Multicenter, double-blind, placebo-controlled trial of seviprotimut-L polyvalent melanoma vaccine in patients with post-resection melanoma at high risk of recurrence.

Background: Most patients with advanced melanomas relapse after checkpoint blockade therapy. Thus, immunotherapies are needed that can be applied safely early, in the adjuvant setting. Seviprotimut-L is a vaccine containing human melanoma antigens, plus alum.

Screening, Brief Intervention, and Referral to Treatment in a rural Ryan White Part C HIV clinic.

About 24% of people living with HIV nationally are identified as needing treatment for alcohol or illicit drug use. Screening, Brief Intervention, and Referral to Treatment (SBIRT) has evolved as a strategy to assess and intervene with substance abuse behaviors in various clinical settings. However, less is known about the processes and outcomes of using the SBIRT intervention in outpatient HIV clinics.

Repair of right pulmonary artery transection after blunt trauma.

Acute pulmonary artery transection after blunt trauma is presumed to be a fatal injury. We report a case of right pulmonary artery transection successfully repaired with cardiopulmonary bypass and primary end-to-end anastomosis.

Strategies in lung cancer detection. Achieving early identification in patients at high risk.

Screening can be crucial for timely identification of lung cancer and thus for early treatment and a favorable prognosis. This conclusion is true particularly for persons at high risk for lung cancer, including those exposed to asbestos or silicon dust. In this article, Drs Bechtel and Petty discuss the types of screening procedures available, their cost, and the approaches and timing that are most beneficial to the public as a whole.

Treatment of the unstable total hip arthroplasty using modularity, soft tissue, and allograft reconstruction.

This is a retrospective analysis of a stepwise approach to the treatment of the unstable total hip arthroplasty. Thirty-two hips in 32 patients were analyzed 9 months to 7 years (average, 3.6 years) after reoperation for instability.

Follow-up evaluation of resected lumbar vertebral chordoma over 11 years: a case report.

Study Design: A case report with an 11-year follow-up assessment after resection and reconstruction for lumbar chordoma is given. The literature relevant to this topic is reviewed.

Objectives: To report the long-term outcome in a case of lumbar chordoma, to review the literature on vertebral chordoma, and to outline the rationale for surgical resection in such cases.

Five year survival and later outcome of patients with X-ray occult lung cancer detected by sputum cytology.

Background: A cohort of 51 consecutive patients with roentgenographically occult lung cancer, identified by sputum cytology and confirmed by bronchoscopy was reported previously.

Methods: All patients have now been followed beyond 5 years and the causes of death ascertained.

Results: The actual 5-year survival of 27 patients who were resected for cure was 74% including death for all causes.

Saccomanno smear slides and Megafunnel slides for sputum specimens. A comparison.

Objective: To compare Megafunnel slides to standard Saccomanno smear slides of sputum specimens and evaluate the use of Megafunnel slides for retrospective studies.

Study Design: Papanicolaou-stained Saccomanno smear and Megafunnel slides (Shandon Lipshaw, Inc., Shandon Inc.

Anatomic position of a herniated nucleus pulposus predicts the outcome of lumbar discectomy.

The purpose of this study was to determine whether the anatomic position of a lumbar disc herniation has any significant effect on the clinical outcome of lumbar discectomy. Between January 1988 and March 1993, 80 patients with simple disc herniations underwent lumbar discectomy for herniated nucleus pulposus. We reviewed preoperative computed tomography scans after discography and magnetic resonance imaging of the lumbar spine.

Examination of p53 alterations and cytokeratin expression in sputa collected from patients prior to histological diagnosis of squamous cell carcinoma.

Mutations in the p53 gene are detected in greater than 50% of squamous cell carcinomas of the lung and to a lesser extent in adenocarcinomas. The p53 protein is also overexpressed in a relatively high percentage of preinvasive lesions of the bronchial epithelium. However, unlike tumor tissue, immunoreactivity does not necessarily imply that cells in preinvasive lesions carry a mutant p53 allele.

