Ulcerative systematized porokeratosis (Mibelli)

An unusual clinical variant of porokeratosis (Mibelli's disease) appeared in a patient soon after birth; the lesions were widely distributed mostly on the right half of the body. Spontaneous recurrent ulcerations occurred over certain sites. The right foot was grossly deformed as a result of atrophic scarring after ulcerations. Biopsy specimens of the classical lesion showed cornoid lamella. It is suggested that the term "ulcerative systematized porokeratosis" be used to describe this clinical variant of porokeratosis.     

Role of genotypic and environmental factors in the origin of cerebral circulatory disorders in young persons

The paper is concerned with the results of a comparative analysis of clinical signs in cerebral crises, strokes and other symptoms seen in 2 groups of patients younger than 45 years of age, and differing only in the presence (104 cases) or absence (108 cases) of hereditary-familial aggravation by a cardio-vascular pathology. Although in the first group of patients there was a certain tendency towards a more severe disorder of cerebral circulation, it was not possible to mark any statistically significant differences in the clinico-biochemical indices. At the same time different negative environmental influences (alcohol abuse, brain injuries, severe acute and chronic mental traumatization, frequent exacerbations of focal chronic infections of the ENT and the lungs, etc.) and a combination of 2 or 3 of them were significantly more frequently seen in patients without hereditary aggravation (34.8%) rather then with it (10.7%). A conclusion is being made that genotypical factors do not play a decisive role in the etiology of cerebral vascular disorders in young people. They only condition a lesser stability of the organism to unfavourable environmental factors and their different combinations.     

Colposcopy and the management of cervical intraepithelial neoplasia

The stable, bound iodine in the thyroid colloid of Triturus helveticus has been studied with the electron microprobe. Some animals show a normal development. Others are accidentally neotenic due to certain ecological conditions. The values of punctate iodine concentrations (CPI) have been computed and expressed in relative units (counts/s). The mean CPI per lumen is very variable from one follicle to another in the same thyroid section. During normal development, the mean CPI per animal is generally higher in metamorphosing individuals than in larvae. During development with neoteny, the mean CPI per animal attains high values if the larval state is maintained in its totality; the CPI decreases in partially metamorphosed animals, but increases again after metamorphosis. The amount of halogen contained in the thyroid colloid has been computed in relative units (colloid iodine pool). Throughout normal development, the pool remains small if the animals have not attained the adult state. In increases considerably in entirely larval neotenic newts, decreases during metamorphosis but increases afterwards. In totally neotenic newts, the thyroid gland receives only a low hypophyseal stimulation and reacts as the thyroid gland of various hypophysectomized Urodeles. Our results pose the problem as to whether TSH regulates the transepithelial iodine flows, which permit the expansion of the colloid iodine pool, when this hormone is secreted at a very low levels.     

The contribution of a bacterially isolated environment to the prevention of infection in seriously burned patients

A new system of patient protection from bacterial crossinfection called the Bacteria Controlled Nursing Unit (BCNU) is described, based on strict environmental control of a 6 x 10 foot area surrounding the patient's bed rather than the entire patient room or isolation ward, plus the ability to deliver all medical care without entering the protective environment and maintaining all monitoring, life support, and i.v. equipment outside the controlled environment. The clinical effectiveness of this system in the treatment of burn patients has been studied and compared with the effectiveness of single room isolation on a burn isolation ward and conventional isolation techniques on an open burn ward. The studies show that the BCNU is significantly more effective in preventing bacterial cross-contamination than conventional precautions (3.8% vs. 13.1%, P < 0.001; and 8% vs. 22.8%, P < 0.001) over a two and four week period. The studies also indicate that there was a significant increase in the probability of infection occurring following cross-contamination than occurring after auto-contamination (65% vs. 39%, P < 0.005), emphasizing the importance of preventing cross-contamination in reducing the overall infection rate in seriously burned patients. Clinical evaluation of the unit proved it to be compatible with intensive nursing and medical care without increasing the nurse to patient ratio. The unit provided sufficient control of bacterial cross-infection to allow reduction in mortality and improvement in the effectiveness of burn care through routine prompt excision of burn eschar and immediate wound closure to be carried out in severe and massively burned patients without a limiting threat of bacterial burn wound sepsis.     

Effects of exercise on fluid exchange and body composition in man during 14-day bed rest

To determine the cause of the body weight loss during bed rest (BR), fluid balance and anthropometric measurements were taken from seven men (19-21 yr) during three 2-wk BR periods which were separated by 3-wk ambulatory recovery periods. Caloric intake was 3,073 +/- 155 (SD) kcal/day. During two of the three BR periods they performed supine isotonic exercise at 68% of VO2max on the ergometer for 1 h/day; or supine isometric exercise at 21% of maximal leg extension force for 1 min followed by a 1-min rest for 1 h/day. No prescribed exercise was given during the other BR period. During BR, body weight decreased slightly with no exercise (-0.43 kg, NS), but decreased significantly (P less than 0.05) by -0.91 kg with isometric and by -1.77 kg with isotonic exercise. About one-third of the weight reduction with isotonic exercise was due to fat loss (-0.69 kg) and, the remainder, to loss of lean body mass (-0.98 kg). It is concluded that the reduction in body weight during bed rest has two major components: First, a loss of lean body mass caused by assumption of the horizontal body position that is independent of the metabolic rate. Second, a loss of body fat content that is proportional to the metabolic rate.     

Feasibility of LC/TOFMS and elemental database searching as a spectral library for pesticides in food

Traditionally, the screening of unknown pesticides in food has been accomplished by GC/MS methods using conventional library-searching routines. However, many of the new polar and thermally labile pesticides are more readily and easily analysed by LC/MS methods and no searchable libraries currently exist (with the exception of some user libraries, which are limited). Therefore, there is a need for LC/MS libraries that can detect pesticides and their degradation products. This paper reports an identification scheme using a combination of LC/MS time-of-flight (accurate mass) and an Access database of 350 pesticides that are amenable to positive ion electrospray. The approach differs from conventional library searching of fragment ions. The concept consists of three parts: (1) initial screening of possible pesticides in actual market-place fruit extracts (apple and orange) using accurate mass and generating an accurate mass via an automatic ion-extraction routine, (2) searching the Access database manually for screening identification of a pesticide, and (3) identification of the suspected compound by accurate mass of at least one fragment ion and comparison of retention time with an actual standard. Imazalil and iprodione were identified in apples and thiabendazole in oranges using this database approach.     

Refusal to eat in the elderly

Refusal to eat by the elderly, and subsequent malnutrition, occurs in both institutional and community settings. Causes include physiologic changes associated with aging, mental disorders such as dementia and depression, and medical, social, and environmental factors. Treatment approaches call for management of these causes while considering the roles that medicine, ethics, and culture play in the process.