The AIN-76A defined rodent diet accelerates the development of heart failure in SHHF rats: a cautionary note on its use in cardiac studies.

Previous studies from our laboratory have shown positive benefits of linoleic acid (LA) feeding for attenuation of rat heart failure (HF). However, another research group concluded LA feeding was detrimental to cardiac function, using the American Institute of Nutrition 76A (AIN) diet as a background diet for the experimental animals only. To reconcile these conflicting results and determine whether (i) AIN has effects on cardiovascular function, and (ii) AIN reverses the positive effects of LA feeding, studies were performed using spontaneously hypertensive heart failure (SHHF) rats in both a survival study with lifetime feeding of AIN (control: Purina 5001) and a 2 × 2 factorial design for 6 weeks in young male SHHF rats with background diet and LA as variables. During a lifetime of AIN feeding, mortality from heart failure is significantly accelerated, cardiolipin altered and triglycerides increased. In young rats, 6 weeks on the AIN diet promoted increased systolic and diastolic blood pressure, increased fed and fasting blood glucose, increased serum inflammatory eicosanoids, decreased docosahexanoic acid, increased posterior wall thickness in diastole and an altered cardiolipin subspecies profile. The addition of LA to the AIN diet was able to rescue blood pressure. However, the combination increased retroperitoneal fat mass, body weight and fed blood glucose beyond the levels with the AIN diet alone. Because the AIN diet has wide ranging effects on cardiovascular parameters, our results suggest that it should not be used in animal studies involving the cardiovascular system unless induction of cardiac dysfunction is the desired outcome.

Basal cell carcinoma. Choosing the best method of treatment for a particular lesion.

Basal cell carcinoma is the most common type of malignant tumor in the United States. The five types of basal cell carcinoma (noduloulcerative, pigmented, morpheaform, and superficial basal cell carcinoma, and premalignant fibroepithelioma) vary in clinical presentation and behavior. Diagnosis is made by skin biopsy. The size, type, and site of a lesion and the age and sex of the patient affect the choice of treatment. Electrodesiccation and curettage, cryosurgery, surgical excision, Mohs' surgery, and radiation therapy are available. Knowledge of these therapies and of when they should and should not be used is important in proper management of basal cell carcinoma.

Photoaging. Cosmetic effects of sun damage.

Given the many ways our culture promotes deeply tanned skin as a symbol of beauty, health, and even happiness, physicians face an uphill battle in promoting the healthy aspects of a pale complexion. Not only can excessive solar exposure accelerate and intensify aging in skin, it can also lead to serious health risks. Drs Browder and Beers tell why photoaging happens and how to prevent it.

Use of cotton-tipped applicators during skin examination and dermatologic surgery.

The cotton-tipped applicator is a widely available and versatile tool for the dermatologist. In addition to the common uses of this inexpensive tool there are many other ways for the dermatologist to use cotton-tipped applicators. From its usefulness in dermatologic examination and potassium hydroxide preparations to its multiple surgical applications, the cotton-tipped applicator is a valuable and underrated tool.

The interferons and their use in condyloma acuminata.

There are three naturally occurring interferons: alfa, beta, and gamma. Alfa, derived from lymphoblastic tissue, is approved by the Food and Drug Administration for the treatment of condyloma acuminata (genital or venereal warts). Genital warts are caused by human papillomaviruses, of which more than 50 subtypes have been described. Traditional therapies have centered on destruction of the lesions by either cytotoxic or physical modalities. Intralesional interferon exerts its antiviral effects on infected cells without causing damage to the surrounding tissue. In general, success rates with intralesional interferon alfa are comparable to traditional modalities. There is also evidence that interferon alfa might be particularly useful in the treatment of lesions that have failed to respond to other modalities.

Multiple endocrine neoplasia type III: case report and review.

Multiple endocrine neoplasia type III (MEN 3), also known as MEN 2b, is a syndrome that may be recognized at a young age by its characteristic numerous mucosal neuromas and marfanoid habitus. These features are generally evident before the development of medullary thyroid carcinoma and pheochromocytoma, allowing for early diagnosis and intervention. Much has been learned recently in this regard to reduce morbidity and mortality. In addition, periodic screening of first-degree relatives of patients with MEN 3 has proved effective in detecting familial cases. Finally, new findings have been made regarding the etiology of MEN 3, with potentially wide-ranging implications.

Microbial associations of 167 patients with psoriasis.

Microbial findings were analyzed from a group of 167 patients with psoriasis in an attempt to discover specific associations. Positive findings include associations between Malassezia ovalis and scalp/ear/face psoriasis and between bacteria and bodyfold, nailfold, and gluteal/rectal psoriasis.

Carbon dioxide retention associated with a humidifier defect.

A case is presented which describes a patient who developed hypercarbia resulting from a defective humidifier. A Puritan-Bennett Cascade I humidifier was incorporated into a circle system between the inspiratory dome one way valve and the patient. A screw which supports the thermal well to the head of the humidifier was missing, thereby allowing an intermittent leak to develop in the system. The leak was present when the system pressure dropped to ambient level; however, at positive system pressure the leak sealed. This allowed exhaled gases into the inspiratory limb of the circuit unchecked by the inspiratory valve yet when the breathing circuit was occluded at the patient end and submitted to pressures of 20 and 40 cm H2O, no leaks were detected. Intraoperatively, PaCO2 was noted to be as high as 68 mmHg just prior to removing the humidifier from the circuit and corrected to 38 mmHg within 15 minutes of removal of the humidifier.

Augmentative communication, evolution, and progress for nonspeaking children.

