Choledochal cysts in adults: a report of two cases and review of the literature.

A choledocal cyst is a dilation of some component of the biliary tract that may include both intra- and extra-hepatic sites. They are classified into six types, all of which are relatively rare. Previously, choledochal cysts were treated with biliary-enteric bypass procedures.

Telomerase activity in the differentiation of benign and malignant adrenal tumors.

Background: Telomerase is an RNA-dependent DNA polymerase that extends the ends of chromosomes by synthesizing the 6 oligonucleotide repeat TTAGGG and thus serves as a marker for cellular immortality. Although absent in most adult somatic tissues, telomerase activity is present in stem cells and is reactivated in nearly all primary human malignancies. In this study we sought to determine whether tumors of the adrenal glands contain telomerase activity and whether telomerase activity can be used to differentiate benign and malignant tumors of the adrenal glands.

Supracervical and total abdominal hysterectomy trends in New York State: 1990-1996.

To describe practice trends for total abdominal hysterectomy (TAH) and supracervical abdominal hysterectomy (SCH) in New York State and to identify fiscal features associated with these two operations, all inpatient discharges for TAH and SCH performed for benign indications from 1990 to 1996 were reviewed using the Statewide Planning and Resource Cooperative System, a centralized data reporting system. For each year examined, the number of TAHs and SCHs performed, the procedure rates adjusted for the total New York State female population, and the per diem charge (calculated from mean institutional charge as a function of average length of stay) were evaluated. While the TAH rate declined in New York State, from 34.

Controlled comparison of percutaneous and microsurgical sperm retrieval in men with obstructive azoospermia.

A controlled comparison of the efficacy and reliability of sperm retrieval by testicular fine needle aspiration (TFNA), percutaneous testicular needle biopsy (PercBiopsy) and microsurgical epididymal sperm aspiration (MESA) was performed in nine patients with obstructive azoospermia. During a planned MESA procedure, sperm retrieval was attempted on the same testis with TFNA and PercBiopsy. Spermatozoa were obtained from all patients using MESA and PercBiopsy.

Human preembryo development on autologous endometrial coculture versus conventional medium.

Objective: To evaluate the effect of autologous endometrial coculture versus conventional medium on preembryo development.

Design: Controlled systematic clinical study.

Setting: University-based IVF center.

Adenovirus vector-mediated perforin expression driven by a glucocorticoid-inducible promoter inhibits tumor growth in vivo.

To evaluate the concept that in vivo transfer of perforin complementary DNA (cDNA) will suppress tumor growth, we constructed an adenovirus vector (AdGRE.PFP) carrying perforin cDNA driven by the glucocorticoid response element (GRE) promoter. We infected A549 lung carcinoma cells with this vector in vitro and in vivo, and evaluated cell growth over time.

Relations of left ventricular mass to fat-free and adipose body mass: the strong heart study. The Strong Heart Study Investigators.

Background: It is unclear whether increased left ventricular (LV) mass in overweight individuals is related to their adiposity or to greater fat-free mass (FFM).

Methods And Results: We compared echocardiographic LV mass to FFM and adipose body mass by bioelectric impedance and to anthropometric measurements in 3107 American Indian participants in the Strong Heart Study. In men and women, the relations of LV mass and FFM (r=0.

Vaclav Havel: one man disturbing the peace.

In summary, I believe that the qualities that Havel exemplifies in his leadership style, namely, his sense of the absurd, his altruism in reluctantly assuming the responsibility for something he started, his amateurish political style, his apologetic stance, and his apolitical ideologies all serve to make him a flexible and idealistic leader who can, indeed must, be trusted and admired by his followers. Despite these personal and leadership qualities, it was fateful that Vaclav Havel was born in a place where his exemplary qualities could be used. Perhaps if he were born in another nation that did not have such a strong tradition of philosopher-kings or a peace-loving nature, he would not have been able to attain such political and idealistic heights.

Ceramide regulates the transcription of cyclooxygenase-2. Evidence for involvement of extracellular signal-regulated kinase/c-Jun N-terminal kinase and p38 mitogen-activated protein kinase pathways.

The ceramide signaling pathway is activated by the sphingomyelinase (SMase)-mediated hydrolysis of cell membrane sphingomyelin to ceramide. We determined whether ceramide, a lipid second messenger, induced cyclooxygenase-2 (COX-2) in human mammary epithelial cells. Treatment of cells with neutral SMase or C2- or C6-ceramide enhanced prostaglandin E2 synthesis and increased levels of COX-2 protein and mRNA.

A survey of risk factors for cryptosporidiosis in New York City: drinking water and other exposures.

We conducted a survey to determine the prevalence of known and theoretical exposure risks for cryptosporidiosis among selected New York City residents. Subjects were recruited from outpatients attending either a practice for persons with HIV infection (n=160), or other medical practices (n=153), at The New York Hospital-Cornell Medical Center. Despite a greater concern for waterborne infection, 82% of HIV-infected subjects reported consuming municipal tap water compared to 69% of subjects from other medical clinics (OR 2.

The effect of lumbar epidural anesthesia on maternal middle cerebral artery blood flow in normal pregnancy: a prospective, randomized, double-blind comparison study.

