Mohs micrographic surgery for periorbital skin cancer

The authors have illustrated the use of the Mohs technique on periorbital skin cancer. The indications for the technique are documented for eyelid and canthal neoplasia, and the case histories illustrate the potential danger of skin cancer in this area. It is the well balanced team of micrographic surgeons and reconstructive surgeons that will give the patient the best result.     

Activation of supraoptic magnocellular neurons by gamma 2-melanocyte stimulating hormone (gamma 2-MSH)

The effects of intracarotid infusions of the peptide gamma₂-melanocyte stimulating hormone (γ₂-MSH) on electrophysiologically and immunohistochemically identified supraoptic nucleus (SON) units were investigated Over a wide dose range this agent always excited SON units, while control infusions of vehicle had no effect. Because neural responses invariably preceded blood pressure elevation, it appears that γ₂-MSH excitation of the magnocellular system was due to a direct effect on the central nervous system and was not a result of systemic cardiovascular responses. These results suggest a forebrain γ₂-MSH sensitive site in the activation of SON magnocellular neurons.     

Increases in α-adrenergic receptors in the hypothalamus of the genetically obese mouse (ob/ob)

Despite significantly elevated hypothalamic norepinephrine levels, genetically obese mice (ob/ob) had more hypothalamic α-adrenergic receptors than their lean littermates. This receptor increase appeared to be specific to the α-receptors in the hypothalamus since no change was found in the number of α-receptors in the cortex or in the dopamine and muscarinic receptors in the cortex and striatum.     

Analysis of Hispanic Motor Vehicle Trauma Victims in Illinois, 1991–1992

Objective: 1) To develop a profile of Hispanic motor vehicle trauma victims in Illinois, 2) to ascertain whether differences exist between Hispanic and general-Illinois-population motor vehicle trauma victims, and 3) to identify potential target areas for future injury intervention programs.
Methods: A retrospective analysis of Illinois motor vehicle trauma patients admitted from July 1991 to June 1992 was made. Participants were motor vehicle trauma victims (drivers and passengers) who presented to one of 73 level I or level II trauma centers throughout Illinois and were entered into the Illinois Trauma Registry (ITR) from July 1, 1991 through June 30, 1992.
Results: Of the 12, 299 motor vehicle trauma victims in the ITR, 771 (6. 3%) were Hispanic, 8, 979 (73. 0%) were white, 1, 115 (9. 1%) were black, and 1, 434 (11. 6%) were other. When compared with the other racial groups, the group of Hispanic victims were younger (25. 2 vs 33. 2 years), had higher male predominance (72. 8% vs 60. 9%), and had the lowest rate of safety equipment/occupant restraint use (21. 7% vs 34. 7%). A high alcohol use rate (30. 7%) and high mean serum ethanol levels (44 mmol/L; 0. 2 mg%) were noted. When contrasted with other racial/ethnic groups, the Hispanic victims had lower Injury Severity Scale scores (p < 0. 001), but mean hospital charges tended to be higher, with fewer alternative sources of payment (p < 0. 001).
Conclusion: Using age-adjusted data from the ITR, Hispanic motor vehicle trauma victim features differ significantly from those of other racial groups. Effective health maintenance and injury prevention strategies should address the basis for these differences.     

Pancreatic lesions and hypoglycemia-hyperinsulinemia in scrapie-injected hamsters

Hamsters injected intracerebrally with scrapie strains 139H or 22CH or with normal hamster brain were assessed for body weight periodically throughout the incubation period. Animals injected with the scrapie strains became obese before the appearance of the motor changes that are indicative of the start of clinical disease. During the latter part of the incubation period and during clinical disease, animals were hypoglycemic and showed marked hyperinsulinemia. At autopsy, there was marked hyperplasia and hypertrophy of the cells of the islets of Langerhans. Thyroid, adrenal glands, liver, and kidney also were enlarged. The data suggest a severe endocrinopathy and point to new areas of pathologic and clinical changes that can be assigned to unconventional slow infections.     

Biochemistry of Vibrio cholerae Virulence III. Nutritional Requirements for Toxin Production and the Effects of pH on Toxin Elaboration in Chemically Defined Media

The investigations described in this report concern the metabolic and physiologic parameters governing cholera enterotoxin production in chemically defined growth media. The results indicate that the minimal nutritional requirements for growth of pathogenic Vibrio cholerae are the same as those for toxin production, and that toxin production parallels growth of the organisms. Studies of the relationship between toxin accumulation and pH reveal that toxin biosynthesis can be separated from toxin release. Toxin is synthesized below pH 7.0, but release and accumulation of extracellular toxin occur only at neutral or alkaline pH values.     

Self-report questionnaire scores in rheumatoid arthritis compared with traditional physical, radiographic, and laboratory measures

STUDY OBJECTIVE: To assess whether scores on a simple self-report questionnaire to depict the clinical status of patients with rheumatoid arthritis are correlated with traditional measures of physical, radiographic, laboratory, functional, and global status. DESIGN: The self-report questionnaire was administered at the same time the following variables were assessed: American Rheumatism Association functional class, joint count, hand radiograph, erythrocyte sedimentation rate, rheumatoid factor titer, walking time, grip strength, button test, and global self-assessment. SETTING: University rheumatology clinic, the rheumatology clinic of a Veterans Administration hospital, and a private rheumatology practice. PATIENTS: The study included 259 patients who met the criteria of the American Rheumatism Association for a diagnosis of definite or classic rheumatoid arthritis. INTERVENTIONS: Standard rheumatologic care for patients with rheumatoid arthritis. MEASUREMENTS AND MAIN RESULTS: Self-report questionnaire scores were significantly correlated with the joint count, radiographic score, erythrocyte sedimentation rate, grip strength, button test, walking time, American Rheumatism Association functional class, and global self-assessment. Patients were categorized into five questionnaire score categories of 1.00, indicating no dysfunction, and 1.01 to 1.50, 1.51 to 2.00, 2.01 to 3.00, and 3.01 to 4.00, indicating progressive dysfunction. In these five categories, more than ten involved joints were seen in 11%, 37%, 67%, 79%, and 100% of patients, respectively, and erythrocyte sedimentation rates greater than 20 mm/h in 29%, 49%, 64%, 74%, and 85% of patients, respectively. Similar results were seen for other physical and radiographic measures. The questionnaire score was as effective in explaining other measures of clinical status as was any other available measure. CONCLUSIONS: A simple self-report questionnaire provides information similar to many traditional measures in rheumatoid arthritis and appears to be an attractive, cost-effective approach to assessing and monitoring quantitatively the status of an individual patient.     

Associative intrusions in the verbal behavior of the first-degree relatives of adult schizophrenics. A preliminary study

The first-degree blood relatives of schizophrenics were compared to a matched control group on a psychometrically matched test of responsiveness to associative intrusions. The groups differed on the subtest containing an associative alternative but not on the equally difficult subtest free of associative distractors. Results were consistent with the hypothesis that an overresponsiveness to associative distractors, well documented in schizophrenics, may also be a characteristic of their nondisturbed first degree blood relatives. The possible existence of cognitive markers in the relatives of schizophrenic patients that might indicate familial psychopathology was supported. Limitations of the present preliminary findings, as well as the case for additional investigation of the cognitive behavior of the first-degree relatives of schizophrenics, are discussed.