Diagnosis of recurrent desmoplastic small round cell tumor by fine needle aspiration. A case report.

Background: Desmoplastic small round cell tumor (DSRCT) is a recently described neoplasm characterized by aggressive biology, occurrence in body cavities, expression of antigens from multiple cell lineages and a specific translocation between chromosomes 11 and 22. Most of the published information on this neoplasm is histologic. The case presented here enabled presentation of the cytomorphologic and immunocytochemical features of aspirated cytologic material obtained from this unique tumor.

Structural analogues of ZAPA as GABAA agonists.

Structural analogues of ZAPA, Z-3-[(aminoiminomethyl)thio]prop-2-enoic acid, an isothiouronium analogue of GABA, are potent GABAA agonists as seen in the isolated guinea-pig ileum and in the facilitation of [3H]diazepam binding to rat brain membranes. Compounds with guanidino or amidine groups replacing the amino functionality of GABA were also found to be active. The highest activity was displayed by the isothiouronium salts in which the conformational flexibility of the molecule is restricted by a Z-substituted carbon-carbon double bond.

Prognosis and management of Crohn's disease in the over-55 age group.

The course, prognosis and management of 62 patients with Crohn's disease aged 55 years or over at diagnosis has been reviewed. The distal ileus was the commonest site of disease in the older patient, where the characteristic presentation was acute after initially mild symptoms. Early local resection was often required, particularly where there was diagnostic doubt or suspicion of caecal malignancy.

Prevalence of gallbladder disease in diabetes mellitus.

A study was undertaken to compare the prevalence of gallstone disease (gallstones observed on ultrasound or history of cholecystectomy) in 308 diabetics and 318 controls. There was a higher prevalence of gallstone disease (GSD) in diabetics (32.7%) compared to controls (20.

Autoradiographic studies indicate regional variations in the characteristics of L-glutamate transporters in the rat brain.

Quantitative autoradiography of [3H]L-aspartate binding in thaw-mounted sections of rat brain has shown that L-trans-pyrrolidine-2,4-dicarboxylate and D-threo-3-hydroxyaspartate but not DL-2 aminoadipate strongly interacted with the binding sites while dihydrokainate, kainate and beta-aminoadipate produced only weak effects. The potency of inhibitors did not vary from one region to another in the telencephalon (neocortex, hippocampus and neostriatum) but, D-threo-3-hydroxyaspartate, L-trans-pyrrolidine-2,4-dicarboxylate, kainate and dihydrokainate inhibited [3H]L-aspartate binding in the cerebellar cortex less potently than that in the forebrain. Characteristics of the known excitatory amino acid transporters can, in part, explain the present results but contributions from additional transporter molecules to the heterogeneity of [3H]L-aspartate binding sites cannot be ruled out.

Pictorial review: the radiological spectrum of vertically-acquired HIV infection.

Anonymous antenatal and newborn screening demonstrates a positive HIV seroprevalence of one in 400 in areas of inner city London. European Collaborative Study data show a vertical transmission rate of 15% and suggests that 23% of infected children will develop clinical manifestations of AIDS before reaching 1 year of age [1], meaning that recognition of the radiological findings in vertically-acquired HIV is important. 75 serial cases of vertically-acquired HIV (age range 6 weeks to 12 years, mean age 35 months) presenting to a national referral centre over 48 months were reviewed; the radiographic findings we describe constitute a core of typical abnormalities together with a selection of the rarer manifestations of vertically-acquired HIV.

Progression of ulcerative proctosigmoiditis: incidence and factors influencing progression.

Objective: To assess the changing distribution of disease within the large bowel in patients presenting with ulcerative proctitis or proctosigmoiditis. To evaluate the influence of clinical exacerbations, smoking, parity and family history in disease extension.

Design: Retrospective single-centre study in a university hospital.

Bilateral endogenous Escherichia coli endophthalmitis: a devastating complication in an insulin-dependent diabetic.

We report a case of bilateral endogenous Escherichia coli endophthalmitis in an insulin-dependent diabetic. This condition appears to occur almost exclusively in diabetics, and is invariably related to a urinary tract infection. Treatment of any infection in diabetics should be aggressive, and any deterioration in vision should be addressed promptly.

Detection of main renal artery stenosis using phase-contrast cine MR angiography.

Objective: The purpose of our study was to assess the ability of phase-contrast cine MR angiography to detect the presence of main renal artery stenosis.

Subjects And Methods: We prospectively evaluated 75 hypertensive patients form main renal artery stenosis using phase-contrast cine MR angiography. Each main renal artery was evaluated as normal or abnormal.

Antibodies against Mycobacterium paratuberculosis in Crohn's disease.

Until recently the investigation of serological responses to mycobacteria in patients with Crohn's disease has been hindered by the considerable degree of cross-reactivity between antigens of M. paratuberculosis, and other mycobacterial subspecies. We evaluated the serological response of Crohn's disease patients to a recently identified species-specific 18 kDa protease-resistant antigen corresponding to M.

Activated clotting time differential is a superior method of monitoring anticoagulation following coronary angioplasty.

The standard high-range activated clotting time (sHR ACT) is used to monitor anticoagulation postangioplasty (PTCA), but may be unreliable. We assessed the accuracy of a new method we termed the ACT differential (ACT Diff), obtained by measuring the difference between an sHR ACT and a heparinase ACT from the same sample. Heparinase removes heparin from its sample and provides a current heparin-free baseline.

