Hearing.

Estimates of the prevalence of hearing impairment individuals over 65 years old are on the order of 30 percent. Although the psychosocial consequences of hearing impairment may be profound, less than 20 percent of hearing-impaired adults use hearing aids to compensate for their hearing loss. Primary care physicians play a vital role in identifying hearing impairment in the elderly and in assisting the older adult in obtaining rehabilitative services, including hearing aids.