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Infections caused by the genus Fusarium have emerged over the past decades and range from onychomycosis and keratitis in healthy individuals to deep and disseminated infections with high mortality rates in immune-compromised patients. As antifungal susceptibility can differ between the different Fusarium species, identification at species level is recommended. Several clinical observations as hyaline hyphae in tissue, necrotic lesions in the skin and positive blood tests with fungal growth or presence of fungal cell wall components may be the first hints for fusariosis. Many laboratories rely on morphological identification, but especially multi-locus sequencing proves better to discriminate among members of the species complexes involved in human infection. DNA-based diagnostic tools have best discriminatory power when based on translation elongation factor 1-α or the RNA polymerase II second largest subunit. However, assays based on the detection of other fusarial cell compounds such as peptides and cell wall components may also be used for identification. The purpose of this review is to provide an overview and a comparison of the different tools currently available for the diagnosis of fusariosis.

Background: The procedures needed to insert nasojejunal tubes (NJTs) are often invasive or uncomfortable for the patient and require hospital resources. The objectives of this study were to describe our experience in inserting a self-propelling NJT with distal pigtail end and evaluate clinical validity and cost efficacy of this enteral nutrition (EN) approach compared with parenteral nutrition (PN). Materials and Methods: Prospective study from July 2009 to December 2010, including hospitalized noncritical patients who required short-term jejunal EN. The tubes were inserted at bedside, using intravenous erythromycin as a prokinetic drug. Positioning was considered correct when the distal end was beyond the ligament of Treitz. Migration failure was considered when the tube was not positioned into the jejunum within 48 hours postinsertion. Results: Fifty-six insertions were recorded in 47 patients, most frequently in severe acute pancreatitis (69.6%). The migration rates at 18 and 48 hours postinsertion were 73.2% and 82.1%, respectively. There was migration failure in 8.9% of cases, and 8.9% were classified null (the tube was no longer in the gastrointestinal tract at 18 hours). There were no reported or observed complications. The mean duration of the EN was 12 ± 10.8 days. Five different types of EN formula were used. The total study cost was 53.9% lower compared with using PN in all patients. Conclusions: Our study demonstrated that bedside insertion of a self-propelling NJT is a safe, cost-effective, and successful technique for postpyloric enteral feeding in at least 73% of the patients, and only 18% of patients could eventually need other placement techniques. It can avoid the need for more aggressive or expensive placement techniques or even PN if we cannot achieve enteral access.

Rationale: It has been shown that early nutrition intervention improves nutrition status (NS) and treatment tolerance in patients with esophageal cancer. However, it remains unknown whether pretreatment parameters of NS are associated with treatment modifications (TMs) during neoadjuvant chemoradiation (CR) in patients who are intensively nutritionally supervised during treatment. Methods:All outpatients with esophageal cancer who were scheduled for CR in the VU medical center from 2006-2015 were included. NS was assessed by body mass index (BMI), weight loss in the past 6 months (WL), fat mass index (FMI) and fat-free mass index (FFMI), handgrip strength (HGS), and energy/protein intake. Logistic regression analyses, adjusted for age, sex, previous tumor, tumor stage, and physical status, were applied. TMs were defined as delay, dose reduction or discontinuation of chemotherapy and/or radiotherapy, hospitalization, or mortality (yes/no). Results: In total, 162 patients were included (73% male; mean age 65 ± 9 years). Mean BMI was 25.1 ± 4.5 kg/m2, and WL was 4.8 ± 5.1 kg. HGS and FFMI were below the 10th percentile of reference values in 21 and 37 patients, respectively. Thirty-five (22%) patients experienced at least 1 TM during CR; unplanned hospitalization (n = 18, 11%) was the most prevalent. After adjustments for confounders, only HGS was statistically significantly associated with TMs (odds ratio, 0.93; 95% confidence interval, 0.88-1.00). Conclusion: In this group of intensively supervised patients with esophageal cancer, pretreatment parameters of NS had little influence on TMs during CR. Only a lower HGS was associated with TMs.

