Hypersensitivity reactions to drugs: correlation between clinical probability score and laboratory diagnostic procedures.

The in vitro diagnosis of allergic drug reactions have not made significant progress in recent years. Specific stimulation of lymphocytes from allergic patients represents an approach to demonstrating sensitization to the implicated drug. So far, skin tests and RAST can only be applied to a limited number of situations.

The induction and functions of murine T-helper cell subsets.

Through the release of distinct sets of cytokines, Th1 and Th2 cells exert characteristic and often mutually exclusive or antagonistic immune effector functions. In the present report, we document and discuss several findings on the induction mechanisms of these cellular subtypes and present recent findings on their respective functions in vivo. The preferential induction of Th1 or Th2 cytokine patterns in mature CD4+ T cells is generally attributed to the action of cytokines.

Open dislocation of the trapezoid.

Isolated dislocation of trapezoid is rare. We report here a new case of open dorsal dislocation of the trapezoid following a high energy crush injury of the left hand in a factory worker. It was associated with multidigital mutilation and metacarpal fractures.

Ovarian sertoliform endometrioid carcinoma.

Sertoliform endometrioid carcinoma (SEC) is a rare ovarian neoplasm occurring almost exclusively in post-menopausal patients. We studied a 71-year-old patient who underwent a total hysterectomy with bilateral salpingo-oophorectomy for a right ovarian mass measuring 25 cm in its maximal dimension. Histology revealed an SEC, featuring foci of typical endometrioid carcinoma and areas of clear cell differentiation.

H-2D haplotype-linked expression and involvement of TNF-alpha in Th2 cell-mediated tissue inflammation.

We recently reported that polyclonal anti-CD3 epsilon-pulsed Th2 cells mediate local tissue inflammation (DTH2) when injected into naive syngenic recipient mice, and that this response is entirely dependent on IL-4 in BALB/c (H-2d) mice. We now describe a different cytokine dependence in mice that bear a H-2b MHC haplotype. Injection of either soluble IL-4R (sIL-4R) or anti-TNF Ab partially inhibited swelling that was mediated by Th2 cells from high TNF-producing C57BL/6 mice.

Auditory magnetic fields in cochlear-implant patients.

Neuromagnetic recordings were used to check if electrical stimulation of the auditory nerve in cochlear-implant patients activates cortical auditory areas in a similar manner as acoustic stimulation in normal hearing subjects or whether the excitation processes are different. The waveform of the evoked magnetic field complex elicited by electrical stimulation of the auditory nerve as well as the distribution of the magnetic responses over the head resemble that of auditory-evoked fields elicited by acoustic stimulation of normal subjects. The location and direction of the equivalent dipole are consistent with activation of the auditory cortex.

Vowel and consonant identification tests can be used to compare performances in a multilingual group of cochlear implant patients.

Vowel and consonant identification tests were conducted in the sound-only condition in a multilingual group of 13 totally deaf patients who are users of the Ineraid multichannel cochlear implant. Native languages ranged across French, German, Italian, Spanish, Albanian and Swahili. We found high correlations (r > -0.

Early clinical trial of MDL 73.147 EF: a new 5-HT3-receptors antagonist for the prevention of chemotherapy-induced nausea and vomiting.

Background: Like MDL 72.222, one of the first selective 5-hydroxytryptamine3 (5-HT3) receptors antagonist discovered, MDL 73.147 EF has been shown to possess antiemetic properties in the ferret model.

Vertigo as manifestation of vertebral artery dissection after chiropractic neck manipulations.

We recently observed a case of vertebral artery (VA) dissection following chiropractic neck manipulations. The first manifestation was unusual; in the form of vertigo. Therefore, the patient was referred to the otoneurologist.

Channel interactions in patients using the Ineraid multichannel cochlear implant.

Electrode interactions were investigated on two totally deaf patients fitted with the Ineraid multichannel cochlear implant. Currents were applied to the most apical electrode (the 'perturbation' electrode) and their effects on psychophysical thresholds on the other electrodes (the 'test' electrodes) of the intracochlear array were studied. Two experimental protocols were used.

Unimage, a new RIS for the DIOGENE 2 environment at Geneva Cantonal University Hospital.

The effective management of a radiology department depends on adequate computing tools for imaging specialists--radiologists and technicians--and administrators. The rapid evolution of imaging techniques in radiology requires flexible systems for describing the daily operation of a service and accessing data generated by every possible source. In order to compensate for the insufficiencies of our current radiology information system (RIS), and within the framework of the migration towards the DIOGENE 2 hospital information system, a new RIS, named Unimage, has been implemented at the Cantonal University Hospital of Geneva.

Fine-needle aspiration in the diagnosis of head and neck growths: the pitfalls of false-positive diagnosis.

The results of fine-needle aspiration cytology (FNA) performed on 235 patients with head and neck growths were analyzed. The accuracy rate was 83%. The FNA was nondiagnostic in 9%, false negative in 7% and false positive in 1% of the cases.

