The American genera of Malvaceae—II

The genera of Malvaceae that occur in North, Central, and South America (including the Caribbean) are enumerated, described, and distinguished, using an artificial key. The usual taxonomic information (bibliographic citations, synonyms, type species, etc.) is presented and the generic names are indexed. The literature is reviewed and summarized for each genus, presenting such information (where appropriate) as the etymology of the name, number of species, infrageneric classification, distribution, chromosome numbers, economic importance, distinguishing features, and reference to representative illustrations. Where useful, the taxonomic history of the genus is summarized. A listing of unresolved taxonomic problems in the family is presented to highlight needs for future study. A detailed bibliography is included. One new combination is made:Palaua sandemanii (Sandwith) Fryxell, based on the PeruvianMalvastrum sandemanii Sandwith.

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Resumen  Los géneros de la familia Malvaceae que se encuentran en Norte América, Centroamérica, y Sudamérica (incluyendo Las Antillas) se enumeran, describen, y distinguen por medio de una clave artificial. Se presentan informaciones tales como citas bibliográficas, sinonimías, y especies tipos para cada género, y se presenta un índice de los nombres, genéricos. Para cada género del que existe información, se presentan datos derivados de la literatura sobre su etimología, número de especies, clasificación infragenérica, distribución geográfica, números cromosómicos, importancia económica, características destacables, y referencias de ilustraciones representativas. Cuando se considera necesario, se presenta la historia taxonómica del género. Se presenta un lista de aquellos problemas taxonómicos no resueltos en la familia y se indican los estudios necesarios para el futuro. Se acompanya una bibliografía detallada. Se hace una combinación nueva:Palaua sandemanii (Sandwith) Fryxell, basada enMalvastrum sandemanii Sandwith.

     

The Future of Smallpox Vaccination: is MVA the key?

Eradication of the smallpox virus through extensive global vaccination efforts has resulted in one of the most important breakthroughs in medical history, saving countless lives from the severe morbidity and mortality that is associated with this disease. Although smallpox is now extinct in nature, laboratory stocks of this virus still remain and the subject of smallpox vaccination has gained renewed attention due to the potential risk that smallpox may be used as a biological weapon by terrorists or rogue states. Despite having the longest history of any modern vaccine, there is still much to be learned about smallpox vaccination and the correlates of protection remain to be formally defined. This Commentary will discuss the strengths and weaknesses of traditional smallpox vaccination in comparison with immunization using modified vaccinia virus Ankura (MVA), a non-replicating virus with a strong safety record but weakened immunogenicity.     

Pain Syndromes—The Use of Nerve Block in Diagnosis and Treatment

There are four distinct pain entities which may be treated by injection of local anesthetic or neurolytic agents. These entities are somatic, visceral, sympathetic mediated and myofascial pain. Each entity should be recognized as separate from other types of pain and the appropriate therapeutic approach prescribed.     

BILIARY TRACT ANOMALIES—The Utilization of Modern Techniques in Differential Diagnosis

The diagnostic aids used in dealing with biliary disease in adults were applied to the study in infants of the principal congenital anomalies of the biliary tract such as choledochal cyst, biliary atresia and biliary stenosis.Choledochal cysts were distinguished from other upper abdominal masses occurring in childhood by the use of intravenous cholecystography.Since the clinical manifestations in infants with biliary atresia or stenosis are almost identical to those associated with the obstructive phase of neonatal hepatitis, the problem of differentiation is difficult. The serial total serum bilirubin curve, a careful analysis of the pigment content of feces and urine and duodenal intubation for bilirubin determinations were found to be useful in making the distinction. Operative cholangiograms were helpful in some cases. Frozen section examinations of liver tissue during operation were of little value except to demonstrate certain unusual cases of intrahepatic biliary atresia. Routine liver function studies, including serum transaminase determination in a limited number of cases, did not help in differentiation.     

SCINTIGRAMS OF THE THYROID GLAND—The Diagnosis of Morphologic Abnormalities with I131

Functioning thyroid tissue containing sufficient radioiodine can be visualized by scanning the gland with a directional scintillation counter.⁴ This visual representation of the gland is called a “scintigram.” Scintigrams have been invaluable in the detection and study of both “toxic” and non-functioning nodules, diffuse enlargement in hyperthyroidism and the subsequent reduction in gland size after treatment, carcinoma, and aberrant thyroid tissue.     

PRIMARY CUTANEOUS COCCIDIOIDOMYCOSIS—The Criteria for Diagnosis and a Report of a Case

Study was made of a case of coccidioidomycosis known to have resulted from primary inoculation of the organisms into the skin. Clinical observations and laboratory data were obtained at the time of clinical illness and for a period of five years thereafter. From the information thus obtained and correlation of it with what already was known of coccidioidomycosis, it was concluded that the disease originates very rarely as the result of primary cutaneous inoculation. In most instances lesions suspected to be of this type have actually resulted by dissemination of the organisms to the skin from a previously unrecognized pulmonary focus.Primary cutaneous coccidioidomycotic lesions closely resemble the primary cutaneous lesions (chancres) in other infectious granulomata, such as syphilis, tuberculosis and sporotrichosis. Spontaneous involution should occur within three months and then there should be immunity to reinfection in all but one or two per thousand instances.From these observations certain criteria were evolved by which to determine in a case of coccidioidomycosis with cutaneous manifestations whether or not the infecting organism entered through the skin.