Introduction. In contemporary pharmaceutical practice among drugs used in dental gels are most effective, that are easily applied to the mucous and long held on the gums to form a protective film and prolonging therapeutic effect. Therefore it developed a new drug with a carbon dioxide Humulus Lupulus extract antimicrobial action in gel form for treatment of the oral cavity. The aim of our study was to investigate the acute and subacute toxicity the gel containing 0.5 % carbon dioxide Humulus lupulus extract. The toxicity of the gel studied at the intragastric route of administration, due to the scope of drug – dentistry. Materials and methods. The object of the research was gel containing 0.5% carbon dioxide Humulus lupulus extract. Studies of acute toxicity gel with carbon dioxide Humulus lupulus extract was performed on white inbred laboratory mice of both sexes, weighing 19–21 gram. Animals received gel single intragastric at maximum tolerated this route of administration dose – 2.0 g/kg [6]. The experiment used by 5 mice of both sexes. The criteria of judgment about the toxicity was the clinical picture of intoxication, animal survival, dynamics of body weight of mice (raw data, 3, 7, 14 days). Observation of animals were carried out within two weeks. Subacute toxicity studied on white inbred laboratory rats of both sexes, weighing 220 – 250 g. Animals were divided into 3 groups, each experimental group were 5 male and 5 female rats. Total experiment used 30 rats. Rats was injected gel with carbon dioxide Humulus lupulus extract once a day for 14 days at doses of 0.2 g/kg and 1.0 g/kg (1/10 and 1/2 of the maximum dose in acute experiment). Control animals were injected comparison drug Kamistad–H gel at a dose of 1.0 g/kg. Evaluation of the toxic effects of investigational gel and reference medicine on the body of the experimental animals were carried out on the following parameters: clinical observations, the survival of animals, food and water consumption, the dynamics of body weight, hematological and biochemical parameters of blood. Clinical observations of the animals was performed daily during the experiment, registering changes in their general condition, behavior, food and water consumption. Clinical and biochemical parameters studied using a reagent kit of "Felicity Diagnostics" (Ukraine) and conventional methods. Body weight of animals recorded in dynamics. The animals were weighed before the experiment, then 7 and 14 days. Results and discussion. Results of the study parameters acute toxicity gel with carbon dioxide Humulus lupulus extract showed that intragastric administration to mice at a dose of 2.0 g/kg caused no clinical symptoms of intoxication. Animals calmly reacted to the introduction of the sample gel, their general condition and behavior remained unchanged. Animal deaths and abnormalities in their general condition and behavior during the observation period were noted. Impact analysis of the sample of gel on the dynamics of body mass animal experiments showed that a single injection of a gel to mice at a dose of 2.0 g/kg did not significantly affect the dynamics of body weight. In experiments on rats were studied subacute toxicity gel with carbon dioxide Humulus lupulus extract. The results of 14 days intragastric introduction gel and reference drug studies at subacute toxicity showed that daily administration of no effect on the general condition, appearance (state of the skin and mucous membranes) and the behavior of rats. Consumption of food and water in animal experimental and control groups had no differences from each other. During the experiment animal deaths were not reported. Data characterizing the dynamics of increase in body weight of rats showed that the animals of experimental groups and the control group by the end of the experiment had equivalent, statistically significant weight gain compared with the output data: males – p ≤ 0. 0001 females – from p ≤ 0.0001 to p ≤ 0.0004. During the experiment, the animals of all experimental groups were observed physiological fluctuations that characterize the pattern of peripheral blood. Results of biochemical studies showed that overall the tested parameters: the concentration of total protein, albumin, thymol test, the activity of alanine and aspartate aminotransferase, the concentration of glucose and cholesterol in the blood serum of rats of all experimental groups answered normal values. There have been fluctuations in biochemical parameters in animals of all experimental groups compared with baseline data did not go beyond the physiological norm. Conclusions. 1. Study of acute toxicity after a single intragastric administration to mice gel with 0.5 % carbon dioxide Humulus lupulus extract have shown that gel does not cause death of animals; no toxic effects on the general state, behavior, food consumption and water weight animals; does not affect the absolute and relative weight of internal organs; does not cause visible changes of internal organs. 2. According to the standard classification gel with 0.5 % carbon dioxide Humulus lupulus extract refers to practically non-toxic substances. 3. Subacute toxicity study results showed that the gel with 0.5 % carbon dioxide Humulus lupulus extract with 14 daily intragastric administration to rats at doses of 0.5 g/kg and 1.0 g/kg, does not cause death of animals; has no toxic effects on the general state, behavior and dynamics of body weight of the experimental animals; no negative impact on the performance of blood of animals; does not change the biochemical parameters characterizing the functional state of the liver of animals. 4. Pharmacological studies of dental gel with 0.5 % carbon dioxide Humulus lupulus extract, such as the results of the study of acute and subacute toxicity found that designed gel to include low-toxic substances (IV class of toxicity), has good tolerability and safety of long-term use.

