This is a report of a patient with the CRST syndrome, a mild variant of scleroderma consisting of calcinosismraynaud's phenomenon, sclerodactyly, and telangiectasia. Typical changes of scleroderma were present in the extremities, esophagus, duodenum and colon. In addition, there was a polypoid filling defect in a colonic diverticulum due to a fecalith. The radiologic appearance at first resembled a colonic neoplasm, although its location within a diverticulum and its speckled appearance suggested the possibility of a fecalith. This was confirmed at colonoscopy, which disclosed numerous wide-mouthed diverticula, with inspissated fecal material projecting from several diverticula. In patients with scleroderma and polypoid filling defects in the colon, the possibility of a fecalith within a diverticulum should be considered. Where the radiologic study is inconclusive, colonoscopy may provide a definitive diagnosis.

Adult↗

PubMedDate not supplied

Reactive oxygen species in acute respiratory distress syndrome.

In the metabolism of almost all human cells, a sequential addition of electrons to oxygen leads to the formation of reactive oxygen species (ROS). ROS have been implicated in more than 100 diseases and may be the common denominator in the pathogenesis of the most important health problems facing the world today. The last decade has been characterized by a progressive increase in the understanding of oxidant chemistry and the role of ROS in pulmonary disease. The majority of deaths among critically ill patients are the result of sepsis and its sequelae, including acute respiratory distress syndrome (ARDS). Nurses must understand the processes involving ROS that are in play when they are caring for patients with ARDS. This article describes what is known about the formation of ROS, the pathophysiology of ARDS, and the role ROS play in the pathogenesis of ARDS.

Critical Care↗

PubMedDate not supplied

Penicillamine-induced immunosuppression: in vitro studies of inhibition of immunoglobulin synthesis.

An in vitro system of T-dependent polyclonally activated B lymphocytes has been used to identify the cellular basis of immunosuppression induced by penicillamine. Suppression of immunoglobulin synthesis was dose dependent, and required the drug to be present at the initial stages of the culture. Coculture studies identified T helper cells as the primary target. Study of T cell membrane receptors identified a susceptible subpopulation characterized by its inability to form tight sheep red blood cell rosettes, a delay in the generation of T mu receptors and reduced "help" for polyclonally activated B cells. B lymphocytes were not primarily suppressed by penicillamine.

B-Lymphocytes↗