Fatal calcific uraemic arteriolopathy (CUA): a case report and review of the literature.

Calciphylaxis, now better known as Calcific uraemic arteriolopathy (CUA), is an uncommon condition characterised by small vessel calcification and occlusion with resultant painful violaceous skin lesions that typically ulcerate to form non-healing gangrenous ulcers. The syndrome is usually found in patients with renal failure. In this report we describe a 61 year old lady who developed lower limb ulceration secondary to calciphylaxis and discuss the current treatment options for this serious condition.

Histological appearances in post-partum de Quervain's disease.

Six patients who developed de Quervain's disease during pregnancy or within 12 months of childbirth were treated surgically. Histopathological examination of the tendon sheaths using alcian blue stain showed that myxoid degeneration was responsible for the thickening observed in the sheath. Characteristic intramural deposits of mucopolysaccharides were present, predominantly in the subsynovial region. Acute or chronic inflammatory changes were not seen. These findings were the same as those described in patients with de Quervain's disease unrelated to pregnancy or childbirth.

Amelanotic malignant melanoma following cryosurgery for atypical lentigo maligna.

Cryosurgery is an alternative treatment option to surgical excision for lentigo maligna. Clinical evidence of recurrence is usually characterized by repigmentation at the treated site. We report two patients who developed amelanotic malignant melanoma following cryosurgery for a pigmented lentigo maligna. These cases illustrate the potential risk of treating lentigo maligna with cryosurgery.

Diffuse neurofibroma of the ankle.

PURPOSE: To correlate the imaging and histological findings in diffuse neurofibroma. PATIENTS AND METHODS: Retrospective review of clinical, imaging and histological findings in two patients with diffuse neurofibroma. RESULTS: CT demonstrates diffuse infiltration of the deep and subcutaneous fat, isodense to muscle. Magnetic resonance imaging shows extensive infiltration of the subcutaneous and deep fat that envelops tendons and vessels but does not involve bone. Superficial masses enhance homogeneously after intravenous gadolinium. The reticular nature of the deep infiltration is seen on all sequences but is most conspicuous on post-gadolinium T1-weighted images which show tumour enhancement and non-enhancing hypointense soft tissue strands. Magnetic resonance angiography and Doppler ultrasound may show enlarged vessels, high blood flow and vascular pools. CONCLUSION: Diffuse neurofibroma has a characteristic appearance on magnetic resonance that is best shown on post-gadolinium T1-weighted images.

Magnesium and lithium antagonism of carbachol- and electrically-induced smooth muscle contractions in the rat gastrointestinal tract.

The pharmacological actions of lithium and magnesium have been investigated using isolated smooth muscle preparations from the rat gastrointestinal tract. Tissue contraction was evoked by means of carbachol or electrical field stimulation and the degree of inhibition of contraction caused by lithium was measured. Lithium effects were compared with those of the chemically similar ions, magnesium and calcium, by manipulation of the physiological buffer solutions. Lithium antagonism was enhanced when tissue contractile mechanisms were dependent on extracellular calcium concentration in the bathing fluid. This suggests that lithium is acting at the cell membrane by preventing calcium entry via ion channels. These results are consistent with evidence from clinical studies which indicate low cellular accumulation of lithium at therapeutic concentrations.

Ileal mucosal absorption of bile acid in man: validation of a miniature flux chamber technique.

A method that allows the quantitative assessment of ileal mucosal cell uptake and transport of bile acids in mucosal biopsy specimens has been validated. Viability of the tissue was confirmed by maintenance of normal cell morphology, wet weight, extracellular space, porosity to polyethylene glycol-900, lactate dehydrogenase release, and transmucosal potential difference. Using 14C-taurocholic acid, absorption was shown to be directional, capable of working against a concentration gradient, reduced by metabolic inhibitors, and sodium dependent. The system showed saturation kinetics with an estimated Km of 10 mumol/l. At a standard substrate concentration of 10 mumol/l ileal mucosal bile acid absorption was compared in patients with colorectal cancer (n = 6), ulcerative colitis (n = 10), and slow transit constipation (n = 8). There was no significant difference in tissue uptake or transport between the three groups.

Brief communication: magnesium absorption in human ileum.

A novel technique utilizing samples of human distal ileum removed at surgery was used to study magnesium (Mg) absorption. Specimens of isolated absorptive mucosa were obtained by careful dissection of the tissue to remove the muscle layers, and were mounted in flux chambers. Mean tissue Mg concentration in human isolated intestinal mucosa was found to be within the postulated normal range for human tissue. Mucosal to serosal Mg transport was unaffected by ouabain or 2,4-dinitrophenol and sodium fluoride. Overall, the data indicate Mg absorption in distal ileum to be passive in nature, although a minor active transcellular component cannot be excluded.

The significance of incomplete excision in patients with basal cell carcinoma.

Sixty-seven patients with incompletely excised basal cell carcinomas are reviewed. No recurrences were seen in seven patients who had immediate supplementary treatment; 23 of 60 patients submitted to a "wait and see" regimen developed recurrent disease, Recurrence was commoner in those in whom both the lateral and deep margins were involved, and when the incomplete excision was for recurrent disease. The latter recurrences were more difficult to control in patients who had previously had radiotherapy, when the deep margin was involved and when a flap had been used to close the resulting defect. A case is made for immediate re-excision for all patients with incompletely excised basal cell carcinomas.

Use of pyrethroid impregnated tags in the control of sheep headfly disease.

Plastic tags containing 8.5 per cent w/w cypermethrin or 10 per cent w/w permethrin reduced the severity of damage caused to sheep by the headfly Hydrotaea irritans. A similar pattern of protection extended from the tagged ewes to their untagged lambs. Tags containing 8.5 per cent w/w fenvalerate failed to reduce the level of headfly damage in gimmers.

Evaluation of three synthetic pyrethroids in the control of sheep headfly disease.

Deltamethrin (0.01 per cent) applied to the heads of lambs and gimmers at 30 day intervals on two separate farms failed to control damage caused by the sheep headfly , Hydrotaea irritans. Permethrin (0.1 per cent) applied to gimmers at monthly intervals achieved a slight reduction in severity of damage but protection did not extend beyond 14 days. Polyvinyl chloride tags containing 8.5 per cent cypermethrin reduced damage in gimmers to a very low level with protection lasting throughout the summer. Weight gains of lambs suffering headfly damage were significantly less than unaffected lambs.