Percutaneous management of lymphatic fluid collections

Eight lymphatic fluid collections were drained percutaneously. There were no immediate or late complications. Seven patients had follow-up; 1 required surgical drainage of a residual or recurrent lymphocele, and another had reaccumulated fluid in a lymphocele which was detected on autopsy. The remaining lymphatic collections responded to percutaneous drainage. Percutaneous drainage is safe and can be an effective tool in the management of lymphatic collections.     

A comparison of the effects of climbing fiber deafferentation in adult and weanling rats

The climbing fiber input to the cerebellar cortex was destroyed using both electrolytic and chemical (3-acetylpyridine) lesions. The long-term effects of climbing fiber deafferentation on the ansiform lobule of weanling and adult rats were examined at both the light and electron microscopic levels. Image analysis of Golgi-impregnated Purkinje cells indicated a significantly lower number of smooth branches and spiny branchlets following climbing fiber deafferentation of both adult and weanling rats. The results suggest that the lower number of smooth branches and spiny branchlets following climbing fiber deafferentation of the weanling rat is the result of a loss of postnatal growth rather than transneuronal degeneration. Ultrastructural evidence is provided in confirmation of these quantitative findings. Formation of ectopic dendritic spines was found following climbing fiber deafferentation of the weanling rat, but not the adult. It is shown that ectopic spines and the denervated dendritic thorns of these animals were synaptically innervated by the parallel fiber system and basket axons. The formation of ectopic spines on climbing fiber deafferentated Purkinje cells may represent a form of dendritic plasticity. Ultrastructurally, the dendritic arborizations of weanling deafferentated Purkinje cells showed no signs of transneuronal degeneration. However, the primary response to climbing fiber deafferentation in the adult rat was marked transneuronal degeneration of the Purkinje cell dendrites. It is suggested that the inability of the adult Purkinje cell to form ectopic spines and to replace the excitatory postsynaptic potential of the climbing fiber varicosity is directly related to the Purkinje cell's subsequent transneuronal degeneration.     

'Reprofessionalization' or 'occupational imperialism'?: some reflections on pharmacy in Britain

Drawing upon preliminary research findings, this paper considers whether pharmacists in Britain face a crisis in their occupational status and identity as a result of changes in their work and market situations. It further examines some of the ways in which they are responding to the challenges and opportunities presented. The paper also comments on the utility of the concepts of 'reprofessionalization' and 'occupational imperialism' in the study of British pharmacy.     

Assessment of caffeine exposure: caffeine content of beverages, caffeine intake, and plasma concentrations of methylxanthines

The caffeine content of all tea or coffee beverages consumed by 17 healthy adults over 24 hours was measured. Plasma caffeine, theophylline, theobromine, and paraxanthine concentrations were determined over the same 24 hours. The average caffeine content per drink was 60.4 +/- 21.8 mg for instant coffee (14-fold range), 80.1 +/- 19.2 mg for brewed coffee (2.8-fold range), and 28.8 +/- 13.7 mg for tea (5.5-fold range). The number of drinks of coffee and tea consumed was a poor index of actual caffeine intake (r2 = 0.42). Caffeine intake correlated poorly with the 24-hour average caffeine concentration (r2 = 0.41), but there was a very good correlation between a single plasma caffeine concentration measured at 5 PM and the 24-hour average concentration (r2 = 0.94). The same was true for paraxanthine (r2 = 0.86). Paraxanthine accounted for 67.3% of the total dimethylxanthines in plasma, while theobromine and theophylline accounted for 24.4% and 8.3%, respectively. Mean caffeine clearance was 1.2 +/- 0.3 ml/min/kg. Plasma caffeine concentration before the first drink in the morning correlated very poorly with caffeine clearance (r2 = 0.07), even when adjusted for caffeine intake (r2 = 0.21).     

Antibodies to HTLV-1 in saliva of seropositive individuals from Japan

Secretory antibodies protect mucosal surfaces against transmission of many viruses. Human T-lymphotropic Virus, Type I (HTLV-I) is transmitted via blood products and via sexual contact across mucosal surfaces. We investigated the presence of HTLV-I-specific antibodies in whole saliva samples from 10 seronegative and 28 seropositive volunteers from a hospital in southern Japan. Antibodies directed to HTLV-I antigens were found in the salivas from 22 of 28 (79%) of the seropositive subjects. None of the seronegative individuals showed evidence of salivary antibodies. Antibodies directed to the envelope antigens of the virus were found in 21 of 22 positive saliva samples. Secretory antibodies may be important in preventing mucosal transmission.     

The effectiveness of intrauterine transfusions

The results of treatment with intrauterine transfusion are presented. The analysis comprised 48 successful transfusions into 29 foetuses. The reference group consisted of 11 transfusions which proved nonfeasible or ineffective and 54 untreated cases. Following blood treatment, the newborn mortality rate dropped more than threefold. Long-term follow-up of 21 children generally showed their good physical and mental development. We also present 4 cases of supsequent pregnancies after intrauterine blood treatment in a preceding pregnancy, showing that it is possible to save the next baby of the same mother.     

Puncture wound osteochondritis of the foot caused by CDC group Vd.

A case of puncture wound osteochondritis of the foot caused by CDC group Vd is presented because of the unusual nature of the infecting organism. This organism may be confused with Pseudomonas aeruginosa, the usual pathogen responsible for this type of infection, but does not have a similar antimicrobial susceptibility profile. For this reason, it is important to obtain appropriate culture specimens and to identify and test the susceptibility of bacterial isolates from cases of puncture wound-associated osteochondritis so that optimal therapeutic regimens can be determined.