Angiogenesis inhibitors have become standard of care for advanced and/or metastatic renal cell carcinoma (RCC), but data on the impact of adverse events (AEs) and treatment modifications associated with these agents are limited. Medical records were abstracted at 10 tertiary oncology centers in Europe for 291 patients >= 18 years old treated with sunitinib as first-line treatment for advanced RCC (no prior systemic treatment for advanced disease). Logistic regression models were estimated to compare dose intensity among patients who did and did not experience AEs during the landmark periods (18, 24, and 30 weeks). Cox proportional hazard models were used to explore the possible relationship of low-dose intensity (defined using thresholds of 0.7, 0.8, and 0.9) and treatment modifications during the landmark periods to survival. 64.4% to 67.9% of patients treated with sunitinib reported at least one AE of any grade, and approximately 10% of patients experienced at least one severe (grade 3 or 4) AE. Patients reporting severe AEs were statistically significantly more likely to have dose intensities below either 0.8 or 0.9. Dose intensity below 0.7 and dose discontinuation during all landmark periods were statistically significantly associated with shorter survival time. This study of advanced RCC patients treated with sunitinib in Europe found a significant relationship between AEs and dose intensity. It also found correlations between dose intensity and shorter survival, and between dose discontinuation and shorter survival. These results confirm the importance of tolerable treatment and maintaining dose intensity.

Ebola virus disease (EVD—formerly known as Ebola hemorrhagic fever) is a severe hemorrhagic fever caused by lipid-enveloped, nonsegmented, negative-stranded RNA viruses belonging to the genusEbolavirus. Case fatality rates may reach up to 76% of infected individuals, making this infection a deadly health problem in the sub-Saharan population. At the moment, there are still no indications on ophthalmological clinical signs and security suggestions for healthcare professionals (doctors and nurses or cooperative persons). This paper provides a short but complete guide to reduce infection risks.

Purpose of review: Artificial corneas are being developed to meet a shortage of donor corneas as well as to address cases where allografting is contraindicated. A range of artificial corneas has been developed. Here we review several newer designs and especially those inspired by naturally occurring biomaterials found with the human body and elsewhere. Recent findings: Recent trends in the development of artificial corneas indicate a move towards the use of materials derived from native sources including decellularized corneal tissue and tissue substitutes synthesized by corneal cells in vitro when grown either on their own, or in conjunction with novel protein-based scaffolds. Biologically inspired materials are also being considered for implantation on their own with the view to promoting endogenous corneal tissue. Summary: More recent attempts at making artificial corneas have taken a more nature-based or nature-inspired approach. Several will in the near future be likely to be available clinically.

Clinical evaluation of 33 patients who underwent orthognathic surgery was performed at Oral & Maxillofacial Surgery, University of the Ryukyus between 1990 and 1998. The results were as follows: 1. The ratio of males to females was 1:2.7. The age of the cases at operation ranged from 16 to 42 years, with a mean of 22.3 years. 2. All of clinical diagnosis was mandibular prognathism and 14 0f them were associated with open bite and/or mandibular asymmetry. 3. The predominant chief complaint was esthetic disturbance. 4. Twenty eight cases (84.8%) underwent sagittal splitting ramus osteotomy (SSRO), and the other cases with severe maxillofacial deformity underwent simultaneously Le Fort I osteotomy of the maxilla with SSRO. 5. 0rthognathic surgeries performed at our clinic have been approached perorally, so the incision of facial skin was not needed. 6. The number of operations have increased in recent years. 7. The average blood loss was 510 ml with SSRO and 750 ml with Le Fort I osteotomy with SSRO. The average operation time was 223 minutes in the former and 356 minutes in the latter. 8. Autologous blood transfusion was applied to 18 cases, and homologous blood transfusion was needed in only 2 cases., 論文

