Orofacial sensitivity reactions and the role of dietary components. Case reports.

Dietary components have proven to be important aetiological factors in orofacial sensitivity reactions such as plasma cell gingivitis and orofacial granulomatosis. The use of elimination diets to identify these dietary antigens can be instrumental in both diagnosis and effective treatment for these disorders.

Causes of hospital-acquired septicaemia--a case control study.

Hospital-acquired septicaemia is common and an important cause of morbidity and expense. Few studies have explored its cause by comparing features of people who do and do not develop septicaemia--the aim of this study. All blood cultures were monitored over one year in a 400-bed tertiary care hospital where special care is taken with intravenous cannulae to prevent septicaemia.

Mucosal immune response in a case of sudden infant death syndrome.

A prospective study to define the normal patterns of development of mucosal immunity in 263 children provided a unique opportunity to study the mucosal immune response in an infant who unexpectedly died from sudden infant death syndrome. The subject initially had a normal pattern of mucosal immune function, which was perturbed after a transient mild upper respiratory tract infection at 3 1/2 wk of age. After the upper respiratory tract infection, there was an increase in mucosal permeability and the appearance of IgA and IgM in saliva.

Yttrium synovectomy: a meta-analysis of the literature.

Background: Yttrium synovectomy for chronic synovitis of the knee enjoys widespread usage in Australia with approximately 400 patients receiving yttrium-90 in 1991. Despite abundant anecdotal evidence of its efficacy there is a paucity of controlled trials and those that have been done have produced conflicting results and have been of insufficient sample size.

Aims: To critically and quantitatively evaluate the published English literature on comparative trials of yttrium-90 therapy for chronic synovitis of the knee.

Admission rates for hip fracture in Australia in the last decade. The New South Wales scene in a world perspective.

Objectives: To study the changes in admission rates for hip fracture in New South Wales in the last decade; and to compare the age-adjusted rates with those from Europe, America and Asia.

Methods: Hospital discharge data for the years 1981, 1986 and 1989-1990 for New South Wales were used. The number of patients discharged with hip fracture (International Classification of Diseases code 820) as one of the diagnoses was calculated.

Development of an in vitro system for the analysis of ultraviolet radiation-induced suppression of natural killer cell activity.

Previous studies have shown that natural killer (NK) cell activity was suppressed in volunteer subjects exposed to ultraviolet radiation (UVR) from solarium lamps. The present studies were carried out to determine the spectrum of UVR responsible for suppression of NK activity and to develop in vitro methods to analyze the effectiveness of sunscreen agents in prevention of UVR-mediated suppression of NK activity and other aspects of immune function. UVR from a xenon arc lamp source was used to irradiate peripheral blood lymphocytes (PBL) in wells of tissue culture flasks, and transmission interference filters were used to eliminate UVR of particular wavelengths.

A comparison of clinical assessment and home oximetry in the diagnosis of obstructive sleep apnea.

In order to determine whether measurement of arterial oxygen saturation (SaO2) could identify patients with obstructive sleep apnea (OSA), 98 consecutive patients referred for assessment of snoring and/or daytime somnolence were assessed clinically and then underwent both unsupervised oximetry in their homes and formal polysomnography. Clinical assessment identified patients with an apnea+hypopnea index (AHI) > or = 15 events per hour with a sensitivity of 79% and a specificity of 50%. Home oximetry analyzed by counting the number of arterial oxygen desaturations recorded was inferior to clinical assessment.

Etretinate therapy of solar-related kerato acanthoma.

Nineteen patients with a total of 22 keratoacanthomas were treated in this trial with 1 mgm/kg/day of etretinate for six weeks. The patients had predominantly solitary keratoacanthoma, all associated with severe solar damage. There was a provision for reduction of dose and also for extension of length of treatment time for lesions which had responded but had not completely disappeared at the end of six weeks.

Modern methods of searching the medical literature.

Objective: To review the methods of electronic retrieval of biomedical journal articles; to demonstrate CD-ROM and online searching techniques; and to compare major biomedical databases.

Design: A CD-ROM MEDLINE search was made by a medical practitioner, with the assistance of an experienced librarian. An online MEDLINE/Excerpta Medica search was made by the same medical practitioner after completion of a two-day course in search techniques.

The importance of hypertension in the aetiology of infarctive and haemorrhagic stroke. The Lower Hunter Stroke Study.

Objective: To determine the importance of hypertension in the aetiology of infarctive and haemorrhagic stroke in persons aged 35-69 years.

Design: A population-based case-control study.

Setting: Lower Hunter Region community.

Changing trends in perforated peptic ulcer during the past 45 years.

Since 1944 there has been a dramatic change in the pattern of admissions for perforated peptic ulcer (PPU) to the Royal Newcastle Hospital, the main teaching hospital of the Hunter Region, Australia. Between 1944 and 1950, females accounted for 6% of all perforations; since then the proportion of females admitted with this complication has risen to 32%. Simultaneously, the modal age for PPU has shifted from the fifth to the seventh decade and the ratio of gastric to pyloroduodenal perforations has fallen from 1.

