Evaluation of a cervical cytology device (cell-sweep) based on comparison to colposcopic findings.

A new cytology sampling device, the CellSweep, identifies squamous intraepithelial lesions with a sensitivity of 75%. The purpose of this study was to evaluate the accuracy of cervical cytology using a new sampling device combining an endocervical brush and ectocervical spatula into one unit (CellSweep, patented by R. Mohajer, Troy, Michigan).

Uniform safety of beating heart surgery using the octopus tissue stabilization system.

Background And Purpose: Minimally invasive coronary artery bypass grafting (CABG) has been facilitated by the introduction of the Octopus Tissue Stabilization system (OTS). OTS improves exposure immobilizing the heart with minimal hemodynamic effects allowing multivessels off cardiopulmonary bypass (CPB) CABG. The purpose of this study was to compare the utilization and clinical outcome of the OTS in three geographically distinct centers.

Experience with collaborative management of symptomatic fibroids by gynecology and interventional radiology.

Objective: The purpose of this paper is to review the initial collaborative experience of a gynecologist and an interventional radiologist in the utilization of embolotherapy in the management of symptomatic uterine myomas.Methods: One hundred five consecutive subjects treated by embolotherapy were selected for review. All patients derived from a single gynecologic practice and were evaluated by the same examiner, using standardized criteria.

ThinPrep cytology in clinical practice.

Objective: To compare ThinPrep cytology to conventional cytology in a gynecologic oncology practice in a university hospital laboratory setting.Methods: From March to September 1997, all Papanicolaou smears in the Division of Gynecologic Oncology were collected with a cervical broom device. A conventional cytology slide was prepared.

The development of a shared governance model in the ambulatory setting.

Many individuals within the ambulatory division have benefited both personally and professionally as a result of this shared governance model and its concepts. Staff who rarely volunteered for projects became involved, and others developed their leadership skills. Although the ambulatory division's shared governance model did not reach maturity, many tasks were accomplished through collaborative efforts.

Electroanatomic left ventricular mapping in the porcine model of healed anterior myocardial infarction. Correlation with intracardiac echocardiography and pathological analysis.

Background: Catheter ablation for ventricular tachycardia in healed infarction is limited to patients with inducible, tolerated arrhythmias. Strategies that would allow mapping during sinus rhythm might obviate this limitation.

Methods And Results: Two sets of experiments were performed in adult pigs to refine a new technique for left ventricular mapping.

Fine-needle aspiration cytology of a mediastinal seminoma associated with multilocular thymic cyst.

Multiloculated thymic cysts are uncommon lesions that can be either acquired or associated with malignancies. This report describes the fine-needle aspiration (FNA) cytology of a mediastinal seminoma with prominent cystic change, confirmed by surgical pathology examination and ancillary studies performed on both the cytology and tissue specimens. The FNA cytology revealed clusters of malignant oval-to-polygonal-shaped cells with large oval nuclei possessing prominent nucleoli set in a pale-to-eosinophilic cytoplasm.

Therapy of desmoid tumors and fibromatosis using vinorelbine.

In patients with either desmoids or fibromatosis who do not tolerate vinblastine and methotrexate because of neurotoxicity, the combination of vinorelbine and methotrexate can be substituted in most. Patients with the same condition who had not been previously treated with a combination of vinblastine and methotrexate responded well to the combination of vinorelbine and methotrexate, with significantly less neurotoxicity and a similar objective and subjective response rate. Sixty percent of patients had either a substantial partial remission or a complete remission.

Head and neck cancer implantation at the percutaneous endoscopic gastrostomy exit site. A case report and a review.

Percutaneous endoscopic gastrostomy is commonly utilized in patients with head and neck cancer. Tumor at the PEG exit site is a rare occurrence, likely due to direct implantation. We present a case report, review of the relevant literature, discussion of the mechanism of spread, and management.

The multidisciplinary in-hospital wound care team: two models.

