Fatal rhino-orbital-cerebral zygomycosis

Rhinocerebral zygomycosis is usually an aggressive, fulminant and, at times, fatal disease most often affecting poorly controlled diabetics of all ages. We report the case of a 13-month-old white boy, a previously undiagnosed diabetic. He came to our hospital with recurrent epistaxis, decreasing consciousness, and a small visible infection at the inner canthus of the left eye. Initial evaluation revealed that the patient was in diabetic ketoacidosis. Despite aggressive medical and surgical treatment, his condition deteriorated rapidly, including the development of diabetes insipidus, and he died 4 days after admission. At autopsy, he was found to have fungal cerebritis (Rhizopus) with multiple areas of infarction and massive cerebral edema.     

Nissen fundoplication by laparoscopy

Short term results following laparoscopic Nissen fundoplication were evaluated in 31 patients with symptomatic gastroesophageal reflux. 6 were females and 26 males, and they ranged in age from 5 months to 64 years (mean: 4.9 years in 19 younger than 18 years, and 39.3 years in 12 adults). Most of the adults who complained of pain and heartburn underwent pH monitoring, endoscopy, and manometry as needed. Milk scan was the most useful diagnostic tool for the evaluation of the children, who suffered mainly from gastroesophageal-related pulmonary disease. Indications for laparoscopic operation were identical with those for conventional open Nissen fundoplication. 1 case of dysautonomia died postoperatively; the rate of complications, mostly minor, was 22.5%. 3 patients required conversion to open Nissen fundoplication due to cardiorespiratory instability secondary to pneumothorax in 2, and to esophageal perforation in the third. 5 adults developed temporary dysphagia. 3 children had only partial improvement in their pulmonary disease following the operation, while the other 15 had complete relief. The total time for the laparoscopic operation averaged 245 minutes in adults, and 228 in children. Discharge was usually on the fourth postoperative day in adults (mean: 6.0 days). Regurgitation and heartburn were cured in 10 out of 11 adults (91%). All parents of children were satisfied. Symptomatic outcomes following laparoscopic Nissen fundoplication compare favorably with those of open surgery with respect to mortality, complications, and outcome.     

New early tertiary primates and a reappraisal of some Plesiadapiformes

A new study of specimens of paromomyid and microsyopid primates clarifies evolution in these primates and reuslts in new concepts of each family. The paromomyid Phenacolemur and its former synonym, Ignacius, are distinct genera, each with new Early Wasatchian species, Plesiolestes, Palaechthon, Torrejonia, Palenochtha, Navajovius, Micromomys, and Tinimomys are removed from the Paromomyidae and transferred to the Microsyopidae. The Plesiadapiformes are classified in three groups which may be differentiated on incisor and molor structure: Plesiadapoidea (Plesiadapidae, Carpolestidae, and Saxonellidae), Microsyopidae, and Paromomyidae. The Paromomyidae, Microsyopidae (and its two subfamilies), and several genera are rediagnosed in the light of new comparative evidence.     

Effect of Corynebacterium parvum, methanol-extraction residue of BCG, and levamisole on macrophage random migration, chemotaxis, and pinocytosis

Three parameters of macrophage function: random migration, chemotaxis, and pinocytosis, were studied in the guinea pig after administration of Corynebacterium parvum, methanol-extraction residue of BCG, and levamisole (LMS), a synthetic anthelmintic. Macrophage migration studies were performed with a modified Boyden chamber. Pinocytosis was assessed by the uptake of colloidal 198Au. After ip administration, each of the three immunostimulators induced an increase in macrophage chemotactic responsiveness and, to a lesser extent and duration, in random motility. Kinetic, dose-response, and time course data for the effect of each agent on macrophage movement were explored. LMS was the most effective stimulator of macrophage activation, which occurred earlier and persisted longer than it did with the other agents. Macrophages from animals receiving each of the agents showed enhanced pinocytosis. Measurement of macrophage random migration, chemotaxis, and pinocytosis appeared to provide a rapid and quantitative assessment of several parameters of macrophage function and, when studied with other immunologic parameters, may provide useful tools for the evaluation of potential immunoadjuvants.     

Failure of LH and/or prolactin to prevent PGF 2alpha-induced luteolysis of ovine corpora lutea

Infusions of phosphate buffered saline, LH (4 microgram/min or 14 microgram/min), prolactin (42 microgram/min) or LH (4 microgram/min) plus prolactin (42 microgram/min) for 12 hr did not prevent luteolysis following intramuscular injections of prostaglandin F2alpha-tham salt two and six hr after beginning the infusion. Likewise, these treatments did not delay luteolysis since a similar rate of decline in peripheral plasma progesterone occurred in all groups. It was concluded that elevation of serum concentrations of LH and prolactin to high levels had no effect on PGF2alpha-induced luteolysis on day 8 following induced ovulation.     

Measurement of plasma contrast levels during excretory urography

Ultraviolet spectrophotometry permits easy measurement of plasma levels of intravenously injected contrast media. The initial results are described from the determination of plasma methylglucamine iothalamate (Conray 60) levels during routine excretory urography in 10 normal patients. This simple procedure has many potential applications in the investigation of contrast media physiology.