Semimalignant ("pseudolymphomatous") cutaneous B-cell lymphomas

Almost 50% of cutaneous B-cell lymphoproliferative infiltrates are derived from follicular center cells. Among these, about 25% show a rapidly progressive course, whereas about 75% account for flattening of the survival curve after about 7 years. This group is referred to as semimalignant ("pseudolymphomatous") cutaneous B-cell lymphoma (SM-CBCL). Clinical, histologic, and phenotypical criteria for their differentiation from B-cell pseudolymphoma and from CBCL have been investigated in 60 patients (11 CBCL, 30 SM-CBCL, 19 PSL). Semimalignant CBCL are different from malignant CBCL because they do not tend to disseminate to extracutaneous sites or to transform into high-grade malignant blast-type lymphomas; follicular center cell formation with CD21 positive dendritic reticulum cells is usually present; and normal survival time is not affected. On the other hand, SM-CBCL differ from PSL in that complete cure of the usually multiple and disseminated skin manifestations is not possible and that follicular center formation and the network of CD21-positive cells in conjunction with a kappa or lambda light chain restriction of cellular surface immunoglobulins is seen. If these and other criteria are taken together, differentiation of these various nosologic entities demanding different therapeutic approaches can be achieved with significant reliability.     

The hypnic ("alarm clock") headache syndrome

Dipeptidyl peptidase IV (DPP IV, CD 26) is an integral membrane serine protease exhibiting a well characterized exopeptidase activity. The present study shows that DPP IV also possesses a novel gelatinase activity and therefore endopeptidase activity, which was directly demonstrated by gelatin zymography. Protease inhibitor profile analysis showed that the endo- and exopeptidase activities of DPP IV share a common active site. Substrate specificity was detected for denatured collagen types I, II, III and V suggesting that DPP IV might contribute to collagen trimming and metabolism. On the basis of these data we propose that DPP IV and the recently sequenced gelatinolytic seprase (FAPalpha) represent a new subfamily of gelatinolytic integral membrane serine proteases.     

Pharyngeal dermoids ("hairy polyps") as accessory auricles

The purpose of this study is to clarify the origin and nature of so-called hairy polyps or dermoids of the pharynx, which are often thought to be a variant of pharyngeal teratoma. For this purpose, a case is reported of a dermoid polyp involving the middle ear of an infant, the features of multiple examples of pharyngeal dermoid polyps and teratomas received for consultation by the Armed Forces Institute of Pathology are examined, and selected pertinent reports from the literature are reviewed. All three means are used to support the conclusion that these lesions are choristomatous developmental anomalies arising from the first branchial cleft area and that they essentially represent heterotopic accessory "ears" (auricles) without the growth potential of a teratoma.     

Methcathione ("cat"): an enantiomeric potency comparison

With regard to its chemical structure, methcathinone is to cathinone what methamphetamine is to amphetamine. Although it is a drug of abuse outside the United States, methcathione is only recently making an appearance on the clandestine market in this country and has just been classified a Schedule I substance under the Emergency Scheduling Act. We have previously demonstrated that racemic methcathinone produces locomotor stimulation in mice, and substitutes for cocaine and (+)amphetamine in rats trained to discriminate either cocaine or (+)amphetamine, respectively, from saline in tests of stimulus generalization. Because an enantiomeric potency comparison has never been reported for the optical isomers of methcathinone, in the present investigation we synthesized samples of S(-)- and R(+)methcathinone and compared them for their ability: a) to produce locomotor stimulation in mice, b) to elicit cocaine-like responding in rats trained to discriminate 8.0 mg/kg of cocaine from saline vehicle, and c) to elicit (+)-amphetamine-appropriate responding in rats trained to discriminate 1.0 mg/kg of (+)amphetamine from saline vehicle. S(-)Methcathinone was about twice as potent as S(+)amphetamine and three to five times more potent than R(+)methcathinone in the three pharmacologic assays. We conclude that both optical isomers possess central stimulant character, but that S(-)methcathinone is somewhat more potent than R(+)methcathinone.     

