Shingles: More than Meets the Eye.

Low-dose once weekly methotrexate (MTX) is the first-line disease-modifying antirheumatic drug (DMARD) to treat rheumatoid arthritis and psoriasis. Although methotrexate is generally considered to have a good safety profile it can occasionally induce severe side effects such as pancytopenia, mucositis, disorders of kidney and liver. Oral mucositis should alert physicians to MTX toxicity. We report a 64-year-old woman with a severe drug reaction including disseminated shingles, oral mucositis and pancytopenia only three days after starting a therapeutic low-dose of MTX. Initially, mucositis and myelosuppression couldn't be accounted for by the underlying disease. In taking the patient's history, MTX intake 10 days ago was missed, the patient reporting only current medications. However, there was more to the skin rash than meets the eye. Only after further inquiry did the patient reveal the intake of 2 doses of MTX and the subsequent withdrawal of medication. Arriving at the correct diagnosis in difficult cases, as in the case presented, requires further evaluation, including repeat history taking and eliciting more details if diagnosis remains elusive.

Assessment of cerebral tissue oxygen saturation in septic patients during acetazolamide provocation - a near infrared spectroscopy study.

UNLABELLED: Sepsis-associated encephalopathy is a multifactorially determined process of the brain parenchyma. Among other factors, vasogenic causes have been shown to play a role in its development. The aim of the present work was to assess whether cerebral tissue oxygen saturation is influenced by administration of acetazolamide in septic patients compared to controls. PATIENTS AND METHODS: 15 patients with severe sepsis and 10 healthy controls were studied. Cerebral oxygen saturation was assessed by INVOS 51 OOC Cerebral Oxymeter (NIRS) before and after administration of 15 mg/kg BW acetazolamide in both groups. RESULTS: The maximal rise that has been found in the partial pressure of CO(2) in the arterial blood of septic patients after administration of acetazolamide was from 35 ± 5 mmHg to 41.1 ± 6.3 mmHg. For the partial pressure of O(2) the observed increase was from 123.7 ± 47.1 mmHg to 139.9 ± 49 mmHg. Vasodilatory stimulus resulted in a similar maximal increase in cerebral oxygen saturation in septic patients and in controls (8.9 ± 6.5% for septic patients and 9.2 ± 4.6% for healthy persons, respectively). CONCLUSIONS: Cerebral vasoreactivity to acetazolamide is preserved in patients with severe sepsis.

One-lung ventilation does not result in cerebral desaturation during application of lung protective strategy if normocapnia is maintained.

BACKGROUND: Previously a report has suggested that administration of lung protective strategy for one-lung ventilation(OLV) results in oxygen desaturation of the brain parenchyma. The aim of our work was to confirm that the maintenance of normocapnia during protective OLV strategy results in alteration of cerebral blood fl ow and cerebral oxygen saturation as compared to double-lung ventilation. METHODS: Data were obtained from 24 patients undergoing thoracic surgery. Cerebral oxygen saturation (rSO2) was continuously monitored by INVOS 5100C Cerebral Oxymeter System along with measurement of cerebral blood fl ow velocity (MCAV) by transcranial Doppler sonography. Arterial blood samples were taken for blood gas analysis in the awake state, in the supine and lateral decubitus position during double-lung ventilation (DLV), and during OLV. RESULTS: When ventilation was changed from DLV to OLV, no significant change was observed in rSO2. A significant decrease of rSO2 was found compared to the value observed during DLV in lateral decubitus at the time point 60 minutes after the start of OLV. No clinically significant changes in the MCAV was observed throughout the course of the thoracic surgical procedure. CONCLUSIONS: OLV does not result in clinically relevant decreases in cerebral blood fl ow and cerebral oxygen saturation during application of lung protective ventilation if normocapnia is maintained.

Physical map and characterization of transcripts in the candidate interval for familial chondrocalcinosis at chromosome 5p15.1.

The gene for familial chondrocalcinosis (MIM 118600; gene symbol CCAL2) has been localized to a 0.8-cM interval on the short arm of chromosome 5, between the polymorphic microsatellite markers D5S416 and D5S2114. We have undertaken the physical and transcript mapping of this interval, as well as regions telomeric to the interval, in an attempt to define ultimately the gene for this disorder. The physical map is composed of YAC, BAC, PAC, and cosmid resources and spans a physical distance of approximately 0.3 Mb. Using cDNA selection, we have identified eight novel transcripts in and around the interval; two of the selected transcripts reside in the candidate interval. We have also more precisely placed several expressed sequence tags (ESTs) that were previously mapped by radiation hybrid analysis and were reported to reside in or near the candidate interval. Two of the ESTs analyzed overlap with the selected cDNAs that reside in the candidate interval. All of the selected cDNAs are expressed partial transcripts, as determined by Northern blot analysis, and using RT-PCR analysis, we have determined that the cDNAs that reside in the candidate interval are expressed in cartilage and synovium, tissues that are presumably relevant to the chondrocalcinosis phenotype.

Activity of glucose-6-phosphate-dehydrogenase enzyme studies in calves with long--survivals with total artificial heart.

The research aimed at studying metabolic changes of erythrocytes in the calves surviving for a long period with total artificial heart of BRNO VII type. The authors studied partly the count of erythrocytes, the plasma levels of free hemoglobin and activity of glucose-6-phosphate-dehydrogenase enzyme. The changes found were compared with the levels measured in a group of 10 healthy calves. Constant decrease of erythrocyte count, slightly increased concentration of free hemoglobin in plasma and repeatedly decreased activity of the enzyme studied were found in the group of 4 experimental calves, from the 5th to 17th weeks of surviving. These changes can be explained by a long-term action of mechanical stress on the erythrocytes that pass through the pump of the total artificial heart. The cells damaged mechanically have the decreased energetic metabolism and, consequently, shortened viability. As young healthy animals with normal erythropoiesis which is stimulated by the application of drugs during the experiment are used, compensated anaemia develops, but it is not a limiting factor for the surviving of the calves with total artificial heart.

Optics in czechoslovakia.

After a brief description of the historical development of optics in Czechoslovakia, a short survey of its present state is given. Research in the fields of image forming, physical, physiological, spectroscopic, and molecular optics carried out at the Czechoslovak Academy of Sciences, in the universities, and in industrial research institutes is described. Brief mention is also made of the optical industry and the training of opticists.