The pathology of pulmonary cryptococcal infections in the acquired immunodeficiency syndrome.

Specimens from premortem pulmonary cytology, transbronchial biopsy, and autopsy were studied in 11 patients with acquired immunodeficiency syndrome who developed pulmonary cryptococcal disease. Nine of 11 patients had culture-proved cryptococcal meningitis. Extremely low T-cell helper/suppressor ratios (mean, 0.

Malignant peripheral nerve sheath tumor arising in an adrenal ganglioneuroma in an adult male homosexual.

The authors report a case of malignant peripheral nerve sheath tumor arising in an adrenal ganglioneuroma in an adult. This is the first such case occurring in the absence of a history of childhood neuroblastoma treated with radiation, and provides evidence that such a transformation can occur spontaneously. The neoplasm demonstrated a highly malignant biologic behavior with rapid growth, local recurrence, and metastasis.

Amyloidosis presenting in the lower respiratory tract. Clinicopathologic, radiologic, immunohistochemical, and histochemical studies on 48 cases.

We studied 48 cases of amyloidosis localized to the lower respiratory tract. Fourteen cases were classified as tracheobronchial amyloidosis. Twenty-eight cases showed solitary or multiple nodules, and six cases had a diffuse interstitial parenchymal pattern.

Pupillary dilation as an index of central nervous system alpha 2-adrenoceptor activation.

In recent years there has been increasing evidence that some antihypertensive drugs like clonidine and alpha-methyldopa (after conversion in the brain to alpha-methylnorepinephrine) may decrease sympathetic tone by stimulating central nervous system (CNS) alpha 2-adrenoceptors. These same drugs also produce pupillary dilation in cats and rats. In this review, evidence is presented supporting the hypothesis that clonidinelike drugs act either directly or indirectly on CNS postsynaptic alpha 2-adrenoceptors to cause pupillary dilation by reduction of parasympathetic neural tone to the iris.

Effect of 11R, 16, 16-trimethyl prostaglandin E2 on meal-stimulated gastric acid secretion in duodenal ulcer subjects.

The effect of varying oral doses of 11R, 16, 16-trimethyl prostaglandin E2 (TmPGE2) on meal-stimulated gastric acid secretion and serum gastrin concentrations was studied in 10 male subjects with asymptomatic duodenal ulcer disease. A liquid protein meal was infused intragastrically 0.5 h and 3.

Incidence and mortality of adult respiratory distress syndrome: a prospective analysis from a large metropolitan hospital.

We examined the incidence and mortality of adult respiratory distress syndrome (ARDS) in patients receiving emergency medical care at a large metropolitan medical center. The patients were classified into eight high-risk categories and monitored prospectively until discharge or death. Over a period of 12 months, 11,112 such patients entered the emergency room.

Neodymium-YAG laser sclerostomy in primates.

A one-stage sclerostomy procedure was performed "noninvasively" in four cynomolgus monkeys solely with the neodymium-YAG laser. The neodymium (Nd)-YAG laser was focused, for the most part, a few diopters behind the focus of the helium-neon aiming beam. This enabled optical breakdown to occur entirely within the sclera to produce a perforating micropuncture of the scleral tissue.

Histologic study of a neodymium-YAG laser sclerostomy.

A glaucoma filtering procedure was performed with the YAG laser in an eye to be enucleated for malignant melanoma. Scanning electron microscopic examination shows the extent and position of the incision and the effects of the procedure on the cornea. To our knowledge, this article represents the first report of complete perforation of the sclera in a living human eye with the use of a laser alone.

Design of new contact lens for YAG laser filtering procedures.

A contact goniolens has been developed specifically for YAG laser filtering procedures both for use in unblocking failed surgical filtering procedures and for performing two-stage or one-stage YAG filtering procedures. The design concentrates the YAG energy and maintains a constant small angle with the cornea.

Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome (AIDS). Diagnosis with bronchial brushings, biopsy, and bronchoalveolar lavage.

Sixty-one diagnostic biopsies for Pneumocystis carinii pneumonia were performed on 40 homosexual male patients with acquired immunodeficiency syndrome (AIDS), using flexible fiberoptic bronchoscopy. Bronchial brushings and bronchoalveolar lavage were performed in conjunction with the biopsy in 58 and 29 bronchoscopies, respectively. Using a rapid methenamine silver stain, P carinii pneumonia was diagnosed in 27 (68 percent) of the patients.

