Hemodynamic effects of peritoneovenous shunts in hemodialysis patients with ascites.

Ascites in hemodialysis patients has been reported in association with systemic diseases, such as cirrhosis or congestive heart failure, and as an idiopathic form. Regardless of the etiology, these patients often are refractory to treatment with intradialytic ultrafiltration because of recurrent hypotensive episodes. In this report we describe the hemodynamic effects of peritoneovenous shunts (PVSs) in three hemodialysis patients with ascites refractory to conventional treatment.

AZT incorporation into mitochondria: study in a human myeloid cell line.

Zidovudine (AZT) is widely used in the treatment of human immunodeficiency virus (HIV) infection because of its ability to act as a false substrate for the viral reverse transcriptase. AZT in the clinical setting has also been shown to produce significant hematologic and other toxicity, even though prior reports in the literature indicate that AZT is not readily incorporated into mammalian nuclear DNA. The human myeloid leukemia cell line HL-60 was grown in the presence of radiolabeled AZT or radiolabeled deoxythymidine as an in vitro model to study AZT toxicity for human myeloid cells.

Transvaginal color Doppler determination of the ovarian and uterine blood flow characteristics in polycystic ovary disease.

Objective: To determine blood flow characteristics of ovarian and uterine arteries in patients with endocrinologically and clinically confirmed polycystic ovary disease (PCOD) in comparison with blood flow parameters observed in patients with spontaneous ovulatory cycles.

Design: Controlled clinical study.

Setting: Patients from Infertility Service in a tertiary care institution.

Combination antiretroviral chemotherapy: a potential strategy in AIDS-related malignancy.

There has been considerable interest and controversy over the potential clinical role of combination antiretroviral therapy, primarily in the treatment of patients with established HIV infection. In order to model the hematologic toxicity of high-dose combination antiretroviral therapy, the HL60 myeloid leukemia cell line was exposed to zidovudine, dideoxycytidine and/or didanosine. The results suggest that the myelotoxicity of high-dose combination antiretroviral therapy may be controlled by using very brief periods of drug exposure.

Anaplastic large cell Ki-1 lymphoma: primary bone presentation in an elderly man.

Ki-1 anaplastic large cell lymphoma (Ki-1 ALCL) is a recently recognized entity. Primary presentation in the bone is very rare. Very few cases of primary bone presentation have been reported.

The postmyocardial infarction syndrome--vanished or vanquished? A twenty-five-year follow-up. A case report.

Although the existence of the postmyocardial infarction syndrome has now long been questioned, the Dressler symptom complex remains widely accepted as a distinct clinical entity. A patient is described whose twenty-five-year follow-up adds to our argument that there is no late or separate multisystem autoimmune disease following acute myocardial infarction. It is suggested that the Dressler complex is an entity that has neither vanished nor been vanquished but one that may never have existed.

AZT modulation of trimetrexate myelotoxicity: evidence from an HL60 model.

AZT is widely used in combination with other potentially myelotoxic drugs. Bone marrow suppression may limit the vigor of therapy directed at HIV itself, opportunistic infections, and/or AIDS-associated malignancies. Evidence from an HL60 model suggests that toxicity is of most concern with simultaneous use of multiple agents, and that staggered use of different agents may in some cases be a more effective strategy.

Chronic relapsing pancreatitis from a scorpion sting in Trinidad.

Chronic relapsing pancreatitis is a rare cause of abdominal pain in children and exceptionally rarely is related to a scorpion sting. We describe a 13-year-old girl who, following envenoming by a scorpion, developed recurrent attacks of sharp, intermittent pain in the umbilical region associated with fever, nausea, anorexia and vomiting, and changes in her psychological behaviour. Thorough clinical evaluation, including CT scanning, disclosed unabated pancreatitis.

Non-giant cell arteritis of the temporal artery presenting as the polymyalgia rheumatica-temporal arteritis syndrome.

We describe a heterogeneous group of 4 elderly patients with atypical vasculitis of the temporal artery who presented clinically with the polymyalgia rheumatica-temporal arteritis syndrome. The first had apparently isolated eosinophilic necrotizing vasculitis without peripheral blood eosinophilia, history of asthma, or pulmonary vasculitis (so called limited form of Churg-Strauss syndrome). Temporal artery biopsy in the 2nd patient revealed small vessel necrotizing vasculitis in the fragment of skeletal muscle surrounding a normal temporal artery (i.

The hemodynamic effect of GnRH agonist therapy on uterine leiomyoma vascularity: a prospective study using transvaginal color Doppler sonography.

