Intralesional corticosteroid therapy for infantile hemangiomas.

Intralesional corticosteroid injections were performed in 31 hemangiomas in 30 infants aged 1 to 10 months at first injection. One to five injections were given, spaced 6 weeks apart. Lesions were located throughout the head and neck region, except one that was on the buttock. A mixture of betamethasone acetate and triamcinolone acetonide was used. Four lesions (13 percent) virtually disappeared, ten (32 percent) showed greater than 50 percent reduction in volume, ten (32 percent) showed definite but less than 50 percent reduction in volume, and seven (23 percent) showed little or no decrease in size. None showed further growth. All injections were performed without anesthesia, and there were not significant complications. We conclude that intralesional corticosteroid injections are safe and effective in properly selected infants with hemangiomas.

Delayed presentation of traumatic diaphragmatic hernia.

More than 111 patients with traumatic diaphragmatic hernia (TDH) were treated in a 5 1/2-year period; eight (7.2%) were first recognized more than 30 days postinjury. All were men, and their average age was 33.4 years. Seven injuries were on the left side; one was on the right side. The mechanism of injury was equally divided between penetrating and blunt trauma. Chest roentgenographic abnormalities were seen in all patients. Visceral reduction and diaphragmatic repair, despite strangulation in four patients, was accomplished without mortality and with minimal morbidity. Delayed presentation of TDH is reviewed, emphasizing diagnostic features encountered in the emergency department (ED).

Microsomal preparations of normal bovine iris-ciliary body generate prostacyclin-like but not thromboxane-A2-activity.

Indomethacin-treated bovine iris-ciliary body microsomes (IBIM) have been studied for their ability to convert PG endoperoxides into either thromboxane-A2 (TxA2)-like or prostacyclin (PGI2)-like activity. The biological activity of the ocular tissue microsomes were compared with either indomethacin-treated human platelet microsomes (for TxA2-like activity) or rabbit aorta microsomes (for PGI2-like activity) under appropriate incubation conditions. No evidence could be found for the formation of TxA2-like activity from PG endoperoxides by the IBIM. In contrast, when the IBIM were incubated with PGH2 for 1 min at 22 degrees C without cofactors, PGI2-like activity was produced, causing profound relaxation of the isolated dog coronary artery preparation without contracting the rabbit aorta and inhibiting arachidonic acid-induced platelet aggregation. Equivalent quantities of boiled IBIM failed to alter the biological activity of PGH2 under identical conditions. Tranylcypromine (500 microgram/ml) completely abolished the appearance of PGI2-like activity. Furthermore, the PGI2-like activity found was stable for 10 min at 22 degrees C at pH 8.5 but completely lost under similar conditions at pH 5.5. It is concluded that microsomal preparations of normal bovine iris-ciliary body can synthesize PGI2-like activity in substantial amounts but not TxA2-like activity.