Immunodeficiency with elevated IgM, lymphoid hyperplasia, autoimmune anemia, and thrombocytopenia.
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Adolescent↗
Biomedical subjects
P Menon
Publications and source records attributed to P Menon.
Cutaneous epithelioid schwannomas: a rare variant of a benign peripheral nerve sheath tumor.
Although benign epithelioid peripheral nerve sheath tumors have been described, they are rare, and benign epithelioid schwannomas have not yet been established as a specific histologic variant. We present four cases of tumors which we believe would meet criteria to be classified as benign epithelioid schwannomas. Biopsy specimens obtained from four different patients were examined with routine and immunohistochemical staining. All the tumors were well-circumscribed lesions that were surrounded by a capsule containing EMA-positive cells. The cellular component was composed of epithelioid cells, in which there was a lack of mitotic activity. Immunohistochemical studies showed the tumor cells were S-100 protein and Leu 7 positive and HMB-45 negative. In addition, type IV collagen encircled individual cells within the tumor, indicating a continuous basal lamina. We report a group of cutaneous epithelioid schwannomas. Although the presence of such tumors is not unexpected, this diagnosis may not be initially considered because of this rare cytologic feature.
Adult↗
Hawaii Poison Center data reveals a need for increasing hazard awareness about household products.
This study examined for the fiscal years 1995-1996 and 1996-1997, the frequency of calls to Hawaii Poison Center related to household products and pesticides poisoning, the frequency of the source of calls (professional versus layperson), and the patient's age distribution. The data was compared with the data recorded in 1989 which was reported earlier in the literature. We found the most frequent calls were from general public (6 to 8 times) and were related to household products (30% in 1996-97, 39% in 1995-96, and 39% in 1989) involving children less than 5 years of age. Results strongly suggest the need for increasing the awareness of hazards related to household products amongst the general public.
Adolescent↗
Neurocristic cutaneous hamartoma: a distinctive dermal melanocytosis with an unknown malignant potential.
Neurocristic hamartomas (NCHs) result from aberrant development of the neuromesenchyme. In addition to a dermal melanocytic component, these tumors can contain neurosustentacular and fibrogenic components and can undergo malignant transformation. Although NCHs have many features in common with other dermal melanocytic neoplasms, including cellular blue nevi and some congenital nevi, they have distinctive clinical and histologic features. We present a case report of a 27-year-old white woman with an NCH of the scalp. The clinical, histologic, and immunohistochemical features are compared with those of other dermal melanocytic neoplasms. The NCH contained epithelioid pigmented melanocytes positive for S-100 and HMB45, within which there were well-circumscribed nodules of S-100+/Leu 7+/HMB45- cells surrounded by a capsule composed of spindle cells positive for epithelial membrane antigen. The stromal cells throughout the tumor were diffusely CD34 positive, and hair follicles were decreased and dystrophic within the tumor. NCHs represent neoplastic dysplasia that involves not only melanocytic cells but also neurosustentacular and fibrocytic effector cells. The histologic and immunohistochemical features, along with the decreased and dystrophic hair follicles, suggest that the abnormalities in the mesenchyme are significant and result from the contribution of neural crest cells to the cellular and matrix components of the mesenchyme.
Adult↗
Child development: vulnerability and resilience.
Many of the challenges facing children now are a function of changing times, including increase in urbanization, political violence, changing family forms, and in some areas decreased supplies of adequate food. This review focuses particularly on those changes in which children are the victims and which induce new threats for them, rather than on problems such as child disability or mental illness. The outcome variables of interest in this paper are dimensions of children's psychosocial development, including cognitive development, psychological adjustment and aggression, whereas the companion paper in this issue (Caldwell P., Child survival: vulnerability and resilience in adversity in the European past and the contemporary Third World, Soc. Sci. Med.) [1] focuses on physical aspects of children's development. The risks that are hurdles in the process of development of a young child begin from conception and carry on into later life. To address them all would be impossible; thus, in order to do justice to the issues at hand, we have chosen those risks that, in our view, are important in a child's psychosocial development in developing countries. This paper will thus provide a discussion of the concepts of risk and resilience, then apply these concepts to the analysis of three examples of risk faced by children today: nutritional threats (e.g. malnutrition due to decline in breastfeeding); family dynamics and types of family forms (e.g. child fostering and non-traditional families); and experiences of violence (domestic or political). In each case, the same four questions will be addressed: what are the consequences of the risk factor for children, what are the etiologies and conditions of risk, are there any children who seem to cope with the risk factor successfully and what are some of the protective factors, and what interventions or programs would help support these children?
Adolescent↗
Passive cigarette smoke-challenge studies: increase in bronchial hyperreactivity.
