Biomedical subjects
Publications and source records attributed to R J Hills.
The Karapandzic technique is easy to perform and provides excellent results for full thickness defects larger than one-third of the lower lip. The flap is slid and rotated into position while an intact neurovascular pedicle is maintained. Accordingly, sensation and circulation of the lip is preserved and function of the orbicularis oris muscle is maintained.
The coefficient of friction of 14 prescribable bath emollients was determined using porcine skin attached to a loaded plunger placed through a bearing in a friction-measuring carriage, held above a reciprocating table powered by a DC motor. The carriage was mounted in low-friction rollers, and restrained by a piezo-electric force transducer connected to an amplifier and recorder. Friction was measured at room temperature, and at 45 degrees C. Emulsifying ointment and Bath E45 had the highest coefficients of friction, at room temperature and 45 degrees C, respectively, and Emmolate and Hydromol had the lowest. Nine of the 14 emollients had a lower coefficient of friction at 45 degrees C, one had a coefficient of friction which was the same at both temperatures, and four had a coefficient of friction which was higher at 45 degrees C.
We report a patient who developed cutaneous metastases in a lymphoedematous leg, from a follicular centre cell lymphoma, in a setting of lymphoedema praecox and recurrent deep-vein thromboses. To our knowledge, this is the first report of such a case. We discuss the possible causes for this localization.
While the relationship of aquagenic pruritus (AP) to haematoproliferative conditions is well-recognized, an association with histiocytic disorders has not previously been described. The case of a child with both AP and juvenile xanthogranulomata (JXG) is reported. The cutaneous lesions were typical of JXG, both clinically and histologically, and in addition there were radiological changes consistent with JXG in the lungs. AP is rare in childhood and the coincidental occurrence with unusually extensive JXG seems unlikely.
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Many combinations of methotrexate and folic or folinic acid have been used to limit the side effects of methotrexate therapy in psoriasis or psoriatic arthropathy. Methotrexate inhibits the enzyme dihydrofolate reductase and prevents the formation of DNA and RNA. Folinic acid, the 5-formyl derivative of tetrahydrofolic acid, is the active form of folic acid. We have confirmed in 5 patients that continuous administration of folinic acid with weekly oral methotrexate prevents improvement of psoriasis. When folinic acid was ceased on the day of methotrexate in these patients their psoriasis improved. Five other patients with previous sensitivity to methotrexate, forcing cessation of therapy, were given weekly oral methotrexate and folinic acid every day except the day of methotrexate. Marked improvement of psoriasis or arthropathy occurred in each case without side effects. This method precisely limits the exposure to methotrexate, allowing a therapeutic effect without complication even in those patients who exhibit methotrexate sensitivity.