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An orbital cyst is a rare complication of orbital trauma and exenteration. Infections of such cysts have not been described, and are potentially dangerous unless treated immediately. The authors describe a case of delayed treatment of such an infected cyst, which resolved following surgical drainage. The potentially hazardous outcome makes knowledge of such cases important.
The results of electroencephalographic screening of 3225 inpatients from a community general hospital psychiatric service were reviewed. When patients with a prior diagnosis of epilepsy were excluded, epileptiform abnormalities were discovered in 2.6% of patients. Patients younger than age 25 years and patients with a diagnostic impression of anorexia nervosa, recent barbiturate abuse, or nonpsychotic explosive behavior were significantly more likely to have epileptiform abnormalities. The use of certain therapeutic agents was associated with a significant excess of epileptiform abnormalities in patients aged 25 years and older. The most frequently encountered epileptiform abnormalities were photoconvulsive responses. Focal temporal epileptiform abnormalities were detected in only four patients without a prior diagnosis of epilepsy. The diagnosis of epilepsy on the basis of a primarily psychiatric presentation and the discovery of epileptiform abnormalities on electroencephalographic screening should be approached with caution.
Because adjuvant chemotherapy has resulted in only modest prolongation of survival for patients with lung cancer, investigators have turned to the evaluation of alternative treatment strategies for this patient population. Immunotherapy with Bacillus Calmette Guerin, Corynebacterium parvum, and levamisole has been evaluated in several prospective randomized trials, and no study has shown a statistically significant difference in overall survival. Interferon has been evaluated in three trials of adjuvant therapy after response to chemotherapy for small cell lung cancer. Different interferon preparations were used, but none of the trials showed a significant prolongation of survival. The retinoids have been evaluated as adjuvant treatment after complete resection of stage IN-SCLC. One trial showed a reduction in second primary tumors, and in particular, tumors to tobacco smoking in patients treated with retinyl palmitate. A second trial using 13-cis retinoic acid is ongoing in North America. In the last decade, several inhibitors of angiogenesis have been identified, and they are now beginning to be evaluated in the clinical setting. The National Cancer Institute of Canada Clinical Trials Group and the European Organization for Research and Treatment of Cancer have initiated a study of adjuvant marimastat, a metalloproteinase inhibitor, for patients who have responded to induction chemotherapy for small cell lung cancer. This is the first adjuvant antiangiogenesis factor trial to be initiated for any tumor type. Other investigational agents which are currently undergoing Phase I and Phase II testing include monoclonal antibodies which may inhibit tumour cell growth by binding to growth factors, or which may be conjugated to toxins or chemotherapeutic agents which result in tumour cell death. In the last decade, we have witnessed an explosion in our knowledge and understanding of the regulation of normal and neoplastic cell growth at the molecular level. It remains only speculative at this time as to whether manipulation of abnormal genes in malignant cells will be clinically possible, and whether treatment of this sort may be applied in an adjuvant setting.
Construction, optimization, and testing of a novel single-sided configuration for a semi-permeable [poly(dimethylsiloxane); PDMS] membrane introduction system for mass spectrometry is described. On-line detection of semi-volatile organic compounds of environmental interest is shown, including lindane (a pesticide), hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) (an explosive), butylated hydroxytoluene (BHT) (an antioxidant), 1,2-dichlorobenzene, dimethylmethyl phosphonate (DMMP) (a chemical warfare agent simulant) and naphthalene. The technique has limits of detection in the sub-ppb range. with rise times of 4 to 7 s and fall times of 12 to 36 s and a response that is linear over 4 orders of magnitude (from 0.1 ppb to 1000 ppb for DMMP). The cycle time, from crude air sampling to acquisition of results, is approximately 1 min. No sample preparation is necessary.
