Histologic features of alopecia areata other than peribulbar lymphocytic infiltrates.

Background: Histologic features other than a lymphocytic infiltrate around follicular bulbs are now recognized as helpful clues to the diagnosis of alopecia areata, especially in long-standing lesions where the peribulbar lymphocytic infiltrate may be sparse or absent.

Objectives: We sought to determine the frequency of peribulbar lymphocytic infiltrates, eosinophils, lymphocytes, and melanin in fibrous tracts, pigment casts in follicles, the presence of catagen/telogen follicles, follicular miniaturization, and dystrophic ("nanogen") follicles in alopecia areata. Secondly, we sought to compare the diagnostic use of transversely sectioned versus horizontally sectioned specimens in those cases for which both were available (15 of 109 cases).

Comparison of a chromogenic factor X assay with international normalized ratio for monitoring oral anticoagulation therapy.

The purpose of the present study was to compare the international normalized ratio with a chromogenic factor X (CFX) assay for monitoring patients on oral anticoagulant therapy using the DiaPharma CFX method on a STA-R Evolution coagulation analyzer. International normalized ratio values were correlated with the CFX for determining normal, subtherapeutic, therapeutic and supratherapeutic ranges for these patients. Specimens were analyzed and grouped as normal or patients on oral anticoagulant therapy with international normalized ratios of less than 2.

Bacteria recovered from patients admitted to a deployed U.S. military hospital in Baghdad, Iraq.

The predominant bacteria and antimicrobial susceptibilities were surveyed from a deployed, military, tertiary care facility in Baghdad, Iraq, serving U.S. troops, coalition forces, and Iraqis, from August 2003 through July 2004.

Colchicine for prophylaxis of acute flares when initiating allopurinol for chronic gouty arthritis.

Objective: The use of colchicine to prevent acute gout flares during initiation of allopurinol therapy is widely practiced despite lack of proven benefit. We investigated if colchicine administration during initiation of allopurinol for chronic gouty arthritis reduces the frequency and/or severity of acute gout flares.

Methods: Patients starting allopurinol for crystal-proven chronic gouty arthritis were randomized to receive colchicine 0.

Substance abuse and withdrawal in the intensive care unit. Contemporary issues.

Because 36% of intentional injury victims are drug dependent, the association between drug abuse and violence, especially in urban settings, is high. Withdrawal syndromes in ICU patients confuse their clinical management, may be extremely difficult to diagnose, are often lethal, need to be suspected, and should be prophylaxed against; therefore, all ICU patients should be considered to be at high risk for drug or alcohol dependence, should be tested for evidence of such drugs, and should be interviewed (together with their family members) for the presence of drug dependence traits. Appropriate patients should be referred for formal evaluation and treatment.

Sinus and facial growth after pediatric endoscopic sinus surgery.

Objective: To determine the effect of functional endoscopic sinus surgery (FESS) on facial skeletal growth in children.

Design: Prospective randomized controlled animal study; retrospective histopathologic study of pediatric FESS specimens.

Setting: Academic tertiary referral medical center.

Gypsum compatibility of antimicrobial alginates after spray disinfection.

Purpose: This investigation examined the gypsum compatibility of two antimicrobial alginates after spray disinfection. Subjective compatibility evaluations were compared with objective quantitative profilometer readings of gypsum cast surface roughness.

Materials And Methods: COE Hydrophilic Gel Alginate, Jeltrate Plus, Antimicrobial Alginate, and their nonantimicrobial counterparts, Coe Alginate and Jeltrate Plus, were used in this study.

Peripheral nervous system involvement in a large cohort of human immunodeficiency virus-infected individuals.

Objective: In individuals who were infected with the human immunodeficiency virus (HIV) we determined the prevalence of peripheral neuropathies (PNs) and explored the relationship between immunologic competence and nerve function.

Design: Cohort survey.

Setting: US Air Force medical center.

Lacrimal drainage system injury in functional endoscopic sinus surgery. Incidence, analysis, and prevention.

Injury to the lacrimal drainage system with resultant epiphora is a complication of functional endoscopic sinus surgery. A study of 24 patients was conducted to determine the incidence and significance of lacrimal drainage system injuries during functional endoscopic sinus surgery. Intraoperative testing demonstrated seven occult injuries (15%) in 46 endoscopic procedures.

Pediatric tracheobronchomalacia and major airway collapse.

Based on histopathologic, endoscopic, and clinical findings of the flaccid airway, new descriptive terms--major airway collapse types 1 through 3--are proposed to better define tracheobronchomalacia. A typing and grading system is offered to objectively analyze and compare clinical cases. Endoscopic and anesthetic techniques are presented for use in children with respiratory distress suggestive of tracheobronchomalacia.

Electrophysiologic study of the effects of aminophylline and metaproterenol on canine myocardium.

Aminophylline and beta-adrenergic agonists are widely used in the treatment of obstructive lung diseases. It has been suggested that combined aminophylline and beta-agonist therapy may promote the development of atrial and ventricular arrhythmias. The effects of these agents in combination on myocardial conduction and tissue refractoriness have not been documented.

