Cellular immune mechanisms in human glomerulonephritis: the role of mononuclear leucocytes

Conclusions Our understanding of the pathologic processes leading to injury in human glomerulonephritis remains limited. Several mediation pathways have been suggested from observations of human biopsies and studies of experimental glomerulonephritis in animals, although the pathogenic mechanism of injury in many situations is obscure. However cells of the monocyte/macrophages series can be identified within glomeruli in glomerulonephritis, especially in more aggressive forms of the proliferative disease in humans. Experimental studies have confirmed the capacity of these cells to induce injury; thus, the role of monocytes as a mediator of glomerular injury is now established. Indirect evidence suggests that T cell-dependent mechanisms may also be involved in glomerulonephritis, but more data are needed to define the extent to which sensitised mononuclear leucocytes participate in the pathogenesis of human glomerulonephritis.     

Cosmetic surgery: the psychiatric perspective

Increased use of cosmetic surgery has led to a growing concern with its psychiatric aspects. This paper reviews psychiatric evaluation of candidates for surgery; considers the rhinoplasty patient as a prototype; examines psychiatric complications of the surgery; and summarizes the outcome in these cases.     

Unrecognized ocular problems associated with port-wine stain of the face in children

The port-wine stain, a relatively rare subgroup of capillary hemangiomas, usually involves the face and in children it may be associated with glaucoma. A series of 50 patients with facial port-wine stains had ocular examination at The Hospital for Sick Children, Toronto. When the facial areas supplied by both the ophthalmic and maxillary divisions of the sensory branch of the trigeminal nerve were involved (26 patients) there was about a 45% chance of diagnosing glaucoma, either as “true” glaucoma (with visual loss and raised intraocular pressure) or as “glaucoma suspect” (without visual loss). Involvement of the area supplied by either division alone was not associated with glaucoma.     

Effect of hyperthyroidism on bronchial reactivity in non-asthmatic patients.

Thyrotoxicosis may be associated with deterioration in asthma. To determine whether bronchial reactivity to histamine is increased in hyperthyroidism 10 thyrotoxic non-asthmatic patients were assessed before and after treatment of their thyrotoxicosis. No significant change in bronchial reactivity was found after treatment.     

An assessment of a postgraduate examination of competence in general practice: Part 1--Reliability

The 1987 part one examination of the Royal New Zealand College of General Practitioners was subjected to an evaluation. The format of the examination and the scope of the review is described. This paper describes the assessment of the reliability of components of the examination. Simulations showed acceptable reliability, however the reliability of the written paper was less satisfactory. The ways in which such reliability may be enhanced are described.     

Treatment of hypercalcaemia in thyrotoxicosis with aminohydroxypropylidene diphosphonate

Two patients had symptomatic hypercalcaemia accompanying thyrotoxicosis, despite initial treatment with volume repletion, beta blockade and antithyroid drugs. They were further managed with intravenous infusions of aminohydroxypropylidene diphosphonate resulting in rapid normalization of the serum calcium, with relief of symptoms. Aminohydroxypropylidene diphosphonate effectively suppressed the increased bone resorption of thyrotoxicosis without any undesirable adverse effects.