BACKGROUND: There has been an explosion in the development of hormonal therapies for the treatment of breast cancer. Several new agents have been approved for the treatment of breast cancer in the metastatic setting, and trials are ongoing in the adjuvant and prevention setting to improve hormonal therapy for the prevention and treatment of breast cancer. METHODS: The literature on new hormonal therapies for the treatment of breast cancer is reviewed, with an emphasis on newer agents. RESULTS: Two antiestrogens are now approved in the United States for the treatment of metastatic breast cancer. Other antiestrogens have activity in metastatic breast cancer as well as in osteoporosis. Newer pure antiestrogens may overcome resistance to tamoxifen. Several aromatase inhibitors are available for the treatment of metastatic breast cancer. CONCLUSIONS: Many hormonal agents are now available for both adjuvant and advanced disease settings. Developments will depend on clarifying mechanisms of resistance to antiestrogens and identifying new classes of agents that lack cross-resistance to standard therapy.
During the period 1971-76, 1055 patients with fresh burns were treated at our hospital. Of these, 461 (88 females, 373 males) had sustained burns on altogether 783 hands. This amounts to 45% of the total number of fresh burns. In 322 cases both hands were involved, amounting to 31% of all cases of fresh burns, or 70% of all patients with burned hands. Whereas 82% of patients with hand burns had injuries to both hands, only 10% had sustained an injury to the right hand alone and 8% to the left hand alone. Cases of burns limited to the hands alone accounted for only 4.7% of all burn injuries. The main cause of burn injuries was thermal accident--most often steam explosions and the spraying of scalding liquids. The total number of hands injured by thermal agents totalled 707, i.e. 90% of all burned hands. Most of these were deep skin burns. Chemical agents were mainly responsible for this type of burn, whereas electrical burns were chiefly full thickness skin injuries. Analysis of the location of burns showed that 643 (82%) hands of the altogether 783 injuries sustained involved the wrist, 620 (79%) the metacarpus, 684 (87%) of the fingers. Some 321 hand burns (41%) were of a circumferential nature. A majority of burned hands were injured on the dorsal surface. The burn injuries of hands in 246 (53%) persons were connected with their professional work.
BACKGROUND: The practice of traditional medicine for the control of fertility in rural Ethiopia is based on folk use of numerous antifertility herbs and Achyranthes aspera is one of these used for this purpose. Many plants are known to possess anti-fertility effect through their action on hypothlamo-pituitary-gonadal axis or direct hormonal effects on reproductive organs resulting in inhibition of ovarian steroidogenesis. OBJECTIVES: The present study focused to investigate the effect of methanolic leaves extract of Achyranthes aspera L. on some indicators for anti-fertility activities such as abortifacient, estrogenesity, pituitary weight, and ovarian hormone level and lipids profile in female rats, in attempt to validate the traditional claim. METHODS: The abortifacient effect of the methanolic extract of the leaves of Achyranthes aspera was determined by counting the dead fetuses in vivo. Effect on estrogenesity was assessed by taking the ratio of the uterine weight to body weight. The ratio of the pituitary weight to body weight was also calculated. The effect of the extract on the level of ovarian hormones and lipid profile was evaluated using electrochemiluminescence immunoassay. RESULTS: The extract showed significant (p<0.05) abortifacient activity and increased pituitary and uterine wet weights in ovarectimized rats. The extract, however, did not significantly influence serum concentration of the ovarian hormones and various lipids except lowering HDL at doses tested. CONCLUSION: The methanolic leaves extract of Achyranthes aspera possesses anti-fertility activity, which might be exploited to prevent unwanted pregnancy and control the ever-increasing population explosion.
