Bullous lymphoma of the skin

We describe an extremely rare case of cutaneous B-cell lymphoma associated with bulla formation. The term, ‘bullous lymphoma’ is proposed for this variant of cutaneous lymphoma.     

Para-Aortic Nodal Irradiation in the Treatment of Carcinoma of the Uterine Cervix: A Report of 22 Cases

Twenty-two patients with previously untreated carcinoma of theuterine cervix were treated by para-aortic nodal irradiationfor the macroscopical metas-tases found at the operation withor without pathological confirmation, at the National CancerCenter Hospital from 1962 to 1980. The irradiation was givenwith 6 MeV X rays. Total doses ranged from 42 to 99 with anaverage of 69 in Time Dose Fractionation factors. All of thepatients died of the tumor within 42 months. The initial siteof relapse was intrapelvic for two patients, extrapelvic for18, and both intra- and extrapelvic for two. Of 12 patientsupon whom autopsies were performed, only one of the patientswho had multiple metastatic tumors of less than i cm in maximumdiameter had the tumor controlled in the irradiated region.     

DECREASED BLOOD PRESSURE IN RESPONSE TO AN ANGIOTENSIN II ANTAGONIST IN ADDISON''S DISEASE

The synthetic angiotensin II antagonist, 1-sarcosine, 8-isoleucine angiotensin II was infused in two patients with untreated Addison's disease. Blood pressure decreased following infusion of this angiotensin II antagonist. Re-infusion of the antagonist after cortisol replacement therapy for one month caused a slight increase in blood pressure. Addison's disease is one of the conditions in which the renin-angiotensin system is involved in the maintenance of blood pressure.     

Virological and serological studies on poliomyelitis in Karachi,Pakistan. I. Outbreaks in 1990-91

Between October 1989 and September 1991, 124 cases of poliomyelitis visited the Department of Paediatrics, Civil Hospital Karachi, Pakistan. The majority of them were between 6 months and 2 years of age and the epidemics occurred during the hot seasons. The dominant serotype was poliovirus type 1 during the epidemic season in 1990 and type 2 in 1991. All the polioviruses isolated from the patients were wild-type. Virological studies also disclosed that enteroviruses other than polioviruses were prevalent among healthy children as well as among diarrheal and polio patients. A serological survey to elucidate the serological efficacy of oral polio vaccine (OPV) showed that: (i) in 112 unimmunized children, after disappearance of transplacental maternal antibody during early infancy, antibody prevalence increased gradually and > 80% of the children were seropositive against all three types of polioviruses at 5 years of age; (ii) in 201 children immunized with full doses of OPV in their infancy, the decrease in antibody titer during infancy was less and seroprevalence rose sharply afterwards: at 2 years of age, > 80% of them were seropositive against all three types of the virus. The rapid increase of seroprevalence might be the effect of OPV administration. However, the prevalence was lower than that in developed countries.     

A study of cognitive development and behavior problems in mentally retarded children

Abstract Cognitive development in seventy-one mentally retarded children (19 autistic, 52 non-autistic; aged 7–19 years) from a school for handicapped children was studied, using Ohta's scale for evaluating cognitive development level based on language comprehension (Ohta's stage), and other developmental scales. Behavior problems were also examined. The present study reports on the utility of Ohta's stage in non-autistic children, and the relationship between cognitive development level and behavior problems in mentally retarded children. In non-autistic children, there were temporal correlations between Ohta's stage and other development scales (a standard developmental test, speech development, symbolic play development, imitation development), suggesting that in non-autistic children as well, Ohta's stage may serve well as a scale for cognitive development, and reflect symbolic representational functioning. In non-autistic children, most behavior problems in feeding, elimination and sleeping, hyperkinesis, hypokinesis, stereotyped behaviors, self-injurious behavior and licking were closely associated with cognitive development level, and were more often noted in children of lower cognitive development level rather than only in the severely mentally retarded children. Some behavior problems may often occur in the sensorimotor period and hardly occur in the symbolic representational period.     

Successful treatment of chemo-refractory pulmonary metastases of renal pelvic cancer by second-line chemotherapy including gemcitabine followed by salvage surgery

A 51-year-old woman developed multiple pulmonary metastases after receiving nephroureterectomy and two cycles of adjuvant chemotherapy for the treatment of renal pelvic transitional cell carcinoma. All metastases disappeared after four cycles of methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) chemotherapy followed by radiotherapy; however, 8 months later two pulmonary metastases recurred. The patient was entered into a phase I study of combination chemotherapy with gemcitabine, etoposide and cisplatin, designed for chemorefractory urothelial cancer. The lung masses showed significant reduction after two cycles of this chemotherapy; following salvage surgery, the patient has been well with no evidence of recurrence for more than 3 years.     

Somatoform pain disorder in a case of Klinefelter's syndrome with multiply operated lower back

Abstract We report a case of Klinefelter's syndrome with multiply operated low back (MOB). Psychological and/or psychosocial problems related to MOB have been of recent interest in the field of orthopedic surgery. Based on psychiatric interviews, this case was diagnosed as a somatoform pain disorder of the DSM-III-R somatoform disorders. In addition to psychological problems, the pain was partly explicable by severe osteoporosis, which was prematurely caused by endocrinological disturbances associated with Klinefelter's syndrome. Patients with this syndrome are more likely to develop severe osteoporosis. In the presenile period of Klinefelter's syndrome with severe osteoporosis, liaison psychiatrists may pay attention to somatoform disorders (e.g. somatoform pain disorder and conversion disorder) linked with the MO.     

Transcatheter Arterial Chemo-Embolization (TAC-E) for Patients with Locally Advanced Breast Cancer

Preoperative transcatheter arterial chemo-embolization (TAC-E)was used for 19 patients with locally advanced breast cancer,to eradicate the extensive loco-regional areas prior to surgeryand hopefully to reduce the postoperative recurrence rate. Theresults were as follows: (1) Each primary tumor showed markedregression within 2 weeks after TAC-E. (2) Surgicopathologyconfirmed the excellent efficacy of TAC-E against both primarytumors and metastatic lymph node tumors. (3) Side effects dueto this treatment were few, compared with other forms of cancerchemotherapy. (4) The prognosis of each patient was good. We conclude that preoperative TAC-E has a great potential forthe treatment of locally advanced breast cancer.     

Oestradiol Release from Self-setting Apatitic Bone Cement Responsive to Plasma-calcium Level in Ovariectomized Rats,and its Physicochemical Mechanism

The effect of plasma calcium levels on the release of oestradiol from a self-setting apatite bone cement containing 0.5% oestradiol was investigated in ovariectomized rats. The profiles of in-vitro release from the cements in simulated body fluid containing 0, 5 or 10 mg calcium per 100 mL indicated that the rate of release of oestradiol decreased with increasing calcium concentration in the dissolution media. After subcutaneous implantation of oestradiol-loaded cement in healthy and vitamin D-deficient rats, oestradiol release in diseased rats with low plasma calcium levels was significantly higher than that in healthy rats. These results suggest that in-vitro release of oestradiol from apatite bone cement was dependent on the calcium concentration in the buffer and that the in-vivo release of oestradiol from apatite bone cement was dependent on plasma calcium levels.