Acetaminophen-induced toxic epidermal necrolysis in a child

Toxic epidermal necrolysis (TEN) is a severe, life-threatening disorder that usually affects adults. It is often drug induced. We report an instance of a severe case of TEN in a 6-year-old boy, probably induced by acetaminophen, and less likely by codeine. A lymphocyte stimulation test could not identify the culprit drug. Treatment with intravenous immunoglobulin seemed to halt the disease progression.     

Delivery of timolol through artificial membranes and pig stratum corneum

The in vitro passive and iontophoretic (applied current density: 0.5 mA/cm(2)) timolol (TM) permeability from a liquid solution through pig stratum corneum (SC) is found to be 0.9 +/- 0.5 x 10(-6) and 3.9 +/- 0.9 x 10(-6) cm/s, respectively. The in vitro iontophoretic TM delivery through the combination of artificial porous membranes with pig SC is investigated as well. When the meso-porous PES-30 membrane is applied, the SC mainly controls the TM delivery. When the microporous NF-PES-10 membrane is applied, both the membrane and the SC contribute to controlling the delivery of TM. When the microporous LFC 1 membrane is applied, the TM delivery is membrane controlled. In all cases, however, the efficiency of the TM delivery is low and would need to be improved for the development of a commercially viable product.     

Variations of p53 in cultured fibroblasts of patients with lung cancer who have a presumed genetic predisposition.

The authors studied cultured skin fibroblasts of 64 patients with lung cancer for constitutive mutations of the p53 tumor suppressor gene by using polymerase chain reaction and single-strand conformation polymorphism covering the entire coding region. The patients were considered to be genetically predisposed because lung cancer had developed in 25 of them before age 46 and because 42 of them had at least one first-degree relative with lung cancer. One mutation was detected at position 235 coding for serine instead of asparagine in the conserved DNA binding domain. The Pro/Pro genotype at codon 72 of p53, considered to harbor an increased risk for lung cancer, could not be detected with increased frequency in this study's patients. From these data, the authors conclude that constitutive variations of the p53 gene do not represent a major genetic determinant for lung cancer.     

Function and complications after ablative and limb-salvage therapy in lower extremity sarcoma of bone

BACKGROUND AND OBJECTIVES: The functional results and the complications after several limb-saving and ablative treatments because of lower extremity bone sarcoma were evaluated. METHODS: Seventy-seven surviving patients were evaluated according to the MSTS (American Musculoskeletal Tumor Society) functional rating system. Fifty-two patients had limb-saving and 25 had ablative therapy. Median follow-up was 97 months in the limb-saving group and 112 months in the ablative group. RESULTS: Functional results in the limb-saving group were significantly better than in the ablative group (P = 0.0001). Functional results in patients with tumors about the knee joint were significantly better (P = 0.0064) after limb-saving surgery (i.e., endoprosthesis, knee arthrodesis, or rotationplasty) compared to functional results after ablative surgery (i.e., hip or knee disarticulation or above-the-knee amputation). Complications were 3 times more common after limb-salvage procedures and 4 times more common after endoprosthetic reconstructions compared to after ablative procedures. Complications after limb-saving therapy were fewest in tumors about the knee joint. In 3/28 patients, the endoprosthetic reconstruction had to be converted to an amputation. CONCLUSIONS: Functional results were significantly better after limb-saving compared to after ablative therapy. Complications, however, were more common after limb-saving therapy.     

The experience of being a partner to a spinal cord injured person: A phenomenological-hermeneutic study

This qualitative focuses on the personal experiences of partners to a spinal cord injured person. Using a Ricoeurian phenomenological-hermeneutic approach, we analysed seven partners’ narratives 1 and 2 years after their partner''s injury. The study revealed how the injury was experienced from the partners’ perspective through the aftermath. In the acute phase after the injury, partners also felt harmed, and support was needed in relation to their own daily activities, eating, resting, and managing distress. During the institutionalized rehabilitation, partners felt torn between supporting the injured partner and the demanding tasks of everyday life outside the institution. After discharge, partners struggled for the injured partner to regain a well-functioning everyday life and for reestablishing life as a couple. The partner struggled to manage the overwhelming amount of everyday tasks. Some sought to reestablish their usual functions outside the family, whereas others focused on establishing a new life together. The partners experienced much distress and appreciated the support they got, but felt that they were mainly left to manage the difficult process on their own.     

Familial resemblance for cognitive abilities in families with P-type dyslexic, L-type dyslexic, or normal reading boys

P-type dyslexic, L-type dyslexic, and normal reading boys, and their parents were administered a number of cognitive tasks. The P- and L-type dyslexic boys showed impaired performances on tasks representing a verbal/memory dimension. In addition, L-type dyslexics performed worse on a figure-rotation task, a result that supported the notion of a visuospatial deficit in this type of reading disturbance. The parents of P- and L-type dyslexics exhibited lowered performances on verbal/memory tasks, but they showed no evidence of impaired visuospatial functioning. Indices of familial resemblance revealed differential familial resemblances in the three types of families. In the families of P-type dyslexics, a high father-son effect was found for the visuospatial dimension. In the families of L-type dyslexics, moderately high single-parent/child effects were found for both fathers and mothers and for both the verbal/memory dimension and the visuospatial dimension. In the families of normal readers, only small single-parent/child effects were found.     

TRA-1-60: a new serum marker in patients with germ-cell tumors.

TRA-1-60 is a monoclonal antibody (MAb) that recognizes a mucin-like antigenic determinant expressed on the surface of embryonal carcinoma (EC) progenitor cells. In order to determine whether this antigen is released into the serum of patients with a non-seminomatous germ-cell tumor (NSGCT), we developed a sensitive 2-step immunoenzymometric assay. Of 42 EC-positive NSGCT patients tested, 32 (76%) were found to release TRA-1-60-reactive antigen into their serum, in contrast to 1 positive finding in 10 EC-negative NSGCT patients. The marker was found in 67% (10/15) of the EC-positive patients who were negative for both AFP and HCG. Sera from seminoma patients did not contain elevated levels of the TRA-1-60 antigen. Therefore, we propose that the TRA-1-60 antigen is a useful additional serum marker for following the progress of NSGCT(EC+) patients.