Dystonia and reflex sympathetic dystrophy induced by ergotamine

A 59-year-old man developed dystonia and reflex sympathetic dystrophy after receiving high doses of ergotamine for migraine treatment. Ischemia is suggested as the precipitating factor.     

Cyclosporin in the management of polymyositis and dermatomyositis.

Three patients with polymyositis refractory to conventional steroid and immunosuppressive treatment, but responsive to cyclosporin A, are described. In a fourth patient cyclosporin A was used as a first line drug in combination with steroids in the treatment of life-threatening dermatomyositis. Cyclosporin A in the management of polymyositis/dermatomyositis requires formal assessment of its costs and benefits compared with conventional treatments.     

Lymphoepithelial (branchial) cyst and amylase

A case of a branchial cyst with a high amylase activity of the cyst fluid was found in a 58-year-old female. The literature on branchial cysts with high amylase activity is reviewed. Amylase that showed high activity in the cystic fluid was revealed to be due to the salivary isoenzymes (S3 and S4) which migrated more to the anodic side on electrophoresis.     

Homogeneous, micelle quenching fluoroimmunoassay for detecting amphetamines in urine

We developed a homogeneous fluoroimmunoassay for detecting amphetamines in urine. Only fluorescence intensity need be measured because the emission of non-protein-bound fluorescein-labeled amphetamine is preferentially quenched by detergent micelles. In a previous reported prototype assay system for measuring gentamicin in serum we used fluorescein and dodecyl sulfate (Anal Chem 1985; 57:1928-30). We have found that favorable hydrophobic and (or) ionic character of the analyte and unfavorable polar and (or) ionic character of the fluor are important determinants of the desired interactions. An anionic detergent and fluorescein, therefore, should be appropriate for apolar of cationic analytes, such as gentamicin and amphetamines. A greater [H+] at the anionic micelle surface is important for quenching emission from the fluor moiety. Millimolar concentrations of dodecyl sulfate rapidly denature immunoglobulin unless hapten is bound with sufficiently high affinity. Affinity was sufficiently high for the antibody used in the prototype gentamicin assay but not for the amphetamine antibody. Thus for the amphetamine assay, we used a non-denaturing detergent, dodecyl(oxyethylene)12 sulfate. The assay requires 30 microL of specimen in 2 mL of total assay volume. Amphetamine(d-,dl-, and meth-), at a concentration of 1 mg per liter of urine, is readily detected.     

Screening for psychosis in the general population with a self-report interview

This analysis applies methods of screening to the problem of psychosis. A probability sample of 810 individuals from the Eastern Baltimore Mental Health Survey was interviewed in the self-report modality with the Diagnostic Interview Schedule and shortly thereafter by a psychiatrist. It is shown that a configuration of responses in the self-report modality can screen moderately well for psychosis, as measured by psychiatrists in the clinical modality.     

Complications following ureteroscopy

We report 4 cases of ureteral injury and stricture formation following ureteroscopic stone manipulation. Possible etiologies of stricture formation and our methods of managing them are discussed. The complications of ureteroscopy have been reported only rarely and the ureteroscopist should be aware that the procedure is not always benign.     

The tenon method of small joint arthrodesis in the hand

A technique for arthrodesis of small joints of the hand is described that uses a tenon to secure apposition that has good intrinsic stability as well as a large surface area of cancellous bony contact. A minimum of postoperative immobilization is required. The tenon arthrodesis method has been employed in 85 joints. The literature shows pseudoarthrosis rates of 0 to 33%. This technique had a 2.3% failure rate that compares favorably with those in other published series.