Haemophilus (Corynebacterium) vaginalis septicemia

Thirteen patients with Haemophilus (Corynebacterium) vaginalis septicemia are reported. In 7 of the 13 patients, facultative or obligatory anaerobe bacteria were concomitantly isolated. In 11 of 13 cases, the bacteriologic studies of the presumed portal of infection revealed the presence of the organism or organisms subsequently isolated from the intravascular compartment.     

Assertion and non-assertion supported by arousal reduction

Subjects imagined assertive conflict situations and imagined responding in an assertive, aggressive or non-assertive manner. Plethysmographic data suggest that for non-assertive subjects non-assertive behavior is most arousal reducing; while for assertive subjects assertive and aggressive behavior is most arousal reducing. These findings are related to assertive training.     

Experimental facial edema: treatment with methylprednisolone

Because the face is an area rich in blood, swelling after technical manipulation in that area often becomes a serious problem. To determine the effectiveness of methyl-prednisolone therapy in controlling this often disabling problem, and experimental animal model was developed which would produce experimental facial edema in the piglet. This new, uncomplicated technique involves dissecting and raising the forehead flap, freeing the flap in the periorbital and supraorbital regions, and closing the wound in a single layer. At the termination of the procedure, randomly selected animals received 1 g of methylprednisolone intravenously and a control group was not treated.Visual observations by two qualified experts and photographic records were made 24, 48, and 72 hr postoperatively, and demonstrated that facial edema developed in 90% of the control group and in only 40% of the methylprednisolone-treated animals. When edema did occur in treated pigs, it was mild and of shorter duration in comparison with the controls.Our results suggest that 1 g of intravenous methylprednisolone, administered immediately following facial surgery, can decrease the incidence and degree of postoperative edema in patients without the complication of infection.     

The classification of depression through cluster analysis

Cluster analysis research has the potential of clarifying the confusion currently extant in psychiatric classification. The paper reviews 11 studies that have used cluster analysis to create new classifications of depression. These studies consistently found a category of retarded/psychotic/endogenous depression. The validation studies by Raskin, Overall, Paykel, and their associates demonstrate the predictive validity of cluster generated classifications. Despite these favorable results, the cluster-analysis studies have had little impact on the literature about depression. The reasons for this lack of impact seem to be: (1) the unsolved statistical problems associated with cluster analysis, (2) the naive empiricism inherent in most of this research, and (3) the failure to be aware of the political nature of classificatory change.     

Effects of the dinoflagellate Karenia brevis on larval development in three species of bivalve mollusc from Florida.

The effects of Karenia brevis (Wilson clone) on larval survival and development of the northern quahog, Mercenaria mercenaria, eastern oyster, Crassostrea virginica and bay scallop, Argopecten irradians, were studied in the laboratory. Larvae were exposed to cultures of whole and lysed cells, with mean total brevetoxin concentrations of 53.8 and 68.9 microgL(-1), respectively. Survival of early (3-day-old) larvae was generally over 85% for all shellfish species at K. brevis densities of 100 cells ml(-1) or less, and not significantly different between whole and lysed culture. At 1000 cells ml(-1), survival was significantly less in lysed culture than whole culture for both M. mercenaria and C. virginica. Survival of late (7-day-old) larvae in all three species was not significantly affected by K. brevis densities of 1000 cells ml(-1) or less. At 5000 cells ml(-1), however, survival was reduced to 37%, 26% and 19% for A. irradians, M. mercenaria and C. virginica, respectively. Development of C. virginica and M. mercenaria larvae was protracted at K. brevis densities of 1000 cells ml(-1). These results suggest that blooms of K. brevis, and particularly their associated brevetoxins, may have detrimental consequences for Florida's shellfisheries by disrupting critical larval processes. Special attention should be paid to blooms of K. brevis where these shellfish occur naturally or where aquaculture and restoration activities are either ongoing or planned.     

Systemic lupus erythematosus presenting as chronic serositis with no demonstrable antinuclear antibodies

Approximately 5 percent of patients with systemic lupus erythematosus by clinical and pathologic criteria have no demonstrable antinuclear antibodies. This figure is likely to be an underestimate, as it does not include the antinuclear antibody-negative patients with limited manifestations in whom the diagnosis of systemic lupus erythematosus is missed. A 23-year-old woman is described who had a history of perplexing bilateral pleural effusions with development of peritoneal effusion after 18 months and positive antinuclear antibody results after 22 months. Tissue pathologic features, initially interpreted as nonspecific, on review revealed striking lymphocytic periarteritis with endothelial swelling and leukocytoclastic vasculitis often seen in systemic lupus. A selective defect in the suppression of T cell effector function, such as direct cell-mediated cytotoxicity, with intact suppressor systems for B cell effector function, such as antibody production, can be postulated in this patient. This would explain the active cellular tissue pathology with the lack of prominent antinuclear antibody production.     

Gaucher's disease affecting the mandible

A case of Gaucher's disease affecting the left body of the mandible is presented. Dentists can recognize this uncommon disease through the medical history of the patient, the presence of characteristic Gaucher cells on biopsy of the lesion, and decreased serum levels of the enzyme glucocerebrosidase.     

Changing trends in the surgical treatment of coarctation of the aorta

From 1974 through 1983, 107 patients 4 days to 27 years old underwent 115 operations for treatment of coarctation of the aorta. Thirty-two patients were infants (1 year old or younger), and 28 of them were newborns. All newborns were seen with congestive heart failure. Seventy-one patients were seen with hypertension. Associated anomalies were present in 72 patients (67%). Resection was performed in 48 patients, patch aortoplasty in 16, bypass of the coarcted segment in 15, and left subclavian artery flap angioplasty (LSAFA) in 36. Ligation of a patent ductus arteriosus was simultaneously performed in 28 patients and pulmonary artery banding, in 4. Follow-up was 6 months to 9.2 years. There was a significant difference in aortic cross-clamp time between 26 patients who had resection (37.9 +/- 12.9 minutes) (mean +/- standard deviation) and 32 patients who had LSAFA (22.9 +/- 7.7 minutes) (p less than 0.05). Six patients died within thirty days after operation; 5 of them had resection, and 1 had bypass. Major postoperative complications included bleeding requiring exploration in 3 patients (2 after resection and 1 after LSAFA) and paraplegia in 1 patient after reoperation (resection) for recurrent coarctation 3 years after patch aortoplasty. Paradoxical hypertension was observed in 13 patients, and sustained systemic postoperative hypertension developed in 11 after effective repair of coarctation. There was no significant difference in early postoperative arm-leg pressure gradients between the types of operation or the various age groups.(ABSTRACT TRUNCATED AT 250 WORDS)