Outcome of patients with nonspecific pleuritis/fibrosis on thoracoscopic pleural biopsies.

Objective: Medical thoracoscopy is recommended in the investigation of patients with exudative pleural effusions, especially when pleural fluid analysis is uninformative. The histological finding of 'nonspecific pleuritis/fibrosis' is common in thoracoscopic biopsies and presents a great uncertainty for clinicians and patients as the long-term outcome of these patients is unclear, and anxieties about undiagnosed malignancy persist.

Method: A retrospective case-note study of 142 patients who underwent medical thoracoscopy over a 58-month period in a tertiary referral centre with a high incidence of mesothelioma.

A rare presentation of a common disease: orificial tuberculosis.

Tuberculosis is a common condition with increasing incidence worldwide. Clinicians should be aware of cutaneous manifestations, even though these are uncommon, as recognition can lead to early diagnosis. Here, we present a case of orificial tuberculosis in a young HIV-negative man.

Tailoring cancer therapy - validating basic science with the 'supertrial'.

A paradigm shift in research culture is needed in order to set up the large ambitious trials needed to make personalised medicine a reality. Emma Wilkinson talks to the experts about the hurdles they face and what needs to change.

Neonatal lipopolysaccharide exposure delays puberty and alters hypothalamic Kiss1 and Kiss1r mRNA expression in the female rat.

Immunological challenge experienced in early life can have long-term programming effects on the hypothalamic-pituitary-adrenal axis that permanently influence the stress response. Similarly, neonatal exposure to immunological stress enhances stress-induced suppression of the hypothalamic-pituitary gonadal (HPG) axis in adulthood, but may also affect earlier development, including the timing of puberty. To investigate the timing of the critical window for this programming of the HPG axis, neonatal female rats were injected with lipopolysaccharide (LPS; 50 microg/kg i.

Molecular characterization of non-subtype C and recombinant HIV-1 viruses from Cape Town, South Africa.

HIV was first diagnosed within South Africa in 1982. Homosexual transmission of HIV-1 dominated the epidemic within the country in the early stages of the 1980s. Currently heterosexual transmission of HIV-1 is responsible for the majority of HIV cases in South Africa with subtype C HIV-1 being responsible for an estimated 95% of infections.

Activated protein C protects against ventilator-induced pulmonary capillary leak.

The coagulation system is central to the pathophysiology of acute lung injury. We have previously demonstrated that the anticoagulant activated protein C (APC) prevents increased endothelial permeability in response to edemagenic agonists in endothelial cells and that this protection is dependent on the endothelial protein C receptor (EPCR). We currently investigate the effect of APC in a mouse model of ventilator-induced lung injury (VILI).

Beta-blockers and heart failure: from maverick idea to gold-standard treatment.

Emma Wilkinson, BSc MA, medical journalist, talks to leaders in heart failure about how beta-blockers--once thought dangerous--became the mainstay of therapy.

Single vertical incision for Baha implant surgery: preliminary results.

Objectives: A single vertical skin incision with subcutaneous tissue removal is a cosmetic alternative for Baha implant placement. We aimed to determine the preliminary complication rate using a 4-cm vertical skin incision.

Study Design: Retrospective review.

Middle ear adenoma with neuroendocrine differentiation (MEA-ND) in the pediatric population.

Middle ear adenoma with neuroendocrine differentiation is an uncommon tumor of the tympanic cavity. The terminology of this entity has suffered due to a poor understanding of the differentiation of these neoplasms, and has included both "adenoma" as well as "carcinoid tumor." Immunohistochemical techniques have helped clarify that these tumors all share elements of neuroendocrine differentiation.

Evaluation of urothelial stretch-induced cyclooxygenase-2 expression in a mouse ureteral obstruction model.

Prostanoids play a major role in the nociceptive response to ureteral obstruction. Cyclooxygenases (COXs) 1 and 2 catalyze the rate-limiting step in prostanoid synthesis; COX-2 is the more inducible isoform. Previous studies in human and animal models have shown that COX-2 is highly induced during ureteral obstruction.

Oncogenic human papillomavirus testing in an adolescent population with atypical squamous cells of undetermined significance.

Objective: The American Society for Colposcopy and Cervical Pathology 2006 consensus guidelines state that oncogenic human papillomavirus (HPV) DNA testing is unacceptable for patients 20 years and younger with atypical squamous cells of undetermined significance (ASC-US). The objective of this study is to determine the HPV frequency in ASC-US patients 20 years and younger and to investigate subsequent colposcopic diagnoses.

Materials And Methods: Cytopathology records at the University of Florida/Shands-UF were reviewed from March 2003 to June 2007 to identify patients 20 years and younger with ASC-US on screening Pap tests.

Down-regulation of hypothalamic kisspeptin and its receptor, Kiss1r, mRNA expression is associated with stress-induced suppression of luteinising hormone secretion in the female rat.

Identification of kisspeptin (Kiss1) and its G protein-coupled receptor 54 (Kiss1r) as an essential component of the hypothalamic-pituitary-gonadal (HPG) axis controlling gonadotrophin secretion raises the possibility that kisspeptin-Kiss1r signalling may play a critical role in the transduction of stress-induced suppression of reproduction. We examined the effects of: (i) three different stressors, known to suppress pulsatile luteinising hormone (LH) secretion; (ii) corticotrophin-releasing factor (CRF); and (iii) corticosterone on Kiss1 and Kiss1r expression in key hypothalamic sites regulating gonadotrophin secretion: the medial preoptic area (mPOA) and arcuate nucleus (ARC). Ovariectomised oestrogen-replaced rats were implanted with i.

A role for the medial preoptic area in CGRP-induced suppression of pulsatile LH secretion in the female rat.

Calcitonin gene-related peptide (CGRP) is involved in a variety of stress responses and plays a pivotal role in stress-induced suppression of the GnRH pulse generator in the rat. Intracerebroventricular administration of CGRP suppresses luteinizing hormone (LH) pulses and increases Fos expression within the medial preoptic area (mPOA) and paraventricular nucleus (PVN). The aims of the present study were to investigate whether the mPOA or PVN are sites of action for CGRP-induced suppression of LH pulses and whether lipopolysaccharide (LPS), restraint or insulin-induced hypoglycaemia, stressors known to suppress LH pulses, affect mRNA expression for CGRP and its receptor subunits (calcitonin receptor-like receptor (CL) and RAMP-1) in the mPOA and PVN.

Audiologic outcomes with the penetrating electrode auditory brainstem implant.

Objective: The penetrating electrode auditory brainstem implant (PABI) is an extension of auditory brainstem implant (ABI) technology originally developed for individuals deafened by neurofibromatosis type 2. Whereas the conventional ABI uses surface electrodes on the cochlear nuclei, the PABI uses 8 or 10 penetrating microelectrodes in conjunction with a separate array of 10 or 12 surface electrodes. The goals of the PABI were to use microstimulation to reduce threshold current levels, increase the range of pitch percepts, and improve electrode selectivity and speech recognition.