Coronary stents.

In this article we review the early history of the coronary artery stent in clinical cardiology, cite a clinical case and assess the potential role of stents in revascularization in the future.     

Intrathoracic carcinoma in an 11-year-old girl showing a translocation t(15;19).

We report here a rare case of intrathoracic undifferentiated carcinoma in an 11-year-old girl. The biopsy tissue stained with antibodies against cytokeratin and carcino-embryonic antigen. The same staining was obtained using a cell line, PER-403, which was derived from the tumor. DNA from PER-403 cells was tested for the presence of Epstein-Barr virus genes, yielding a negative result. The cytogenetic analysis found a translocation t(15;19) (p12;q13), which has not previously been described in a carcinoma.     

Digital subtraction dynamic cavernosography

Digital subtraction angiography (DSA) was used in the investigation, by dynamic cavernosography, of 35 men with acquired erectile impotence. The benefits of using DSA included shorter examination times, lower contrast medium dosage and better definition of abnormal veins. In particular deep crural veins are more clearly seen than in conventional studies and these may be of more importance than was previously thought.     

The impact of HIV disease on an Irish prison population.

Between January 1987 and January 1991, 168 known HIV-infected prisoners have been incarcerated in Dublin's Mountjoy prison. This figure constitutes 16.6% of the total HIV-infected population in the Republic of Ireland over the same period. One hundred and forty-one (84%) of these prisoners have attended the Department of Genitourinary Medicine, St James's Hospital, Dublin. This group displayed considerable morbidity from HIV-related disease. Respiratory tract infection was the most frequent complication seen. Much additional morbidity was directly attributable to intravenous drug use. A survey of a representative group of inmates revealed that 64.7% were diagnosed HIV-positive in prison. The mean length of time spent incarcerated since the diagnosis of HIV infection was 38.9 months. Twenty-nine of 34 individuals who answered a questionnaire were imprisoned for drug-related crimes and 32 of 34 prisoners admitted to parenteral drug use within the prison. As the HIV epidemic unfolds in Dublin, increasing numbers of prisoners with symptomatic HIV disease will spend time incarcerated in Mountjoy prison. This will pose a considerable burden on prison and hospital medical services alike.     

Autopsy findings in the tongues of 20 patients with AIDS

An extensive examination of the tongue was performed at autopsy in 20 consecutive patients who had died with AIDS. Abnormalities in the tongue were detected in 18 (90%) of the cases; the commonest lesions were ulceration (11), candidosis (8) and small foci of hyperkeratosis (10). The most extensive lesions were caused by Aspergillus infection (1), non-Hodgkin's lymphoma juxtaposed with Kaposi's sarcoma (1), herpetic infection (1) and candidosis (5). The disease causing death was identified in the tongue in two cases. There was a surprisingly low prevalence of oral hairy leukoplakia. which may be related to anti-viral or retroviral therapy.     

Thirty cases of Irukandji envenomation from far north Queensland

The Irukandji jelly fish (Carukia barnesi) is responsible for a significant number of envenomations in northern Australia during the summer. Emergency physicians in these coastal areas frequently manage patients who have been envenomed by this potentially serious marine creature. The jelly fish is small (its bell is up to 2.5cm across) but the tentacles may be up to half a metre in length. It is rarely seen before envenomating. The sting usually initially causes localised pain followed by systemic symptoms known as the ‘Irukandji syndrome’, which include potentially life threatening pulmonary oedema. This article discusses Irukandji envenomation and its treatment, and reviews our experience in treating 30 patients who presented to the Emergency Department of Cairns Base Hospital in December of 1996 having been stung by the Irukandji. Of these cases, 27 (90%) patients developed systemic symptoms (the Irukandji syndrome) and 19 (63%) required admission. Twelve (40%) patients required more than 100mg of titrated, intravenous pethidine to relieve the pain. There were no cases of pulmonary oedema. All patients were discharged home well within 24 hours.