Primary sternal closure and mediastinal decompression by inlay autologous rib grafts.

Hemodynamic instability and arrhythmia after cardiopulmonary bypass occasionally requires delayed sternal closure or placement of a stenting device. A primary sternal closure with autologous inlay rib grafts can ensure a secure, stable sternal repair and avoids prolonged ventilator support and the concerns, risks, and expense associated with a secondary sternotomy repair.

Surgical results for proliferative vitreoretinopathy.

We reviewed 88 consecutive eyes that underwent vitrectomy for retinal detachment with proliferative vitreoretinopathy (PVR) and were followed a minimum of six months. A primary goal of the surgery was the meticulous trimming of the vitreous base in hopes of decreasing the incidence of post-operative reproliferation and anterior PVR. Those eyes with anterior PVR had aggressive release of vitreous base contraction (anteroposterior and circumferential) with intraocular scissors.

Outcome of 51 patients with roentgenographically occult lung cancer detected by sputum cytologic testing: a community hospital program.

Background: Lung cancer is the most common fatal malignant neoplasm of both men and women. It is usually caused by tobacco smoke. However, at present there is no systematic approach to early diagnosis.

Two cases of intraocular infection with Alaria mesocercaria (Trematoda).

We encountered two cases of human intraocular infection with mesocercariae of Alaria (Trematoda), involving unrelated Asian men who had unilateral decreased vision. Both patients had pigmentary tracks in the retina, areas of active or healed retinitis, or both, and other signs of diffuse unilateral subacute neuroretinitis. Similar, nonnematode worms were seen in the patients' retinas and vitreous, respectively, several years after apparent infection.

Severe diabetic retinopathy after cataract surgery.

We retrospectively compared the visual acuity and degree of background diabetic retinopathy in 32 consecutive patients with diabetes who had cataract surgery in one eye (study group) and compared them with the visual acuity and degree of diabetic retinopathy in 32 patients with diabetes who had not had cataract surgery (control group) to determine if the retinopathy was asymmetric and worse in the operated-on eye. Twenty-three (72%) of the 32 study patients had asymmetric retinopathy (with the more severe retinopathy in the eye that underwent cataract surgery in each case) compared with three (9%) of the control group (P < .0005).

Case report: recurrent hematuria and hematospermia due to prostatic telangiectasia in classic von Willebrand's disease.

A previously healthy 32-year-old man presented with recurrent exercise induced painless gross hematuria and hematospermia. An extensive evaluation demonstrated classic von Willebrand's disease associated with vascular telangiectasia of the prostate gland as the locus of hemorrhage. The bleeding resolved spontaneously and without recurrence.

Gender- and age-specific changes in motor speed and eye-hand coordination in adults: normative values for the Finger Tapping and Grooved Pegboard Tests.

Normative values for the Finger Tapping and Grooved Pegboard Tests were developed on a sample of 360 normal volunteers stratified according to gender, three educational groups ranging from 7 to 22 years, and four age groups subdivided between the ages of 16 to 70 years. Retest reliability was estimated for both measures. The Finger Tapping Test showed significant gender differences, since women were substantially slower, particularly in the older age groups.

Central retinal vein occlusion in young adults.

Central retinal vein occlusion (CRVO) is usually seen in older adults and is often associated with systemic vascular disease. CRVO can be seen in young adults, and although it is occasionally associated with a systemic disease, in the majority of cases it occurs in an otherwise healthy patient with no known systemic disease or ocular problem. Inflammation of the central retinal vein has been proposed as a cause of the occlusion in young adults and for that reason it has been called papillophlebitis.

Predictors of outcome following severe head trauma: follow-up data from the Traumatic Coma Data Bank.

Outcome as a function of employment status or return to school was evaluated in severely head-injured patients. A priori we selected the most salient demographic, physiological, neuropsychological and psychosocial outcome predictors with the aim of identifying which of there variables captured at baseline or 6 months would best predict employability at 6 or 12 months. Based on the patients evaluated at 6 months, 18% of former workers had returned to gainful employment and 62% of former students had returned to school.