The cost of community- and hospital-acquired pressure ulcers is particularly high in terms of both patient morbidity and economics. Multidisciplinary wound care teams were developed independently at two different hospitals to deal with the needs of patients with pressure ulcers and to control costs. Although the goals of the teams at both institutions were similar, the strategies for achieving the goals were different because they were adapted to the needs of the particular institution.

Comparison of resistive index versus pulsatility index in assessing the benign etiology of adnexal masses.

Retrospective analysis of pelvic sonograms with colorguided spectral Doppler evaluation of 189 adnexal masses yielded four malignancies, 20 benign neoplasms, 32 cysts, and 14 endometriomas. Fifty-eight masses were presumed benign on additional imaging. Pulsatility index (PI) < 1.

External ventriculostomy: a practical application for the acute care nurse.

External ventricular drainage systems (EVDs), or external ventriculostomies, are challenging additions for the neurosurgical patient. An EVD involves a catheter placed in the ventricular space. It is used to drain off excess cerebrospinal fluid that is causing hydrocephalus and increased intracranial pressure.

The effects of cobalt chromium upon macrophages.

The purpose of this study was to elucidate the mechanisms by which cobalt chromium particulate wear debris contribute to the aseptic loosening of total joint prostheses. Incubation of macrophages with cobalt chromium led to release of tumor necrosis factor-alpha (TNF-alpha) and prostaglandin E2 (PGE2), but did not lead to release of interleukin-1 beta (IL-1 beta) or interleukin 6 (IL-6). Exposure of macrophages cocultured with osteoblasts to cobalt chromium also led to significant release of TNF-alpha and PGE2, but did not lead to significant IL-6 or IL-1 beta production.

Head trauma: CT scan interpretation by radiology residents versus staff radiologists.

Purpose: To determine the rate and clinical outcome of discrepancies in interpretation by radiology residents and staff neuroradiologists of posttraumatic cranial computed tomographic (CT) scans.

Materials And Methods: Prospective evaluation was performed for 419 consecutive emergency posttraumatic cranial CT studies that had been interpreted by radiology residents on call over a 16-month period. Discrepancies between the interpretations made by residents and those made by staff radiologists were divided into two groups: failure to recognize an abnormality (false-negative finding) and interpretation of normal as abnormal (false-positive finding).

A valid and reliable tool to quantify stool output in tube-fed patients.

A major problem in determining whether diarrhea exists in tube-fed patients is the quantification of stool output. On the basis of this need a stool output assessment tool was developed and tested for validity and reliability. Interrater reliability and construct validity were determined by using staff nurses' and principal investigators' observations.

Pulmonary and cardiac function in advanced fibrodysplasia ossificans progressiva.

Fibrodysplasia ossificans progressiva is a rare genetic disease characterized by heterotopic ossification in soft tissues. Severe disability results from progressive immobilization of the limbs, jaw, and chest wall. To determine whether cardiac function is altered in this disease, 25 patients ranging in age from 5 to 55 years (disease duration 1-51 years) were studied.

Soft-tissue complications of intra-arterial chemotherapy for extremity sarcomas.

High-grade sarcomas have a high rate of local recurrence as well as distant metastases. This has led to the development of intra-arterial chemotherapy (IAC) as part of a multimodal approach to control local disease and/or reduce the extent of surgical resection. Intra-arterial catheters are positioned by an interventional radiologist into the feeding vessels of the tumor.

Diagnosis and management of traumatic aorto-right ventricular fistulas.

Background: Traumatic aorto-right ventricular (Ao-RV) fistulas are rare lesions that result in congestive heart failure if left untreated. Early diagnosis and prompt surgical intervention are required to avoid the natural outcome of cardiac decompensation.

Methods: All cases of traumatic Ao-RV fistula described in the English literature since 1958 were reviewed.

Cardiac xenotransplantation.

Heart failure is an important medical and public health problem. Although medical therapy is effective for many people, the only definitive therapy is heart transplantation, which is limited severely by the number of donors. Mechanical devices presently are used as "bridges" to transplantation.