Objective: Lumbar epidural anesthesia is associated with a transient elevation in intracranial pressure in both animals and humans and decreased cerebral blood flow in animals. We sought to determine the effect of medium-onset and slow-onset local anesthetic lumbar epidural anesthesia on maternal cerebral blood flow in normal human pregnancy.

Study Design: In an Institutional Review Board-approved, double-blind study, 24 healthy, normotensive, nonlaboring, term gravida women undergoing elective cesarean section were prospectively placed into random groups to receive either 2% lidocaine with 8.

Treatment of retinoblastoma with the transscleral diode laser.

Purpose: To report a case of retinoblastoma successfully treated by contact transscleral photocoagulation with a diode laser.

Methods: In an 18-month-old girl, a small (6.6 x 4.

Outbreak in a New York City teaching hospital burn center caused by the Iberian epidemic clone of MRSA.

During an 18-month period in a burn center (January 1995 through June 1996), 109 single-patient MRSA isolates were identified and 102 isolates (94%) were available for DNA fingerprinting. Ninety-nine isolates (97%) carried the mecA polymorph I and Tn554 type E. Pulsed-field electrophoresis (PFGE) identified 8 patterns, of which 60 isolates were of pattern F2.

Late-life depression and functional disability: the role of goal-focused group psychotherapy.

This study compares the efficacy of two time-limited group psychotherapies for depression and functional disability in late life. Goal-focused group psychotherapy (GFGP) utilized focused psychoeducation and skills training to assist each patient in the achievement of individualized goals. Reminiscence therapy (RT) emphasized individual life review to facilitate discussion.

Preoperative screening for genetic abnormalities in men with nonobstructive azoospermia before testicular sperm extraction.

Purpose: Men with nonobstructive azoospermia may be treated with testicular sperm extraction and assisted reproduction. However, in men with severely impaired spermatogenesis genetic anomalies may be a cause of low sperm production. We present the results of genetic screening of men with nonobstructive azoospermia who are testicular sperm extraction candidates.

Adenovirus-mediated expression of melanoma antigen gp75 as immunotherapy for metastatic melanoma.

Melanocyte differentiation antigens, such as the brown locus protein gp75, are potential biological targets for immunotherapy. We investigated whether expression of the murine gp75 cDNA mediated by an adenovirus (Ad) vector could induce melanoma rejection using this model self antigen that usually induces tolerance, and whether Ad vector-directed production of interleukin-2 (IL2) might augment this response. To evaluate this approach, Ad vectors were constructed containing the murine gp75 cDNA (Ad.

CholecystokininB receptor antagonist increases food intake in rats.

To investigate the role of cholecystokininB (CCKB) receptors in the brain in the control of food intake, we administered PD-135158, a specific and potent CCKB antagonist, into the lateral ventricle of male, Sprague-Dawley rats 30 min before a 60-min intake test. PD-135158 (0.001-0.

Prolongation of intermeal interval by gastrin-releasing peptide depends upon time of delivery.

We have previously shown that brief, vena caval infusion of gastrin-releasing peptide1-27 (GRP), delivered shortly (5 min) after the end of the first spontaneous nocturnal meal, significantly prolongs the postprandial intermeal interval (IMI) without affecting the size of the subsequent meal in freely-feeding rats. In the present study, we tested whether varying the time at which GRP was delivered during the IMI affected its ability to prolong the interval. Specifically, rats (n = 9), fed milk ad lib and with indwelling inferior vena caval catheters, were infused for 1 min with saline or 10 nmol/kg of GRP either 5, 15, or 30 min after the end of the first spontaneous nocturnal meal.

Prostaglandin E1 improves pulsatile preservation characteristics and early graft function in expanded criteria donor kidneys.

Unlike simple cold storage, machine preservation allows dynamic assessment and manipulation of the donor organ before transplantation. The effects of four pharmacologic agents added to the perfusate during machine preservation of expanded criteria donor (ECD) kidneys were prospectively compared to 1) describe their influence on perfusion parameters and 2) determine their influence on early graft outcome. Between 1 January 1995 and 1 October 1997, 125 consecutive ECD kidneys were preserved in the authors' laboratory.

Comparison of clinical outcome after cryopreservation of embryos obtained from intracytoplasmic sperm injection and in-vitro fertilization.

The impact of intracytoplasmic sperm injection (ICSI) on cryopreserved zygotes and embryos was evaluated by comparing embryo survival and implantation between embryos derived from ICSI and those derived from standard insemination procedures. The study included patients whose excess zygotes and embryos were cryopreserved between September 1993 and December 1994 and who subsequently underwent a frozen embryo transfer. Embryo survival, clinical pregnancy rates per transfer and pregnancy outcome were compared.

AZFb deletions predict the absence of spermatozoa with testicular sperm extraction: preliminary report of a prognostic genetic test.

Genetic abnormalities, including partial deletions of the Y-chromosome, are commonly detectable in men with non-obstructive azoospermia (NOA). NOA can be treated using testicular sperm extraction (TESE) with intracytoplasmic sperm injection (ICSI). Recent studies have shown that the presence of deletions involving the AZFc region do not appear to affect the chance of retrieving spermatozoa or have a significant impact on fertilization or pregnancy rates with ICSI.