Effect of education and legislation on bicycle helmet use in a multiracial population.

Objective: To observe the effect of new legislation and a boroughwide bicycle helmet educational campaign on bicycle helmet use in a multiracial population.

Design: A prospective observational study. Observations were made at randomly selected sites in Queens (study group) and Brooklyn (control group), NY, in May 1994, before a New York State law affecting both boroughs was enacted and before a bicycle helmet educational campaign was conducted in Queens.

Nutrient dilution before and after X irradiation increases the radioresistance of log- and plateau-phase Chinese hamster V79 cells.

Previous observations have shown that cells cultured in standard growth medium (100%) demonstrated similarly enhanced survival when incubated postirradiation either in non-growth-promoting conditioned medium or in growth-promoting 40% growth medium (Reddy and Lange, Radiat, Res. 119, 338-347, 1989). From these results, it was suggested that nutrient dilution altered radiosensitivity by a mechanism independent of progression of cells through the cell cycle.

Fractional direct dialysis quantification: a new approach for prescription and monitoring hemodialysis therapy.

We describe a new methodology, fractional direct dialysis quantification (FDDQ) utilizing the Fresinius Dialysate Sampling Module (DSM), for quantitating total solute removal during hemodialysis (HD). Our data demonstrate that this technique and Direct Dialysis Quantification (DDQ) yield virtually identical results. FDDQ, however, obviates the practical obstacles that have limited the applicability of DDQ.

Phenformin-associated lactic acidosis due to imported phenformin.

Objective: To emphasize the continued incidence of phenformin-associated lactic acidosis.

Case Report: We report a case of phenformin-associated lactic acidosis in a Chinese man who received phenformin while in China. Diagnosis was made; the patient was treated appropriately and survived.

Management of peripheral vascular disease: innovative approaches using radiation therapy.

Despite the early successes at vascular recanalization with percutaneous transluminal angioplasty, vascular restenosis has emerged as a clinical problem of near epidemic proportions. Numerous pharmacologic and mechanical adjuncts have been tried with little success. Over the last few years, there have major advances in our understanding of the biology of the restenotic process.

Essential thrombocythemia and epidural analgesia in the parturient. Does thromboelastography help?

Background And Objectives: It is often considered that essential thrombocythemia contraindicates placement of an epidural catheter because of the danger of epidural hematoma. Thromboelastography offers a possible means of determining the appropriateness of epidural analgesia in a patient with this disorder.

Methods: A pregnant woman with essential thrombocythemia and a history of spontaneous abortions was evaluated by thromboelastography at 38 weeks of gestation to determine the safety of using epidural analgesia for labor pain management.

Newer systemic antifungal drugs for the treatment of onychomycosis.

Onychomycosis, the infection of the nail unit by any fungus, far from being just a cosmetic problem, has significant psychological, physical, social, and financial implications. Further, it has experienced a dramatic rise in incidence in recent years. The introduction of newer systemic antifungal drugs (itraconazole, fluconazole, and terbinafine) offer an increased cure rate, a broader spectrum of activity, shortening of the treatment period, and increased safety, compared with the traditional systemic antifungal drugs griseofulvin and ketoconazole.

Human papillomavirus-associated oral epithelial dysplasia (koilocytic dysplasia): an entity of unknown biologic potential.

Intraepithelial neoplasia of the female genital tract has long been associated with human papillomavirus infection. To date, there have been no previously published studies of oral dysplasia that have identified light microscopic features predictive of the presence of human papillomavirus. We identified a variant of oral epithelial dysplasia, koilocytic dysplasia, that exhibited light microscopic features suggestive of HPV infection.

Elective bedside tracheostomy in the intensive care unit.

Background: Tracheostomy is a frequently performed procedure, and historically has had a high reported complication rate. This has led some authors to suggest that a tracheostomy should be done only in the operating room (OR). Concerns regarding the hazards of transporting critically ill patients to the OR may inhibit the use of tracheostomy.

The effect of leukotrienes B and selected HETEs on the proliferation of colon cancer cells.

Eicosanoids have been implicated in colon carcinogenesis, but very little is known on the potential role of leukotrienes (LTs) and hydroxyeicosatetraenoic acids (HETEs) in this process; such compounds are produced by colonocytes and tumor infiltrating leukocytes. We studied the effect of LTB4, LTB4 methyl ester, LTB5, 12(R)-HETE, 12(S)-HETE and 15(S)-HETE (10(-10), 10(-8), 10(-6) M) on the proliferation rate, the cell cycle distribution, and the rate of apoptosis in HT-29 and HCT-15 human colon carcinoma cells. Our data show that LTB4, a lipoxygenase product, increased the proliferation rate of both cell lines in a time- and concentration-dependent manner.

Serum ionized magnesium and other electrolytes in the antenatal period of human pregnancy.

Objective: To determine: 1) the concentrations and fractions of serum ionized magnesium (IMg2+) in normal antenatal patients and 2) whether they are altered by concentrations of other cations and serum proteins.

Design: A cross sectional study design.

Setting: An urban community hospital obstetrics clinic.

Granulomatous hepatitis associated with glyburide.

A wide variety of diseases and injuries can cause granulomatous hepatitis, and drug-induced granulomatous hepatitis is a well-described entity. Sulfonylurea derivatives, which are commonly used oral hypoglycemic agents in the treatment of non-insulin-dependent diabetes mellitus, have been implicated in liver disease. However, glyburide, a second-generation sulfonylurea and a potent hypoglycemic drug, is considered to have less hepatic side effects than chlorpropamide.

Laser treatment of orthodontically induced gingival hyperplasia.

Several studies have shown that gingivitis is common in children and adolescents. Introduction of orthodontic devices may exacerbate the gingival inflammation. Orthodontically induced gingival hyperplasia in adolescents, its etiology, and treatment alternatives are discussed.

