Free me from this nail! Please!

Ingrowing toenails are a very frequent pathology in children and adolescents. There is an anatomic component, but also other factors, such as inadequate shoes and incorrect nail-trimming. We treated 47 patients with 69 ingrowing toenails, between one and 15 years of age. The evolution time was one month to 10 years and 11 patients had precedent surgeries. Lateral electrosurgical matricectomy was the choice technique. With a follow up of at least eight months, there is only one case of recurrence.     

The distribution and significance of CNS adrenoceptors examined with in situ hybridization

Several of the established alpha 1-, alpha 2- and beta-adrenoceptors have now been isolated and cloned. The in situ hybridization method has been used to map the distribution of many of these adrenoceptors within cells of the CNS. These studies add complementary and new information to our knowledge of adrenoceptor localization provided previously by radioligand-mediated autoradiography. Neuronal cell groups containing one or more mRNAs for seven adrenoceptor subtypes throughout the rat CNS have been mapped. In the present review Anthony Nicholas, Tomas H?kfelt and Vincent Pieribone will examine these localizations and discuss the additional information these maps supply, as well as some implications for understanding central noradrenaline and adrenaline systems.     

A new serum alpha-amylase assay of high sensitivity

This four-week study included 336 patients aged eleven to 80 years with complaints suggestive of stress-related emotional lability, and was intened to discover a possible relationship between the effects of pimozide and the initial psychic defence phenomena in this condition: the discouragement type of reaction was registered in 243 cases, overcompensation in 80, and a mixture of the two in the remaining 13. In most cases, the daily dose of pimozide remained close to the initial 2 mg, and treatment could be entirely discontinued after three-four weeks in five patients. Control evaluation after two and four weeks revealed a significant improvement of all pathological scores of a 17-item questionnaire, but failed to show any susbstantial difference between the three subgroups. No side-effects were reported.     

Histopathologic observations on human eyes following cyclocryotherapy for glaucoma

This is a clinicopathologic study of 12 human eyes that previously had been subjected to cyclocryotherapy. In ten cases detailed information was available regarding technical factors, such as temperature of the cryoprobe at the time of surgery and the like. The interval from treatment to enucleation ranged from 12 days to 4 1/2 years. On pathologic examination permanent, often massive, destruction and scarring of both layers of the ciliary body's epithelium was found in all 12 patients. The pigment epithelium was more susceptible to cryosurgical damage than was the nonpigment epithelium. Scarring of the ciliary body stroma and muscle occurred in 11 patients, scleral damage was present in 9, and a fibrous membrane lined the inner surface of the ciliary body in 5. This study indicates that cyclocryotherapy is an effective way of inducing permanent destruction of the human ciliary epithelium. Factors other than regrowth of epithelial cells account for failure to control the intraocular pressure in those patients in whom cyclocryotherapy proves ineffective.     

Assessment of spinal musculature using surface electromyographic spectral color mapping

STUDY DESIGN: A technique is described for analyzing electromyogram data from lumbar spinal muscles, with special reference to discrimination of people with back pain. The ability to discriminate was evaluated in 99 people (61 healthy and 38 with chronic or acute back pain), and the influence of load was assessed. OBJECTIVES: To evaluate methods of analysis of complex electromyogram data and to assess correlation of electromyogram information with clinical condition in people with and without back pain. SUMMARY OF BACKGROUND INFORMATION: In previous analyses of electromyogram data, only a small part of the data have been used. Spinal muscular decompensation has been postulated in chronic low back pain, but there has been no direct demonstration of this phenomenon. Objective measures are still elusive. METHODS: Lumbar spinal surface electromyograms were recorded during an isometric lifting task. The data were represented graphically as color-coded plots of electromyogram frequency, time, and electromyogram amplitude. Spectral width at half-peak amplitude (spectral half width) was calculated from the digitized, summed data. Ninety-nine people were tested: 48 men (29 with no recent [in the past 2 years] history of back pain, 16 with chronic back pain, 3 with acute back pain) and 51 women (32 with no recent back pain and 19 with chronic back pain). RESULTS: Spectral color maps in people with chronic back pain were markedly different from those in healthy people. Spectral half width was greater in people with chronic back pain than in healthy people (P < 0.01). Blinded analysis of spectral color maps allowed discrimination of people with back pain from healthy people with a sensitivity of 76% and a specificity of 81%. People with a history of back pain had markedly variable half widths. CONCLUSIONS: A new method of analysis of electromyogram data from lumbar spinal muscles has allowed discrimination between people with back pain and healthy people. This provides direct evidence of a correlation between muscular electrical function, measured by electromyogram, and low back pain. This technique may have potential as an objective measurement tool.     

Leukocyte integrin very late antigen-4/vascular cell adhesion molecule-1 adhesion pathway in splanchnic artery occlusion shock

Two MAIPA (monoclonal antibody [MAb] immobilization of platelet antigen) assays were performed to determine (a) autoantibodies to platelet glycoproteins (GP) and (b) serum antibodies recognizing mouse MAbs used in the assay. In MAIPA I, control platelets were incubated simultaneously with human serum and a mouse MAb to a platelet glycoprotein (GP IIb-IIIa, Ib-IX, Ia-IIa, IV and p24). In MAIPA II, the control platelets were incubated first with the human serum and then, after washing, with the selected mouse MAb. A series of 25 patients with autoimmune thrombocytopenic purpura (ATP) associated or not with other autoimmune states were examined. Autoantibodies (both MAIPA I and MAIPA II positive) or anti-mouse Abs (MAIPA I positive and MAIPA II negative) were frequent in both groups of patients. Statistically significant differences existed in the incidence of anti-mouse Abs between patients (56.5%) and healthy donors (10%). This suggests that their production may be related to thrombocytopenias associated with autoimmune disease. We speculate that the presence of anti-mouse antibodies could reflect an abnormality in the immunological modulation of the idiotypic network.