'Naevophobia'

In recent years there has been intensive media interest in pigmented lesions and several skin cancer prevention/early detection campaigns.^1,2 Pigmented lesions may cause great anxiety, although patients are usually reassured once their moles have been examined by a dermatologist. We describe a case in which a young man with multiple pigmented naevi attempted to remove all the lesions himself. This self-mutilation occurred despite his having attended a dermatology clinic.     

The Mechanism of Arterial Hypoxia Occurring in Acute Pancreatitis

Respiratory Function has been measured in 14 patients with acutepancreatitis, none of whom had a previous history of cardiacor respiratory disease. Their mean age was 40 years, mean PaO2on admission, 11 kPa, and all had normal chest radiographs atthat time. Arterial hypoxia was a common development and themean PaO2 at the time of most severe hypoxia was 8·6kPa with the lowest individual recording 4·9 kPa. Inadditiion to daily arterial blood gas monitoring, dynamic ventilatorytests and measurements of lung volume, transfer factor, closingvolume, right to left shunts and studies of gas exchange wereperformed. Gas exchange and shunt measurements indicated thatthe major abnormality responsible for arterial hypoxia was rightto left shunting. Seven patients developed radiological abnormalities,five of whom had pleural effusions. Five patients showed a mildrestriction in lung volume but there were no major consistentabnormalities of dynamic ventilatory tests, transfer factor,or closing volumes. Thus small airway closure, in dependentparts of the lung and less certainly loss of surfactant areunlikely to be major factors in the aetiology of arterial hypoxiain patients with acute pancreatitis. All measurements were repeatedat least three months after the acute illness. The respiratoryinsufficiency which occurs in this disease is possibly anothervariant of the adult respiratory distress syndrome.     

Inhaled Fenoterol powder in asthma: a long term study

ABSTRACT. A study was designed to assess the long term efficacy of Fenoterol powder in asthmatic children. The design included an initial assessment period and a further evaluation after six months, in which Fenoterol or placebo treatments were administered on consecutive days. Objective measurements were obtained from PEFR and FEV. A diary record was kept to monitor compliance and side effects. A minimum dose of 200 mcg Fenoterol powder was prescribed three times per day.
The bronchodilator action of Fenoterol was sustained after a period of six months, in the absence of significant side effects.     

Immunohistological Diagnosis of Primary Brain Lymphoma Using Monoclonal Antibodies: Confirmation of B—Cell Origin

The antigenic characteristics of 20 primary cerebral lymphomas have been defined by their reactivity with a panel of monoclonal antibodies recognizing differentiation antigens of lymphocytes and other cell types. In 7 out of 20 cases (35%), immunohistological results were diagnostically crucial and this approach appeared almost to double the detection rate of brain lymphomas over a 10-year period. All 20 tumours were confirmed as B-cell neoplasms by the use of a monoclonal antibody (B-1) specific for B-lymphocytes, rather than by the demonstration of immunoglobulin production. Further immunophenotyping with antibody FMC7 indicated that the neoplastic B-cells had been 'arrested' at a relatively mature stage of differentiation. The importance of monoclonal antibody markers in the accurate diagnosis and characterization of primary cerebral lymphomas has now been established.