The objective of this study was to correlate, during 12 weeks of therapy with gonadotropin releasing hormone agonist (GnRH-a), the chronological effect and the hemodynamic changes on the uterine artery and the leiomyometrial supplying vessels. Twenty-three premenopausal women with clinically diagnosed uterine leiomyomas received 3.75 mg of leuprolide acetate intramuscularly every 4 weeks for 12 weeks.

Renal actions of endothelin-1 and endothelin-3: interactions with the prostaglandin system and nitric oxide.

Endothelins (ET) possess both vasodilatory and vasoconstrictive properties. The renal actions of ET-1 and ET-3, as well as in vivo interactions of these two isopeptides with the prostaglandin and endothelium-derived relaxation factor/nitric oxide systems were studied in anesthetized dogs. The ETs were infused intrarenally at doses not affecting systemic hemodynamics.

The use of a particulate, microporous, calcified copolymer as a ridge maintenance device in dogs.

HTR polymer Synthetic Bone was found to be an osteoconductive, biocompatible, reliable nonresorbable matrix ridge maintenance material (Ridge Preservation). When used as socket implants immediately after the extraction of teeth over a one-year period in 16 beagle dogs, HTR was observed clinically and radiographically and compared with controls (unimplanted, sutured) extraction sites. As the control areas resorbed, the stability and effectiveness of the synthetic bone material in the operative sites became more clearly delineated.

Renal hemodynamics in acute unilateral ureteral obstruction: contribution of endothelium-derived relaxing factor.

The increase in ureteral pressure after acute unilateral ureteral obstruction (UUO) is associated with an initial increase in renal blood flow (RBF). The present study examines the role of nitric oxide, a major endothelium-derived relaxing factor (EDRF), in UUO-induced renal hyperemia in anesthetized dogs. In Group 1, vehicle solution was infused into the left renal artery.

Paclitaxel effect on a leukemia cell line: importance of paclitaxel concentration.

The efficacy of a drug may be a complex function of the length of drug exposure and the drug concentration. One traditional way to model these variables together has been to look at the area under the curve (AUC) when drug concentration is plotted against time. Experiments in an HL60 leukemia cell model suggest that, for the antineoplastic drug paclitaxel, AUC is not a good predictor of efficacy.

Computers and the clinical laboratory.

Quality control in the clinical laboratory has long been an important concern. The techniques used for several decades have relied heavily on aggregated data analysis of the data within the clinical laboratory itself, techniques which were feasible even in a system of manually maintained laboratory records. The development of increasingly sophisticated computerized hospital information systems presents an opportunity to significantly expand upon traditional quality control efforts.

Hyperendemic penicillinase-producing Neisseria gonorrhoeae genital infections in an inner city population.

Purpose: To determine: 1) the proportion of Neisseria gonorrhoeae caused by penicillinase-producing Neisseria gonorrhoeae (PPNG) in our inner-city population; 2) any difference in the isolation rates of PPNG between adolescents and adults; 3) co-infection rates with Chlamydia trachomatis in this adolescent population; and 4) the appropriateness of current CDC recommendations for initial treatment of patients with suspected gonococcal infection.

Methods: Genital cultures for GC were obtained from 1990 patients seen in the emergency room or primary care clinics. Of these, 285 were adolescents between 12 and 19 years of age.

Perspectives on screening and interviewing international medical graduates for psychiatric residency training programs.

The authors have found that international medical graduates (IMGs) constitute a valuable pool of applicants for residency training. The wide variation in their medical educations, prior careers, and cultural backgrounds requires a special approach to screening and interviewing IMGs. The authors share techniques and viewpoints developed in their program to screen applicants about their autobiographical statements, medical credentials, reference letters, and visa and immigration statuses.

Radiation-induced malignant melanoma: the dog that did not bark.

A history of exposure to ultraviolet rays, such as those in sunlight, has been strongly associated with malignant melanoma. Gamma rays consist of much more energetic photons, but yet they have much more tenuous links to melanoma. A literature review suggests that relatively little evidence has been adduced for gamma radiation as a cause of malignant melanoma.

Emergence of resistance to VP-16/cisplatin chemotherapy: study in a lymphoblast model system.

Etoposide (VP-16) and cisplatin are widely used in the treatment of malignancy. It is a common clinical observation that patients may initially respond to this two drug combination but later become resistant to it. Data from the CCL-159 lymphoblast cell line suggests that the emergence of resistance may be by means other than multiple drug resistance gene expression.