Ocular manifestations of malignant disease.

Systemic malignancies may produce a variety of ocular manifestations, reflecting both direct infiltration of ocular tissue by neoplastic cells and secondary phenomena related to tumour-induced physiological disturbances. The diagnosis and significance of these often neglected aspects of clinical oncology are discussed.     

Use of latex agglutination testing in diagnosing pediatric meningitis.

BACKGROUND. Latex agglutination (LA) tests are ordered frequently on cerebral spinal fluid (CSF) specimens obtained from pediatric patients to identify pathogenic bacteria as early as possible in an acute infection. METHODS. Six hundred ten LA tests were performed on 176 patients suspected of having meningitis. RESULTS. Five patients with meningitis had positive LA tests. We found that the CSF white blood cell (WBC) count, and differential were the best predictors of meningitis. CONCLUSIONS. By limiting the use of LA tests to those patients having CSF with abnormal WBC counts or with positive Gram stains, the number of tests ordered would have been reduced. This practice would greatly reduce laboratory expense.     

Choledochoenterostomy with an anti-reflux mechanism

A new technique of choledochoenterostomy was devised to solve some of the problems of enterobiliary anastomosis with a normal calibre. The distal extremity of the common bile duct is completely surrounded by the bowel mucosa to a length of 3 cm after seromyectomy of a bowel wall rectangle of 4 × 1 cm. Experimental studies in rats and dogs demonstrated that this procedure prevents the risks of anastomotic disruption and functions like a mechanical unidirectional valve, which has great efficacy in stopping enterobiliary reflux. Studies in ten patients with obstructive jaundice with an extrahepatic biliary dilation less than 1.2 cm diameter submitted to this procedure Confirmed the experimental results. All patients were asymptomatic, without jaundice and with normalization of the liver enzymes after 2 months. The permeability of the valvular anastomosis studied by cholangiography, the HIDA ^99mTc test and manometry was quite similar to other classical biliary-enteric anastomosis. In contrast, anti-reflux efficacy was only demonstrated in patients with a valvular anastomosis.     

Chronical administration of anti-DNA antibodies by subcutaneous injection of hybridoma clones in BALB/c and NZBxNZW/F1 mice. Experimental model of the pathogenic role of DNA in acute lupus disease.

Several sets of data suggest that specific classes of anti-DNA antibodies could be implicated in the genesis of glomerular lesions in SLE. The goal of this work is to investigate if this pathogenic role could be related to the antibodies' genetic origin--from BALB/c or NZBxNZW/F1 mice--or to their physiological origin--induced either by DNA or by polyclonal B cell activation in normal mice. For this purpose, anti-DNA antibody hybridoma clones produced from different origins were subcutaneously injected in BALB/c or NZBxNZW/F1 female mice, followed by studies of immunological parameters and kidney lesions. Results concur that the induced anti-DNA antibodies can play a role in fatal disease development, related to clonal specificity but not to the way of stimulation which was either polyclonal B cell activation or DNA immunization. Also, they emphasize the possible very lethal role of serum circulating DNA.     

The early history of pediatrics in Mecklenburg. 2: The first specialized facilities for handicapped children, child and infant mortality, clinical facilities for pediatrics in Mecklenburg]

Particular attention is given to social and regional aspects in this report on the development of special care facilities for handicapped children, infant and child mortality in Mecklenburg, and an analysis of their causes. The restricted opportunities available for influencing the relevant conditions and for introducing prophylactic measures are described. The establishment and development of medical facilities for treating sick children in Mecklenburg are outlined, special emphasis being placed on the hospitals at Ludwigslust, the importance of Schwerin's Anna Hospital and their facilities for hospital, surgical and outpatient treatment of children.     

Biochemical markers of atherogenesis in a nephrotic form of glomerulonephritis in children]

A study was made of the regularities and changes in the fatty acid spectrum of total lipids of the blood serum, in interaction of carbohydrate lipid metabolism, and in the hypophyseal and thyroid system in 92 patients with the nephrotic form of acute and chronic glomerulonephritis. It has been discovered that the nephrotic form of glomerulonephritis is marked by a complex of changes in the fatty acid spectrum of the blood serum, in carbohydrate lipid metabolism at the sites of their conjunction, and in the hypophyseal and thyroid system which can be regarded as metabolic potentialities of atherosclerosis formation.     

Determinants of preterm birth in Cura?ao, Netherlands Antilles.

In order to identify risk factors for preterm birth in singletons, data from a population-based case control survey on the island of Curacao were re-analysed. Both medical and sociodemographic variables were examined. Overall, a history of previous preterm birth and severe hypertension during the index pregnancy were indicators of adverse pregnancy outcome, in terms of preterm birth. The contribution of sociodemographic factors to the risk of preterm birth is relatively low.     

Social desirability and irritable bowel syndrome.

The Marlowe-Crowne Social Desirability Scale, a 33-item self-report questionnaire, was administered to an age-matched sample of twenty-five irritable bowel syndrome (IBS) patients, twenty-four psychiatric patients meeting a diagnosis of major depression, and nineteen controls. As predicted, planned comparisons analysis showed a significant group effect: IBS group scores were significantly higher than both depressed and control group scores (p less than .05). Implications of this social desirability response set for the psychological assessment and treatment of IBS are discussed.     

Intraoperative cholangiography revisited.

The charts of 1351 patients undergoing cholecystectomy at our institutions from 1985 through 1989 were reviewed retrospectively to evaluate the indications for and the success of intraoperative cholangiography. A total of 800 patients underwent intraoperative cholangiography. They were divided into two groups based on the absence (CR-) or presence (CR+) of clinical and/or operative criteria suggestive of the existence of common bile duct stones. Intraoperative cholangiography in CR- patients was of limited benefit, being negative (normal) in 95.7%, true-positive (abnormal) in 3.3%, and false-positive in 1%. False-positive intraoperative cholangiography resulted in unnecessary common bile duct explorations. Intraoperative cholangiography in CR+ patients proved useful, avoiding unnecessary common bile duct exploration in 55%. In those select CR+ patients with palpable common bile duct stones or cholangitis, little additional information was gained by the intraoperative cholangiography. We conclude that routine screening intraoperative cholangiography in CR- patients be reconsidered, as should the use of intraoperative cholangiography in CR+ patients with a palpable common bile duct stone or cholangitis. Intraoperative cholangiography in the remainder of CR+ patients proved beneficial and should be continued.