Abnormal flow volume loops in patients with intrathoracic Hodgkin's disease.

Study Objectives: To study the incidence of upper airway obstruction, as measured on the flow volume loop (FVL), in patients with bulky mediastinal Hodgkin's disease; to correlate the FVL with CT of the chest; and to follow the changes in the FVL after treatment of the tumor.

Design: Retrospective study of pulmonary function tests (PFTs) and chest CTs performed as part of a clinical trial for Hodgkin's disease.

Setting: Memorial Sloan-Kettering Cancer Center, a comprehensive cancer care center.

Role of general and specific competence skills in protecting inner-city adolescents from alcohol use.

Objective: The purpose of this longitudinal investigation was to test whether higher levels of general competence are linked to greater refusal assertiveness that is, in turn, related to less subsequent alcohol use among inner-city adolescents.

Method: A large sample of students attending 22 middle and junior high schools in New York City participated. Students completed surveys at baseline, at 1-year follow-up and at 2-year follow-up (N = 1,459; 54% female).

Small bowel ischemia following laparoscopic cholecystectomy.

Background: Among a myriad of physiological adverse affects of pneumoperitoneum-associated intra-abdominal hypertension, compromise of the mesenteric circulation is well documented.

Methods: After experiencing a case of fatal small bowel ischemia in the aftermath of laparoscopic cholecystectomy, the literature was reviewed.

Results: A Medline and Index Medicus search revealed at least 6 cases of small bowel ischemia following laparoscopic cholecystectomy.

Characterization of arginine decarboxylase in rat brain and liver: distinction from ornithine decarboxylase.

We compared the properties of mammalian arginine decarboxylase (ADC) and ornithine decarboxylase (ODC) in rat liver and brain. Mammalian ADC is thermally unstable and associated with mitochondrial membranes. ADC decarboxylates both arginine (Km = 0.

Kala-azar as an AIDS-related opportunistic infection.

Visceral leishmaniasis (kala-azar) is a worldwide disseminated protozoal infection primarily transmitted by sand flies. Because host defense against this intracellular infection is T-cell-dependent, kala-azar has predictably joined the list of AIDS-related opportunistic infections in endemic areas. The vast majority of patients with AIDS-associated kala-azar are currently found in southern Europe (the Mediterranean basin, especially Spain in injection drug users); future cases will inevitably arise in other endemic regions including India, East Africa and Sudan, and Brazil.

Perioperative alterations in plasma endothelin-1 and echocardiographic correlates of right heart function.

Objective: To determine whether greater changes in plasma endothelin-1 (ET-1) concentrations and right ventricular systolic pressure occur after major thoracic surgery than after major abdominal operations.

Design: Prospective study.

Setting: University hospital.

Psychiatric care and communities.

Psychiatrists have been concerned with communities both as settings for the lives and treatment of their patients, and as human organizations which have characteristics that can be studied, understood, and modified by the concepts and strategies developed in more traditional psychiatric work. Our growing understanding of psychiatric disorders has increasingly emphasized their chronic course with long periods of premorbid predisposition, inter-episode vulnerability and post-episode sequelae, and the role of the community as a social context with stressors, protectors, and critical variables which often dwarf the power of our therapeutic interventions.

Psychotherapy adherence of therapists treating HIV-positive patients with depressive symptoms.

Adherence monitoring, a technology to specify research psychotherapies, was used in the NIMH Treatment of Depression Collaborative Research Program (TDCRP). The authors present adherence data from a similar randomized treatment trial of 56 depressed HIV-positive patients, comparing 16-week interventions with cognitive-behavioral therapy, interpersonal psychotherapy, and supportive psychotherapy alone or with imipramine. Therapists were certified in manualized treatments.

Aggressive combination treatment for invasive fungal sinusitis in immunocompromised patients.

Invasive sinonasal fungal disease is a potentially fatal complication of chemotherapy-induced immunosuppression and neutropenia. We reviewed the outcomes of seven cancer patients who had been diagnosed with invasive fungal sinusitis; six patients had hematologic malignancies and one had breast cancer. At the time of their sinus diagnosis, all patients had been hospitalized and were receiving combination chemotherapy for their underlying malignancy.

Effect of cytokine therapy on survival for patients with advanced renal cell carcinoma.

Purpose: To evaluate the relationship between treatment with cytokine therapy and survival, investigate the effect of nephrectomy on survival, and identify long-term survivors among a cohort of 670 patients with advanced renal cell carcinoma (RCC).