Accumulation of hypointense lesions ("black holes") on T1 spin-echo MRI correlates with disease progression in multiple sclerosis

MRI findings are increasingly used as outcome measures in therapeutic trials in MS. The discrepancy between the extent of the lesions on conventional T2 images and the clinical condition of the patient is one of the problems encountered in such studies. This clinical-radiological paradox prevents the use of MRI data as surrogate markers of disability in MS. A recent pilot study suggested a relationship between hypointense lesions on T1 MRI and disability. To assess in more detail the correlation of changes in hypointense lesion load on T1-weighted spin-echo MR images ("black holes") with changes in disability in MS, we studied 46 patients with clinically definite MS at baseline and after a median follow-up of 40 months. There was a significant correlation between baseline disability and hypointense lesion load (Spearman rank correlation coefficient [SRCC] = 0.46, p = 0.001). In secondary progressive patients, the rate of accumulation of these "black holes" was significantly related to progression rate (SRCC = 0.81, p < 0.0001). We speculate that the appearance of hypointense lesions is the MRI equivalent of a failure of remission. Overall, T1 lesion load measurements correlated better with clinical assessments than T2 lesion load measurements. Quantification of hypointense lesion load on T1-weighted spin-echo MRI helps to resolve the clinical-radiological paradox between disability and MRI and has the potential to be a surrogate marker of disability in MS.     

The sterols of Cucurbita moschata ("calabacita") seed oil

From the sterol fraction of seed oil from commercial Cucurbita moschata Dutch ("calabacita") delta 5 and delta 7 sterols having saturated and unsaturated side chain were isolated by chromatographic procedures and characterized by spectroscopic (1H and 13C-nuclear magnetic resonance, mass spectrometry) methods. The main components were identified as 24S-ethyl 5 alpha-cholesta-7,22E-dien-3 beta-ol (alpha-spinasterol); 24S-ethyl 5 alpha-cholesta-7,22E,25-trien-3 beta-ol (25-dehydrochondrillasterol); 24S-ethyl 5 alpha-cholesta-7,25-dien-3 beta-ol; 24R-ethyl-cholesta-7-en-3 beta-ol (delta 7-stigmastenol) and 24-ethyl-cholesta-7, 24(28)-dien-3 beta-ol (delta 7,24(28)-stigmastadienol).     

Optimal ("stent-like") acute angiographic results pursuable by traditional PTCA

OBJECTIVES: This study was undertaken: 1) to assess the efficacy of traditional PTCA in affording "optimal" initial dilatation (OID) of coronary stenoses (as assessed by on-line quantitative angiography) defined as a post-procedure residual lumen narrowing < or = 20%; 2) to determine clinical and angiographic correlates of these types of successes. BACKGROUND: Recent reports have shown that acute angiographic results achieved by traditional PTCA, resembling those obtainable by elective stenting, carry low risks of restenosis. However, safety and the ability of conventional PTCA to consistently provide acute stent-like results are still practically unknown. PATIENTS AND METHODS: Using a "standardized" procedural protocol intended to optimize acute angiographic results, 878 consecutive non-selected patients, 750 men and 128 women aged 29-78 years (mean 60.5 yrs) underwent PTCA on 1054 lesions. Compliant balloons reaching nominal dimensions at 6 atm and predicted balloon-artery ratios of 0.92-1.05 (mean 1.02) were used. An inflation pressure of 5 atm was gradually and slowly applied initially (usually sufficient to reach the point of plaque fracture). Inflation times of 60 seconds and step-increases in inflation pressure of 1 atm were subsequently utilized, until a large lumen with smooth contours (the nearest to normal) or any wall damage were detected by angiographic tests performed at each step. Inflations were stopped when, even in the presence of sub-optimal dilatation, the inflation pressure of 14 atm was reached (which usually corresponded to an effective balloon/artery ratio < 1.15). RESULTS: Overall traditional primary successes were 830 (94.5%) for patients and 1001 (95%) for lesions. Major complications, without mortality, were 24 (2.7%). CABS was necessary in 17 patients (1.9%) while acute myocardial infarction occurred in 7 patients (0.8%). OID was obtained in 65.4% of the treated lesions: 77.9% in type A, 73.9% in B1, 54.0% in B2 and 32.5% in C lesion subgroups of the AHA/ACC classification scheme. Multivariate analysis showed that no clinical variables significantly influenced OID. Lesion-related variables such as chronic occlusion, diffuse disease, length > 10 mm, heavily calcified and markedly angulated lesions emerged as (negative) determinants of success. CONCLUSIONS: Acute stent-like angiographic results are obtainable by conventional PTCA in a consistent percentage of eligible coronary lesions. Following a safe modality of balloon-stress application in performing angioplasty, probability of safely achieving OID of coronary stenoses is related to specific angiographic lesion characteristics.     

