High dose-rate intraluminal irradiation in bronchogenic carcinoma. Technique and results.

Patients who present with symptomatic airway obstruction often have limited therapeutic options. Intraluminal irradiation has been used in an attempt to obtain sustained palliation. Patients treated with high dose-rate endobronchial irradiation have shown good to excellent palliation of symptoms, as well as a high rate of local control; however, these results have not always been devoid of complications.

Ionized serum magnesium levels in umbilical cord blood of normal pregnant women at delivery: relationship to calcium, demographics, and birthweight.

Using a novel ion-selective electrode for ionized Mg (IMg2+), we sought to: (1) determine levels and fractions of IMg2+ in umbilical vessels of normal pregnant women: (2) determine their relationships with ionized calcium (ICa2+) levels: (3) determine whether any demographic or clinical parameters affect these levels of divalent cations: and (4) compare levels of IMg2+, total Mg, percent IMg2+, and ICa2+ with sera of normal pregnant and nonpregnant women. We obtained umbilical arterial and venous serum from 38 normal subjects and venous samples from 26 normal pregnant women and 42 nonpregnant women. The mean umbilical venous IMg2+ level (0.

Cholesterol crystal embolization-associated renal failure after therapy with recombinant tissue-type plasminogen activator.

We report the occurrence of renal failure due to cholesterol crystal embolization following thrombolytic therapy with intravenous recombinant tissue-type plasminogen activator (t-PA). No invasive vascular procedure had been performed. Although there is one case report of cholesterol crystal embolization following t-PA therapy with only extrarenal manifestations (N Engl J Med 321:1270, 1989), this is the first reported case of atheroembolic acute renal failure following t-PA therapy.

Ionized magnesium and calcium levels in umbilical cord serum of pregnant women with transient hypertension during labor.

Using a new ion selective electrode (ISE) to measure ionized magnesium (IMg2+), we compared levels of IMg2+ with total magnesium (TMg) and serum ionized calcium levels (ICa2+) in umbilical arterial and venous serum of 13 parturients who developed transient hypertension in labor with levels in 38 who remained normotensive. Ionized, but not total magnesium levels were significantly lower in the umbilical veins of the hypertensive compared to the normotensive subjects (0.46 +/- 0.

Rectal thermoluminescent dosimeter measurements using the MicroSelectron High Dose Rate afterloader in postoperative intravaginal radiation cases.

Purpose: The purpose of this study is twofold: First, to measure the dose distribution along the anterior and posterior rectal wall, compare them to the prescribed dose and establish the rectal length receiving the maximum dose. Second, to carry out in-phantom dose measurements in order to confirm that the dose planned is in fact the dose delivered.

Methods And Materials: The dose distribution along the anterior and posterior rectal wall was measured for a group of 25 Gynecologic cases treated with a vaginal cylinder, using the MicroSelectron High Dose Rate system.

Intraoperative brachytherapy in non-small cell lung cancer.

The lung cancer incidence and mortality rates have risen steadily each year. Survival rates during the same period have improved marginally even by the best treatment approaches. A small proportion of patients with limited disease can be offered surgical resection as the primary curative treatment.

Ovarian carcinoma metastasis to the breast case report and review of the literature.

Metastasis to the breast from extramammary malignancies is rare, but its recognition is important because the prognosis and treatment differ from that of primary breast cancer. We report a case of ovarian cancer with metastasis to the breast, which was found at the time of presentation. A 57-year-old woman presented with shortness of breath and was found to have a malignant pleural effusion.

Effect of sulbactam on infections caused by imipenem-resistant Acinetobacter calcoaceticus biotype anitratus.

A recent outbreak of multiresistant strains of Acinetobacter calcoaceticus biotype anitratus was observed mostly, but not exclusively, in the surgical intensive care unit in our hospital. Disk diffusion and microdilution susceptibility studies demonstrated resistance to imipenem, all aminoglycosides, and all individual beta-lactam antibiotics. Only ampicillin plus sulbactam, cefoperazone plus sulbactam, and polymyxin produced zone sizes and MICs in the susceptible ranges.

Dialysis adequacy in hypoalbuminemic continuous ambulatory peritoneal dialysis patients.

We examined the interrelationship between hypoalbuminemia (HA) and the normalized protein catabolic rate (NPCR; g/kg/day) in the face of adequate Kt/V and weekly creatinine clearances in 40 end-stage renal disease patients on long-term continuous ambulatory peritoneal dialysis (CAPD). We also evaluated serum albumin (SA) levels as an additional marker of nutritional status of the PD patients receiving adequate dialysis therapy in terms of Kt/V greater than 1.5 per week.

