Significant variation of immunohistochemical marker expression in paired primary and metastatic clear cell renal cell carcinomas.

Objectives: To compare the immunohistochemical expression of diagnostic markers in primary clear cell renal cell carcinomas (RCCs) and their matched metastases.

Methods: Tissue microarrays were constructed from 15 pairs of primary and metastatic clear cell RCCs and then evaluated for the immunohistochemical expression of renal cell carcinoma antigen (RCCA), kidney-specific cadherin, carbonic anhydrase IX (CAIX), and paired box genes 2 (PAX2) and 8 (PAX8).

Results: There was significantly higher overall marker expression in metastatic tumors compared to their matched primaries (P < .

Influence of intracardiac pressure on spontaneous ventricular arrhythmias in patients with systolic heart failure: insights from the REDUCEhf trial.

Background: The implantation of a combination hemodynamic monitor-cardioverter-defibrillator in the Reducing Decompensation Events Utilizing Intracardiac Pressures in Patients with Chronic Heart Failure (REDUCEhf) study allowed assessment of the relationship between daily intracardiac pressure and occurrence of ventricular arrhythmic (VT/VF) events.

Methods And Results: Median estimated pulmonary artery diastolic pressures (ePAD) were calculated every 24 hours in 378 subjects with New York Heart Association functional class II-III heart failure who had at least 60 days of hemodynamic data. Forty-six subjects experienced 140 VT/VF events on 80 unique study days in which daily median ePAD was available.

Myocardial deformation in the fetal single ventricle.

Background: In postnatal life, patients with single ventricle (SV) with morphologic right ventricles have a worse prognosis than those with morphologic left ventricles. The aim of this study was to test the hypotheses that (1) the SV in fetuses with SV has decreased longitudinal strain compared with fetuses with normal cardiac anatomy, and (2) fetuses with SV right ventricular (RV) morphology have decreased strain compared with those with SV left ventricular (LV) morphology.

Methods: Fetal echocardiograms with SV RV and SV LV morphology were retrospectively compiled.

A neoadjuvant biochemotherapy approach to stage III melanoma: analysis of surgical outcomes.

Aims: Completion lymph node dissection (CLND) and adjuvant therapy are recommended for node-positive melanoma patients. We sought to analyze our institution's experience with neoadjuvant biochemotherapy in stage III patients.

Methods: Clinical information was extracted from a retrospective database on stage III melanoma patients.

The increasing onset of type 1 diabetes in children.

Objective: To identify trends in the recent onset of type 1 diabetes (T1D) in Colorado youth seen at the Barbara Davis Center (BDC) and compare these changes over time.

Study Design: A retrospective chart review was performed of patients ages 0-20 years at diagnosis of T1D and type 2 diabetes who were seen at the BDC, were living within Colorado at diagnosis, and were seen within 1 month of diagnosis between 1996 and 2010. The review included age of onset, sex, month and season of onset, islet autoantibodies, diabetes type, hemoglobin A1c level, and body mass index.

Partial breast irradiation in a patient with bilateral breast cancers and CREST syndrome.

Purpose: To describe the first documented use of partial breast irradiation (PBI) in a patient with calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasias (CREST) syndrome.

Methods And Materials: A 50-year-old woman with well-controlled CREST syndrome for 6 years was diagnosed with bilateral early-staged breast cancers. She underwent bilateral lumpectomies, sentinel lymph node biopsies, and PBI delivered via bilateral MammoSite catheters (Cytyc Corp.

The history of COPD.

The evolution of knowledge concerning COPD and its components--emphysema, chronic bronchitis, and asthmatic bronchitis--covers 200 years. The stethoscope and spirometer became important early tools in diagnosis and assessment. Spirometry remains the most effective means of identification and assessment of the course of COPD and responses to therapy, and is grossly underused for this purpose.

Mycoplasma pneumoniae infection is associated with Stevens-Johnson syndrome, not erythema multiforme (von Hebra).

A review of the English-language medical literature revealed at least 70 cases of well-documented Mycoplasma pneumoniae infections associated with the Stevens-Johnson syndrome. There were no cases associated with erythema multiforme (von Hebra). Most of the patients were children and young adults, and male patients were more commonly affected.

Complications of tarsoconjunctival grafts.

The authors reviewed 44 tarsoconjunctival grafts performed from 1983 to 1993 to determine the nature and severity of complications related to these grafts. Follow-up ranged from 3 weeks to 10 years, with a mean of 23 months. The complications were categorized as none, minor, or major.

HWA-448 reduces gentamicin toxicity in LLC-PK1 cells.