Hexachloroethane is used in organic synthesis as a retarding agent in fermentation, as a camphor substitute in nitrocellulose, in pyrotechnics and smoke devices, in explosives, and as a solvent. In previous long-term gavage studies with B6C3F1 mice and Osbourne-Mendel rats (78 weeks of exposure followed by 12-34 weeks of observation), hexachloroethane caused increased incidences of hepatocellular carcinomas in mice. However, survival of low and high dose rats was reduced compared with that of vehicle controls, and the effects on rats were inconclusive. Therefore, additional toxicology and carcinogenesis studies were conducted in F344/N rats by administering hexachloroethane (approximately 99% pure) in corn oil by gavage to groups of males and females for 16 days, 13 weeks, or 2 years. Genetic toxicology studies were conducted in Salmonella typhimurium and in Chinese hamster ovary (CHO) cells. Urinalysis was performed in conjunction with the 13-week studies. Sixteen-Day Studies: In the 16-day studies (dose range, 187-3,000 mg/kg), all rats that received 1,500 or 3,000 mg/kg and 1/5 males and 2/5 females that received 750 mg/kg died before the end of the studies. Final mean body weights of rats that received 750 mg/kg were 25% lower than that of vehicle controls for males and 37% lower for females. Compound-related clinical signs seen at 750 mg/kg or more included dyspnea, ataxia, prostration, and excessive lacrimation. Other compound-related effects included hyaline droplet formation in the tubular epithelial cells in all dosed males and tubular cell regeneration and granular casts in the tubules at the corticomedullary junction in the kidney in males receiving 187 and 375 mg/kg. Thirteen-Week Studies: In the 13-week studies (dose range, 47-750 mg/kg), 5/10 male rats and 2/10 female rats that received 750 mg/kg died before the end of the studies. The final mean body weight of male rats that received 750 mg/kg was 19% lower than that of vehicle controls. Compound-related clinical signs for both sexes included hyperactivity at doses of 94 mg/kg or higher and convulsions at doses of 375 or 750 mg/kg. The relative weights of liver, heart, and kidney were increased for exposed males and females. Kidney lesions were seen in all dosed male groups, and the severity increased with dose. Papillary necrosis and tubular cell necrosis and degeneration in the kidney and hemorrhagic necrosis in the urinary bladder were observed in the five male rats that received 750 mg/kg and died before the end of the studies; at all lower doses, hyaline droplets, tubular regeneration, and granular casts were present in the kidney. No chemical-related kidney lesions were observed in females. Foci of hepatocellular necrosis were observed in several male and female rats at doses of 188 mg/kg or higher. Dose selection for the 2-year studies was based primarily on the lesions of the kidney in males and of the liver in females. Studies were conducted by administering hexachloroethane in corn oil by gavage at 0, 10, or 20 mg/kg body weight, 5 days per week, to groups of 50 male rats. Groups of 50 female rats were administered 0, 80, or 160 mg/kg on the same schedule. Body Weight and Survival in the Two-Year Studies: Mean body weights of high dose rats were slightly (5%-9%) lower than those of vehicle controls toward the end of the studies. No significant differences in survival were observed between any groups of rats (male: vehicle control, 31/50; 10 mg/kg, 29/50; 20 mg/kg, 26/50; female: vehicle control, 32/50; 80 mg/kg, 27/50; 160 mg/kg, 32/50). Nonneoplastic and Neoplastic Effects in the Two-Year Studies: Incidences of kidney mineralization (vehicle control, 2/50; low dose, 15/50; high dose, 32/50) and hyperplasia of the pelvic transitional epithelium (0/50; 7/50; 7/50) were increased in dosed male rats. Renal tubule hyperplasia was observed at an increased incidence in high dose male rats (2/50; 4/50; 11/50). These lesions have been described as characteristic of the hyaline droplet nephropathy that is associated with an accumulation of liver-generateted with an accumulation of liver-generated a2μ-globulin in the cytoplasm of tubular epithelial cells. The severity of nephropathy was increased in high dose male rats (moderate vs. mild), and the incidences and severity of nephropathy were increased in dosed females (22/50; 42/50; 45/50). The incidences of adenomas (1/50; 2/50; 4/50), carcinomas (0/50; 0/50; 3/50), and adenomas or carcinomas (combined) (1/50; 2/50; 7/50) of the renal tubule were also increased in the high dose male group. One of the carcinomas in the high dose group metastasized to the lung. No compound-related neoplasms were observed in females. The incidence of pheochromocytomas of the adrenal gland in low dose male rats was significantly greater than that in vehicle controls (15/50; 28/50; 21/49), and the incidences for both dosed groups were greater than the mean historical control incidence (28% ± 11%). Genetic Toxicology: Hexachloroethane was not mutagenic in S. typhimurium strains TA98, TA100, TA1535, or TA1537 when tested with and without exogenous metabolic activation. In CHO cells, hexachloroethane did not induce chromosomal