Fungal Pseudoallescheria boydii lung infiltrates unresponsive to amphotericin B in leukaemic patients.

The management of patients with acute leukaemia is often complicated by serious fungal infections, especially of the lungs. The outcome of therapy has historically depended on the early use, efficacy and toxicity of amphotericin B. Pseudoallescheria boydii is an uncommon cause of such infections but as it is more often resistant to amphotericin B early identification may enable the prompt use of alternative and newer antifungal agents.

Active immunotherapy with viral lysates of micrometastases following surgical removal of high risk melanoma.

Patients who develop lymph node metastases from melanoma are known to be at risk of developing further recurrences from melanoma following surgical removal of lymph node metastases. The purpose of the present study was to examine whether immunization over a 2 year period with a vaccine made from vaccinia viral lysates of an allogeneic melanoma cell (VMCL), following surgical removal of lymph node metastases, would help prevent the development of distant metastases and improve survival from the disease. Eighty patients treated with VMCL alone and followed for a minimum of 5.

Resolution of cyclosporin A (CsA)-induced gingival enlargement following reduction in CsA dosage.

Gingival enlargement due to the immunosuppressive drug, cyclosporin A (CsA), will resolve following discontinuation of drug therapy or extraction of adjacent teeth. This report presents a clinical observation on a patient in whom CsA-induced gingival enlargement failed to resolve with improved plaque control and scaling, but resolved quickly following reduction in the daily dosage of CsA. Despite less than optimal plaque control, the CsA-induced gingival enlargement did not recur on the reduced drug dosage over a 2-year observation period.

Is the patient with an arthritic neck at risk during endoscopy?

To determine whether upper gastrointestinal endoscopy poses a risk to patients with arthritis of the neck, 486 members of the Gastroenterology Society of Australia were surveyed by postal questionnaire. Replies were obtained from 323 members. More than 1.

Differences in the symptoms of men and women with obstructive sleep apnoea.

In order to determine whether the clinical features of obstructive sleep apnoea (OSA) are the same in men and women we reviewed the records of 22 women with OSA. The women were matched with 44 men of similar age (+/- 5 years) and frequency of respiratory events (less than or equal to 15/hr, 16-40/hr, 41-70/hr and greater than 70/hr). The degree of daytime somnolence was similar in men and women.

Reversal of acute glomerular renal allograft rejection: a possible effect of OKT3.

A major cause of renal allograft loss is glomerulovascular rejection. This case report is about an episode of histologically proven acute glomerular rejection that was successfully reversed. Monoclonal antibody OKT3 may have been the effective agent.

Behavioral conditioning prolongs heart allograft survival in rats.

Conditioned immunosuppression using a taste aversion paradigm has been demonstrated in a number of laboratory models but few reports have demonstrated changes in immunity sufficient to be of clinical relevance. The experiments reported here demonstrate that the survival of heart allografts in rats can be prolonged by behaviorally conditioned immunosuppression using cyclosporin A (CsA) as an unconditioned stimulus in taste aversion conditioning. Conditioned animals received saccharin as the conditioned stimulus paired with an injection of CsA at 10 and 6 days prior to transplantation.

Arg-Gly-Asp-containing peptides expose novel collagen receptors on fibroblasts: implications for wound healing.

Integrins are a family of cell-surface receptors intimately involved in the interactions of cells with their extracellular matrix. These receptors comprise an alpha and beta subunit in noncovalent association and many have been shown to recognize and bind an arginine-glycine-aspartate (RGD) sequence contained within their specific extracellular matrix ligand. Fibroblasts express integrin receptors belonging to two major subfamilies.

Peritoneal eosinophilia associated with Paecilomyces variotii infection in continuous ambulatory peritoneal dialysis.

A 65-year-old woman maintained on continuous ambulatory peritoneal dialysis (CAPD) presented with a 5-month history of intermittent cloudy bags and sterile peritoneal and peripheral blood eosinophilia, which failed to clear despite conventional antibiotics. Impaired catheter inflow and delayed effluent drainage gradually occurred and intracatheter streptokinase, administered to rectify catheter dysfunction, dislodged a catheter cast composed of fungal hyphae of Paecilomyces variotii. Fungal peritonitis and Paecilomyces fungemia ensued, which were treated with amphotericin B and catheter removal.

The microbiology of peritonitis in continuous ambulatory peritoneal dialysis--experience in a provincial centre 1986-1989.

Laboratory procedures for isolating the causative microbe from infected effluent in continuous ambulatory peritoneal dialysis (CAPD) are still being refined. Our recovery rate from culturing centrifuged deposits of 10 mL of fluid averaged 55% for leukocytotic fluids from 1986 to 1989, a little lower than the published reports using blood culture methods. A combined use of spun deposit and blood culture broth should improve the yield without excessive cost in time and labor.