Hodgkin's disease rarely involves the skin and when it does is an indication of advanced stage disease. Primary cutaneous Hodgkin's disease is exceedingly rare, and only a few cases are reported. We describe a patient who developed multiple cutaneous lesions of Hodgkin's disease 2 years before manifesting nodal disease of mixed cellularity subtype. Reed-Sternberg cells in the skin as well as lymph nodes and bone marrow were positive for Epstein-Barr viral transcripts and expressed viral latent membrane protein. Epstein-Barr virus has not previously been demonstrated in primary cutaneous Hodgkin's disease, and its presence in lesions in all sites in this case supports a diagnosis of primary cutaneous disease with subsequent evolution into systemic disease.

Ventilation-perfusion changes after right-sided pulmonary contusion (PC) in swine were investigated by means of the multiple inert gas elimination technique (MIGET). Anesthetized swine (injury, n = 8; control, n = 6) sustained a right-chest PC by a captive-bolt apparatus. This was followed by a 12-ml/kg hemorrhage, resuscitation, and reinfusion of shed blood. MIGET and thoracic computed tomography (CT) were performed before and 6 h after injury. Three-dimensional CT scan reconstruction enabled determination of the combined fractional volume of poorly aerated and non-aerated lung tissue (VOL), and the mean gray-scale density (MGSD). Six hours after PC in injured animals, Pa(O(2)) decreased from 234.9 +/- 5.1 to 113.9 +/- 13.0 mmHg. Shunt (Q(S)) increased (2.7 +/- 0.4 to 12.3 +/- 2.2%) at the expense of blood flow to normal ventilation/perfusion compartments (97.1 +/- 0.4 to 87.4 +/- 2.2%). Dead space ventilation (V(D)/V(T)) increased (58.7 +/- 1.7% to 67.2 +/- 1.2%). MGSD increased (-696.7 +/- 6.1 to -565.0 +/- 24.3 Hounsfield units), as did VOL (4.3 +/- 0.5 to 33.5 +/- 3.2%). Multivariate linear regression of MGSD, VOL, V(D)/V(T), and Q(S) vs. Pa(O(2)) retained VOL and Q(S) (r(2) = .835) as independent covariates of Pa(O(2)). An increase in Q(S) characterizes lung failure 6 h after pulmonary contusion; Q(S) and VOL correlate independently with Pa(O(2)).

SUMMARY Evidence is presented that both the one‐minute and five‐minute Apgar score have value in predicting infant morbidity, and that the five‐minute score is the better predictor. Morbidity is defined in terms of a diagnostic impression regarding neurological abnormality at one year of age, and by more specific findings regarding motor retardation, muscle tone and prehensile grasp. Low birth‐weight is also related to abnormal neurological outcome at one year of age. Within combinations of birth‐weight and five‐minute score groups, abnormal outcome is associated most strongly with the combination of low birth‐weight and low five‐minute score. In general, the percentage of abnormality within each birth‐weight group is greater among infants with scores of 0–3 than among infants in the same birth‐weight group with scores of 7–10. It appears that while both birth‐weight and Apgar scores at one and five minutes have predictability value regarding neurological abnormality at one year, this predictability value increases considerably when birth‐weight and five‐minute scores are combined. RÉSUMÉ Les auteurs mettent en évidence la valeur des deux scores d'Apgar, celui de une minute et celui de cinq minutes, pour prédire la morbilité infantile; pour cette prédiction le score de cinq minutes est à leur avis, le meilleur. La morbilité est définie en termes de diagnostic subjectif de L'anormalité neurologique à L'âge d'un an, et par des observations plus spécifiques du retard moteur, du tonus musculaire et de L'étreinte préhensile II existe également une relation entre faible poids de naissance et issue neurologique à L'age d'un an. A L'intérieur des groupes formés par combinaison poids de naissance—scoie de cinq minutes Tissue anormale est associée plus fortement avec la combinaison poids de naissance faible et score de cinq minutes faible. En general le pourcentage d'anormalitéà L'intérieur de chaque groupe de poids de naissance est plus grand parmi les enfants avec des scores de 0–3 que parmi les enfants du même groupe de poids de naissance avec des scores de 7–10. Le poids de naissance et les scores d'Apgar d'une et de cinq minutes ont tous deux une valeur de prediction de L'anormalité neurologique, mais cette valeur de prédiction augmente considérablement, semble‐t‐il, lorsque poids de naissance et scores de cinq minutes sont combines. ZUSAMMENFASSUNG Es wird Beweis erbracht, dass sowohl die Eine‐ als auch Fünf‐Minuten Apgar‐Punktzahl wertvoll sind in der Vorhersage der Säuglings‐Morbiditat, und dass die Fünf‐Minuten Punktzahl besser im voraussagen ist. Morbiditat wird definiert in der Form des diagno‐tischen Eindruckes hinsichtlich neurogischer Abnormität im Alter von einem Jahr und spezifischeren Befunden, die die motorische Retardation, Muskelton und Beherrschung des Greifens betreffen. Niederes Geburtsgewicht wird ebenfalls in Verbindung gebracht mit abnormen, neurologischen Ergebnisi m Alter von einem Jahr. Innerhalb der Kombinationen von Geburtsgewicht und Fünf‐Minuten Punktzahl‐Gruppen tritt abnormes Resultat am ...

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