Tumor ploidy as a risk factor for disease recurrence and short survival in surgically treated Dukes' B2 colon cancer patients.

The risk factors for colon cancer recurrence following a curative intent surgery include the tumor location and size, the presence of adhesions, perforation, bowel obstruction, depth of invasion, histological grade, percentage of S phase content and cell kinetic profile. The DNA content of tumor cells has recently been suggested as an additional prognostic factor. In this study we assessed the tumor ploidy as a prognostic factor for recurrence and survival in colon cancer patients.

Placental abruption after insertion of catheter tip intrauterine pressure transducers: a report of four cases.

Background: Although intrauterine pressure transducers have proven efficacious in the management of certain laboring women, their use has been associated with small but definite risks to both mother and fetus. The introduction of catheter tip pressure transducers has facilitated the evaluation of intrauterine pressure, but there has been a paucity of data regarding complication rates with these newer devices.

Cases: We report four cases of placental abruption following insertion of catheter tip intrauterine pressure transducers.

Bacterial vaginosis in lesbians: a sexually transmitted disease.

Sexual transmission of bacterial vaginosis (BV), a common syndrome in sexually active women, has not been previously established. Because no male counterpart for BV has been found, a population of lesbians is an ideal one in which to test the hypothesis that BV is sexually transmitted. We studied 103 homosexual women (lesbians) who sought gynecologic care at a community clinic and in a private gynecology practice in New York City.

Primary gastric T-cell lymphoma with cutaneous involvement. A case report and review of the literature.

Primary gastric T-cell lymphomas are extremely rare. We report a Ki-1 negative primary gastric T-cell lymphoma of the anaplastic large cell type associated with extensive involvement of the skin, gastrointestinal tract, and other organ involvement in a patient not known to be immunocompromized. Biopsy of the stomach and distal esophagus showed infiltration of gastric mucosa and the squamous epithelium by nests of large atypical cells with vacuolated or clear cytoplasm, consistent with large cell lymphoma.

Intraoperative brachytherapy using Gelfoam radioactive plaque implants for resected stage III non-small cell lung cancer with positive margin: a pilot study.

Complete surgical resection of stage III non-small cell lung cancer (NSCLC) is at times impossible. Adjuvant radiation therapy is required to sterilize the residual tumor. This study is to investigate the safety, reproducibility, and effectiveness of intraoperative I-125 or Pd-103 Gelfoam plaque implant technique as an adjuvant treatment for resected stage III NSCLC with positive surgical margin.

Quinupristin/dalfopristin (RP 59500) therapy for vancomycin-resistant Enterococcus faecium aortic graft infection: case report.

A 46-year-old woman was admitted to the hospital with severe peripheral vascular disease, requiring multiple vascular surgical procedures. During the sixth hospital week, after prior therapy with multiple antibiotics, Enterococcus faecium was isolated as the only organism from an operating room culture of an infected aortic graft. Histological examination of the graft showed infiltration with polymorphonuclear leukocytes.

Tumor ploidy as a risk factor for disease recurrence and short survival in surgically-treated Dukes' B2 colon cancer patients.

The risk factors for colon cancer recurrence following a curative intent surgery include the presence of metastatic disease, the tumor location and size, number of positive lymph nodes, the presence of adhesions, perforation, bowel obstruction, depth of invasion, histological grade, percentage of S-phase content, and cell kinetic profile. The DNA content of colon cancers in 20 Dukes' B2 patients in follow-up evaluation at our center, who relapsed, either locally or systemically following surgical treatment was measured by image analysis. The data were pair-matched for age, sex, tumor site, and grade with 20 Dukes' B2 patients who had no evidence of disease.

Serum ionized magnesium levels during intravenous MGSO4 therapy of preeclamptic women.

Using a novel ion-selective electrode, we have shown that there is over a 100% increase in venous serum levels of ionized Mg during intravenous MgSO4 therapy of preeclamptic patients. By 6 hours of therapy, the range is 0.92-1.

Successful subdural anesthesia for cesarean section and postoperative pain management.

Subdural catheterization is a well described, but uncommon complication of attempted epidural block. Aspiration of blood or cerebrospinal fluid and use of a test dose can help identify venous or subarachnoid catheter placement but do not rule out subdural catheter placement. An unexpected high level of sensory block with relative sparing of lower extremity motor function is a consistent feature of subdural block.

Chinese hamster V79 cells harbor potentially lethal damage which is neither fixed nor repaired for long times after attaining maximal survival under growth conditions.

The kinetics of the repair and fixation of potentially lethal damage (PLD) was studied in log-phase Chinese hamster V79 cells. The postirradiation (10 Gy) survival of cells treated with hypertonic saline increased when these cells were incubated further in conditioned medium but not in growth medium, indicating that damage which is neither fixed by hypertonic saline nor amenable to repair in growth medium is nonetheless repaired in conditioned medium. Recovery of X-irradiated cells incubated in growth medium or in conditioned medium was maximal by about 70 min and was two times higher in conditioned medium than in growth medium.

Ionized serum magnesium and potassium levels in pregnant women with preeclampsia and eclampsia.

A prospective, cross-sectional study was performed to determine whether patients with preeclampsia or eclampsia had difficult serum levels or fractions of the active, ionized form of magnesium (IMg2+) as compared to normal, pregnant women. Using a novel ion selective electrode, we determined the IMg2+ levels and fractions as well as ionized calcium, sodium and potassium (K) in venous serum drawn on admission from 33 normal, pregnant women; 12 women with preeclampsia; and 2 women with postpartum eclampsia. Levels in 42 nonpregnant, age-matched, healthy women were also measured.