Conjunctival pseudolymphoma in infectious mononucleosis]

BACKGROUND: The most frequent manifestation of an infection with Epstein-Barr virus is the mostly unilateral transient follicular conjunctivitis. PATIENT: A 19-year-old man was evaluated for a unilateral salmon colored subconjunctival mass that had developed over one week. Additionally, the patient had painful cervical lymph nodes and a sore throat. Blood tests demonstrated a lymphocytosis and a high titer for Epstein-Barr-Virus-IgG and -IgM which was consistent with infectious mononucleosis. A biopsy form the conjunctival mass showed a mixed cellular infiltrate including lymphocytes, plasma cells, histocytes, and cells with a prominent eosinophilic nucleolus. The lesion displayed a spontaneous regression over the following 8 weeks. CONCLUSION: Infectious mononucleosis should be considered with a conjunctival tumor which may mimic a lymphoma.     

Initial clinical experiences with the Dresden 3D display in conjunction with the Heidelberg Retina Tomograph (HRT)]

BACKGROUND: For years the Heidelberg Retina Tomograph has been an established method to diagnose early glaucomatous damages at the optic nerve head. The major difficulty consists in defining the outlayer of the optic nerve head in a 2-dimensional reflective or topographic picture. A 3-dimensional presentation of the ocular fundus could ease the defining very much. The Dresden 3D-display tested provides a true 3-dimensional presentation of the HRT-values measured. METHODS: For the study 5 groups of prediagnosed follow-up examinations were formed, which in their course showed various progression. The examination firstly was carried out by manual defining of the papilla contour on the Dresden 3D-display and secondly by the new automatic contour-finding of the 3D-software. RESULTS: Through the 3-dimensional presentation a more correct position of the contour can be found when drawn manually. As a result some diagnoses of the 2-dimensional HRT-pictures had to be revised. The results proved considerable differences between the automatic outlayer-finding and the probably real position of the papilla borders. CONCLUSION: The 3-dimensional presentation of the HRT-pictures represents an subjective improvement regarding the accuracy of manual contour definition. In particular, the fact that it is feasible to make the pictures rotate around the axes offers completely new insights to the morphology of the disc.     

Expression of the fibroblast growth factor 4 (FGF-4) gene is regulated by serum in Tera-2 embryonal carcinoma cells

Expression of the fibroblast growth factor 4 (FGF-4) gene is tightly regulated during mammalian development. Dysregulation of FGF-4 gene expression results in cell transformation and tumorigenesis. It is therefore pertinent to investigate the regulatory mechanisms which control expression of FGF-4. In an initial attempt to identify exogenous factors other than retinoic acid which might control FGF-4 expression, we have investigated the response of endogenous FGF-4 to serum in a number of embryonal carcinoma and embryonic stem cell lines. We have identified a human embryonal carcinoma cell line (Tera-2) in which the FGF-4 gene can be induced by serum. In Tera-2 cells made quiescent by serum deprivation, expression of the FGF-4 gene is repressed. Subsequent addition of serum reactivates FGF-LC expression and further addition of cycloheximide results in superinduction of mRNA suggesting that FGF-4 may be classified as an early response gene. It is suggested that this observation may be explained, at least in part, by the stage of differentiation of the Tera-2 cells.     

Protocol for strength testing and rehabilitation of the upper extremity

The development of the upper body table (UBXT) provided trunk and pelvis stabilization, necessary for accurate testing of the strength (and power) of the upper extremity with the Cybex II(R) lsokinetic Dynamometer; however, a standard protocol for set-up and testing did not immediately exist in 1979. During treatment of patients with upper extremity problems, Sportclinic, Providence Medical Center, Seattle, Washington, developed a complete protocol for rehabilitation and testing with the Cybex II and the UBXT, using fast speeds, a 90-foot-pound torque scale, and special adaptations of equipment and procedure. The objectives of the protocol were to increase accuracy in testing and decrease the chance of injury to the patient J Orthop Sports Phys Ther 1983;4(4):229-235.     

Importance of the orbital collateral circulation for the origin of ischemic ophthalmopathy in stenotic diseases of the internal carotid artery

Ischemic ophthalmopathy is the leading ocular symptom of occlusive processes of the internal carotid artery. It can be preceded by embolic symptoms as amaurosis fugax or occlusion of a branch or the main stem of the central retinal artery. Both, ophthalmologists and neurologists, should be familiar with these disturbances as they can involve important diagnostic and therapeutic consequences. Five out of six patients with an angiographically demonstrated extracranial occlusion of one internal carotid artery and a retrograde collateral circulation to the intracranial space via the external carotid and the ophthalmic arteries showed an ischemic ophthalmopathy of the ipsilateral eye. This high coincidence supports the notion that an ischemic ophthalmopathy may not be the result of the occlusive process of the internal carotid artery per se, but may be caused by ocular "steal mechanisms" due to the retrograde orbital collateral circulation.     

The components of satisfaction with outpatient pharmacy services

The true objective of a pharmacy manager is not just to measure satisfaction, but to improve it by identifying and meeting the needs of the patient. This study was undertaken with the objective of determining the relevant components of outpatient pharmacy service which impact the patient's perception of satisfaction, and to develop an on-going instrument to track satisfaction with pharmacy services over time. A survey was mailed to 391 outpatients. Simple correlation was used to identify the salient components of patient satisfaction. Multiple regression was used to determine the relative contribution of each of these components to overall satisfaction. Principle components analysis (PCA) provided the basis for delineating the underlying dimensions of which patient satisfaction is comprised. The two most meaningful factors derived from these data can be defined as professional communication and the physical and emotional well-being of the patient. By understanding the dynamics of the components of satisfaction, pharmacy managers can emphasize those areas which will produce a more satisfied patient, repeat patronage, and enhanced viability for the pharmacy.     

Contact lenses and corneal shields

Contact lenses are widely used all over the world. If fitted and handled properly, contact lenses can be good cosmetic and therapeutic tools. In this review, the different indications for contact lens wear are discussed. Contact lenses can also lead to serious problems. Tear film and morphologic alterations of the cornea, as well as corneal infections of microbial origin, are reviewed. Collagen bandage lenses have been used for some time in the treatment of corneal epithelial defects. Currently, these lenses are being tested as drug delivery systems, especially for use with poorly penetrating drugs, in serious infections of the cornea.     

Pulsus paradoxus: a definition revisited

Pulsus paradoxus is associated with many clinical conditions and is defined as a greater than 10 mm Hg end-inspiratory decrease in systolic blood pressure. Kussmaul's original definition of pulsus paradoxus is presented, along with an explanation of his choice of the term "pulsus paradoxus." A case of pulsus paradoxus is graphically described using simultaneous two-dimensional targeted M-mode, Doppler echocardiographic, and high-fidelity pressure recordings.