Arcanobacterium haemolyticum pharyngitis and exanthem. Three case reports and literature review.

BACKGROUND: Arcanobacterium haemolyticum is a bacterial pharyngeal pathogen that infects adolescents and young adults, frequently causing an exanthem that may mimic a viral exanthem, toxic erythema, or drug eruption. To our knowledge, the cutaneous manifestations of A haemolyticum infection have not previously been reported in the dermatologic literature. OBSERVATIONS: The severity of this infection can range from mild pharyngitis to a diphtheria-like illness and even septicemia. We report three cases that demonstrate the spectrum of manifestations of this disease, including an unusual case with acral distribution of the associated exanthem. CONCLUSIONS: Arcanobacterium haemolyticum infection should be considered in the differential diagnosis when evaluating a young adult with an exanthem. Antibiotic treatment is reliably efficacious, but the throat swab must be specifically cultured on 5% human blood agar in order to make the diagnosis.

Case report: squamous cell carcinoma of the skin in both palms, axillary node, donor skin graft site and both soles--associated hyperkeratosis and porokeratosis.

A 74-year-old woman presented with skin squamous cell carcinomas on both palms, ankles and soles. The patient also had biopsy-proven porokeratosis. There was hyperkeratosis of the palms and soles. The left palm cancer was excised and skin grafted, but recurred. A nodule in the scar of the donor site of the skin graft in the left upper arm was biopsy-proven squamous cell carcinoma. A metastatic left axillary lymph node was excised. There were no palpable metastatic lymph nodes in either the groin or right axilla. All cancers were irradiated and disappeared, as did the incidentally irradiated hyperkeratosis. Porokeratosis may be associated with skin squamous cell carcinoma, yet in this case porokeratosis could not be identified in the heavily hyperkeratotic palms and soles. Despite poor prognostic signs, i.e. the location in the palm, and metastasis, the patient has done well so far.

Mild hemophilia A as a cause of bleeding in dermatologic surgery.

A 63-year-old male had major postoperative bleeding complications following the excision of a basal cell carcinoma. The patient denied a prior history of bleeding complications and had normal coagulation screening studies. After coagulation evaluation, he was found to have mild hemophilia A with 23% of normal Factor VIII C. We discuss an approach to the evaluation of coagulation in patients with perioperative and postoperative bleeding. Also, we outline treatment alternatives for patients with hemophilia A who need cutaneous surgery.

Feasibility of gated single-photon emission transaxial tomography of the cardiac blood pool.

A procedure for gated single-photon emission transaxial tomography of the cardiac blood pool using a commercially available rotating camera and a computer is described. During image acquisition, the end-diastolic and end-systolic frames are retained after each of the 16 angular steps of the rotation of the camera around the anterior side of the patient's chest. Complete acquisition takes 25 minutes; 10 more minutes are required for the reconstruction and processing of the sections. One set of images is oriented transaxially; the other set includes vertical sections obtained by rotation around a vertical axis passing through the center of the left ventricular cavity. Results from the planar and tomographic examinations were in good agreement for most of the 18 patients who underwent both studies, although more inferior abnormalities were detected with tomography.

Chronoendocrinological studies in athletes. III. Certain psychoendocrinological correlations.

In 83 healthy athletes, statistically highly significant circadian rhythms of psychological parameters (as measured with the SAN-questionnaire [8]: feelings of well-being, activation [1], mood) have been validated and quantified by cosinor analysis. There were significant correlations between some personality factors, as measured with Cattell 16PF questionnaire, in 32 fencers, and some mean circadian hormone blood concentrations. No significant correlations have been found between parameters measured with Eysenck test or with the D48 test and the mean circadian blood levels of T3, TSH, CSL, T, HGH, IRI.

Chromoendocrinological studies in athletes. IV. Multiple hormonal responses to submaximal muscular exercise.

Responses of serum hormones and factors measured with the SAN-test (feelings of well-being, activation, mood) to a submaximal work load in 83 health athletes were expressed in per cent of the values expected individually according to the respective circadian rhythm [5,6,7]. In the most subjects a significant increase of serum HGH and a significant decrease of serum T (= testosterone) was found under the work load. Within 45 min after the completion of the work the level of HGH returned to the expected one, according to the circadian rhythm, while the level of T did not. Some other minor hormonal responses were observed. No significant differences were shown between the actual values of factors measured with the SAN-test and the respective values expected according to the circadian rhythm.

Rotating conventional gamma camera single-photon tomographic system: physical characterization.