The term "isotopic response" was coined by Wolf et al in 1995 to describe the occurrence of a new skin disorder at the site of another unrelated and already healed skin disease. When this term was found to be unsuitable for Medline searches because it generated hundreds of references that were linked with radioactive isotopes, it was changed to "Wolf's isotopic response" and eventually included as such in Stedman 's Illustrated Dictionary of Dermatology Eponyms . Our search of the literature yielded 176 cases of Wolf 's isotopic response. We describe this entity and present representative clinical examples. Some problems in the definition of Wolf 's isotopic response are provided with special emphasis on its overlapping with the Koebner isomorphic response, a similar, but different, phenomenon. Also addressed are a number of issues associated with another term, "isotopic nonresponse," which had been introduced in analogy to the "isomorphic nonresponse" for describing the absence of an eruption at the site of another unrelated and already healed skin disease, or the sparing of the sites of another unrelated and already healed skin disease. In the spirit of the present issue, this contribution discusses only the clinical morphology and not the etiology, pathomechanism, or molecular biology of Wolf 's isotopic response.

Objective: to determine the prevalence and characterization of ectasias diagnosed by corneal topography in the Eye Clinic Solex Ltda. [Sucre - Bolivia] in the first half of 2013.Methods: a descriptive cross-sectional observational study. The population were patients with corneal topography in the first half of 2013 at the Eye Clinic Solex Ltda.Results: of 170 patients who entered the study 57.6% were female and 42.6% male. The minimum age was 7 years and maximum of 64 years with an average of 28.2 years; appearing more frequently patients 30 years [13 patients - 7.6%]. According to the topographic pattern it shows that 57.2% corresponds to the irregular shape, value of great significance. The lower display corresponds to the asymmetric bowtie [14 presentations].Conclusions: in this study a difference between female gender [57.6%] and men [42.4%] of 15.2% was found. In terms of age distribution shows a range between 7 and 64 years. Of the 339 279 topographies that were made they had a great shot and 60 present a reduced quality due to lack of placido rings, however the team classifies with 97% of analyzed area [normal]. The prevalence of corneal ectasia in the Eye Clinic Solex Ltda. of Sucre, was 57.2%. Law 47.9% and 52.1% in the left eye on total of 339 tests, eye is important to note that it is a high prevalence Objetivos: determinar la prevalencia y caracterización de ectasias diagnosticadas por topografía corneal en la Clínica Oftalmológica Solex Ltda. en el primer semestre de 2013 Sucre, Bolivia.Materiales y métodos: estudio observacional descriptivo de corte transversal. La población fueron los pacientes con topografía corneal en el primer semestre del 2013 en la Clínica Oftalmológica Solex Ltda.Resultados: de 170 pacientes que entraron al estudio el 57,6% son del género femenino y 42,6% masculino. La edad mínima fue de 7 años y la máxima de 64 años con un promedio de 28,2 años; presentándose mayor frecuencia los pacientes de 30 años [13 pacientes, 7,6%]. De acuerdo con el patrón topográfico se evidencia que el 57,2% corresponde a la forma irregular, valor de gran significancia. La de menor presentación corresponde al corbatín asimétrico [14 presentaciones].Conclusiones: en el presente estudio se encontró una diferencia entre el género femenino [57,6%] y masculino [42,4%] del 15,2%. En cuanto a la edad su distribución muestra un rango comprendido entre los 7 y 64 años. De las 339 topografías que se realizaron 279 tuvieron una excelente toma y 60 presentó una calidad reducida debido a falta de anillos de placido, sin embargo, el equipo los clasifica con un 97% de área analizada [normal]. La prevalencia de ectasias corneales en la Clínica Oftalmológica Solex Ltda. de Sucre, fue del 57,2%. En ojo derecho 47,9% y del 52,1% en ojo izquierdo sobre un total de 339 exámenes, es importante destacar que es una prevalencia alta.[Martínez AE, Guerra F, Guerra GM, Ibáñez KD, Cárdenas JA. Prevalencia de las ectasias corneales en la Clínica Oftalmológica Solex Ltda. En el primer semestre de 2013, Sucre, Bolivia. Ustasalud. 2014;13(2): 150 - 155]

