Fulminant Cutaneous T-cell Lymphoma and Sézary Syndrome

The term cutaneous T-cell lymphoma (CTCL) has recently been coined to describe a group of rare lymphoproliferative T-cell disorders classically beginning in the skin and pursuing a chronic, progressive, and indolent course eventually followed by visceral involvement. This term encompasses the spectrum of the traditional mycosis fungoides and Sézary syndrome. A unique case of CTCL that developed a fulminant course leading to death within a few months following the initial symptoms is presented. The clinical course bears a striking similarity to a group of acute T-cell malignancies, while the cytologic-pathologic findings favor the diagnosis of Sézary syndrome. Regardless of the exact classifications, this entity appears to be a highly malignant T-cell disorder, resistant to chemotherapy.     

5-Methoxy Psoralen, Etretinate, and UVA for Psoriasis

This first Australasian randomized trial of 5-methoxy psoralen (5-MOP) PUVA for psoriasis shows, conclusively, less acute side effects than 8-MOP PUVA. Daily addition of oral etretinate to the PUVA regimen (Re-PUVA) produces a valuable reduction in total joules and more so with 5-MOP than with 8-MOP. The clearing phase with 5-MOP Re-PUVA is quicker than with 8-MOP Re-PUVA in skin types 1, 2, and 3 (most Anglo-Saxon-Celtic Australians). Doses, when adapted to total body surface rather than mg/kg, allow superior control of therapy. Emollient creams, tar gels, nonsteroidal scalp applications, etc. allow more patient comfort.     

Evaluation of Muscle Strength Among Different Sports Disciplines: Relevance for Improving Sports Performance

A pilot cross-sectional study among 262 service sportsmen belonging to different sports disciplines was carried out to evaluate various indicators of muscle strength, such as peak torque, peak torque to weight, time to peak torque, maximum power, explosive work etc., using isokinetic testing during flexion and extension of the knee joint in sitting positions at different angles. It was found that peak torque varied significantly among the various sports disciplines depending on the requirement of each sports discipline (p < 0.01). The relevance, advantages and limitations of the tests to enhance sports performance have been discussed. However, discussion has been restricted to review of western literature on the subject as no Indian studies in the field were available for comparison.Key Words: Isokinetic testing, Muscle strength, Peak torque, Sports     

AN EPIDEMIC OF PLEURISY AMONGST MILITARY RECRUITS

An epidemic amongst recruits who presented with acute viral exudative pleural effusion with lymphocytic pleocytosis is analysed. Histologic and bacteriologic proof of tuberculosis was lacking in majority. Most of them recovered without pleural thickening. Overcrowding, inadequate clothing protection, stress and strain of vigorous recruit training could be important precipitating factors. None reported with parenchymal tuberculosis in two year follow up.KEY WORDS: Pleural effussion, Viral     

Normal and stenotic renal arteries: experimental balloon-expandable intraluminal stenting

Elastic recoil of the vessel wall is a common cause of failure of percutaneous transluminal angioplasty in renal arteries. To oppose such recoil, balloon-expandable metal stents were implanted in artificially stenotic renal arteries in pigs and normal renal arteries in dogs and pigs. The stents were then examined angiographically and histologically at regular intervals. All stents were completely covered with endothelialized neointima in 3 weeks. There was no difference in intimal thickness between the stenotic and nonstenotic renal arteries. A large stent diameter and a large open or nonmetal surface may cause less intimal hyperplasia, but nonturbulent, fast arterial flow is probably the most important factor in ensuring long-term patency of the vessel.     

Occupational allergy in an entomological research centre. I. Clinical aspects of reactions to the sheep blowfly Lucilia cuprina.

Twenty eight per cent (15) of 53 workers engaged in a sheep blowfly breeding programme designed to control genetically the pest Lucilia cuprina experienced allergic manifestations resulting from contact with this insect. The most common symptoms were rhinitis, affected eyes, rashes, and lower respiratory symptoms, usually, but not always, immediate in type. A personal history of non-insect related asthma, allergic rhinitis, or eczema, or a combination of these was more common in the fly allergic group but some workers experienced allergic symptoms only when exposed to the adult sheep blowfly. Raised levels of serum IgE antibodies specific for adult and larval allergens were found in approximately 70% of symptomatic workers, whereas only 30% and 7% of two groups of asymptomatic workers were found to have these antibodies. It is concluded that the sheep blowfly is an important source of airborne allergens and can prove a considerable occupational health hazard. Measures designed to reduce worker contact with blowflies and their emanations considerably reduced the incidence of allergic symptoms in the exposed workers.     

Visibility of gallstone fragments at US and fluoroscopy: implications for monitoring gallstone lithotripsy

To assess the value of ultrasound (US), fluoroscopy, and spot radiography in the detection, counting, and measurement of gallstone fragments during lithotripsy, in vitro visibility studies were conducted on fragments from 20 stones. Fluoroscopic visibility was evaluated during and after lithotripsy on 185 fragments placed in an anthropomorphic phantom. Three US experiments were performed on the fragments to study the visibility of fragments as a function of size, the accuracy of the count with large numbers of fragments, and the ability of observers to detect and count fragments larger than both 4 mm and 5 mm. With fluoroscopy, fragment detection rates ranged from 20% (fragments larger than 2.5 mm) to 80% (fragments larger than 4.5 mm). With US, all fragments larger than 1.5 mm were detected, and US was significantly better than fluoroscopy and spot radiography for detection of fragments 2.5 mm or smaller. US was also more accurate than fluoroscopy (11% vs 59% error) in the assessment of the number of fragments. When fragments larger than 4 mm or 5 mm were being counted with US, 92% of the fragments were visualized. The results suggest that US is more accurate for monitoring gallstone lithotripsy than fluoroscopy or spot radiography.