Suppressor-cell dysfunction in children with histiocytosis-X

Suppressor-cell activity of peripheral blood mononuclear cells were examined and lymphocyte subsets analyzed in children with histocytosis-X and in healthy, age-matched subjects. Suppressor-cell function was assessed by two methods, the indomethacin stimulation of mitogen-activated cultures and the concanavalin A-inducible suppressor-cell assay. The results of these two assays indicate that children with active disease have significantly decreased suppressor-cell activity. Additionally, the percentage and absolute number of OKT8⁺ lymphocytes were decreased in children with active disease. Suppressor-cell activity and lymphocyte subsets returned to normal, baseline levels with disease remission. This study documents for the first time suppressor-cell dysfunction and supports previous investigations in which suppressor T lymphocytes are deficient in children with active disease. These findings may explain certain clinical manifestations seen in children with histiocytosis-X.     

Surgical resection for metastatic melanoma to the lung

From 1971 through December 1986, the courses of 47 patients who underwent thoracotomy for pulmonary metastases from melanoma were retrospectively reviewed to determine the efficacy of this approach in the management of selected patients with melanoma. The overall five-year survival rate was 25% (median survival, 19 months). Thirty-eight patients were free of disease following thoracotomy. These patients fared significantly better than those who had residual disease following thoracotomy, with a five-year survival rate of 31% (median survival, 24 months) compared with 0% (median survival, six months). Survival was not influenced by the addition of adjuvant therapy or duration of time before the development of metastases (less than 12 months vs greater than or equal to 12 months). In selected patients with melanoma metastatic to the lung, thoracotomy with complete excision of the metastatic deposits results in improved survival and should be considered the treatment of choice.     

Treatment of resistant distal intestinal obstruction syndrome with a modified antegrade continence enema procedure

We report a case of a patient with CF who had a long history of recurrent distal intestinal obstruction syndrome. She had been treated with conventional treatment including gastrografin, n-acetyl cysteine, Klean prep and Picolax. She underwent a modified antegrade continence enema procedure. She currently irrigates her conduit every 2-3 days. She has had no further symptoms of distal intestinal obstruction syndrome.     

Diazepam antagonizes effects on dopamine metabolism produced by PCP receptor agonists.

1. Male rats were injected with either saline, diazepam, MK-801, or diazepam plus MK-801. 2. In previous work with phencyclidine (PCP), diazepam significantly reduced the increase in homovanillic acid (HVA) in olfactory tubercle and prefrontal cortex. 3. Diazepam also lowered the HVA increase following MK-801 in caudate, olfactory tubercle, and prefrontal cortex. 4. Benzodiazepine receptors may modify dopaminergic function at PCP receptors that affect dopamine neurotransmission.     

Lymphoma presenting as a salivary gland mass

A retrospective review of 36 cases of lymphoma presenting as a salivary gland mass was conducted over a 34-year period. A significant increase in the occurrence of lymphoma was noted in proportion to other salivary gland tumors (P less than 0.01, chi 2 analysis: 1954-1972, 11 of 714 (1.5%); 1973-1979, 9 of 201 (4.5%); 1980-1987, 16 of 265 (6.0%). The mean age was 61 years, sex distribution was equal, and 75% occurred in the parotid. Only 42% presented with signs or symptoms other than a painless mass. Glandular excision was done in early stages of the disease while biopsy was done at later stages. Frozen section analysis was accurate in all but one case and was useful in determining if biopsy were adequate. All patients were definitively treated with chemotherapy and/or radiotherapy. Several instructive points are apparent. Any patient presenting with an isolated salivary gland mass can have a lymphoma. There has, in fact, been a significantly increasing proportion of salivary gland lymphoma among the various salivary gland tumors in our patient population. In contrast to other salivary gland tumors, surgery is reserved for diagnosis and not for treatment. A lymph node biopsy may be sufficient to establish a diagnosis, in which case, glandular excision is unnecessary. Most of the patients presented with an asymptomatic isolated salivary gland mass. The presence of adjacent adenopathy, a rubbery feel to the mass, and the intraoperative appearance were the most suggestive signs of lymphoma. Frozen section analysis is helpful in determining the appropriate extent of surgery and is recommended.