An LLC-PK1 cell culture model was used to evaluate for a direct protective effect of the pentoxifylline analogue HWA-448 in gentamicin nephrotoxicity at the cellular level. Cells exposed to 2 mM gentamicin for 6 days displayed a significant decrease in specific activities of leucine aminopeptidase, NaK ATPase, and N-acetyl glucosaminidase, and an increase in total cellular phospholipids (P < .05).

Historical progress and the future of human cell culture research.

Progress in human cell culture research is discussed based primarily on our hematopoietic cell culture studies. The article includes a historical background of Burkitt lymphoma cell lines, discovery of EBV, normal B-lymphoblastoid cell lines with EBV, a variety of leukemia, lymphoma, and myeloma cell lines, clinical and theoretical contributions made by studies of T-cell leukemia cell lines, the discovery and clinical relevance of HTLV, HIV and HBLV, early attempts at adoptive immunotherapy of patients with cancer, and the future of human cell culture research. Despite the fact that current cell culture methods permit maintenance of only limited cell types of both normal and malignant origins, biotechnological advances such as hybridoma and recombinant DNA technologies should continue to provide unlimited research opportunities in all fields.

Toxicity of tubule fluid iron in the nephrotic syndrome.

This study was carried out in rats with nephrotoxic serum nephritis after autologous phase proteinuria was well established to determine the effect of tubule fluid iron chelation on the course of this disease. Deferoxamine administration caused a reduction in urinary iron potentially capable of catalyzing hydroxyl radical (.OH) formation and kidney iron uptake (224 +/- 60 vs.

Extrusion of enucleation implants: treatment with secondary implants and autogenous temporalis fascia or fascia lata patch grafts.

We performed one autogenous fascia lata graft and 11 autogenous temporalis fascia grafts in eight patients with extrusion of an orbital enucleation implant and in four patients with a bulging implant who could not wear a prosthesis. Excluding one patient with inadequate follow up, 10 of the 11 patients (91%) successfully retained their implant. One patient had severe conjunctivitis followed by anterior migration of his implant 2 1/2 years after patch grafting, necessitating replacement of the implant.

Development of a somatic cell hybrid mapping panel and molecular probes for human chromosome 3.

A somatic cell hybrid mapping panel and molecular probes have been developed for human chromosome 3. This panel defines 11 regions for the short and long arms of the chromosome. Four hundred thirty-two probes have been mapped using these hybrids.

Mild ischemia predisposes the S3 segment to gentamicin toxicity.

The purpose of these studies was to determine if a functionally insignificant ischemic insult, occurring prior to gentamicin administration, enhanced gentamicin nephrotoxicity. Bilateral renal pedicle clamp studies demonstrated that 15 minutes of ischemia did not increase the plasma creatinine yet markedly enhanced gentamicin nephrotoxicity. Further studies, in uninephrectomized rats, demonstrated that following fifteen minutes of renal ischemia and four hours of reperfusion inulin clearance, FENa+ and cellular morphology were normal.

Penetrating neck trauma: a 5-year review of the literature, 1983 to 1988.

Penetrating neck trauma remains controversial: some trauma centers continue to pursue a policy of mandatory exploration while others advocate selective exploration. The literature regarding penetrating neck trauma published during the past 5 years is reviewed in this report. The majority of reports support selective exploration, and most civilian centers report a mortality of 3% to 6% regardless of the type of exploration performed.

Pancreatitis in children on chronic dialysis treated with valproic acid.

Four children treated with maintenance dialysis, three peritoneal and one hemodialysis, developed pancreatitis while receiving valproic acid (VPA) for chronic seizure disorders. Two patients recovered, eventually resuming VPA therapy after successful cadaveric renal transplantation. Two children died after complications of pancreatitis.

The paranoid patient: surgeon beware!

Patients who have a paranoid disorder have a general expectation of being exploited or harmed. Assessment of personality and mental health is an important aspect of the preoperative patient evaluation. Paranoid patients can be troublesome or even physically dangerous, but may be difficult to detect preoperatively.

Ischemia-induced loss of epithelial polarity. Role of the tight junction.

In proximal tubular cells ischemia is known to result in the redistribution of apical and basolateral domain-specific lipids and proteins into the alternate surface membrane domain. Since tight junctions are required for the maintenance of surface membrane polarity, the effect of ischemia on tight junction functional integrity was investigated. In vivo microperfusion of early loops of proximal tubules with ruthenium red (0.

Cherubism and its orbital manifestations.

Cherubism is a rare, fibroosseous lesion of the jaws that may have orbital manifestations of proptosis, lower eyelid retraction, superior globe displacement, and visual loss. Management of the orbital tumors in two cases from the same family is described. The original description of the disorder is reviewed.