ABSTRACT
Subacute sclerosing panencephalitis (SSPE) virtually disappeared from the US after mass measles immunization programs dating from the 1960s. However, SSPE has reappeared in internationally adopted children and in refugee children emigrating from developing or war torn countries lacking effective measles immunization programs. SSPE usually occurs 6 to 8 years after a bout of measles in early childhood; death typically follows within 1 to 3 years. What is often not reported in textbooks is that spontaneous remission occurs in a small subset of children with documented SSPE.
Subject(s)
Refugees , SSPE Virus/isolation & purification , Subacute Sclerosing Panencephalitis/diagnosis , Bosnia and Herzegovina , Child , Electroencephalography , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Phenytoin/therapeutic use , Risk Assessment , Severity of Illness Index , Subacute Sclerosing Panencephalitis/drug therapy , United StatesABSTRACT
Computers are integral to medical practice, education, and research. While medical students learn computer skills during their training, many practicing physicians do not have the same computer experience. To familiarize this group with the exciting developments in medical informatics, the Himmelfarb Health Sciences Library and Department of Computer Medicine at the George Washington University Medical Center organized a workshop "Introducing Your Office Computer!" for attending physicians. The workshop featured a short lecture/video presentation on computer applications in medicine followed by a "computer fair" of five computer applications. Eleven physicians attended the workshop. Feedback was very positive; many called later to request more detailed instructions on using the programs demonstrated. It was a valuable experience for the staff, and new bridges were built between departments and clients.
Subject(s)
Computer User Training/methods , Libraries, Hospital , Medical Staff, Hospital/education , District of Columbia , Hospital Bed Capacity, 300 to 499 , Organizational Objectives , Planning Techniques , Program Development/methodsABSTRACT
The presence of a peripheral zone of (presumed intracellular) plasminogen activator in the normal rabbit cornea has suggested that activator, once released, might regulate the permeability of limbal vessels and angiogenesis, by plasmin-dependent pathways. Plasminogen activator (urokinase [UK]) in rabbit serum albumin (RSA) was injected once (20 microliter, 3.7 CTA U) into the corneal stroma, 2 mm from the limbus. Sprouts arose from the engorged circumlimbal vessels (16 of 20 corneas) beginning on the third day and grew into the cornea over the next several days. Histologically, PMNs were observed in association with growing vessels. Contralateral corneas injected with UK (in RSA) previously inactivated by 99.7% with the specific active site inhibitor, Phe-Ala-Arg-chloromethyl ketone showed minimal vessel engorgement or stromal edema and no vascularization (0 to 20 corneas). Injuries to the so-called (plasminogen activator-containing)"critical zone" of the cornea which elicit neovascularization possibly do so by causing extracellular release of endogenous plasminogen activator. Thus, in addition to initiating the destructive events of ulceration, activator might initiate increases in vessel permeability and also neovascularization, which would result in the eventual arrest of ulceration.
Subject(s)
Cornea/drug effects , Corneal Ulcer/physiopathology , Endopeptidases/pharmacology , Neovascularization, Pathologic/drug effects , Urokinase-Type Plasminogen Activator/pharmacology , Amino Acid Chloromethyl Ketones/pharmacology , Animals , Cornea/blood supply , Plasminogen Activators/pharmacology , RabbitsABSTRACT
This study reports the histological findings in human eyes after severe penetrating trauma. The findings confirm the high incidence of retinal detachment in eyes with severe penetrating injuries. The retina was detached in 32 out of the 34 eyes examined, with 27 having evidence of traction on the retina. These eyes were characterized histologically by intraocular cellular proliferation producing cyclitic, epiretinal, and retroretinal membranes. Intraocular cellular proliferation was discernible or established within 1 week of injury and typically resulted in a cyclitic membrane at about 6 weeks. Epiretinal and retroretinal membranes were found between 1 and 2 weeks after injury in eyes with a detached retina. The results indicate that a damaged lens, the admixture of lens material and vitreous, and the presence of vitreous haemorrhage were all factors promoting intravitreal fibroblastic proliferation. Vitreous surgery may be a rational method of treatment for these severely injured eyes by removing the stimulus and vitreous scaffold for intravitreal fibroblastic proliferation. From this series it would appear that vitrectomy should not be delayed beyond the second week of injury, by which time massive cellular ingrowth may already be under way.
