RESUMO
The immune status of four men with bowenoid papulosis was evaluated. Each case had been refractory to multiple methods of treatment. Three of the men had other infections and demonstrated a depletion of T4-helper cells. Two of these patients were anergic on skin testing, and the third showed weak reactivity. The fourth patient, who had no evidence of additional infections, had a normal T4 value and T4/T8 ratio, but was anergic on skin testing. All the men were serologically negative for human immunodeficiency virus antibodies. One of the immunosuppressed patients developed squamous cell carcinoma of the tongue, which, along with his bowenoid papulosis, contained human papillomavirus 16 DNA. We suggest that patients with persistent bowenoid papulosis be investigated for altered immune status and followed up as potential candidates for the development of epithelial malignant neoplasms.
Assuntos
Tolerância Imunológica , Infecções Tumorais por Vírus/imunologia , Adulto , Biópsia , Linfócitos T CD4-Positivos , Carcinoma de Células Escamosas/microbiologia , Neoplasias dos Genitais Masculinos/imunologia , Neoplasias dos Genitais Masculinos/microbiologia , Humanos , Contagem de Leucócitos , Masculino , Neoplasias Bucais/imunologia , Neoplasias Bucais/microbiologia , Papillomaviridae , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/microbiologia , Testes Cutâneos , Infecções Tumorais por Vírus/patologiaRESUMO
The effects of three anesthetic techniques on liver function were compared in patients with mild alcoholic hepatitis who required surgery, both peripheral and superficial. Thirty patients were randomly assigned to receive one of three anesthetics: thiopental, nitrous oxide and oxygen, enflurane, plus muscle relaxant; thiopental, nitrous oxide and oxygen, narcotic, plus muscle relaxant; or spinal anesthesia with tetracaine. Measurements of hepatic function were made preoperatively (on the day of operation) and on the first and third postoperative days. Levels of serum bilirubin, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, and lactate dehydrogenase liver isoenzyme were similar in the three groups on both postoperative days. They were not significantly different from those obtained preoperatively, although mean values decreased by the first postoperative day and again on the third. The data suggest that the choice among the three anesthetic methods studied could be based on factors other than the presence of mild alcoholic hepatitis and that, when peripheral surgery is required, one may not anticipate a worsening of any biochemical disorder in the first three postoperative days.
Assuntos
Anestesia , Hepatite Alcoólica/fisiopatologia , Fígado/fisiopatologia , Adulto , Alanina Transaminase/sangue , Anestesia Geral , Raquianestesia , Aspartato Aminotransferases/sangue , Bilirrubina/sangue , Enflurano , Hepatite Alcoólica/sangue , Humanos , Isoenzimas , L-Lactato Desidrogenase/sangue , Pessoa de Meia-Idade , Entorpecentes , Óxido Nitroso , Distribuição Aleatória , Tetracaína , TiopentalRESUMO
The results of this study of 134 patients confirm the increased incidence of previously unrecognized inguinal hernias after ventriculoperitoneal shunting procedures. Infants with intraventricular hemorrhage appeared to be the most susceptible, although associated prematurity may play an additional role. Close observation of infants and children who undergo ventriculoperitoneal shunting is required, to allow early detection and repair of inguinal hernias. Inguinal herniorrhaphy can be performed safely with few or no postoperative complications and no deleterious effects to the VP shunt.