Gastrointestinal stromal tumor in ileal neobladder

Abstract  Gastrointestinal stromal tumor (GIST) is a recently described mesenchymal tumor that can develop in any portion of the gastrointestinal tract. The occurrence of a GIST in the urinary tract is rare, but GIST can present as tumor of the urinary tract or invade the urinary tract. This is the first reported case of GIST in the ileal neobladder, which presented as a submucosal tumor. The patient underwent an open exploration and partial resection of the neobladder pouch.     

SCREENING FOR ALCOHOLISM IN GENERAL MEDICAL PATIENTS

Medical patients (N = 108) were administered a brief screeninginstrument (LAMSI) and a structured diagnostic interview (SUDDS).Twenty-five patients met DSM-III criteria for an alcohol usedisorder, 20 current, five in remission. The four-item scaleembedded in the screen identified the alcoholics with 88% sensitivityand 96% specificity.     

Fenestration and occlusion of the posterior semicircular canal for benign positional vertigo

Benign positional vertigo is a potentially disabling condition characterized by episodic vertigo following certain provocative head movements. In most patients it is self limiting; however, in a few it may prove intractable, causing considerable social morbidity. In these patients surgery may be considered. Surgery previously involved section of the vestibular or singular nerves, involving a significant risk to hearing and to the facial nerve. Ablation of the labyrinth may even be considered. The new surgical technique of occlusion of the posterior semicircular canal has proved to be curative in most patients with benign positional vertigo with little risk to hearing. This paper describes our experience of fenestration and occlusion of the posterior semicircular canal in four patients.     

Studies on the In-vitro Percutaneous Penetration of Indomethacin from Gel Systems in Hairless Mice

The influence of co-solvents on the in-vitro percutaneous penetration of indomethacin from gel systems was studied using a simplex lattice experimental design. Gel formulations were prepared by gelling the vehicle mixture of water, either alcohol or isopropanol and either propylene glycol or PEG 400 with 1% w/w Carbomer 940. Hairless mouse skin was employed as the barrier in a Franz-type diffusion cell. The penetration rates at steady state for seven formulations were fitted to a polynomial equation based on this simple lattice method and a three-dimensional plot was constructed. The formulation having the maximal penetration rate was determined to be the vehicle with a solvent ratio of water: alcohol: propylene glycol equal to 15:33:52, and which possessed a solubility parameter of 15 and a drug solubility of around 10 mg mL^?1. When the solubility parameter of the vehicle was > 15, the drug solubility increased. However, the penetration rate decreased with an increasing solubility parameter. For those vehicles with a solubility parameter < 15, both the drug solubility and the penetration rate decreased with a decrease in the solubility parameter. There was shown to be an approximately 20-fold increase in the relative enhancement factor when using both alcohol and isopropanol, but only a threefold increase for both propylene glycol and PEG 400, when compared with water.     

Usage of oral rehydration solutions (ORS): a critical assessment of utilization rates

Oral rehydration solutions (ORS) are widely promoted as a treatmentfor the dehydration associated with childhood diarrhoea. Manynational and global programmes have adopted ORS use rates derivedfrom surveys as their principal indicator of programme success.However, such widespread reliance on ORS use rates is ill-advised.The rate is very sensitive to the way the survey questions areasked. Discussed here are the terms identifying diarrhoeal episodes,the length of the reference period, and the ordering of questionsabout treatment practices. Furthermore, ORS rates are frequentlyused inappropriately, often in situations in which treatmentof a proportion of all diarrhoeal episodes is not the principalobjective.     

Pityriasis rubra pilaris in the setting of HIV infection: clinical behaviour and association with explosive cystic acne

The development of pityriasis rubra pilaris (PRP) in three patients with human immunodeficiency virus (HIV) infection is described. Two of the patients had onset of severe generalized cystic acne concomitant with their development of PRP. PRP and acne conglobata should be added to the group of cutaneous disorders that can present in a more virulent manner in the setting of HIV infection. The association of cystic acne with PRP and their response to treatment are discussed.     

Permeation of nickel through human skin in vitro—effect of vehicles

The effect of the vehicle on the permeation rate of nickel ions through excised human skin was evaluated. Different hydrogels were compared with the standard patch test in petrolatum. A hydroxypropyl methylcellulose gel seemed to be the most promising alternative to petrolatum. It gave high bioavailability of the nickel and had good film forming properties leaving the nickel spread across the skin surface as a thin film without microscopically detectable crystals. The content of nickel in the various skin layers after cutaneous application was determined, and nickel was found to accumulate in the epidermis, probably due to epidermal binding. A significant amount of nickel was found also in the dermis. Occlusion and application of higher nickel concentrations increased the transport rate and must be considered in patch testing using this hydrogel. We conclude that nickel permeation is highly dependent of the choice of vehicle and the vehicle should, therefore, be an important consideration in patch testing with nickel.