Neuroleptic malignant syndrome associated with multiple joint dislocations in a trauma patient

The structure of the O-antigenic polysaccharide from Escherichia coli O141 has been determined. NMR spectroscopy and sugar and methylation analyses were the principal methods used. The sequence of the sugar residues could be determined by NOESY and heteronuclear multiple-bond connectivity (HMBC-) NMR experiments. The polysaccharide is composed of pentasaccharide repeating units with 1 O-acetyl group/repeating unit. The following structure, where Rha is 6-deoxymannose is concluded: carbohydrate sequence [see text].     

Disturbances of the retinal vessels as a result of Purtscher's retinopathy (author's transl)

A 31-year-old patient was buried at canal-building. He sustained Purtscher's retinopathy on his left eye. A fluorescein-angiography displayed six years after the trauma a large neovascular frond and intraretinal neovascular network. These findings demonstrate the severe lesions of the retinal microcirculation caused by the trauma.     

A case of multiple trauma following a motor cycle accident

This paper reports a fractured femur, jejunal laceration and a torn aorta in a young man who appeared reasonably well on admission to hospital. The diagnostic problems and treatment of this case are discussed.     

Pontine-crossed paralysis consequent to multiple trauma: case report

The case of a multiple trauma victim with a brain-stem injury, resulting in a syndrome of pontine-crossed paralysis, is presented. Demonstration of these disorders in the setting of multiple trauma is highly unusual, but the diagnosis is established quickly and accurately through magnetic resonance imaging. A possible mechanism of injury is presented for discussion.     

Adaptive computer use for a person with visual impairment

A single-subject research design that used multiple baselines across behaviors compared traditional adaptations (e.g., the use of readers) to adapted computer technologies for typical reading activities performed by an adult with severe visual impairment. A Macintosh IIci equipped with software that translated information displayed on the monitor into synthesized speech was paired with a page scanner and optical character recognition software to convert scanned images of printed text into computer documents. These computer technologies were applied to three reading behaviors: proofreading of word-processed documents, reading of printed research articles, and reading of common printed materials such as letters and instruction sheets. The findings demonstrated that the use of adapted computer technology, rather than traditional methods, increased the subject's reading efficiency and frequency. The increased functional independence that occurred as a result of the computer technology improved the subject's patterns of adaptation in reading-related tasks and improved the quality of her life.     

A case of bone marrow mastocytosis associated with multiple myeloma

Mastocytosis is a term used for a spectrum of disorders characterized by abnormal growth and accumulation of mast cells. The cutaneous variants of the disease have to be distinguished from systemic mastocytosis (SM), in which at least one extracutaneous organ is involved. In contrast to cutaneous mastocytosis, SM is often associated with another hematologic neoplasm. In most cases clonal myeloid malignancies such as a myeloproliferative or myelodysplastic syndrome occur. In a few cases of SM, however, clonal lymphoid disorders have been described. We here report on a case of SM associated with multiple myeloma. At first presentation, the 48-year old female patient showed monoclonal IgGlambda gammopathy and bone marrow (BM) mastocytosis, but no BM plasma cell infiltrates. Eight years later, the patient presented with BM mastocytosis and overt multiple myeloma. The co-existence of myeloma and mastocytosis was demonstrable by staining serial BM sections with antibodies against mast cell tryptase, CD68R, and the plasma cell marker VS38c. Interphase FISH analysis of BM sections revealed a numeric gain of chromosome 5 and chromosome 7 in the plasma cells but not in the mast cell infiltrates, thereby confirming the presence of two different neoplastic cell populations. To our knowledge, this is the first report describing the co-existence of multiple myeloma and mastocytosis.     

Erythrocytosis associated with multiple cutaneous leiomyomata: report of a case with demonstration of erythropoietic activity in the tumour

A patient with leiomyomata of the skin and erythrocytosis is reported. After surgical removal of the larger skin tumours there was remission of the haematologic abnormalities and the erythrocytosis and the red cell mass decreased to normal levels. The raised serum erythropoietin levels were reduced but remained slightly elevated and less than those recorded prior to surgery. Tumour extracts contained significant erythropoietic activity. This seems to be the first documented case of erythrocytosis associated with skin leiomyomata.     

Occlusal trauma: a case in perspective

Spinocerebellar ataxia type 1 (SCA1) is an autosomal dominant neurodegenerative disorder caused by expansion of a CAG trinucleotide repeat which codes for glutamine in the protein ataxin-1. We have investigated the effect of this expansion on ataxin-1 by immunoblot analysis. The wild-type protein is detected in both normal and affected individuals; however, a mutant protein which varies in its migration properties according to the size of the CAG repeat is detected in cultured cells and tissues from SCA1 individuals. The protein has a nuclear localization in all normal and SCA1 brain regions examined but a cytoplasmic localization of ataxin-1 was also observed in cerebellar Purkinje cells. Our data show that in SCA1, the expanded alleles are faithfully translated into proteins of apparently normal stability and distribution.     

