Generalized eruptive histiocytoma: report of a case and electron microscopic finding of Michaelis–Gutmann bodies

A 67-year-old woman with generalized eruptive histiocytoma since 1973 and type IV hyperlipidaemia, which was corrected by diet alone, is presented. Michaelis-Gutmann (MG) bodies, usually characteristic but not specific for malakoplakia, were identified and confirmed ultrastructurally in one earlier biopsy but not in the subsequent skin lesions. This case differs clinically and pathologically from xanthomas secondary to type IV hyperlipidaemia, and malakoplakia of the skin. The pathogenesis of the MG bodies in this case is unknown.     

Epidermolysis bullosa acquisita with pulmonary tuberculosis: a case report

Our case is that of a 67-year-old man who presented with a blistering, scarring eruption at sites of trauma. Histologically the blistering was subepidermal. IgG and C₃ were present at the basement membrane zone. Electronmicroscopy demonstrated bulla formation to be beneath the basal lamina and that it contained amorphous electron-dense material. These clinical and investigational findings are consistent with a diagnosis of epidermolysis bullosa acquisita (EBA). The patient also had pulmonary tuberculosis which again highlights the association between EBA and diseases in which the immune system is compromised.     

Use of Reduced-Calorie/Reduced-Fat Foods by Young Adults: Influence of Gender and Restraint

Reduced-calorie/reduced-fat (RC/RF) foods are widespread in the food supply, but there are few published data on who is using them and why. A total of 226 college men (n=76) and women (n=150) participated in a survey investigating the influence of gender and dietary restraint on eating habits, dieting and the use of 11 categories of RC/RF foods. Men did not differ from women in their overall use of RC/RF foods, although specific foods were consumed by a greater percentage of women. Restrained eating was strongly related to use of all the foods (p<0·001). Women and those higher in restraint used the foods primarily for weight-control purposes, whereas men and those lower in restraint tended to use the foods for both weight control and other reasons. Women and those high in restraint were also more likely to have changed their eating habits to achieve weight loss and maintenance goals and to achieve a healthier lifestyle. In contrast, a greater percentage of men and those low in restraint wanted to achieve weight gain. These data suggest that RC/RF foods were popular among respondents in the study, but that the reasons for their use by restrained and unrestrained eaters might reflect gender differences in body weight and health concerns.     

The Cesarean Section Patient Is a New Mother Too

Some patients who must have a cesarean section receive only routine postoperative care. There is little concern for their needs as maternity patients. Defined below are the affects of a superimposed surgical procedure on the mothering patterns and on the physical and psychologic postpartum progress. The nurses'role in helping these patients and their families through the crisis is discussed; postpartum and postoperative nursing care is reviewed.     

Enzyme linked immunosorbent assay (ELISA) for IgG and IgE antibodies to protein and polysaccharide antigens of Aspergillus fumigatus

ELISA has emerged as a useful alternative to other more costly and complex tests. Polystyrene microhaemagglutination plates have been used as solid phase to absorb Aspergillus fumigatus protein and polysaccharide components for detection of specific antibodies in patients with various forms of pulmonary aspergillosis. IgG and IgE antibodies to the polysaccharide as well as the protein allergens have been found. For the IgE test a double antibody technique has been developed, which is more sensitive than the conventional indirect ELISA.     

ALCOHOL ABUSE IN ADOLESCENCE

Twenty patients between the ages of 11 and 15 years who presentedat hospital in 1981 having ingested alcohol were studied. Twowere poisoned by another person. The data on the 18 adolescentswho poisoned themselves were analysed in detail. Three groupsemerged: A — 4 patients had drunk alone as an experiment,act of mischief or act of defiance; B — 9 patients hadbeen involved in peer group activity; C — 5 patients hadeither made an attempt at suicide or a plea for help. There was a predominance of females. The average age was 13years 5 months. Most alcohol was obtained from the patients'own homes. The higher-proof beverages caused most problems.Four patients in group C combined alcohol with medicinal drugsand 2 of these had had previous episodes of self-poisoning.No clear evidence of habitual drinking emerged. Only those 8patients who had emotional or behavioural problems prior toadmission were followed up. The importance of the home as asource of alcohol and the pre-existing instability of many ofthe adolescents indicates that in the management of these youngpeople and in any preventative work the whole family must beinvolved.     

Renin, aldosterone and renal haemodynamics in cirrhosis with ascites

The interrelationships between the renin-angiotensin-aldosterone system, renal haemodynamics and urinary sodium excretion were investigated in fifty-six non-azotaemic cirrhotics with ascites. In twelve additional patients the renal renin secretion rate was also studied. Plasma renin activity and concentration and plasma aldosterone ranged from normal to very high values. There was a significant inverse relationship between plasma aldosterone and the urinary sodium excretion. Plasma aldosterone showed a highly significant direct correlation with plasma renin activity, and plasma renin concentration was closely and directly related to the estimated renin secretion rate. Neither plasma renin activity, plasma renin concnetration nor the estimated renin secretion rate correlated with the renal plasma flow or the glomerular filtration rate. These results suggest that in non-azotaemic cirrhosis with ascites the renin-angiotensin-aldosterone system is an important factor influencing sodium excretion, increased plasma renin and aldosterone concentrations are mainly due to an increased secretion rate, and total renal perfusion is not a major factor influencing renin secretion.