Crystalloids in a cystic lesion of parotid salivary gland: Diagnosis by fine-needle aspiration

Crystalline structures measuring < 800 pm in length, were found in smears of a fine-needle aspirate of a cystic lesion in a parotid salivary gland. Numerous neutrophil leukocytes were also present, intimately mixed with the crystalloids. The lesion was re-aspirated and the cyst completely evacuated, with no recurrence after a 6-month follow up.     

Diffuse hemangiomatosis of the colon

We report extensive colonic hemangiomatosis in two young adults. In the first, the hemangioma contiguously involved the entire colon. In the second, a large venous angioma affected the bladder, rectosigmoid, and descending colon. Venous angioma, a variant of hemangioma, is frequently confused with cavernous hemangioma because of their similar histologic appearance. The angiographic features, however, may enable a more accurate preoperative diagnosis and prevent unwarranted biopsy. We review and put into perspective pertinent previous reports of cavernous and venous angioma.     

Effect of Sodium Valproate on Psychomotor Performance in Children as a Function of Dose, Fluctuations in Concentration, and Diagnosis

Forty-six children receiving sodium valproate monotherapy, and with well-controlled seizures, were tested three times, at weekly intervals in the morning, on an extensive battery of psychomotor tests. The first session was a practice session to minimize subsequent practice effects. On one of the remaining 2 test days, morning medication was delayed until after testing (low concentration condition), whereas sodium valproate was given before testing on the alternate session (high concentration day). The data were analyzed for the effects of diagnosis (partial vs. generalized epilepsy), dose (above or below 20 mg/kg/day), and time of medication (low and high drug concentration days). Four variables discriminated between the diagnostic groups, all favoring children with generalized epilepsy. Another four measures were significantly associated with dose, with those on lower doses performing at a superior level. Time of medication had virtually no effect on performance, however. The findings were related to previous diagnostic and dosage research. Although a deterioration in performance at higher doses appears to be consistent with other dosage research, the absence of an effect due to time of medication suggests that performance does not fluctuate between drug administrations.     

Preliminary clinical experience with the titanium Greenfield vena caval filter

Preliminary clinical experience in 40 patients from three institutions is reported for a new titanium model of the Greenfield vena caval filter. The titanium filter is slightly larger than the standard stainless steel filter and can be loaded into a 12 F diameter carrier system as opposed to the 24 F stainless steel filter. In patients ranging from 17 to 94 years of age, percutaneous insertions were made from the right femoral vein in 24 patients, the left femoral vein in 11 patients, and the right internal jugular in 2 patients. Operative access was obtained in 1 patient each from the right femoral, right jugular, and a lumbar vein at laparotomy. Insertion was completed in all cases but 1 and only 1 patient (3%) showed postoperative femoral vein thrombosis. Distal filter migration was seen in 3 cases (7.5%) without sequelae, and there was no proximal migration. The titanium Greenfield vena caval filter provides improved ease of insertion, and the sheath technique should prevent misplacement. Distal migration should be preventable by techniques to promote hook engagement at the time of insertion.     

Different gene loci for hyperkalemic and hypokalemic periodic paralysis

The periodic paralyses are dominantly inherited disorders in which patients acutely develop muscle weakness in association with changes in the level of blood potassium. We recently reported genetic linkage of hyperkalemic periodic paralysis (HIKPP) to the gene encoding the adult form of the skeletal muscle sodium channel on the long arm of chromosome 17. In this paper, we exclude genetic linkage between hypokalemic periodic paralysis (HOKPP) and this sodium channel gene, demonstrating that there is non-allelic genetic heterogeneity among different forms of periodic paralysis. Electrophysiological abnormalities in muscle sodium conductance have been reported for both HIKPP and HOKPP as well as other muscle disorders characterized by membrane hyperexcitability or myotonia (myotonia congenita, paramyotonia congenita and the Schwartz-Jampel syndrome). The possibility that there may be a family of human muscle diseases arising from mutations in the sodium channel suggests these disorders may be classified by categories of mutations within this critical voltage-sensitive membrane protein.     

Role of counter-conditioning in the treatment of asthma

Twenty asthmatic children between the ages of 8 and 16 were given a counter- conditioning treatment. The treatment involved the instigation of bronchial constriction followed by training in bronchial dilation through biofeedback reinforcement. The results of a follow-up for one year indicated that the improvement in the experimental group was significantly greater than in the control group with regard to the frequency of asthmatic attack, emergency room visits and the amount of medication during that period.