The retroperitoneal, left flank approach to the supraceliac aorta for difficult and repeat aortic reconstructions.

Between 1986 and 1990, 11 patients with relative or absolute contraindications to standard infrarenal reconstructions underwent supraceliac aortofemoral bypass. The operation was performed through a left-flank incision extended into the eleventh intercostal space with retroperitoneal and extrapleural dissection. Indications included multiple failed infrarenal reconstructions in four patients, previous removal of infected aortofemoral bypass graft with failure of extra-anatomic bypass in five patients, prior para-aortic lymph node dissection and radiotherapy in one patient, and aortic aneurysmal disease proximal to the renal arteries in one patient.

New set of pediatric laryngoscopes.

With new advances in pediatric otolaryngology, the awareness of difficulties with existing laryngoscope instruments has become more apparent. The following paper introduces four new pediatric laryngoscopes for use in premature infants, the neonate and infant, the toddler-size child, and the preadolescent-size child. The reasons for the need of new laryngoscopes are explained, and the modifications to existing scopes that are currently employed are discussed.

Melkersson-Rosenthal syndrome.

Melkersson-Rosenthal syndrome is a rare condition, classically associated with a triad of facial and/or lip edema, fissured tongue, and relapsing facial palsy. This article offers a review of the literature and presents two cases of Melkersson-Rosenthal syndrome associated with elevated serum levels of angiotensin converting enzyme in two patients of Thai descent.

Mesenchymal hamartoma of the liver. A 35-year review.

Mesenchymal hamartoma of the liver occurs almost exclusively in infancy and childhood, with approximately 140 total cases reported. We report the experience with 18 patients at the Childrens Hospital of Los Angeles (Calif) during the past 35 years. The charts of all patients with mesenchymal hamartoma were retrospectively reviewed.

Leptospirosis. Epidemiological features of a sporadic case.

Leptospirosis occurred in a 45-year-old man with presumed infection from an exposure to contaminated water at his source of employment. An intensive epidemiological investigation, including serological examination of all family members and pets and cultures on the patient and his family pets (cats and dogs), proved that the leptospiral organism was acquired by the patient's exposure to his dogs. The risk of acquiring infection from dogs that are asymptomatic and vaccinated is emphasized by this report.

Chronic exposure to tumor necrosis factor in vivo preferentially inhibits erythropoiesis in nude mice.

The anemia of chronic disease (ACD) is associated with conditions in which macrophage activation occurs. Activated marrow macrophages suppress erythropoiesis in vitro and produce tumor necrosis factor (TNF). Therefore, we tested the effects of chronic in vivo exposure to TNF to determine if it was a candidate for a mediator of ACD.

Role of lung injury in the pathogenesis of hyaline membrane disease in premature baboons.

To test the hypothesis that hyaline membrane disease (HMD) has a multifactorial etiology in which barotrauma plays a major role, we compared the immediate institution of high-frequency oscillatory ventilation (HFOV; 15 Hz, n = 5) with positive-pressure ventilation with positive end-expiratory pressure (PPV; n = 7) in premature baboons (140-days gestation) with HMD. Measurements of ventilation settings and physiological parameters were obtained and arterial-to-alveolar O2 (PaO2-to-PAO2) ratio and oxygenation index [(PaO2/PAO2)-to-mean airway pressure ratio (IO2)] were calculated. At death (24 h), static pressure-volume (PV) curves were performed, and phospholipids (PL) and platelet-activating factor (PAF) were measured in lung lavage fluid.

Schwannomatosis. An unusual variant of neurofibromatosis or a distinct clinical entity?

Multiple schwannomas have frequently been seen in patients with neurofibromatosis. Recently, the association of multiple cutaneous schwannomas, central nervous system tumors, and various neurologic deficits has been described in Japanese patients as a condition called schwannomatosis. We describe the first non-Japanese cases of schwannomatosis and compare and contrast this unusual condition with the well-known variants of neurofibromatosis.

Neuropsychological and neurological function of human immunodeficiency virus seropositive asymptomatic individuals.

Although individuals with acquired immunodeficiency syndrome (AIDS) are often impaired on a variety of neuropsychological tasks, questions remain as to when neuropsychological decline can be reliably detected during the course of human immunodeficiency virus (HIV) infection. Detailed neuropsychological testing was accomplished on a cohort of 83 immunologically and neurologically intact asymptomatic HIV-infected individuals drawn from a larger pool of 649 US Air Force personnel with HIV antibodies. These asymptomatic subjects were compared with a group of HIV-negative subjects, and no significant differences in neuropsychological functioning were found.

Oxygen delivery rate and sufficiency of oxygenation during ECMO in newborn baboons.

Minimum acceptable O2 delivery (DO2) during extracorporeal membrane oxygenation (ECMO) remains to be defined in a newborn primate model. The right atrium, carotid artery, and femoral artery were cannulated, and the ductus arteriosus, aorta, and pulmonary artery ligated in neonatal baboons (Papio cynocephalus) under a combination of ketamine, diazepam, and pancuronium. The internal jugular vein was also cannulated retrograde to the level of the occipital ridge.