Renal stone disease treated with extracorporeal shock wave lithotripsy: short-term observations in 100 patients

The immediate posttreatment findings are described for 100 patients who underwent extracorporeal shock wave lithotripsy (ESWL) for renal stone disease. Excretory urography was performed both before and 24-72 hours after ESWL. In 21 patients, stones were completely disintegrated, and stone fragments were passed rapidly. Stones were fragmented but not passed entirely within 24-72 hours in 76 patients. There was no appreciable effect on stones in three patients. In nine of 27 patients who had mild to severe ureteral obstruction caused by stone fragments, relief procedures (retrograde ureteral manipulation or percutaneous stone extraction) were necessary. Overall, 70 patients experienced successful stone disintegration without complications. Continued investigation is needed to determine prevalence of residual calculi, reversibility of acute effects of ESWL on the kidney, and possible development of late hypertension.     

Influence of narrow-band UVB phototherapy on cutaneous microbiota of children with atopic dermatitis

OBJECTIVE: In the present work, the effect of narrow-band ultraviolet B (UVB) phototherapy on a cutaneous microbial population was evaluated in patients with atopic dermatitis (AD) and compared with control patients (vitiligo). METHODS: Count, isolation and identification of cutaneous microbiota from anticubital fossa were performed in 10 controls and 10 AD patients, both submitted to similar levels (P > 0.05) of UVB phototherapy (4.3 +/- 0.9 and 4.3 +/- 0.8 accumulated joules, respectively). Additionally, Staphylococcus aureus isolates were screened for the production of exotoxins. RESULTS: The total and staphylococcal cutaneous microbial population levels were higher (P < 0.05) in AD patients than in the controls. All these population levels decreased (P < 0.05) for both AD and control patients after UVB phototherapy, which also decreased the SCORAD for AD patients. All patients with AD and 50% of controls were carriers of S. aureus, and harboured the bacteria simultaneously on skin and anterior nares. All of the S. aureus strains recovered from AD patient skin produced toxin and the B type was the most frequently detected (70%), followed by C (20%) and A (10%) toxins. Only 40% of the S. aureus isolates from control patients produced toxin. After UVB treatment, microbial population levels of AD patients were similar (P > 0.05) to the ones found in control patients before phototherapy, and toxin production ability of S. aureus isolates decreased drastically. CONCLUSION: The results of the present study show the beneficial effect of UVB phototherapy on AD and suggest that this may be attributable not only to reduction of skin surface bacteria but also to the suppression of superantigen production from S. aureus.     

MULTIPLE BOWEN'S DISEASE OF THE FINGERS ASSOCIATED WITH HUMAN PAPILLOMA VIRUS TYPE 16

Background. The occurrence of multiple Bowen's disease (bd ) in skin away from the anogenital area is rare. In contrast, multiple lesions of bd involving the anogenital skin (bowenoid papulosis) are not so rare and have been found to associated with human papilloma virus (hpv ) usually type 16. We encountered a patient with multiple BD of the fingers and endeavored to detect hpv in his lesions. Methods. Separate bd lesions from 3 fingers of the patient were investigated for the presence of hpv by means of the polymerase chain reaction, followed by dot blot hybridization. Other cases of bd with coexistent HPV infection excluding the anogenital area were collected from the literature for comparative study. Results hpv type 16 was detected in each of the three finger lesions of bd . Twenty cases of hpv related bd involving sites other than the anogenital area were found in the literature. Three of these cases had multiple lesions. Conclusions. Review of the 4 cases with multiple hpv related nonanogenital bd and the 17 others with solitary lesions reveals predilection for the hands and feet (90%) and affinity for type 16 infection (81%). The lesions usually present as verrucous plaques.     

The Effect of Chlorphentermine Pretreatment on the Toxicity of Nitrogen Dioxide in Mice

The Effect of Chlorphentermine Pretreatment on the Toxicityof Nitrogen Dioxide in Mice. HASTINGS, C. E., JR., DENICOLA,D. B., REBAR, A. H., TUREK, J. J., BORN, G. S., AND KESSLER,W. V. (1987). Fundam. Appl Toxicol 9, 69–81. ChlorphentermineHCl (CP) was used to induce preexisting alveolar alterationsresembling a pulmonary lipidosis in mice to study these effectson the severity and duration of nitrogen dioxide (NO²) toxicity.Results indicated that a daily dose of 120 mg/kg for 14 daysproduced consistent histopathologic changes characterized byan accumulation of large foamy macrophages. Male Swiss-Webstermice were divided into a control and three treatment groups.Group 1 received 120 mg/kg CP po daily for 2 weeks followedby exposure to air for 48 hr. Group 2 received 20 ppm NO² for48 hr via whole-body inhalation, and group 3 received 120 mg/kgCP daily for 2 weeks followed by 20 ppm NO² for 48 hr. The fourthgroup served as a nontreated control and received water in placeof CP and air in place of NO². All groups were compared by morphologicevaluation of pulmonary tissues at the light and electron microscopiclevels at Days 0, 1, 3, 5, and 7 after the 48-hr exposure toair or NO². In a second experiment using the same treatmentgroups, thin-section light microscopy was used to count thenumber of type I and type II cells and macrophages. NO² exposurealone caused deaths in 20.8 and 18.5% of the mice in the twostudies, but no deaths were seen in the combination groups fromboth experiments. Histopathologic evaluation showed a typicalcellular response to the NO² exposure, but differences werenoted between the two groups receiving NO² on this treatment.There was increased type II cell hyperplasia and terminal bronchiolitison Days 0 and 1 but less on Days 3 to 7 in the combination groupcompared to the NO² alone group. CP treatment prior to NO² exposurecaused less terminal bronchiolar epithelial hyperplasia andless pulmonary edema than was seen in the NO² along group. TheCP treatment appeared to protect against the lethal effectsof NO² at the concentration and time of exposure used and alteredthe cellular repair mechanism that occurs in response to NO²toxicity. CP treatment prior to NO² exposure caused significantlyless loss of type I cells and less increase in type II cellsdue to NO² damage. The combination treatment also caused anincrease in macro phages greater than that seen in either individualtreatment, and this number remained increased through 5 dayspost-NO² exposure, whereas the NO² alone caused a steady increasein macro phages following the exposure until Day 3. Overall,prior treatment with CP offered partial protection against NO²toxicity.