aberrations with or with out metabolic activation but did produce sister chromatid exchanges in the presence of exogenous metabolic activation. Audit: The data, documents, and pathology materials from the 2-year studies of hexachloroethane have been audited. The audit findings show that the conduct of the studies is documented adequately and support the data and results given in this Technical Report. Conclusions: Under the conditions of these 2-year gavage studies, there was clear evidence of carcinogenic activity of hexachloroethane for male F344/N rats, based on the increased incidences of renal neoplasms. The marginally increased incidences of pheochromocytomas of the adrenal gland may have been related to hexachloroethane administration to male rats. There was no evidence of carcinogenic activity of hexachloroethane for female F344/N rats administered 80 or 160 mg/kg by gavage for 103 weeks. The severity of nephropathy and incidences of linear mineralization of the renal papillae and hyperplasia of the transitional epithelium of the renal pelvis were increased in dosed male rats. The incidences and severity of nephropathy were increased in dosed female rats. Synonyms: carbon hexachloride; ethane hexachloride; hexachlorethane; hexachloroethylene; 1,1,1,2,2,2-hexachloroethane; perchloroethane Trade Names: Avlothane; Distokal; Distopan; Distopin; Egitol; Falkitol; Fasciolin; Mottenhexe; Phenohep
The importance of drugs of plant origin in the pursuit of fertility regulating agents for the male from natural products has long been recognized. This review includes 80 plants with 205 references, up to year 2002. The type of extract, dose, animal model and pharmacological activity of these materials have been reviewed in this paper to add impetus to further research and collaboration to resolve the problem of population explosion.
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The past decade has witnessed a veritable explosion of interest in the simple molecule nitric oxide (NO) as a vasodilator, neurotransmitter, and antimicrobial agent. NO and other reactive nitrogen intermediates exhibit cytostatic or cytocidal activity against a remarkable breadth of pathogenic microorganisms. Mammalian cells, including human cells, produce nitric oxide both constitutively and inducibly in response to inflammatory stimuli. This review will provide a brief overview of current knowledge regarding the antimicrobial activity of NO and the possible importance of this activity in infection, particularly with regard to intracellular pathogens.
Diarrheal diseases hold profound messages as well as opportunities that range from public health to basic science. From the spread of cholera around the world, we are reminded of the global impact of tropical diseases, that disease may provide a litmus test for poverty to drive a sanitary revolution, that disease spread may be worsened by political denial, and that many ecologic and epidemiologic secrets such as interepidemic microbial niches remain poorly understood. Diarrheal diseases other than cholera teach us that heavy disease burdens do not control population growth but are associated with population overgrowth (i.e., improved health is key to controlling the population explosion), the societal impact of diarrhea morbidity may exceed even that of its mortality, that new agents continue to emerge, and that nosocomial diarrhea is an underrecognized threat in our hospitals. Finally, from the laboratory of the developing world also come messages for basic science. Microbial toxins continue to elucidate a new understanding of cell signaling, and mechanisms once thought to be clear (such as that of cholera toxin) now appear much more complex. Traditional remedies hold new pharmacologic secrets, e.g., such as gingko extracts that inhibit platelet-activating factor. Finally, from basic physiology can come widely applicable practical solutions such as oral rehydration therapy and simplified diagnostics for inflammatory diarrhea. Health problems such as diarrheal diseases that plague the disadvantaged are linked to population overgrowth and provide some of the greatest challenges to modern science and the industrialized world.
Surgical skin planing is, in the hands of an experienced operator, a safe and highly effective procedure for treating a number of cutaneous defects, most notably pitted acne scars. The operation is facilitated by the use of a new instrument (jet-spray handpiece) which allows the operator to freeze the skin and plane it almost simultaneously, and by a new freezing agent, dichlorotetrafluoro-ethane, which adds to the safety by eliminating the old hazards of inflammability, explosion, and the toxic inhalation of ethyl chloride. The ability to sharply differentiate between keloid and hypertrophic scar is fundamental to surgical skin planing. A hypertrophic scar results from the removal or destruction of the cutaneous appendages (hair follicles, oil and sweat glands and ducts); whereas a keloid is an idiosyncratic response without regard to damage of the appendages.Properly performed surgical planing does not entirely remove these appendages and therefore healing occurs without scarring.