The authors have studied 53 patients with essential tremor, focusing its clinical and epidemiological aspects. There were familial history in 37.70% of all cases, prevailing in females (56.60%) and white people (69.80%); nevertheless this difference can not be assured from the statistical point of view due to lack of population data. We agreed that the main incidence of this syndrome occurred beyond the 5th decade, specially during the 6th and 7th decades. Topographically, we could observe that the hand tremor predominated, with an incidence of 96.20% of the total number of cases, followed by head tremor (28.30%), voice tremor (16.99%), leg tremor (11.30%), tongue tremor (3.78%) and trunk tremor (1.88%). These focal tremors were seldom observed alone and we noted frequent association with hand tremor. Foram analisados 53 casos de tremor essencial (TE) do Ambulatório de Distúrbios do Movimento da Disciplina de Neurologia do Hospital Universitário Pedro Ernesto - UERJ, quanto a história familiar, sexo, idade e áreas de acometimento corporal. Dos pacientes avaliados, somente 37,70% apresentavam história familiar para TE. Observa-se predomínio do sexo feminino (56,60%) em relação ao masculino (43,40%) e da raça branca (69,80%) sobre as demais, entretanto, não se pode afirmar que esta diferença seja estatisticamente significativa, por não se dispor de dados populacionais. Nossos achados mostraram maior incidência após os 50 anos de idade, predominando nas 6ª e 7ª décadas, principalmente nesta última. O acometimento das mãos (96,20%) prevaleceu sobre as demais áreas corporais: cefálico (28,30%), de voz (16,99%), de pernas (11,30%), de língua (3,78%) e de tronco (1,88%). Estes dificilmente se apresentavam isolados e ocorriam, em sua maioria, associados ao tremor de mãos.

The intubating conditions and neuromuscular blocking profile following 600 micrograms.kg-1 rocuronium (Org 9426) have been investigated in patients under various experimental conditions. They were compared with conditions following 1.5 mg.kg-1 suxamethonium, preceded by a precurarising dose (10 mg) of gallamine, and with those in a control group in the absence of a muscle relaxant. Rocuronium produced good to excellent intubating conditions at 60 as well as at 90 s after administration, even though there was only a partial blockade of the adductor pollicis muscle. Intubating conditions following suxamethonium were comparable with those after rocuronium. Half of the control patients could be intubated. The clinical duration and the recovery time of 600 micrograms.kg-1 of rocuronium were 24(4) and 9(3) min (mean(s.d.)), respectively. Rocuronium may have a major advantage over existing non-depolarising muscle relaxants due to the early presence of excellent intubating conditions. The results indicate that rocuronium may replace suxamethonium in procedures in which rapid sequence induction is required.

1977年から1984年までの8年間に経験した尿道炎患者について, 臨床的観察を行った.1)尿道炎新患数は徐々に増加し, 8年間で約2.5倍の増加がみられた.1981年を除いて, NGU(非淋菌性尿道炎)がGU(淋菌性尿道炎)よりも若干多くみられた.2)陰部ヘルペスと尖形コンジローマの増加傾向が認められた.3) GU, NGUとも20, 30歳代に最も多くみられた.4) GU, NGUとも特殊浴場からの感染が最も多かった.5)潜伏期間はGUでは1週間以内が60%以上と最も多く, 全例が1ヵ月以内であった.NGUでも1週間以内が最も多かったが, GUより潜伏期間の長い傾向がみられた.6) GUに対して, 1979年以前では主にPCGの投与が, 1980年以降ではMINOあるいはDOXYとSPCMの併用投与が最も多く行なわれ, 治癒成績はそれぞれ94%, 99%であった.7) NGUに対して, 1979年以前にはMINOあるいはDOXYは7例(10%)に投与されたにすぎなかったが, 1980年以降では152例(89%)に投与され, その成績はそれぞれ43%, 97%の治癒率であった, Clinical observations were made on patients with urethritis, syphilis, chancroid, genital herpes and venereal warts for the last eight years at Gifu City Hospital. The patients with urethritis, genital herpes and venereal warts tended to increase yearly, and the number of the cases with urethritis increased about 2.5 times in the eight years. Slightly more patients had nongonococcal urethritis than gonococcal urethritis excluding 1981. Of the patients with gonococcal urethritis seen between 1977 and 1979, 58% were treated with benzylpenicillin intramuscularly, and 43% of the patients seen between 1980 and 1984 were treated with a concomitant therapy of spectinomycin intramuscularly and minocycline or doxycycline orally. The cure rate for each treatment was 94% and 97%, respectively. Of the patients with nongonococcal urethritis seen between 1980 and 1984, 89% were treated with minocycline or doxycycline orally, and the cure rate was 97%. On the other hand, the cure rate was 43% for the treatment between 1977 and 1979, only 10% of whom had received treatment with minocycline or doxycycline.