Needle-wire localization of an infratemporal fossa foreign body using computed tomography.

We report a case involving the localization and surgical removal of a traumatically introduced foreign body deep within the infratemporal fossa. Needle-hookwire placement with computed tomographic guidance allowed the precise localization and marking of the foreign body. Surgical removal under local anesthesia and without extensive exploration was, therefore, possible.

Epithelioid angiosarcoma of the maxilla. A case report and review of the literature.

Epithelioid angiosarcoma is a rare vascular tumor composed of a proliferation of cytologically malignant epithelioid endothelial cells. These tumors are fully malignant and can pursue a rapidly progressive course. A case of primary epithelioid angiosarcoma of the maxilla is presented.

Multifocal adult rhabdomyomas of the head and neck.

Rhabdomyomas are usually found in the myocardium. Of the extracardiac sites, the head and neck is the most frequent region where this rare tumor arises. Multifocal head and neck lesions have only been described in 11 cases.

Postprandial hypoglycemia in islet beta cell hyperplasia with adenomatosis of the pancreas.

Organic hyperinsulinism causing hypoglycemia in adults is caused by insulinoma, islet hyperplasia, or a combination of adenomata and hyperplasia. We present a patient with long-standing symptoms of postprandial hypoglycemia occurring within 15 minutes of meals in the absence of fasting hypoglycemic symptoms. An intravenous glucagon stimulation test resulted in a rise of plasma insulin from 194 to 21,883 pmol/L at 7.

Impact of epoetin beta on dialyzer clearance and heparin requirements.

The present studies were undertaken to determine whether treatment with recombinant human erythropoietin (epoetin beta [Marogen Sterile Powder, Chugai-Upjohn, Rosemont, IL] ) necessitates an alteration in dialysis prescription or in heparin requirements. All patients had end-stage renal disease (ESRD), were on chronic hemodialysis (either high-flux or conventional) for more than 3 months, and had participated in large-scale, multicenter epoetin beta clinical trials. Nine patients were entered into the clearance study.

Effect of a beta-lactamase inhibitor, tazobactam, on growth and penicillin-binding proteins of Borrelia burgdorferi.

The effects of tazobactam, a relatively new beta-lactamase inhibitor, were investigated on growth and penicillin-binding proteins (PBPs) of Borrellia burgdorferi. A previous communication from our group demonstrated several proteins capable of binding labelled penicillin in this organism. Of these proteins, 94-kDa and 57-kDa PBPs possessed the highest affinity for penicillin and were assumed to be essential proteins involved in cell-wall synthesis.

A multidisciplinary QA program for enteral nutrition in high-risk patients.

An increase in elderly patients and severity of illness rates means greater use of nasogastric feeding tubes for both high-risk acutely ill and chronically ill patients. When the QA screening process at Booth Memorial Medical Center revealed a certain percentage of complications with small bore, weight-tipped feeding tubes inserted through the nares, a multidisciplinary peer review committee (MPRC) was formed to review the enteral nutrition program. After a literature review to determine possible complications, the MPRC identified lung perforations due to tube misplacement, tube feeding aspiration into the lungs leading to possible aspiration pneumonia, and an internal tip separation from the tube product failure.

Role of brachytherapy in recurrent extremity sarcoma in patients treated with prior surgery and irradiation.

The treatment options for recurrent extremity sarcoma following conservative surgery and irradiation are limited. Amputation is the treatment of choice offered for the majority of these patients. In a selected group of patients with recurrent sarcoma, we have investigated the role of brachytherapy along with function-preserving resection.

Penicillin-binding proteins in Borrelia burgdorferi.

Penicillin-binding proteins were identified in Borrelia burgdorferi membranes. A 94-kilodalton penicillin-binding protein was the first to be labeled with tritiated penicillin and was the first band to disappear in a competition experiment. Its binding ability was destroyed when membranes were preboiled.

Traumatic juxtarenal aortocaval fistula and pseudoaneurysm.

We discuss the treatment of a fistula located between the aorta and inferior vena cava which was caused by trauma. Fewer than 30 such cases have been reported in the English literature. A juxtarenal pseudoaneurysm and aortocaval fistula resulting from a gunshot wound, unrecognized upon the initial presentation of the patient, is reported herein.

Recent advances in chemotherapy. Administration and nursing implications.

This article provides an overview of the recent advances in the use of chemotherapy as a treatment modality with selected types of cancers. During the next decade, additional gains should be made in the development of effective therapeutic regimens with the development of new drugs and different combinations as well as changes in dosages and scheduling. It is hoped that these advances will result in prolonging disease-free as well as overall survival.