Interdigital pilonidal sinus ("barber's disease")--a rare occupational disease

Barber's disease is produced by short hairs that penetrate the interdigital spaces of the hands. The following chronic inflammatory reaction causes fistulas or sinuses and cysts. We present the case of a patient with interdigital pilonidal sinuses of all web spaces in both hands. Such an extensive case of this occupational disease has so far not been reported.     

Metabolism of 4-methylaminorex ("EU4EA") in the rat

Metabolism studies were conducted on 4-methylaminorex (4,5-dihydro-4-methyl-5-phenyl-2-oxazolamine [4-MAX]), a potent central nervous system stimulant that has emerged as a drug of abuse under the name "EU4EA", "EU4Euh", and "Ice". Tritiated norephedrine was cyclized with cyanogen bromide to form 3H-4-MAX, which was administered to rats at a dose of 10 mg/kg orally and intravenously. Radioactivity was excreted almost entirely in urine (40% of the dose was excreted by 24 h), primarily as the parent drug (60% of the total excretions were as the parent compound). Three metabolites were identified by high-performance liquid chromatography-tandem mass spectrometry with thermospray ionization: norephedrine, 5-phenyl-4-methyl-2-oxazolidinone, and 2-amino-5-(p-hydroxyphenyl)-4-methyl-2-oxazoline. Stability studies showed that 4-MAX in aqueous solution degraded very slightly to norephedrine upon standing. There was no evidence for glucuronide or sulfate conjugation. These results suggest that the metabolic fate of 4-MAX is similar to that of the amphetamines in that it is eliminated primarily unchanged but undergoes some slight oxidative deamination and aromatic hydroxylation. Hydrolytic degradation back to the synthetic precursor can also occur. There was no evidence for the hydrolysis of the oxazolamine ring to form a urea that has been reported for the demethylated congener aminorex. This suggests that 4-methyl substitution of the oxazoline ring may inhibit metabolism similar to the alpha-methyl substitution of beta-phenylethylamines.     

Ultrastructure of ischemic contracture of the left ventricle ("stone heart")

Myocardial biopsies from two patients who had developed "stone heart" (myocardial rigor mortis; ischemic contracture of the left ventricle) were studied by electron microscopy. The ultrastructure of tissue in stone heart, though ischemic in nature, differed from that of classic myocardial infarction in some respects. Apart from depletion of glycogen and distension of the sarcoplasmic reticulum and T-tubules, myofibrillar degeneration was much more widespread. Mitochondrial degeneration with active lysosomal autodigestion, disruption of the microcirculation, and lymphedema were prominent changes also observed. In the light of known clinical and experimental observations, our findings suggest that stone heart is an accelerated form of ischemic injury occurring in vulnerable (hypertrophied) hearts and is probably related to ischemia-triggered release of endogenous catecholamines.     

Suggested ("hypnotic") visual hallucinations: Experimental and phenomenological data.

Tested 74 female student nurses' responses to a pretreatment hallucination suggestion to see an object that was not present. Each S was then exposed to either hypnotic induction procedure or task motivational instructions, and was again tested on response to an equivalent posttreatment hallucination suggestion. Next, each S was assessed on the Barber Suggestibility Scale (BSS) and on a self-rating of hypnotic depth measure. Finally, Ss were interviewed individually by a "blind" E to determine their phenomenological experiences during the posttreatment hallucination suggestion. There were significant positive correlations between scores on the posttreatment hallucination suggestion and scores on the BSS, self-ratings of hypnotic depth, and pretreatment hallucination suggestion. Similar phenomenological experiences were reported by Ss tested under the hypnotic induction and task motivational treatments, and by Ss who reported that they "saw" and those who reported that they "vividly imagined" the suggested object. (22 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship of message unity ("pull") to the recipient's response potential.

"The hypothesis is that response potential is a function of message unity." It was tested by sending messages to potential buyers of vitamins and having them respond to a questionnaire. The messages were classified into 3 groups according to message unity. The results of this research, used as the basis for an MA thesis, verified the hypothesis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intubation dacryocystography in patients with a clinical diagnosis of chronic canaliculitis ("streptothrix")

Magnification dacryocystography in 18 patients with chronic infective canaliculitis showed dilatation and irregularity of the affected lacrimal canaliculi, with prominent filling defects in almost all cases. Filling defects are uncommon in other diseases of the canaliculi and serve to confirm the diagnosis.