Degree and duration of bronchial hyperreactivity (BHR) after environmental tobacco smoke (ETS) inhalation was assessed in 31 smoke-sensitive subjects with asthma who exhibited lower airway symptoms on ETS exposure (group I) and 39 smoke-sensitive subjects without asthma who manifested only upper airway symptoms on cigarette-smoke exposure (group II). Subjects were challenged with ETS for 4 hours in a static-test chamber. The atmosphere was continuously monitored for airborne particulate levels (800 cpm), total suspended particulates (1266 +/- 283 micrograms/m3), and airborne nicotine levels (226 +/- 49 micrograms/m2). Methacholine challenges were performed before and serially after cigarette-smoke exposure, and the provocative dose causing a 20% fall in FEV1 was determined. Five of the 31 smoke-sensitive subjects with asthma and none of the smoke-sensitive subjects without asthma reacted to cigarette-smoke challenge (greater than or equal to 20% fall from baseline FEV1). Thirty-two percent (10/31) of the subjects with asthma demonstrated increased BHR at 6 hours, 29% (9/31) at 24 hours, and 13% (4/31) up to day 14 after ETS challenge. Of the subjects without asthma, 18% (7/39) demonstrated increased BHR at 6 hours, 10% (4/39) at 24 hours, and 8% (3/39) at 3 weeks. These studies demonstrated an increase in BHR after cigarette-smoke challenge in a number of study subjects (although they were clinically asymptomatic) and suggest that prolonged subclinical airway inflammation can occur in the absence of demonstrable change in airway caliber on exposure to ETS.
Adolescent↗
Comparison of cockroach allergenic activity in whole body and fecal extracts.
Previous studies have established cockroach allergens as important sensitizing agents in the induction/exacerbation of urban asthma. The present investigation compared saline extracts of American cockroach (Periplaneta americana) whole bodies and feces and German cockroach (Blattella germanica) whole bodies and feces as important sources of allergens. All extracts were tested before or after gel filtration on Sephadex G-75 columns (fraction 2) as previously described. Skin test studies of 69 subjects with asthma with extracts of American or German cockroaches demonstrated a significant correlation of reactivity to whole body and fecal extracts for both species. Direct RASTs of 13 sera from cockroach skin test-positive subjects were generally greater to both German whole body extracts (GWBEs) and German fecal extracts (GFEs) as compared to American whole body and fecal extracts. There was a good correlation of RAST reactivity to GWBE with GFE. RAST inhibition demonstrated that GFE contained most of the allergenic activity present in GWBE. These studies demonstrate the allergenic similarities of cockroach whole body and fecal extracts and suggest that cockroach feces are an important sensitizing agent in atopic asthma.
Allergens↗
Mortality of fecal bacteria in seawater.
We propose a method for determining the mortality rate for allochthonous bacteria released in aquatic environments without interference due to the loss of culturability in specific culture media. This method consists of following the disappearance of radioactivity from the trichloroacetic acid-insoluble fraction in water samples to which [3H]thymidine-prelabeled allochthonous bacteria have been added. In coastal seawater, we found that the actual rate of disappearance of fecal bacteria was 1 order of magnitude lower than the rate of loss of culturability on specific media. Minor adaptation of the procedure may facilitate assessment of the effect of protozoan grazing and bacteriophage lysis on the overall bacterial mortality rate.
Colony Count, Microbial↗
Skin test reactivity to whole body and fecal extracts of American (Periplaneta americana) and German (Blatella germanica) cockroaches in atopic asthmatics.
Forty-six atopic asthmatic subjects aged 3 to 58 years attending the allergy clinic of a university hospital were evaluated for prick skin test reactivity with commercially available extracts of cockroach (CCE) and house dust (HD). Additionally, skin testing was performed with American cockroach whole body (AWBE) and fecal extracts (AFE) as well as German cockroach whole body (GWBE) and fecal extracts (GFE) prepared in our laboratory. Commercial cockroach extract was prepared from American, German, and Oriental cockroach whole bodies. Skin test reactivity to the different extracts were as follows: 83% to HD, 70% to CCE, 70% to AWBE and/or GWBE, 63% to AWBE, 57% to GWBE, 63% to AFE and/or GFE, 52% to AFE, 50% to GFE, 48% to both AWBE and GWBE, and 39% to both AFE and GFE. The subjects with positive skin tests to AWBE and/or GWBE (70%) were the same individuals who showed skin test reactivity to CCE (70%). Subjects from lower income families (less than $10,000) had a significantly higher skin test reactivity to cockroach allergens than those from families with an annual income of $11,000 to $24,000 (P = .04). These results demonstrate the significance of cockroach sensitization in atopic asthmatics, suggest the importance of fecal cockroach allergens, and support earlier observations of shared interspecies allergens between American and German cockroach whole bodies.
Adolescent↗
Asymptomatic proteinuria and/or haematuria in 265 Malaysian adults.
Two-hundred and sixty-five patients with asymptomatic proteinuria and/or haematuria were studied at the Department of Medicine, Universiti Kebangsaan Malaysia and Department of Nephrology, General Hospital Kuala Lumpur. They represented 25.4% of all the renal biopsies performed during the period 1980-88. All the three races were affected with 71.3% occurring between the ages of 20-39 years and 41.1% were detected during routine medical examination. Excluding those patients with lupus nephritis, IgA nephropathy was the commonest histological diagnosis (51.7%). The presence of severe and advanced histological changes in a significant number of biopsies emphasises the need for more effective screening and early referral of this group of patients.
Adolescent↗
IgA nephropathy in Malaysia.