Technology has provided a recent emergence of augmentative communications systems for nonspeaking children. The effective use of such systems is dependent on the knowledge and skills of physicians, speech-language pathologists, educators, parents, and other professionals working with the child. This article examines the components of an augmentative system including the mode of communication, which includes choices among manual, non-electronic, and electronic systems. The advantages of each mode are discussed. Another major component, the symbol selection process, follows an ascending hierarchy from a representational code involving actual objects to a complex symbolic code with spelling and numerals. Clinical application at the Child Development and Rehabilitation Center of the Oregon Health Sciences University points to the need for thorough interdisciplinary team evaluation during system selection or modification. Data obtained from assessment of 28 multihandicapped children reveal necessary changes, additions, and follow-up for both the mode and symbol system in the majority of children examined.

Cancer risk in adulthood from early life exposure to parents' smoking.

We obtained data on smoking by parents from 438 cancer cases and 470 controls to investigate whether cancer risk in adult life is related to transplacental or childhood exposure to cigarette smoke. Cancer cases were between ages 15 and 59 at time of diagnosis. All sites but basal cell cancer of the skin were included. Cancer risk was increased 50 per cent among offspring of men who smoked. Increased risk associated with father's smoking was not explained by demographic factors, social class, or individual smoking habits, and was not limited to known smoking related sites. Relative risk (RR) estimates associated with father's smoking tended to be greatest for smokers, males, and non-Whites. There was only a slight increase in overall cancer risk associated with maternal smoking. Mother's and father's smoking were both associated with risk for hematopoietic cancers, and a dose-response relationship was seen. The RR for hematopoietic cancers increased from 1.7 when one parent smoked to 4.6 when both parents smoked. Although they should be considered tentative, study findings suggest a long-term hazard from transplacental or childhood passive exposure to cigarette smoke.

A case-control study of cancers of the nasal cavity and paranasal sinuses.

To examine occupation, smoking, and other risk factors for nasal cancer, a case-control study was conducted among 160 patients, who were admitted to four hospitals in North Carolina and Virginia between 1970 and 1980, and 290 controls. Employment in the furniture industry was not associated with squamous cell tumors, but such employment increased the risk of nasal adenocarcinoma by fivefold. In addition, approximately threefold excess risks of adenocarcinoma were observed for those employed in other industries involving possible exposure to wood dust. Elevated risks among males were also associated with occupational exposures to chromates (relative risk (RR) = 5.1) and chemicals (RR = 2.7). Among females, an excess risk was associated with employment in the textile industry, particularly for jobs involving dust exposure (RR = 2.3). Although there was no evidence that alcohol consumption affected risk, heavy cigarette smokers were at a two- to threefold excess risk (predominantly for squamous cell tumors); in addition, there was evidence that there was an elevated risk associated with the use of snuff. Elevated risks were also associated with histories of nasal polyps (RR = 8.3), recurrent nose bleeds (RR = 2.0), and sinus trouble (RR = 2.7). These findings provide leads for further studies, and underscore the importance of distinguishing between histologic types.

Mucoepidermoid carcinoma in a cervical cyst: a case of branchiogenic carcinoma?

A patient with a primary oral epidermoid carcinoma with presumed neck metastasis is presented who at operation was found to have a cervical mucoepidermoid carcinoma arising in the wall of a benign cyst. The case for considering this tumor a primary branchioma of mucoepidermoid type is presented, and the criteria for making the diagnosis of branchiogenic carcinoma are discussed.

Pediatric diagnosis and management of children with developmental disabilities.

Mail surveys were conducted in 1976 and 1980 with Oregon primary care pediatricians to determine patterns of in-depth evaluations, followup, and availability of diagnostic and treatment services for children with developmental disabilities. It was assumed that changes might reflect the impact of recent federal legislation. Patterns of referral were related more to the type and disorder than to the location of the physician's practice. The majority of pediatricians referred children for evaluation for mental retardation, cerebral palsy, learning disabilities, autism, and multihandicapping conditions. Over half reported doing their own evaluations for convulsive disorders. Referrals were most often to multidiscipline teams except for learning disabilities and convulsive disorders. The present study emphasizes the pediatricians' utilization of specialized interdisciplinary centers for diagnosis of children with major developmental disabilities. There was little change in practice patterns during the study period, but some significant shifts in perceived service needs were observed. The most significant change seems to be a heightened awareness of these children's needs for services. Pediatricians continue to express a need for more training in diagnosis and care of developmental disabilities.

Basal cell epithelioma. Types, treatment methods, and prognosis.

Basal cell epithelioma (BCE) is the most common cutaneous malignancy. Primary BCE (ie, previously untreated) can be satisfactorily treated by a variety of methods, including curettage with electrodesiccation, scalpel excision, cryosurgery, and radiotherapy. Cure rates approach 98%. Recurrent BCE is much more difficult to treat and deserves particularly aggressive therapy, such as chemosurgery.

Measurements of the thermal expansion of six optical materials, from room temperature to 250 degrees C.

Coefficients of linear thermal expansion are reported in the range from room temperature to 250 degrees C for six optical materials: Polytran potassium chloride and Polytran calcium fluoride-Harshaw; chemical-vapordeposited (CVD) zinc selenide and zinc sulfide-Raytheon; single-crystal germanium-Eagle-Picher; and lithium niobate-Harshaw. For the last named, an anisotropic crystal, thermal expansion was measured both parallel and perpendicular to the c axis. Curves are given to illustrate the expansion behavior of the materials over the 60-500-K range.