Congenital dislocation of the hip. Treatment in infancy to walking age

Early management of congenital dislocation of the hip has been necessary and has resulted in a high percentage of normal-appearing and functioning hips. The risk of complications and problems has been lessened. Further, the techniques employed are simpler and less demanding or difficult for patients, family, or physicians.     

Human glomeruli release fatty acids which stimulate thromboxane synthesis in platelets

The cell-free medium of isolated human glomeruli exhibited a procoagulant activity and stimulated thromboxane (TXB2) synthesis in human platelets in a dose-dependent manner. The amount of TXB2 measured was 16-fold higher than what could have been predicted (TXB2 synthesized by the platelets under control conditions plus TXB2 present in the glomerular supernatant). The lipid extract of the glomerular supernatant and its purified fraction including the fatty acids was still able to stimulate--although at a lesser degree--TXB2 synthesis in platelets. Stimulation was abolished after treatment of this fraction by charcoal or albumin. Gas chromatography/mass spectrometry analysis demonstrated the presence in the purified glomerular fraction of several long-chain saturated or monoenoic fatty acids at a total concentration of 80 microM with the following order of abundance: stearic, palmitic, myristic and oleic acids. Addition to human platelets of these same exogenous synthetic acids resulted in a dose-dependent stimulation of TX synthesis. It was maximum with three or four fatty acids tested in combination, but still present with myristic acid used separately. Arachidonic acid was absent in the glomerular supernatant. Thus the stimulation observed could not be related to a greater availability of substrate. Fatty acids did not act on platelets through a non-specific detergent effect since addition of high doses of detergents inhibited TXB2 formation in platelets. The combination of fatty acids from glomerular origin identified in the present study represents a novel factor involved in the control of intracapillary hemostasis, but different from the procoagulant activity common to many tissues.(ABSTRACT TRUNCATED AT 250 WORDS)     

Spontaneous fractures of the lesser metatarsals secondary to an amputated hallux and peripheral neuropathy

A general overview of the literature concerning the development of diabetic neuropathic arthropathy is discussed. A case report is presented dealing with spontaneous fractures of the lesser metatarsal in a patient with an amputated hallux and peripheral neuropathy secondary to diabetes mellitus.     

Pericardial effusion complicating breast cancer.

Thirty-five patients with metastatic breast cancer and pericardial effusions are described. They were treated with specific endocrine or chemotherapy. Twenty-two (63%) had presented in cardiac tamponade and were rapidly relieved by pericardiocentesis. Eighteen (82%) of these required no further local treatment, 2 obtained relief from a second aspiration and 2 needed additional treatment (intrapericardial bleomycin instillation and surgical pleuropericardial window). The median survival was 13.2 months. No patient relapsed again in the pericardium, suggesting that their prognosis was that of the underlying disease. Cardiac tamponade should be considered in any breathless patient with malignancy. In breast cancer, periocardiocentesis is lifesaving and systemic treatment can usefully prolong life.     

Mouse antisera specific for desmosomal adhesion molecules of suprabasal skin cells, meninges, and meningioma.

Mouse polyclonal antisera were raised to the Mr 130,000 and Mr 115,000 cell surface glycoproteins, desmocollins, of desmosomes from bovine nasal epithelium. Immunoblotting confirmed that the antisera were specific for the desmocollins. An immunofluorescence study showed that the antisera distinguished between the basal and suprabasal layers of bovine and human epidermis. The antibodies reacted with cultured keratinocytes only after calcium-induced stratification. In epidermis, therefore, there appears to be a difference between the desmocollins of basal and suprabasal cells that may be important in relation to epidermal differentiation. Previous work has shown that polyclonal antisera raised in other animals (guinea pigs and rabbits) against desmocollins, as well as against other desmosomal components, react with all desmosome-containing epithelia. In contrast, an immunofluorescence survey of bovine, rat, and human tissues showed that the present mouse antisera stained only suprabasal skin cells and the arachnoid layer of the meninges, demonstrating that these have common determinants that distinguished their desmocollins from those of all other tissues. The antibodies also stained 11 of 12 meningiomas and, therefore, may be useful as a marker not only for the diagnosis of these tumors but also for investigation of their histogenesis.     

Ovarian and omental ependymomas in peritoneal washings: cytologic and immunocytochemical features

The cytologic findings in peritoneal washings of two women, one of whom had an ovarian ependymoma and the other a primary omental ependymoma, are reported. The ependymomas were characterized by the presence of numerous, isolated, spindle and stellate cells as well as groups of cells forming true rosettes. The tumor cells displayed slightly pleomorphic, round-to-oval eccentric nuclei and abundant fibrillary cytoplasm with tapering cytoplasmic processes. In addition, one of the patients had numerous papillae and cell clusters with associated psammoma bodies indistinguishable from those found in low-grade serous carcinoma. The demonstration of glial fibrillary acidic protein (GFAP) in both cases by immunocytochemical procedures indicates the usefulness of this method in cytologic preparations to confirm the diagnosis of these uncommon neoplasms.