Rhinoplasty update: preoperative evaluation of 4,040 cases

A total of 4,040 cases of cosmetic rhinoplasty surgery was evaluated in terms of sex distribution, age, marital status, and motivating factors. There was a male to female ratio of 1:15.9. Of the 1,880 patients operated on between 1975 and 1980, there were 40.2% females and 33.3% males over the age of 24 years. This is an increase over a previous patient group of 2,160 patients treated between 1964 and 1974, in which older women comprised 26.8% and older men 24% of those treated. The proportion of married patients has increased since 1975, with 29.1% of the women married and 11.4% of the men (versus 18.6% and 4.8%, respectively, for the earlier period). Motivating factors included the patient's own desire for a change, external influences such as advice from family or friends, and observation of someone who had undergone rhinoplasty successfully.

A practical approach to the treatment of burn shock in childhood

A simple method of evaluating and treating burn shock has been used with very good results and low mortality. The amounts of fluids given in a specific time and the type of fluids given are dependent upon the evaluation of a few simple observations. We believe that shock is a treatable condition and that 'shock kidney' is preventable. We stress the difficulty of trying to compare the results of two different burn units.

Pericarditis with effusion casued by Actinomyces israelii

Actinomyces israelii is a rare cause of pericarditis. Infection spreads to pericardium from an intrathoracic focus. Branching gram-positive filaments are seen on microscopic examination of clinical specimens. Cultures should be performed under anaerobic conditions. Both surgical drainage and antibiotics (penicillin) are required for treatment. Nocardiosis may resemble actinomycosis in many respects.

Clinical evaluation of the phase contrast microscope as a motivational aid in oral hygiene

In a pilot study, phase contrast microscope and plane microscope demonstrations of plaque were compared in two controlled groups to evaluate their relative effect on long-term motivation toward good oral hygiene. Plaque and calculus scores were used as indexes. During a seven-month period, the group using the phase contrast microscope showed statistically significant imporvement in plaque scores compared with the group using the plane microscope. However, the difference in actual plaque amounts between groups was of a small magnitude and cannot be considered clinically significant. Both groups showed significant statistical improvement in plaque scores at seven months as compared with pretests socres. This maintained plaquereduction at seven months was of a magnitude that could be clinically significant.

Possibility of diagnosing meningitis by gas chromatography: cryptococcal meningitis

Cerebrospinal fluid (CSF) from eight patients with cryptococcal meningitis, from ten patients with viral meningitis, and from four control patients without meningitis were analyzed by electron-capture gas-liquid chromatography (EC-GLC). All cryptococcal specimens had similar EC-GLC profiles, and these differed from those of the controls. Viral EC-GLC patterns were different from those obtained with specimens from the patients with cryptococcal infection and from the controls. In addition, specimens from patients with various types of viral infections gave profiles that differed from each other. Two normal CSFs were inoculated with Cryptococcus neoformans; aliquots of these cultures showed an EC-GLC pattern very similar to that seen in CSF of patients with cryptococcal meningitis. The EC-GLC procedure is rapid, reproducible, and easy to perform and may hold promise as an additional aid in the diagnosis of cryptococcal infection.

Herellea vaginicola and ocular infections

This case report describes a chronic medically-refractory corneal ulcer which eventually yielded Herellea vaginicola from resected corneal tissue. A review of the literature cites the occurrence of this organism as an inhabitant of normal conjunctiva, as an infrequent cause of conjunctivitis, and as the causative agent in two previous cases of corneal ulcers. This case illustrates the difficulty in the isolation of the organism and indicates the need for diagnostic and therapeutic keratectomy in conjunction with a conjunctival flap.