Metastasis of unknown origin: the role of fine-needle aspiration cytology.

Metastasis of unknown origin (MUO) manifests either as a tumor deposit in an organ, often cervical lymphadenopathy, or as a multiorgan carcinomatosis. As a diagnostic and therapeutic challenge, the definition of its cell type and possibly its origin is imperative, although a limited diagnostic investigation is usually recommended. At Hines VA Hospital from 1986 to 1994, there were 116 cases with admitting clinical diagnosis of MUO, evaluated by fine-needle aspiration cytology (FNAC).

Fine-needle aspiration cytology of extraskeletal Ewing's sarcoma.

Extraskeletal Ewing's sarcoma (EES) is a round-cell malignancy that manifests most commonly in the paravertebral and intercostal regions. It occurs predominantly in adolescents and young adults, between the ages of 10 and 30 yr, and follows an aggressive course with a high recurrence rate. Distant metastasis is also common.

Fetal lung maturation. Comparison of biochemical indices in gestational diabetic and nondiabetic pregnancies.

Objective: To compare the biochemical maturation of the components of the lung profile according to gestational age between reliably dated gestational diabetic and nondiabetic pregnancies.

Study Design: Lung maturation was compared in reliably dated pregnancies in 501 gestational diabetic women and 561 nondiabetic women. Lecithin/sphingomyelin ratio (L/S) and phosphatidylglycerol (PG) were evaluated by analysis of variance according to the presence or absence of diabetes and weeks of gestational age.

Cytomegalovirus enteritis in a premature infant.

Background/purpose: Up to 2.5% of newborn infants are cytomegalovirus (CMV) positive at birth. Five percent will be symptomatic at birth, including cytomegalic inclusion disease.

Immunolocalization of V1 vasopressin receptors in the rat kidney using anti-receptor antibodies.

By using immunocytochemical techniques we have been able to localize the V1 vasopressin receptor in the rat kidney. Immunoblotting using an antiserum raised against an affinity-purified vasopressin receptor showed a 55,000 daltons protein band that has a molecular mass similar to that of the liver V1 vasopressin receptor, as demonstrated by cross-linking studies. Immunoblotting of the antibody showed a band of 55,000 daltons in A-10 cells, which contains the V1 subtype, whereas it did not stain LLC-PK1 cells, which possess the V2 subtype, showing that the antibody recognizes the V1 vasopressin receptor.

Breast and cutaneous mycobacteriosis: diagnosis by fine-needle aspiration biopsy.

The breast and skin are considered to be rare sites of extrapulmonary mycobacterial infection, comprising 0.1% to 0.5% of all tuberculosis cases, respectively.

Pleural effusion cytology of embryonal rhabdomyosarcoma.

This case report concerns an embryonal rhabdomyosarcoma of the testis in a 31-yr-old white male patient who underwent radical left orchiectomy, followed by combined irradiation and chemotherapy, and who 2 yr later presented with dyspnea at rest, nonproductive cough, and lower back pain for 1 wk. Chest radiographs demonstrated a bilateral pleural effusion and diffuse infiltrating lesion of the pleurae, mimicking a mesothelioma. The pleural fluid displayed noncohesive, malignant, small, round cells about 2-5 times larger than mature lymphocytes.

A directional clustering technique for random data classification.

This paper introduces a new clustering technique for random data classification based on an enhanced version of the Voronoi diagram. This technique is optimized to deal in the best way possible with data distributions which in their spatial representations experience overlap. A mathematical framework is given in view of this enhanced analysis and provides insight to key issues involving (a) the use of a correction process to complement the traditional Voronoi diagram and (b) the introduction of directional vectors in Gaussian and elliptical data distributions for enhanced data clustering.

Retrospective assessment of antibiotic and tourniquet use in an ambulatory surgery center.

In this study, 459 lower extremity surgeries were evaluated to assess and improve the quality of patient care at the Carnegie Surgery Center, Cleveland, Ohio. Two aspects of surgery were studied: the antibiotic usage and tourniquet application. The authors analyzed the rate of infection and the number of tourniquet complications that resulted from the surgeries.

Cutaneous and subcutaneous masses of the chest wall: a fine-needle aspiration study.

Primary cutaneous and subcutaneous neoplasms of the chest wall are uncommon. However, metastatic tumors involving this region may be seen in local recurrence, widespread metastases, or as the first manifestation of an occult malignant neoplasm. We report a series of 81 fine-needle aspirations (FNA) of cutaneous and subcutaneous masses involving the chest wall of 45 males and 36 females (age range 32-89 yr, mean 63 yr).

Synovial metastasis: diagnosis by fine-needle aspiration cytologic investigation.

Synovial metastases are a rare occurrence. Only 28 cases have been reported in the literature, 10 of which were diagnosed by fluid cytologic evaluation. We discuss 2 additional cases in which the diagnosis was made by fine-needle aspiration cytologic investigation.

A complex retinoic acid response element in the uncoupling protein gene defines a novel role for retinoids in thermogenesis.

Retinoids have been implicated in the control of cell proliferation and differentiation, and in several developmental processes. We report here the molecular bases for a metabolic role of RA, by showing that the expression of the uncoupling protein (UCP), the key element in brown adipose tissue (BAT) thermogenesis, is stimulated by retinoic acid (RA). Both all-trans-RA and 9-cis-RA powerfully increase UCP messenger RNA levels in isolated rat brown adipocytes.