Patients And Methods: A total of 670 patients with advanced RCC treated on 24 clinical trials of systemic chemotherapy or cytokine therapy were the subjects of this retrospective analysis. Treatment was categorized as cytokine (containing interferon alfa and/or interleukin-2) in 396 patients (59%) and as chemotherapy (cytotoxic or hormonal therapy) in 274 (41%).

How calcium from calcium carbonate and milk benefit peptic ulcer patients.

Calcium from calcium containing antacids and milk enhance the integrity of gastrointestinal mucosa and mucus, as it is the natural linker agent of these structures, which strengthens their defense function.

Rice hurts the stomach by its stickiness.

Rice masses remove mucus from the stomach and duodenum as the sticky starch binds the sticky mucus, weakening the defense against acid and pepsin which may in turn cause heartburn and ulcer. Such unwanted effect can be avoided by taking enough water with rice meal as water converts rice masses into slurry.

The effect of lithocholic acid on proliferation and apoptosis during the early stages of colon carcinogenesis: differential effect on apoptosis in the presence of a colon carcinogen.

Lithocholic acid (LCA) is implicated in human and experimental animal carcinogenesis. Its effect on apoptosis and proliferation of the colonic epithelium was studied in a 1,2-dimethylhydrazine (DMH)-induced murine carcinogenesis model. Four groups of mice, control, LCA, DMH and DMH+LCA, were studied for 4 weeks, a period corresponding to early stages of carcinogenesis.

Value of radiologic imaging and computer assisted surgery in surgical decisions of the anterior skull base lesions.

The role of radiologic imaging in surgical decision making of anterior skull base lesions has been found to be critical in the endoscopic surgical management of these lesions. The non-invasive radiologic imaging may include the use of CT scans, MRI scans, MRA scans and their subtraction technique. The imaging offers an understanding of the vascularity of the lesion, the relationship to the nearby neurovascular structures and the type of tissue density of these lesions.

Apoptotic signaling through the beta -adrenergic receptor. A new Gs effector pathway.

Stimulation of beta-adrenergic receptor normally results in signaling by the heterotrimeric G protein G(s), leading to the activation of adenylyl cyclase, production of cAMP, and activation of cAMP-dependent protein kinase (PKA). Here we report that cell death of thymocytes can be induced after stimulation of beta-adrenergic receptor, or by addition of exogenous cAMP. Apoptotic cell death in both cases was observed with the appearance of terminal deoxynucleotidyl transferase-mediated UTP end labeling reactivity and the activation of caspase-3 in S49 T cells.

Carcinoid tumor of the kidney. The use of somatostatin receptor scintigraphy in diagnosis and management.

Three patients were diagnosed with carcinoid tumors of the kidney. The diagnosis was rendered after biopsy with the assistance of immunohistochemical stains. In all three patients, a pentetreotide scan was helpful in staging.

Stress fractures in women.

Stress fractures are common overuse injuries, reported more frequently in female athletes than in male athletes. The clinician should have a high index of suspicion for this injury whether an athlete presents with complaints of acute pain and disability or insidious onset of pain that is aggravated by activity and relieved by rest. Radiographs, bone scans, CT scans, and MR imaging may all be useful in confirming the diagnosis.

The evaluation of high risk and pre-invasive breast lesions and the decision process for follow up and surgical intervention.

Atypical epithelial hyperplasia, lobular carcinoma in situ (lobular neoplasia), radial scar, and ductal carcinoma in situ are considered high-risk lesions that predispose toward the future development of non-invasive or invasive breast cancer. Generally, those women with atypical epithelial hyperplasia, radial scar, or lobular carcinoma in situ can be managed conservatively by close surveillance. The minority of women may consider prophylactic mastectomy.

Adenocarcinoma of the rectum with associated colorectal adenomatous polyps in tuberous sclerosis: a case report.

The authors present the case of a 17-year-old girl with tuberous sclerosis (TS) who presented with symptoms of intussusception. Although endoscopically diagnosed with multiple colonic polyps, presumed to be hamartomas, and an invasive rectal adenocarcinoma, postoperative pathology findings confirmed the rectal cancer and showed multiple colonic adenomas. Multiple colonic adenomatous polyps in a young girl with tuberous sclerosis is extremely rare.

Saturation of, and competition for entry into, the apical secretory pathway.

To investigate mechanisms of apical sorting in the secretory pathway of epithelial cells, we expressed varying amounts of the 165 amino acid isoform of vascular endothelial growth factor (VEGF(165)) and transforming growth factor beta1 (TGF-beta1) via replication defective adenoviruses. Apical sorting of both proteins was efficient at low expression levels but saturated or was reversed at high expression levels. High expression levels of TGF-beta1 were effective at competing VEGF(165) out of the apical pathway; however, VEGF(165) did not compete out TGF-beta1.