Intraoperative electrically evoked vestibular potentials in humans.

Electrically evoked short latency vestibular potentials were recorded in 9 patients during vestibular neurectomy. Patients were operated on because of intractable Meniere's disease. The VIIIth cranial nerve was exposed through a limited retrosigmoidal approach; the vestibular nerve was contacted in the cerebello-pontine angle with a bipolar platinum-iridium electrode and stimulated with biphasic current pulses (100 microseconds/phase, 0.

Diagnosis of cerebellopontine angle tumors.

Between 1980 and 1990, 9,176 patients suffering from otoneurological disorders were investigated in our clinic. Sixty-six (0.72%) internal auditory canal or other cerebellopontine angle tumors (CPAT) were diagnosed.

Penetrating wounds of the ear with oval window fistulas. Reports of 2 cases.

In 2 patients with penetrating wounds of the ear lesions involved the tympanic membrane and the ossicular chain. The long process of the incus was lying on the fallopian canal and the stapes was deeply depressed into the vestibule. In spite of a large oval window fistula, cochleovestibular signs were minimal.

Geneva experience with the Ineraid multichannel cochlear implant.

Ineraid is a multichannel intracochlear implant of recent design that can provide high levels of speech recognition to totally deaf patients. We chose this device when it became available in 1985 because of our clinical and research interests. We had no commercial ties and could therefore critically assess the value of this implant in an array of patients, including congenital deafness, ossified cochleas and perilingual children.

Exploratory cochleotomy. Assessment of auditory nerve excitability and anatomical conditions in cochlear implant candidates.

The exploratory cochleotomy is a new diagnostic procedure for the selection of cochlear implant candidates. We use this procedure to assess the excitability of the auditory nerve, the patency of the cochlea and to detect undesirable side effects of electrical stimulation, such as facial nerve activation. The exploratory cochleotomy is a limited surgical procedure performed under local anesthesia in adults and light sedation in children.

Electrically evoked auditory brainstem responses in cochlear implant patients.

Electrically evoked auditory brainstem responses (EABR) were recorded in completely deaf patients implanted with Ineraid multichannel cochlear implants. Clear and reproducible EABR were obtained from all patients. Parametric differences with auditory brainstem responses (ABR) were demonstrated and can be explained by the different natures of both types of stimulations (electric versus acoustic).

Intracochlear potential distribution with intracochlear and extracochlear electrical stimulation in humans.

Intracochlear potential distributions were measured from subjects implanted with the Ineraid multichannel cochlear implant. The electrode array provided direct accessibility for obtaining measurements. Different modes of stimulation were used.

Comparative evaluation of an ELISA based on recombinant polypeptides and IFA for serology of malaria.

In the present investigation we compare the performance of a solid-phase assay based on three recombinant polypeptides corresponding to three asexual blood-stage antigens of P. falciparum (ELISA MIXT) with the reference method for the measurement of antimalaria antibodies: indirect immunofluorescence antibody assay (IFA). Sera collected from persons with various degrees of exposure to malaria were selected: sera from inhabitants of a malaria endemic area (Group I), European patients with acute malaria infection (Group II) and blood donors with clinical symptoms of sickness or fever during a stay in malaria endemic areas.

Bilateral electrical stimulation of a congenitally-deaf ear and of an acquired-deaf ear.

Two identical multichannel intracochlear prostheses were implanted in the same patient. The first prosthesis, implanted in the congenitally-deaf right ear, elicited clear sound perception but no speech recognition. After 2 years, a second prosthesis, implanted in the acquired-deaf left ear, enabled the patient to understand speech without lip-reading.

Neuro-otological manifestations in different stages of HIV infection.

A systematic investigation of the incidence and type of peripheral and central auditory and vestibular disorders occurring in different stages of HIV infection was performed: 43 HIV-seropositive patients (14 were symptomatic with manifestation of AIDS or related complex and 29 were clinically asymptomatic) were compared with a matched control group of 33 HIV-seronegative homosexual volunteers. Among the symptomatic patients 8 (57%) out of 14 and among the asymptomatic HIV-positive patients, 13 (45%) out of 29 had abnormal results in various audiological, vestibular and electrophysiological tests. Only minor anomalies were found in 4 (12%) of the 33 seronegative homosexuals.

Low frequency hearing threshold determination in newborns, infants and mentally retarded children by middle latency responses.

Middle latency (10-50 ms) responses (MLR) evoked by tone-pips (1,000 Hz 500 Hz) and early (0-10 ms) auditory evoked potentials (EAEP) evoked by chicks were recorded on 68 newborn babies (premature or at term), infants and children, some with central nervous system or psychiatric disorders, who had normal or impaired hearing. MLR were obtained either during sleep, chloral-hydrate sedation or ketamine anesthesia. Thresholds estimated from MLR and EAEP were compared to those from subsequent psychoacoustic pure tone testing.