A whole-body single-photon emission computed tomography system has been evaluated in terms of its physical performance. It consists of a standard GE 400 T maxi camera rotating on a ring stand, coupled to an Informatek Simis 3 computer system. In its standard mode of operation, 64 or 128 successive views of 64 X 64 or 128 X 64 matrices are collected at regular angular samples. The reconstruction of up to 64 possible adjacent transverse sections, sorted into coronal, sagittal, and oblique sections, is obtained by filtered backprojection. A conventional parallel-hole collimator is used. The uniformity of the camera field of view is corrected by the GE hardware module. The resolution in the transverse plane is typically of 15.5 mm in a 20 cm Lucite phantom, and independent of radial distance. The physical slice thickness is 19 mm (full width at half maximum of the longitudinal response using a point source) with only slight variations along the diameter of the image. The sensitivity is approximately 7,000 cps mCi-1 as measured using a 99m Tc thin source, enabling images of reasonable signal-to-noise ratio to be obtained in 10 min. The effect of the energy window, the number of angular samples, and the linear sampling modes on the transverse resolution and contrast is measured and discussed.

Chronoendocrinological studies in athletes. Circadian rhythms of HGH and IRI.

The serum concentrations of HGH and IRI studied over a 24-hour span in 83 healthy athletes under normal rest conditions in a normal living environment show statistically significant rhythms, validated and quantified by cosinor analysis; for each hormone three different types of the circadian rhythm (with a peak of acrophase between: 6.30 a.m. and 1.30 p.m., 1.30 p.m. and 10.30 p.m., 10.30 p.m. and 6.30 a.m.) were observed. The IRI response to a meal load underwent cyclic variations during the day.

Chronoendocrinological studies in athletes. Circadian rhythms of T3, TSH, cortisol and testosterone.

Endocrine functions were studied in 83 healthy athletes, maintained under normal light-dark conditions, with normal activity-sleep patterns. In these subjects statistically significant circadian rhythms of T3, TSH, cortisol (CSL) and testosterone (T) were found; for each hormone two or three different types of circadian rhythm (with peaks of acrophase between: 6.30 a.m. and 1.30 a.m., 1.30 p.m. and 10.30 p.m., 10.30 p.m. and 6.30 p.m.) were observed. The following correlations have been demonstrated between the length of participation (in years) in performance sports and the mean circadian blood hormone concentration: a negative one for CSL (p less than 0.01) and a positive one for TSH (p less than 0.05). An increase of the mean circadian values of T concentration in venous blood was found in females fencers (n = 9).

Estimation of the dynamic carotid flow in patients with normal radionuclide cerebral perfusion.

Radioisotope angioscintigraphy following intravenous injection bolus of 99mTc-pertechnetate was performed in 49 patients with cerebrovascular disturbances. The region of interest placement on the sequential analog images of both middle cerebral and internal carotid arteries and time-activity curves were displayed on the video monitor. In 35 cases of this group we have noticed symmetrical cerebral perfusion and a significant difference between right and left internal carotid flow, and in 33 cases of which dynamic studies were made stenosis or occlusion of the extracranial part of the carotid internal artery was revealed by the X-ray angiography.

Fully automatic computer-assisted pancreas imaging.

Good pancreas imaging is difficult to achieve even if a computer is applied. The special computer program proposed here was developed to optimize the results and to minimize the operator interaction with the data processing system.

A scintigraphic method of examining the patency of oviducts using 133Xe.

Described below is the radioisotope method of examining the patency of oviducts using a solution of 133Xe. Scintigraphic pictures of the uterine cavity and oviducts were obtained with a Jumbo Toshiba gamma-camera; they were subsequently analysed by an Informatek SIMIS-3 data processing system. A total of 30 women aged between 20 and 36 with primary or secondary infertility were examined. The patency of oviducts and the shape of the uterine cavity was assessed on the basis of: the overall picture of the activity of 133Xe in the uterine cavity and oviducts, the isocontours of the overall picture, curves of increasing and decreasing activity in the fallopian tubes, and the spatial picture of activity distribution in the uterus and fallopian tubes. The results of the examinations corresponded in all cases with the diagnosis made on the basis of hysterosalpingography. An advantage of the isotope method of examining the patency of fallopian tubes and the shape of the uterine cavity is the fact that it is an examination of a dynamic nature, completely safe for the patient and exposes the patients to a considerably lower dose of irradiation than during hysterosalpingography.