The role of common carotid artery end-diastolic velocity in near total or total internal carotid artery occlusion.

Objectives: To evaluate the role of the end-diastolic velocity (EDV) in the common carotid artery (CCA) as a marker of internal carotid artery (ICA) occlusion.

Design: Validation of retrospective data in a prospective clinical study.

Methods: The EDV in 94 patients with total ICA occlusion and in 24 patients with high grade (95-99%) unilateral ICA stenosis identified on extracranial carotid colour-flow Duplex imaging (CFDI) and arteriography was reviewed, and was retrospectively compared to the EDV of 176 normal individuals.

Should percutaneous transluminal angioplasty be recommended for treatment of infrageniculate popliteal artery or tibioperoneal trunk stenosis?

Purpose: The purpose of this study was to determine the effectiveness of percutaneous transluminal angioplasty (PTA) for treatment of patients with localized stenosis of the infrageniculate popliteal artery and tibio-peroneal trunk (IGPA).

Methods: The records of 25 patients undergoing IGPA PTA from 1983 to 1993 were reviewed. Patients underwent follow-up with clinical examinations, ankle-brachial indexes, Duplex scanning, and arteriography.

Idiospermuline, a trimeric pyrrolidinoindoline alkaloid from the seed of Idiospermum australiense.

Purification of a methanol extract from the seed of Idiospermum australiense, guided by bioactivity on a rat brain cortical wedge preparation has afforded two known dimeric alkaloids, the piperidinoindoline (+)-calycanthine [1] and the pyrrolidinoindoline, (-)-chimonanthine [2] along with a new trimeric pyrrolidinoindoline alkaloid, (-)-idiospermuline [3]. Te structure of idiospermuline [3] was determined by spectroscopic methods and the absolute configuration by an X-ray crystallographic study of idiospermuline trimethiodide [4].

Strain variation in tumor necrosis factor induction by parasites from children with acute falciparum malaria.

A small proportion of individuals infected with Plasmodium falciparum develop cerebral malaria. Why it affects some infected individuals but not others is poorly understood. Since tumor necrosis factor (TNF) has been implicated strongly in the pathogenesis of cerebral malaria, here we have compared different parasite isolates for their ability to induce TNF production by human mononuclear cells in vitro.

Emphysematous gastritis in an immunocompromised host.

Emphysematous gastritis is a rare, often lethal condition of gastric mural inflammation and gaseous dissection. Infection with gas-forming organisms is the most frequently cited cause. In all previously reported patients, the clinical presentation was dramatic.

Diagnosis of obstructive hydronephrosis in infants: comparison sonograms performed 6 days and 6 weeks after birth.

Objective: The purpose of this study was to compare the usefulness of renal sonograms obtained 6 days and 6 weeks after birth in differentiating obstruction from nonobstruction in patients with antenatal pyelocaliceal dilatation shown by sonography and to establish sonographic criteria to determine the degree of postnatal pyelocaliceal dilatation that warrants further investigation.

Materials And Methods: Criteria for an infant to enter the study were fetal pyelectasis of 4 mm or greater, two postnatal sonograms with the second showing persisting pyelectasis extending at least into the infundibula, and a voiding cystourethrogram showing normal findings. One hundred thirty kidneys in 100 infants met the study criteria.

Detection of obstructive uropathy in the fetus: predictive value of sonographic measurements of renal pelvic diameter at various gestational ages.

Objective: The goal of our study was to analyze the fetal renal pelvic diameters measured sonographically at several gestational intervals in live-born neonates subsequently found to have either obstructive uropathy or normal kidneys. This information will improve the efficacy of sonography in the diagnosis of obstructive uropathy.

Subjects And Methods: From an ongoing prospective study assessing the significance of fetal renal pelvic diameters of 4 mm or more at obstetric sonography, the findings in 29 obstructed kidneys in 24 babies were compared with the findings in 380 kidneys from 233 infants who had no obstruction.

Occult small bowel adenocarcinoma complicating Crohn's disease: a report of three cases.

Three patients with Crohn's disease are described who were treated by ileal resection for intestinal obstruction. Histological examination of the resected specimen in each case established the diagnosis of adenocarcinoma of the small intestine complicating Crohn's disease. This diagnosis should be considered in patients with longstanding macroscopic Crohn's disease who present with severe or recurrent symptoms.

A controlled trial of a behavioral and educational intervention following coronary artery bypass surgery.

Purpose: Patients who have undergone coronary artery bypass graft surgery (CABG) are obvious candidates for rehabilitation programs because of the potential for progression of disease. Such programs have been shown to foster risk-factor modification, improve quality of life, and prolong survival among post-myocardial infarction (MI) patients. However, the efficacy of these programs has not been established among patients who have undergone CABG.

Recombinants are isolated at high frequency following in vivo mixed ocular infection with two avirulent herpes simplex virus type 1 strains.

Mixed infections with different strains of herpes simplex virus type 1 (HSV-1) may result in more severe disease than infection with either strain alone. This phenomenon is important because it may facilitate the identification of virulence genes through the transfer of virulence determinants between complementing strains, and it may pose a problem in the use of attenuated HSV strains for vaccines and gene delivery vectors. In this study, we have compared the percentage of recombinants present after mixed infection with HSV-1 strains OD4 and 994 in vitro and in vivo.