Rapid ultrastructural examination of FNAs in the diagnosis of intrathoracic tumors.

By coupling radiologic imaging procedures with a fine-needle aspiration (FNA) technique, superficial and deep-seated tumors of the thorax may be sampled for cytopathologic evaluation with relative ease, minimal trauma to the patient, and may avert unnecessary or contraindicated surgery. However, the cytodiagnostic limitations that apply to FNA specimens from other sites also obtain for tumors of the thoracic cavity. Although application of histo- and immunohistochemistry offers some expansion of cytodiagnostic limits, their inherent problems of technical failure and biological capriciousness demand a highly critical if not outright skeptical appraisal of the result when applied to cytology specimens.

Reducing the risk for transfusion-transmitted cytomegalovirus infection.

Objective: To define the groups of patients at risk for transfusion-transmitted cytomegalovirus infection and to define the methods to reduce this risk.

Data Sources: English-language publications on transfusion medicine.

Study Selection And Data Extraction: Studies were selected that described cytomegalovirus infection in transfusion-dependent patients.

Radiation-induced malignant fibrous histiocytoma of the pulmonary artery.

We describe a malignant fibrous histiocytoma (MFH) of the pulmonary artery. The patient received, 25 years ago, at the age of 43 years, radiation therapy to the chest for squamous-cell carcinoma of the lung. We believe the patient's second tumor was induced by radiation and, to our knowledge, this case represents the first report of radiation-induced MFH of the pulmonary artery.

Decreased technique-related morbidity for continuous ambulatory peritoneal dialysis.

Patients who began continuous ambulatory peritoneal dialysis (CAPD) at the Mayo Clinic from 1979 to 1982 were hospitalized during that period 7.8 days per patient year (PPY) for access-related causes, whereas home hemodialysis (HHD) patients were hospitalized 1.6 days PPY.

Ultrastructural changes produced in dorsal root ganglia in vitro by exposure to ethylene oxide from hemodialyzers.

Ethylene oxide (EO) gas, used to sterilize hemodialysis equipment, is a known neurotoxin and residual gas remains in dialyzers after airing. If tissue culture medium is incubated in dialyzers and then rat dorsal root ganglion (DRG) cultures are exposed to this medium, characteristic changes occur. These include axonal swellings and the death of neurons after five days.

RAP1 protein activates and silences transcription of mating-type genes in yeast.

RAP1 is a sequence-specific DNA-binding protein essential for cell growth. The occurrence of RAP1-binding sites in many promoter regions, the mating-type gene silencer elements, and telomeres suggests that RAP1 has multiple functions in the cell. To assess its role in transcription, temperature-sensitive mutations in RAP1 were generated.

The pharmacokinetics of racemic verapamil in patients with impaired renal function.

The pharmacokinetics of verapamil were studied in patients with renal failure who were undergoing maintenance hemodialysis and in normal subjects after an IV infusion of 10 mg and a single oral dose of 120 mg. Plasma levels of verapamil and its active metabolite, norverapamil, were analyzed by a sensitive and specific HPLC procedure. Severe renal failure requiring hemodialysis did not change the time course of verapamil and norverapamil plasma concentrations after either the IV or oral dose.

Coronary artery bypass operation in dialysis patients.

To analyze the short- and long-term morbidity and mortality among maintenance dialysis patients who have undergone coronary artery bypass operations, we identified 25 such patients at the Mayo Clinic and three recently published large single-center studies that provided sufficient detail for meaningful comparison. Two independent observers reviewed the new information with regard to pertinent historical, clinical, and laboratory data. The perioperative mortality was 20%.

Inaccurate blood flow rate during rapid hemodialysis.

Simulated hemodialysis with isotonic saline was performed to compare the requested blood flow rate (BFR-r) with the actual blood flow rate (BFR-a) delivered during rapid, efficient hemodialysis. Four different blood pumps and blood lines from three different manufacturers were used for the studies. BFR-r was set on each blood pump, and a timed outflow specimen from the dialysis circuit was used to measure the BFR-a delivered.

Mechanisms involved in the response to prolonged infusion of atrial natriuretic factor in patients with chronic heart failure.