Clinical observations were made on patients with urethritis, syphilis, chancroid, genital herpes and venereal warts for the last eight years at Gifu City Hospital. The patients with urethritis, genital herpes and venereal warts tended to increase yearly, and the number of the cases with urethritis increased about 2.5 times in the eight years. Slightly more patients had nongonococcal urethritis than gonococcal urethritis excluding 1981. Of the patients with gonococcal urethritis seen between 1977 and 1979, 58% were treated with benzylpenicillin intramuscularly, and 43% of the patients seen between 1980 and 1984 were treated with a concomitant therapy of spectinomycin intramuscularly and minocycline or doxycycline orally. The cure rate for each treatment was 94% and 97%, respectively. Of the patients with nongonococcal urethritis seen between 1980 and 1984, 89% were treated with minocycline or doxycycline orally, and the cure rate was 97%. On the other hand, the cure rate was 43% for the treatment between 1977 and 1979, only 10% of whom had received treatment with minocycline or doxycycline.

A previously healthy 68-year-old woman presented with fever and sore throat. Her condition was initially diagnosed as necrotizing streptococcal tonsillitis and was treated with penicillin G, given intravenously. A swab of her throat taken for culture at the time of admission yielded Corynebacterium diphtheriae 48 hours later. At that time an electrocardiogram showed new T-wave inversion — evidence of diphtheritic myocarditis. She was immediately given 60 000 units of equine diphtheria antitoxin (following a test dose), but later that day she began choking, became apneic and died. The patient had not received any immunizing agents as a child, and no antitoxin was detected in a blood sample obtained prior to administration of the antitoxin. Her death re-emphasizes the seriousness of diphtheria, an infection to which many elderly people are susceptible.

Dysgonic fermenter 2 (DF-2) is a fastidious gram-negative pathogen that is capable of causing multiorgan disease in humans. In the case reported here infection resulted in subacute bacterial endocarditis, brain abscess and chronic type 1 membranoproliferative glomerulonephritis, a form of renal disease not previously reported in DF-2 infections. The literature is reviewed, and difficulties in diagnosis and treatment are discussed.

Two cases of dysphagia due to osteophytes at the level of the fifth and sixth cervical vertebrate are reported. The patients were two women aged 47 and 50 years. The diagnosis was confirmed by means of roentgenography, barium studies and, in one case, esophagoscopy. Both patients were successfully treated surgically. The importance of properly investigating cervical dysphagia is stressed. Doctors in many different fields of practice should be aware of this rare cause of dysphagia.

An active, 74-year-old man with coarctation of the aorta is described. This case is rarely found in patients over the age of 70, and the patient had been in good health.

Genital tuberculosis is usually associated with tuberculous involvement of the kidney. A case is reported of clinically isolated tuberculosis of the epididymis

Dactylitis commonly occurs in patients with homozygous hemoglobin S disease (sickle cell anemia), sickle cell-hemoglobin C disease or sickle cell-beta-thalassemia. A case is reported of dactylitis associated with sickle cell trait, a very rare occurrence. It may be that in this patient the disorder was secondary to severe diarrhea and dehydration.

We describe a patient in whom lung cancer developed several years after he had received combined-modality therapy for Hodgkin's disease. The literature concerning second malignant diseases, particularly thoracic tumours, that occur following combined-modality therapy for cancer is reviewed. It is important to recognize these entities, because chest symptoms or findings on x-ray films may be misinterpreted as representing late recrudescence of the first neo-plastic disease.

The clinical and serologic features of 36 patients with polymyositis (PM) or dermatomyositis (DM) were observed over a 5-year period. The mean age of the patients at the time of diagnosis was 48.5 years, and 61% were female. According to widely accepted diagnostic criteria 50% had PM (group I), 14% DM (group II), 11% PM or DM associated with malignant disease (group III) and 25% PM or DM associated with a connective tissue disorder (group V). None of the patients had childhood PM or DM associated with vasculitis (group IV). All the patients had muscle weakness, and 94% of the patients tested had an elevated serum level of creatine kinase. The average delay from the onset of symptoms to diagnosis was 14 months overall but only 2.3 months for the DM patients. Of the 30 patients whose serum was tested, 73% had antinuclear antibodies, with antibodies to nuclear ribonucleoprotein being most common in group V patients and antibodies directed against the Jo-1 antigen being restricted to patients with PM alone (group I).