Salmonella osteomyelitis and the hand-foot syndrome in sickle cell disease.

I investigated 11 cases of hand-foot syndrome, three of which were associated with Salmonella osteomyelitis. These three cases are described to highlight the difficulty in differentiating infection from infarction in the hand-foot syndrome.     

The natural history of recurrent dislocation of the patella. Long-term results of conservative and operative treatment.

From 1970 to 1978, 29 patients had a unilateral operation for bilateral recurrent dislocation of the patella. We examined 21 of them at a mean of 14 years postoperatively. Eighteen of these patients had evidence of generalised joint laxity. Six of the operated knees and four of the unoperated knees still had recurrent dislocations. The operated knees were clinically worse, with a significantly higher incidence of osteoarthritis. We concluded that the operations used to treat recurrent dislocation of the patella may have had short-term benefits, but did not cure the patients in the long term.     

A method combining morphological, immunocytochemical and chromosomal examinations of the same cell in the study of lymphoproliferative diseases

6 cases of different lymphoproliferative diseases were studied with the new MAC (Morphology-Antibody-Chromosome) method in order to find out 1) if the abnormal karyotype is confined to the monoclonal cell population, 2) if there are, within this clone, also cells with a normal karyotype, and 3) if the method can help the pathologist to diagnose malignant lymphoproliferative diseases. The MAC method allows a simultaneous study in the same metaphase cell of the karyotype, surface markers, and some morphological features. In all cases in which a monoclonal cell proliferation was detected immunohistologically, the MAC examination showed a chromosomal abnormality for the same light chain as was detected in immunohistology, but not in other cells. In all but a single case, all mitotic cells belonging to the clonal cell proliferation had an abnormal karyotype. In this case with lambda clonality, 2/8 lambda-positive mitoses had a normal karyotype. However, all the normal mitoses occurred in small lymphocytes whereas the abnormal mitoses were seen in large blastic cells. In 1 case, the MAC method helped in confirming the diagnosis of malignant lymphoma (nodular small cleaved cell type). Especially in lymphomas composed of a mixed cell population, the MAC method makes it possible to find out which cell types have an abnormal karyotype and which have a normal karyotype.     

Indices of the body's neurohumoral activity and hemodynamic types in hypertension

A study of neurohumoral parameters in patients with essential hypertension and different hemodynamic types demonstrated different patterns of hormonal change in patients with hyperkinetic, eukinetic and hypokinetic hypertension. Elevated blood tri-iodothyronine and thyroxine, seen in patients with hyperkinetic hemodynamic type, and increased catecholamine excretion in patients with hypokinetic hemodynamics may be indicative of the pathogenetic significance of the hormones in question for the formation of respective variants of essential hypertension.     

THE EFFECT OF INDOMETHACIN ON THE PSYCHOMOTOR FUNCTION OF PATIENTS WITH RHEUMATIC DISEASES

We have compared the effect of single and multiple doses ofindomethacin and placebo on objective measurements of psychomotorimpairment in patients. Following a single 50 mg dose (n = 8),indomethacin produced psychomotor disturbance in only thosepatients who had no recent history of NSAID exposure. Aftermultiple doses of indomethacin (25 and 50 mg tid for 5 days),no significant psychomotor impairment was observed. We concludethat other NSAIDs may induce cross-tolerance to the psychomotoreffects of indomethacin. Tachyphylaxis may develop to the psychomotordisturbance caused by indomethacin. KEY WORDS: Tachyphylaxis, Tolerance, NSAID, Central nervous system, Flicker fusion threshold, Choice reaction times     

Treatment of labile forms of diabetes mellitus by transplantation of cultured pancreatic islet cells

The authors presented data on the transplantation of human fetal and pig pancreatic islet cell cultures to 89 patients with type I diabetes mellitus of a labile course. Allo- and xeno-transplantations of pancreatic islet cell cultures in combination with exogenous insulin administration were shown to improve the patients' general status raising their working capacity. As a result of 118 islet cell transplantations hypoglycemic comas either stopped or became milder and were better corrected. Stabilization of metabolic processes was observed in the patients. Clinicobiochemical indices and subjective signs of diabetes stabilization were observed within 12-15 months after transplantation.     

Factors associated with progression of cervical human papillomavirus (HPV) infections into carcinoma in situ during a long-term prospective follow-up

Summary. In the course of a prospective study of 508 women with papillomavirus (HPV) lesions of the uterine cervix, 66 lesions that progressed into carcinoma in situ (CIS) were identified and treated by conization during a mean follow-up period of 35 months. The lesions were investigated with light microscopy and with in-situ DNA hybridization using ³⁵S-labelled probes for HPV 6,11,16,18, 31 and 33. After radical cone treatment, 11 of the 66 women (16-7%) have presented with a recurrent HPV infection. The recurrence rate increased with the duration of the follow-up period from <10% at the mean follow-up of 25 months to 16.7% at the most recent follow-up at 35 months. Most of these 66 HPV lesions (89%) presented with concomitant CIN in the first punch biopsy, but it is noteworthy that the other 11 % presented without concomitant CIN. HPV DNA of at least one of the six types examined was found in 73% of the first biopsies and it is noteworthy that the so-called 'low-risk' types, HPV 6 and 11, were found as frequently as the 'high-risk' types, HPV 16 and 18 (18% and 17%, respectively). This would suggest a similarity in the biological behaviour of these two HPV groups. Although the concept of the 'high-risk' and 'low-risk' HPV types may remain at least partially valid, it is imperative to realize that infection by HPV 6 and 11 by no means excludes the possibility for clinical progession into CIS and eventually to an invasive carcinoma.