We examined the mechanisms involved in the cardiovascular and renal response to prolonged infusion of atrial natriuretic factor (ANF) in patients with chronic heart failure. ANF infusion was titrated to produce a 30% decrease in pulmonary capillary wedge pressure or a 20% increase in cardiac output, and this dose (average, 75 +/- 4 ng/kg/min) was then administered for 20 hours. The short-term response to ANF included significant reductions in central filling pressures, increases in cardiac output, modest increases in diuresis and glomerular filtration rates, significant reduction in plasma aldosterone levels, and a 3.

Involvement of the silencer and UAS binding protein RAP1 in regulation of telomere length.

The yeast protein RAP1, initially described as a transcriptional regulator, binds in vitro to sequences found in a number of seemingly unrelated genomic loci. These include the silencers at the transcriptionally repressed mating-type genes, the promoters of many genes important for cell growth, and the poly[(cytosine)1-3 adenine] [poly(C1-3A)] repeats of telomeres. Because RAP1 binds in vitro to the poly(C1-3A) repeats of telomeres, it has been suggested that RAP1 may be involved in telomere function in vivo.

Adherence to diabetes regimens: empirical status and clinical applications.

Adherence to diabetes treatment regimens has proved to be a conceptual and empirical enigma. Consequently, reliable and valid applications to the clinical practice of diabetes care and education have been wanting. Rates of nonadherence are staggeringly high, regardless of the methodology employed, and verification of self-reports is complicated by social desirability to appear compliant.

Failure to detect extremely high levels of serum IgE with an immunoradiometric assay.

Two patients with extreme elevations in serum IgE were found to have falsely low levels of IgE when measured by a commercial immunoradiometric assay. Dilution studies performed on serum from both patients revealed the rise and subsequent fall of the dose-response curve characteristic of the high-dose "hook" or prozone effect. Specimens with unexpectedly low levels of serum IgE obtained by either commercial immunoradiometric assay or enzyme immunoassay should be reanalyzed after dilution.

Esophageal achalasia secondary to mesothelioma.

Achalasia secondary to malignancy is rare, with most cases associated with gastric adenocarcinoma of the gastroesophageal junction. This report describes the clinicopathologic features of a 64-year-old man found to have mesothelioma as the cause of secondary achalasia. To our knowledge, this is the first case of secondary achalasia produced by a mesothelioma.

Behavioral effects of prenatal exposure to lidocaine in the rat: effects of dosage and of gestational age at administration.

Pregnant Long-Evans hooded rats were dosed via injections into the gum with 3, 6, or 9 mg/kg lidocaine, or vehicle, or were uninjected, on gestational day 4 (GD4), GD11, or GD18. Offspring (8-11 litters/group) were tested on a variety of tests of behavioral development and adult behavior. No effects of any dose at any time of administration were found upon maternal weight gain in gestation, litter size, or initial birth weight or weight gain of the pups.

Alterations in offspring behavior induced by chronic prenatal cocaine dosing.

Sperm-positive female Long-Evans hooded rats were dosed subcutaneously with 10 mg/kg/day cocaine or an equal volume of vehicle (0.9% sterile saline) from gestation day 4 (GD4) through GD18. Offspring were assessed for development of negative geotaxis, righting reflex, spontaneous alternation, and open field activity, and for adult behaviors including DRL-20 acquisition, water maze, visual discrimination, barbiturate sleep time, shuttlebox avoidance, footshock sensitivity, and tail flick latency.

Deferoxamine and coated charcoal hemoperfusion to remove aluminum in dialysis patients.

We studied the in vitro and in vivo characteristics of aluminum (Al) removal by coated charcoal hemoperfusion (HP) in combination with intravenous deferoxamine (DFO). DFO enhanced the clearance of Al by HP in vitro after 180 minutes of perfusion with a solution containing 403.3 +/- 14.

Erosive spondyloarthropathy in long-term dialysis patients: relationship to severe hyperparathyroidism.

We describe the development of a destructive, erosive spondyloarthropathy in three long-term dialysis patients (mean duration of dialysis, 96 months). In all three patients, the lesions caused symptomatic vertebral pain and developed during a period of only a few months. All patients had extremely elevated levels of immunoreactive parathyroid hormone, and two patients had evidence of severe hyperparathyroidism on bone biopsy specimens.