Evaluation of differential toxicity of varying doses of bevacizumab on retinal ganglion cells, retinal pigment epithelial cells, and vascular endothelial growth factor-enriched choroidal endothelial cells.

Purpose: To evaluate in vitro the effects of bevacizumab, an anti-vascular endothelial growth factor (VEGF) antibody, on retinal pigment epithelial cells (RPE) and retinal ganglion cells (RGC), at doses that were inhibitory to VEGF-enriched choroidal endothelial cells (CEC).

Methods: Monkey CEC (RF6A), human RPE cells (ARPE-19), and rat RGC (RGC-5) were exposed for 24 h to increasing doses of bevacizumab. Cell numbers were quantified with WST-1 assay.

Childhood scleromyositis with a negative PM/Scl antibody.

Overlap syndromes, such as scleromyositis, antisynthetase syndrome and mixed connective tissue disease, consist of a blend of clinical features involved in two separate autoimmune disorders. Scleromyositis, the most common overlap syndrome, is usually observed in adults, and has rarely been documented in childhood. Here, the case of a 10-year-old African American female with scleromyositis is reported.

Prioritizing neurosurgical education for pediatricians: results of a survey of pediatric neurosurgeons.

Object: Pediatricians play a vital role in the diagnosis and initial treatment of children with pediatric neurosurgical disease. Exposure of pediatrics residents to neurosurgical diseases during training is inconsistent and is usually quite limited. After residency, opportunities for pediatricians' education on neurosurgical topics are few and fall mainly on pediatric neurosurgeons.

Unusual histological variant of Ewing's sarcoma of mandible.

Ewing family of tumors (EFTs) comprise highly malignant, nearly undifferentiated neoplasms including Ewing's sarcoma (ES), primitive neuroectodermal tumor (PNET) and a spectrum of other unusual variants. In general, EFTs are included among small blue cell tumors. Establishing histological diagnosis can be difficult; CD99 and FLI1 immunohistochemical staining has improved diagnosis, but these markers are not specific for EFTs.

Analysis of the reporting of search strategies in Cochrane systematic reviews.

Background: The Cochrane Handbook for Systematic Reviews of Interventions provides instructions for documenting a systematic review's electronic database search strategy, listing elements that should be in the description. Complete documentation of the search strategy allows readers to evaluate the search when critically appraising a review's quality.

Objective: The research analyzed recently published Cochrane reviews to determine whether instructions for describing electronic database search strategies were being followed.

Practice patterns in academic otolaryngology 2006: a tool for the future.

Although the American Academy of Otolaryngology-Head and Neck Surgery conducts a workforce survey annually, no study has been conducted to examine practice patterns as they pertain specifically to academic otolaryngology. Therefore, I developed the Academic Otolaryngologist Survey for this purpose. This survey, conducted in 2006, was mailed to 856 practicing otolaryngologists in the United States; 230 responded, for a return rate of 26.

Randomized comparison between traditional and traditional plus interactive Web-based methods for teaching seizure disorders.

Background: Teaching seizure disorders requires use of multiple formats including pictures and videos. Web technology permits combination of formats and interactive features to deliver information.

Purpose: The purpose of this study was to determine the benefits of incorporating Web-based interactive methodology into a neurology clerkship to enhance the teaching about seizure disorders to 3rd-year medical students.

Learning portfolios in radiology residency education: how do I get started?

As medical education and continuous professional development shift toward an outcomes-based model, there is increasing focus on the documentation of physician self-assessment and a commitment to lifelong learning. The Accreditation Council for Graduate Medical Education is helping prepare trainees for these changes by increasing the focus of graduate medical education on outcomes through the development of the 6 competencies. As part of this process, the learning portfolio is a new component of the Accreditation Council for Graduate Medical Education radiology residency program requirements.

Changing epidemiology of acute post-streptococcal glomerulonephritis in Northeast Florida: a comparative study.

The objective of this study was to review the epidemiological patterns of acute post-streptococcal glomerulonephritis (APSGN) in a pediatric population. We compared incidence, pathogenesis, clinical presentation and outcomes in two APSGN pediatric patient cohorts in northeastern Florida. Retrospective medical records were reviewed of children who were admitted to our institution with a diagnosis of APSGN.

Acute bilateral simultaneous angle closure glaucoma after topiramate administration: a case report.

Introduction: A case of severe acute bilateral angle closure glaucoma with complete visual loss after oral topiramate therapy.

Case Presentation: A 34 year-old woman developed bilateral severe visual loss 2 days after doubling the dosage of topiramate. Her best-corrected visual acuity (BCVA) was counting fingers in both eyes (OU).

End-stage renal disease due to polyomavirus in a cardiac transplant patient.

Background: A 51-year-old male orthotopic cardiac transplant recipient experienced a prolonged rejection episode immediately after transplantation. Three years and 5 months after transplantation, he presented with lower extremity swelling; at this presentation, the patient's serum creatinine level was 345 micromol/l (3.9 mg/dl), his urinalysis was trace positive for both protein and blood, the urinary sediment had no casts and his 24-hour urine collection showed 750 mg protein.

Challenges to radiology resident education in the new era.