Interactions among receptors, thyroid hormone response elements, and ligands in the regulation of the rat uncoupling protein gene expression by thyroid hormone.

Uncoupling protein (UCP) is essential to the thermogenic function of brown adipose tissue (BAT). Thyroid hormone stimulates the rat UCP gene through two thyroid hormone response elements (TRE) located upstream of -2,300 and separated by 27 bp. They are an everted repeat (upstream TRE or upTRE) and a direct repeat (down-stream TRE or dnTRE).

A complete genomic screen for multiple sclerosis underscores a role for the major histocompatability complex. The Multiple Sclerosis Genetics Group.

Multiple sclerosis (MS), an inflammatory autoimmune demyelinating disorder of the central nervous system, is the most common cause of acquired neurological dysfunction arising in the second to fourth decades of life. A genetic component to MS is indicated by an increased relative risk of 20-40 to siblings compared to the general population (lambda s), and an increased concordance rate in monozygotic compared to dizygotic twins. Association and/or linkage studies to candidate genes have produced many reports of significant genetic effects including those for the major histocompatability complex (MHC; particularly the HLA-DR2 allele), immunoglobulin heavy chain (IgH), T-cell receptor (TCR) and myelin basic protein (MBP) loci.

Peritoneal fibrosis in cirrhotics treated with peritoneovenous shunting for ascites. An autopsy study with clinical correlations.

Of 554 cirrhotics autopsied during 1975-1993, 69 had had peritoneovenous shunts. Generalized peritoneal fibrosis with cocoon formation was found in 26 (38%) of those with shunts but in only one of 485 without shunts (P = 0.00002).

Photoaffinity labelling of a receptor structure for macrophage cytotoxicity inducing factor (MCF).

Monocyte cytotoxicity inducing factor (MCF) is a cytokine derived from CD4+ lymphocytes which was isolated using its ability to cause human blood monocytes to become cytotoxic for tumour targets. An N-terminal derived biologically active peptide (GAAVLEDSQ) of the intact molecule was previously used to demonstrate a single class of high affinity binding sites on human blood monocytes and U937 cells. Photoaffinity labelling was carried out to identify the receptor.

Deep infection of the hand with Mycobacterium avium-intracellulare: two case reports.

Two case reports of deep hand infections with Mycobacterium avium-intracellulare are presented. Both occurred in elderly men. Aggressive surgical débridement combined with antitubercular chemotherapy resulted in an excellent outcome in both cases.

Severe eosinophilia and hepatocellular carcinoma: an unusual association.

Peripheral eosinophilia is an unusual but recognized paraneoplastic manifestation of malignant diseases. We report a case of eosinophilia associated with hepatocellular carcinoma which is the second case described in English literature.

Myxoid liposarcoma of the anterior mediastinum. Diagnosis by fine needle aspiration biopsy.

The mediastinum is an uncommon primary site of liposarcoma, which constitutes < 1% of tumors at that site. We report a case of myxoid liposarcoma evaluated with fine needle aspiration biopsy in a 66-year-old male who presented with cardiac tamponade, superior vena cava syndrome and radiologic evidence of a large anterior mediastinal mass. Cytologically the neoplastic cells were strikingly dyscohesive, with ovoid or spindle-shaped, hyperchromatic nuclei.

Utilization of fine-needle aspiration biopsy in the diagnosis of metastatic tumors to the pancreas.

There is relatively little information concerning the use of fine-needle aspiration biopsy (FNAB) to diagnose a mass in the pancreas that is secondary to metastatic tumor. This study reviews the incidence and types of neoplasms which metastasize to the pancreas and assesses the contribution FNAB can make in their diagnosis. Of 117 radiologically guided FNABs of the pancreas, 11% (n = 13) showed metastatic malignancy.

Pulmonary lymphoma in cardiac transplant patients treated with OKT3 for rejection: diagnosis by fine-needle aspiration.

At Hines VA Hospital, three out of 38 cardiac transplant patients, who were 9, 10, and 14 mo post-surgery and treated with immunosuppressive drugs, including OKT3 prophylaxis for acute rejection, developed a solitary pulmonary nodule. Fine-needle aspiration biopsy of the nodules in these three patients revealed a hypercellular, monotonous population of large lymphoid cells. These abnormal cells were isolated, with small aggregates occasionally seen.

Gunshot wounds to the elbow.

Gunshot wound injuries to the elbow are rare. This article presents the experience of the King/Drew Medical Center. Classification and management of these injuries are emphasized.

Pharmacokinetic optimization of the treatment of oral candidiasis with fluconazole: studies with a suspension.

An open crossover study was performed in 12 healthy subjects to investigate the pharmacokinetics in saliva and plasma of a 100 mg oral dose of fluconazole, administered as either a capsule or as a suspension, the latter being used to rinse the mouth and retained for 2 min before being swallowed. In terms of fluconazole plasma concentrations the capsule and the suspension were essentially bioequivalent. While the saliva concentrations of fluconazole after capsule administration reached their peak at 3.