Quantitative assessment of ocular norepinephrine concentration in the rabbit using liquid chromatography with electrochemical detection.

An assay technique that utilizes liquid chromatography with electrochemical detection to determine the norepinephrine (NE) concentration of the rabbit aqueous humor (AH) and iris-ciliary body (ICB) is discussed. NE concentration was monitored in control preparations as well as in experiments involving stimulation of the cervical sympathetic nerve (CSN) or 24 h following extirpation of the superior cervical ganglion. In 15 control rabbits, the baseline AH NE concentration was determined to be 7.

Ocular effects of adrenergic stereoisomers in the rabbit.

Because of the need to develop ocular hypotensive agents with low incidence of side effects, the dextrorotatory enantiomers of adrenergic agents have prompted some attention. In the present study, the relative potency and efficacy of various adrenergic stereoisomers with respect to their ocular hypotensive and mydriatic effects have been determined after topical administration to conscious rabbits. The relative order of potency was found to be, iris: 1-epinephrine much greater than d-epinephrine congruent to 1-norepinephrine congruent to dl-alpha-methyl-norepinephrine greater than dl-alpha-methyl-epinephrine greater than d-norepinephrine; intraocular pressure (IOP): l-epinephrine greater than dl-alpha-methyl-epinephrine greater than d-epinephrine greater than dl-alpha-methyl-norepinephrine greater than d-norepinephrine congruent to 1-norepinephrine.

Studies on the mechanism of clonidine-induced mydriasis in the rat.

Intravenous administration of clonidine hydrochloride (3-100 micrograms/kg) produced a dose-dependent pupillary dilation in anaesthetized rats. All experiments were carried out in rats in which vagosympathetic nerve trunks were sectioned bilaterally at the cervical level. Clonidine-induced mydriasis was present only in those preparations having intact parasympathetic neural tone to the iris.

Experimental YAG laser sclerostomy.

A Q-switched neodymium-YAG laser was used to produce a corneoscleral perforation in human cadaver eyes. A through-and-through incision could be created solely with the YAG-laser at peak pulse energies of 16 millijoules (mJ). The minimal total energy required for perforation was 3,312 mJ.

Acute intraocular pressure elevation produced by argon laser trabeculoplasty in the cynomolgus monkey.

The short-term effect of argon laser trabeculoplasty (ALT) was studied in a nonhuman primate model. The ALT treatment produced a consistent intraocular pressure elevation in the treated eye for eight hours. A statistically significant indomethacin-resistant increase in aqueous humor protein concentration was also observed.

Necropsy findings in acquired immunodeficiency syndrome: a comparison of premortem diagnoses with postmortem findings.

Necropsies were performed in 12 patients who fulfilled the Centers for Disease Control (CDC) criteria for acquired immunodeficiency syndrome (AIDS), and the postmortem findings were compared with the premortem diagnoses. All of the patients were men with a male sexual preference and histories of multiple episodes of venereal diseases. Four patients were intravenous drug abusers, while two abused amyl nitrate.

Immunopathologic and clinical studies in pulmonary hypertension associated with systemic lupus erythematosus.

PH is an uncommon manifestation of SLE. The symptoms of PH develop within a few years after the onset of the multisystem disease. The most common presenting complaints of SLE patients with PH are dyspnea on exertion, chest pain, nonproductive cough, edema, and fatigue or weakness.

CNS adrenergic inhibition of parasympathetic oculomotor tone.

Inhibition of parasympathetic neural tone to the iris was produced by electrical stimulation of the afferent sciatic nerve, medullary reticular formation, and posterior hypothalamus in anesthetized cats in which only the parasympathetic nerves to the eye were intact. Stimulation of all 3 sites of activation produced a graded pupillary dilation and reduction of tonic nerve activity in the short ciliary nerves. Intravenous administration of the alpha-2-adrenoceptor antagonist, yohimbine hydrochloride, (0.

A physiological and pharmacological analysis of the electrodermal response in the rat.

Electrodermal responses (EDR) of the sympathetic-cholinergic sudomotor system were elicited in the footpads of the hindpaws of anesthetized rats. The most reactive CNS loci were caudal to the region of the posterior hypothalamus. Peripherally evoked responses were elicited by electrical stimulation of the decentralized tibial nerve.