Over the past decade, there have been many developments that have changed the practice of radiology and the education of radiology residents. These include workforce issues, the institution of the Accreditation Council for Graduate Medical Education duty-hours restrictions, the increased use of night float systems, and the implementation of picture archiving and communication systems as well as voice recognition. This article reviews the impact on resident education, summarizes potential problems introduced by these changes, and examines proposed solutions.

Effect of changes in contractility on the index of myocardial performance in the dysfunctional left ventricle.

Background: The index of myocardial performance has prognostic power in patients with cardiomyopathy and following myocardial infarction. As the index of myocardial performance has been shown to be preload and afterload dependent, the effect of altering contractility on IMP and its components with left ventricular dysfunction has been incompletely delineated.

Methods: Chronic left ventricular dysfunction was induced in 10 canines using coronary microsphere embolization.

The effect of acute hypertension on left ventricular diastolic pressures in a canine model of left ventricular dysfunction with a preserved ejection fraction and elevated left ventricular filling pressures.

Background: Decompensated heart failure with preserved left ventricular (LV) ejection fraction (EF) is often accompanied by hypertensive episodes. We hypothesized that acute increase in arterial pressure results in elevated early and late diastolic LV pressures as a result of further impaired LV relaxation.

Methods: To test this hypothesis, we used a chronic canine model of LV systolic dysfunction with preserved LV function (LVDPEF) (EF > 50%) and elevated LV end-diastolic pressure using coronary microsphere embolization.

A model for training pediatricians to expand mental health services in the community practice setting.

A model of training pediatricians in mental health diagnosis and intervention was developed to increase the pediatrician's competency in dealing with the increasing number of children with these problems. The model consisted of a pediatric psychiatrist working in collaboration with community pediatricians and training pediatricians in mental health interview and evaluation techniques, recognition and diagnosis of behavioral and mental disorders, and intervention and treatment. Following implementation of this model, the community pediatricians demonstrated an increase in mental health diagnoses in their practices.

Magnetic resonance quantitative myocardial perfusion reserve demonstrates improved myocardial blood flow after angiogenic implant therapy.

Purpose: The purpose of this study is to follow myocardial angiogenesis temporally using quantitative magnetic resonance first pass perfusion imaging and compare this with the "gold standard" of radioactive microspheres in a random subset of animals.

Materials And Methods: Ameriod constrictors were placed around the left circumflex in 15 pigs to induce an ischemic area. Two groups were randomized to receive either a sham operation or treatment with angiogenic implants inserted into myocardium in the distribution of the left circumflex artery (LCX).

Primary treatment with temporary subcutaneous peritoneal shunts for postoperative spinal cerebrospinal fluid fistulas.

Object: The authors describe a series of attempts to treat with minimally invasive surgery cerebrospinal fluid (CSF) fistulas that develop following operations of the spine for congenital anomalies.

Methods: Sixteen patients in whom CSF fistulas developed following repair of congenital spinal disorders (nine lipomeningoceles, one arachnoid cyst, two myelocystoceles, three tethered cords after myelomeningocele repair, and one scoliosis surgery) underwent placement of a temporary subcutaneous peritoneal shunt. The CSF fistulas resolved in all instances.

The index of myocardial performance and aortic regurgitation: the influence of a volume overload lesion.

Objective: The index of myocardial performance (IMP) is a global cardiac function index with prognostic utility in patients with myocardial infarction and dilated cardiomyopathy but is preload dependent. We hypothesized that a volume overload lesion prolonging LV ejection time (LVET) may reduce IMP despite LV dysfunction (LVD).

Methods: The study groups consisted of 35 normals, 26 with LV dysfunction, and 60 with aortic regurgitation (AR): 40 with ejection fraction (EF) >50% (AR+Normal EF) and 20 with ejection fraction > or = 50% (AR+Reduced EF).

The effect of intravenous fluid replacement on the response to mannitol in experimental cerebral edema: an analysis of intracranial pressure, serum osmolality, serum electrolytes, and brain water content.

Albino rabbits that had undergone a cryogenic insult over the left parieto-occipital cortex were analyzed for serum osmolality, serum electrolytes, brain water content, and intracranial pressure (ICP) following either a baseline infusion of intravenous (i.v.) fluid (45 mL total) for 3 hours or above-maintenance isotonic saline (73.

Trends in emergency coronary artery bypass grafting after percutaneous coronary intervention, 1994-2003.

Background: In the last decade, percutaneous coronary intervention (PCI) has undergone profound changes in techniques used to achieve revascularization and in patient selection. We examine trends in emergency surgical revascularization after PCI.

Methods: Using The Society of Thoracic Surgeons National Cardiac Surgery Database, we examined patients undergoing coronary artery bypass grafting within 6 hours of PCI from 1994 to 2003.

Index of myocardial performance is afterload dependent in the normal and abnormal left ventricle.

Background: The index of myocardial performance (IMP) has been used as a prognostic systolic-diastolic index for patients with dilated cardiomyopathy and postmyocardial infarction. To date, systematic evaluation of afterload alteration (arterial pressure) on IMP has not been performed with normal or reduced left ventricular (LV) function.

Methods: We studied 15 mongrel dogs at baseline, after the induction of acute ischemic LV dysfunction, and with chronic LV dysfunction.