Acne vulgaris is very common, 85% of teenagers being affected at any one time. In most cases, the disease is mild and patients do not present to the dermatologist. Most are instead treated with over-the-counter products and conventional treatment such as peeling agents or topical and systemic antibiotics. Isotretinoin has revolutionized the treatment of severe acne unresponsive to oral antibiotics. Explosive and very severe acne such as pyoderma faciale, acne conglobata and acne fulminans are rare, the features that distinguish acne fulminans from the other conditions being systemic upset with fever, joint pain, malaise and leucocytosis, while there have been two reports of the condition associated with erythema nodosum. The recommended treatment for acne fulminans is a combination of oral steroids and systemic antibiotics, isotretinoin probably not being the treatment of choice. We now report a patient who developed acne fulminans and erythema nodosum within 3 weeks of starting isotretinoin and then responded to dapsone without oral steroids.
CASE REPORT: A 34-year-old white male was executing blasting works in an operation of a quarry several times a month during a period of 1 year. Each time he worked with explosives, he complained of headache, vertigo and concentration failure which started shortly after beginning and continued several hours after. The results of the physical examination on a day without blasting works were normal. Because of the exact working parallel appearance of the symptoms we did further explorations at the workplace which showed the usage of nitroglycerin blasting agents without observance of the safety regulations. The symptoms only at blasting workdays with normal clinical findings at break led considering the relation with the occupational conditions to the diagnosis "headache due to exposure to nitroglycerin explosives". It was reported to the employer's liability insurance association as an occupational disease with the aim of improving occupational conditions. CONCLUSION: Occupational toxic agents as a potential trigger of unclear headache support the requirement of an exact anamnesis of working conditions and environment.
A novel electrolyte has been developed for the effective separation by capillary electrophoresis of cations detected in low explosive residue. This electrolyte, with a pH of 4.4, employs 17.5 mM alpha-hydroxyisobutyric acid (HIBA) as the complexing agent, 6 mM imidazole as the ultraviolet visualization agent, 4 mM 18-crown-6 ether as a modifier to enhance the selectivity of the inorganic cations, and 5% (v/v) acetonitrile as an organic additive. Studies which assessed the value of the addition of 18-crown-6 and acetonitrile demonstrated conclusively that both were required in order to achieve unambiguous baseline separation of ammonium, potassium and monomethylammonium ions. The major advantages of the use of this electrolyte are a total run time of less than 7 min and symmetrical peak shapes. Validation on a series of preblast and postblast explosives materials determined that this procedure is reliable and robust.
1,4-Dioxane is a flammable liquid and tends to form explosive peroxides. Its formation in glycols (low parts-per-million levels), which are used as dehumidifying agents in refineries, may take place by condensation. 1,4-Dioxane thus formed gets distilled over with benzene in the refinery process. Therefore, it is necessary to identify and determine the levels of 1,4-dioxane in glycols as well as benzene. Gas chromatography (GC) is probably the best technique for this purpose. GC analysis may be carried out using a flame ionization detector. Results show that 1,4-dioxane can be comfortably determined down to 2 ppm in glycols and benzene.
Remarkable results have been achieved in the field of organ transplantation over the past 40 years, perhaps inconceivable in the pioneering days of the 1950's. Factors which have contributed to these results include better immuno-suppression, matching for HLA, better preservation, and resolution of most of the technical problems associated with organ transplantation. Nevertheless, major problems still remain to be resolved. Chronic rejection leads to a steady attrition of all solid organ grafts. In addition, the penalty of our more potent immunosuppression is becoming evident with the ever-increasing incidence of cardiovascular disease and malignancy in long-surviving patients. These problems would be solved by the achievement of tolerance to an organ graft. However, there will never be sufficient human organs or tissues to meet the demand, which has led to a revival of interest in xenotransplantation, but enormous immunological and infectious problems have still to be resolved. New immunosuppressive agents, both drugs and biological agents, are being evaluated continually in the laboratory and some are going on to clinical trials. The explosion in molecular biology is allowing new approaches, such as genetic engineering, to be taken in the achievement of tolerance as well as solving some of the problems of xenotransplantation. Cloning of tissues and perhaps even organs may become possible in the future. Undoubtedly transplantation will look very different in twenty years' time as we enter the "Dawn of the New Millennium".