A total of 164 patients with IgA nephropathy were diagnosed at the Department of Medicine, Universiti Kebangsaan Malaysia and the Department of Nephrology, General Hospital, Kuala Lumpur between 1981-1988. This represented an incidence of 20.1% of all primary glomerulopathies seen in both units. The 3 major ethnic groups were equally affected with 59.7% occurring between the ages of 20-36 years. It was not uncommon in females. The high prevalence of hypertension, renal failure, heavy proteinuria at presentation and the increased chronicity index in the biopsy, suggest that IgA nephropathy is progressive disease leading to chronic renal failure.
Adolescent↗
Isotretinoin-basal cell carcinoma prevention trial. Design, recruitment results, and baseline characteristics of the trial participants. The ISO-BCC Study Group.
The Isotretinoin-Basal Cell Carcinoma Prevention Trial (ISO-BCC Study) is a double-masked, randomized, placebo controlled, multicenter clinical trial. It is the first intramural cancer chemoprevention trial sponsored by the Division of Cancer Prevention and Control of the National Cancer Institute. This trial was designed to evaluate the effectiveness of chronic administration of low dosage levels (10 mg) of a synthetic retinoid, isotretinoin, in reducing the incidence of basal cell carcinoma in a high-risk population and to determine the incidence and severity of side effects associated with this long-term treatment. Between 1984 and 1987, eight clinical centers enrolled 981 participants between the ages of 40 and 75, who had two or more biopsy proven basal cell carcinomas in the 5 years before trial entry. This article describes the trial design, recruitment results, and baseline characteristics of the participant population in the ISO-BCC Study.
Adult↗
Antinuclear antibodies and anticytoplasmic antibodies in bronchial asthma.
The presence of antinuclear antibodies and anticytoplasmic antibodies was evaluated in the sera of 50 patients with bronchial asthma and 35 matched control subjects with miscellaneous medical diseases with the use of an indirect immunofluorescent assay with HEp-2 cells as substrate. The results were compared to age, sex, atopic status, dose, and duration of the antiasthmatic medication, immunotherapy, severity of the disease, and presence or absence of myalgia. The patients had mild to moderate asthma. The incidence of fluorescent anticytoplasmic antibodies (FACA) in the sera of patients with asthma was statistically significant (p = 0.02) in comparison to FACA in the sera of the control subjects. The combined incidence of fluorescent antinuclear antibodies (FANA) and FACA was found to be significantly higher among atopic subjects with asthma (p = 0.03) and the subjects with asthma and with myalgia (p less than 0.05). The 20% incidence of FACA in this group of subjects with asthma was significantly greater (p less than 0.0001) than the reported 2.7% incidence of FACA in a group of patients with various rheumatologic diseases. Variables, such as dose and duration of antiasthma medications and immunotherapy did not appear to influence the presence of FANA and FACA in their sera. The significance of positive FANA and FACA in this group of subjects with asthma is not known and needs to be evaluated by long-term studies.
Antibodies↗
Assessment of response to oral metaproterenol sulfate by forced oscillation in young children.
The dose response characteristics and side effects of three doses of oral metaproterenol sulfate (MS) (0.4, 0.6, and 0.8 mg/kg) were compared with a placebo in ten asthmatic children (3 to 6 years). The bronchodilator efficacy was objectively assessed by evaluating the decrease in mean total respiratory resistance (MTRR) using Oscillaire. The mean percentage changes from baseline in MTRR showed that MS in all three doses was more effective than placebo. Lack of objective demonstration of bronchodilator efficacy, concern for possible side effects and uncertainty of the precise dosage for adequate bronchodilation are some of the factors that account for the lack of specific dosage recommendations for bronchodilators such as oral metaproterenol sulfate in children under 6 years of age. Until recently, it was not possible to objectively measure the response to bronchodilators in children below 6 years of age because of their inability to reliably perform forced expiratory maneuvers required for spirometry and their unwillingness to have airway resistance (or conductance) measurements by body plethysmography. Direct measurements of airflow resistance have been made in children with a pneumotachograph at the mouth and a balloon in the esophagus to record transpleural pressure changes; however, these techniques are invasive and require sedation. Total respiratory resistance and reactance of the respiratory system, as measured by forced oscillation technique, are pulmonary function tests that can be performed in young children who are unable to cooperate with conventional spirometric maneuvers.
Administration, Oral↗
Methadone withdrawal regime for heroin misusers: short-term outcome and effect of parental involvement.
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Adolescent↗
Serum glutamic oxaloacetic transaminase in tetanus.
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Adolescent↗
Mucoepidermoid carcinoma of the bronchus: is conservative surgery always justified?
A case of mucoepidermoid carcinoma of the bronchus in a 7-year-old boy is reported. The patient underwent right pneumonectomy. Histologically, the tumor was a low-grade muco-epidermoid carcinoma arising from the bronchus with lymph node metastasis in the drainage area. Presence of lymph node metastasis in this low-grade tumor suggests the possibility of early progression of disease in what has until now been considered a very slow growing tumor. Aggressive surgery may be necessary in these situations.
Bronchial Neoplasms↗