Myxofibroma of the maxilla: a case report with computed tomogram findings

A rare case of a large myxofibroma of the maxilla is presented. Computerized tomographic features, in conjunction with clinical appearance, were highly suggestive of a definitive diagnosis. Computerized tomography may play an important role in the planning of surgical management of this tumor known for its local aggressiveness and high recurrence rate.     

Acute effects of high-dose thyrotropin releasing hormone infusions in Alzheimer's disease

Thyrotropin releasing hormone (TRH) was administered intravenously to ten patients with Alzheimer's Disease (AD) in a high-dose paradigm, thought to maximize central nervous system effects and potentially produce facilitation of cholinergic function, a known property of the neuropeptide. Acute effects of TRH on behavioral, cognitive and physiologic measures were assessed after patients received 0.1 mg/kg TRH, 0.3 mg/kg TRH and placebo, the higher TRH dose and placebo being given in a randomized, double-blind fashion. Patients showed statistically significant increases in arousal and improvement in affect, as well as a modest improvement in semantic memory, all after receiving the higher TRH dose. Both TRH doses produced transient rises in systolic blood pressure, with no effect on diastolic blood pressure, heart rate or temperature. This study suggests that high-dose TRH can be safely administered to AD patients and is neurobehaviorally active; further studies are needed to determine the extent and mechanism of the cognitive and psychobiological properties of this peptide in AD and other neuropsychiatric disorders.     

Morphological and biochemical correlates of chemical induced injury in the lung

We have reviewed some of the factors which contribute to lung damage by various toxicants. These include disposition of the chemical, its metabolism, individual cell type susceptibility and the potential for the tissue to repair. We have discussed the use of biochemical parameters to measure the functional activity of individual cell types in order to predict the damage to specific cell types and concluded that careful morphological analysis of lung tissue is likely to provide a more sensitive and informative measure of specific cell type injury. However, in order to investigate the mechanism of toxicity of pulmonary toxicants it is essential to establish the primary biochemical event that leads to cell damage and morphological change. The importance of separating the relevant biochemical change(s) from the cascade of biochemical events associated with dead and dying cells and the reparative response of the lung is emphasised.This report results from a discussion sponsored and organised by the Advisory Subgroup in Toxicology (AST) of the European Science Foundation's Standing Committee for the European Medical Research Councils and held at the Medical Research Council Toxicology Unit, Carshalton, U. K. Those taking part were: W. N. Aldridge (AST; as above); J. Bignon (Unit for Research in Renal and Pulmonary Pathology, University of Paris, Creteil, France); P. H. Burri (Section of Developmental Biology, Institute of Anatomy, University of Berne, Switzerland); G. M. Cohen (as above); D. Dinsdale (MRC Toxicology Unit, Carshalton U. K.); P. Hedqvist (Dept. of Physiology, Karolinska Institute, Stockholm, Sweden); D. Henschler (AST; Dept. of Toxicology and Pharmacology, University of Wurzburg, FDR); G. J. Laurent (Biochemistry Unit, Cardiothoracic Institute, University of London, London, U. K.); R. Lauwerys (AST Industrial and Medical Toxicology Unit, University of Louvain, Brussels, Belgium); F. Lembeck (AST; Dept. for Experimental and Clinical Pharmacology, University of Graz, Austria); N. Lery (AST; Poison Control Centre, Lyon, France); P. Moldeus (Dept. of Forensic Medicine, Karolinska Institute, Stockholm, Sweden); B. Nemery (MRC Toxicology Unit, Carshalton, U. K.); A. Saria (Dept. for Experimental and Clinical Pharmacology, University of Graz, Austria); L. L. Smith (as above);B. Terracini (AST; Dept. of Pathology and Cancer Epidemiology, University of Turin, Italy)     

Liver transplant and hepatitis C in methadone maintenance therapy: a case report

Methadone maintenance therapy for the treatment of opioid dependence continues to carry a social stigma. Until recently, patients on methadone were not considered for liver transplantation. We describe the first case of a patient on methadone who received a liver transplant for end stage liver disease and was successfully treated for recurrent hepatitis C. More than five years post transplant and three years post viral clearance, the patient continues to do well and is stable on low-dose methadone. This case emphasizes the need to reconsider the non-evidence based policy adopted by transplant centers that require methadone maintenance therapy patients to stop methadone prior to consideration for transplant evaluation.     

Nurse Migration from a Source Country Perspective: Philippine Country Case Study

Objectives. To describe nurse migration patterns in the Philippines and their benefits and costs.
Principal Findings. The Philippines is a job-scarce environment and, even for those with jobs in the health care sector, poor working conditions often motivate nurses to seek employment overseas. The country has also become dependent on labor migration to ease the tight domestic labor market. National opinion has generally focused on the improved quality of life for individual migrants and their families, and on the benefits of remittances to the nation. However, a shortage of highly skilled nurses and the massive retraining of physicians to become nurses elsewhere has created severe problems for the Filipino health system, including the closure of many hospitals. As a result, policy makers are debating the need for new policies to manage migration such that benefits are also returned to the educational institutions and hospitals that are producing the emigrant nurses.
Conclusions and Recommendations. There is new interest in the Philippines in identifying ways to mitigate the costs to the health system of nurse emigration. Many of the policy options being debated involve collaboration with those countries recruiting Filipino nurses. Bilateral agreements are essential for managing migration in such a way that both sending and receiving countries derive benefit from the exchange.     

Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion

Serum zinc levels and urinary zinc excretion were compared in 15 patients with essential hypertension taking chronically a combination of hydrochlorothiazide and amiloride as monotherapy, eight patients maintained with hydrochlorothiazide alone, and eight control subjects. Serum zinc values were statistically comparable in all three groups. However, urinary zinc excretion was abnormally elevated in the two patient groups. In the dosage used, amiloride did not have a zinc-sparing effect.     

Seasonal variation in contact lens-associated corneal ulcers

We undertook a retrospective analysis of 112 patients admitted to Wills Eye Hospital, Philadelphia, between 1983 and 1985 with corneal ulcers associated with the use of contact lenses to test the clinical impression that such ulcers are more common in summer. Over half of the admissions (51%) occurred between June and September. The seasonal variation of the ulcers was statistically significant (p less than 0.01). Possible factors predisposing to corneal ulcers in people who wear contact lenses in the summer include enhanced growth of bacteria at warmer temperatures and wearing the lenses while swimming.     

Prospective analysis of photokeratoscopy for arcuate keratotomy to reduce postkeratoplasty astigmatism

Seven eyes of seven patients with visually disabling postkeratoplasty astigmatism underwent arcuate keratotomy to reduce astigmatism. Keratotomy length was prospectively determined by comparing the corneal shape change needed by each patient with shape changes in cadaver eyes induced by arcuate keratotomy. Keratograph ring ovality quantified corneal shape change. Keratotomies were placed in the wound interface using a diamond knife with blade length set to 100% of corneal thickness. Prekeratotomy keratometric astigmatism was 9.27 +/- 2.14 D (mean +/- SD), and at 2.0 to 18.4 months after keratotomy, astigmatism was 2.75 +/- 2.25 D (mean +/- SD). All corneas had decreased keratometric astigmatism and less oval keratoscope rings. Five corneas had 3.00 D or less residual keratometric astigmatism. Change in ring ovality was significantly correlated with keratotomy length and keratometric astigmatism change. The utility of keratoscope ring ovality as a corneal topography metric was demonstrated by systematically investigating the response to arcuate keratotomy.