Traffic multiple trauma patient with head injuries: a study of 146 cases

146 cases of traffic multiple trauma associated with head injuries were studied. There was a significant difference in the ratio of associated injuries in various parts of the body. The three most encountered parts were chest, shoulder and leg. Death were mainly due to severe head injury, chest injury and shock. Atypical ushing syndrome was due to severe blood loss, even intracranial hypertension existed. The blood pressure decreased rapidly after operation. Since comatous patients were unable to provide chief complaint, misdiagnosis occurred during emergency stage.     

Torsades de pointes: a case with multiple variables

PURPOSE: The human medulloblastoma cell line D283 Med (4-HCR), a line resistant to 4-hydroperoxycyclophosphamide (4-HC), displays enhanced repair of DNA interstrand crosslinks induced by phosphoramide mustard. D283 Med (4-HCR) cells are cross-resistant to 1,3-bis(2-chloroethyl)- -nitrosourea, but partial sensitivity is restored after elevated levels of O6-alkylguanine-DNA alkyltransferase (AGT) are depleted by O6-benzylguanine (O6-BG). Studies were conducted to define the activity of 4-HC and 4-hydroperoxydidechlorocyclophosphamide against D283 Med (4-HCR) after AGT is depleted by O6-BG. METHODS: Limiting dilution and xenograft studies were conducted to define the activity of 4-HC and 4-hydroperoxydidechlorocyclophosphamide with or without O6-BG. RESULTS: The activity of 4-HC and 4-hydroperoxydidechlorocyclophosphamide against D283 Med (4-HCR) was increased after AGT depletion by O6-BG preincubation. Similar studies with Chinese hamster ovary cells, with or without stable transfection with a plasmid expressing the human AGT protein, revealed that the AGT-expressing cells were significantly less sensitive to 4-HC and 4-hydroperoxydidechlorocyclophosphamide. Reaction of DNA with 4-HC, phosphoramide mustard, or acrolein revealed that only 4-HC and acrolein caused a decrease in AGT levels. CONCLUSIONS: We propose that a small but potentially significant part of the cellular toxicity of cyclophosphamide in these cells is due to acrolein, and that this toxicity is abrogated by removal of the acrolein adduct from DNA by AGT.     

Crystalline retinopathy associated with chronic retinal detachment

OBJECTIVE: To describe the presence of crystalline opacities located at the level of the inner retina in patients with chronic retinal detachment. METHODS: We reviewed the clinical records, fundus photographs, and fluorescein angiograms of patients with superficial retinal crystals in the presence of a chronic retinal detachment. RESULTS: Eleven eyes in 11 patients with chronic retinal detachment were found to have these peculiar crystalline opacities on the inner retinal surface. In 5 patients, the crystalline opacities were noted on initial assessment prior to surgery and persisted without change in appearance or number after surgical repair. In 6 eyes, the crystals were not appreciated until after surgical repair of the retinal detachment. The crystals appeared similar in all 11 eyes, were highly refractile, and were located in the posterior pole. Eight of the eyes had retinal detachment associated with retinal dialysis and 6 of these had a history of trauma. There was a definite history of vitreous hemorrhage in 2 eyes. The crystals did not seem to be associated with any visual deficit. CONCLUSIONS: Chronic retinal detachment can be associated with crystals on the inner retinal surface. The cause and composition of these crystals are unknown. They seem to be visually inconsequential and unchanging.     

Urolithiasis associated with Crohn's disease: a case report

We report a case of urolithiasis caused by surgical treatment for Crohn's disease. A 28-year-old woman was referred to our department for further examination of renal stones from the medical department in September, 1995. She suffered from Crohn's disease and had a history of jejuno-ileal resection because of perforation of the ileum in 1988. Radiographs revealed multiple bilateral renal stones, and the urine oxalate concentration was elevated. She was treated with extracorporeal shock wave lithotripsy and the administration of sodium bicarbonate and citrate, but these treatments did not prevent recurrence and enlargement of stones. Renal function was gradually worsened and we performed transurethral lithotomy and percutaneous nephrolithotripsy. The stones were mainly composed of oxalate calcium monohydrate. A renal biopsy was performed at the operation, showing deposition of crystals in almost all renal tubules. Diet therapy (low oxalate and low fat) and the administration of sodium bicarbonate and citrate were performed strictly and recurrence was not recognized 10 months after complete removal of the stones.     

A case report of multiple hepatic hilar cyst associated with hepatocellular carcinoma

Two types of cDNA encoding gonadotropin beta subunits (GTH beta) were isolated from a cDNA library prepared from pituitary gland of Baikal omul (Coregonus autumnalis migratorius Georgi). The nucleotide sequences of cDNA were determined. The CTHI beta and GTHII beta cDNAs code for polypeptides of 137 and 142 amino acids, respectively. Both of them include a putative signal peptide of 24 amino acids. The predicted amino acid structures of omul gonadotropins were compared with those of other vertebrate species.