In vivo or in vitro anti-CD3 epsilon chain monoclonal antibody therapy for the prevention of lethal murine graft-versus-host disease across the major histocompatibility barrier in mice.

We explored the use of a single in vivo dose of an anti-CD3 epsilon mAb for graft-vs-host disease (GVHD) prevention in mice. Anti-CD3 epsilon (145-2C11) given on the day of bone marrow (BM) transplant was highly effective in preventing GVHD in a dose-dependent manner. However, mice experienced acute toxicity as measured by early post-BM transplantation mortality, severe weight loss, and cachexia, which is likely due to T cell-dependent lymphokine production.

Distal hypospadias repair without stents: is it better?

We previously reported the results of the meatal based flap urethroplasty (Mathieu) for distal hypospadias repair. Of 49 patients in whom stents were left indwelling for 2 to 5 days meatal stenosis developed in 1 and there were no fistulas. In view of these good results and to decrease postoperative discomfort from bladder spasms, we performed 37 consecutive meatal based flap repairs without stents.

Pilot evaluation of 15-deoxyspergualin for refractory acute renal transplant rejection.

15-deoxyspergualin (DSG) is a novel immunosuppressant which has been shown to be effective in preventing and treating rejection in animal allo- and xenotransplant models. Preliminary clinical studies suggest that DSG is an effective antirejection agent. In our study, 4 patients with biopsy-proven rejection episodes that were resistant to steroid and antibody therapy were then treated with DSG.

The impact of an acute rejection episode on long-term renal allograft survival (t1/2).

An acute renal transplant rejection episode has been shown to be associated with decreased 1-year graft survival. The impact on long-term outcome is undefined. We studied the impact of an acute rejection episode on t1/2, the time it takes for 1/2 of the grafts functioning at 1 year to fail.

Duplex and color Doppler sonography of complications after percutaneous interventional vascular procedures.

Duplex and color Doppler sonography have proved to be excellent noninvasive modalities for evaluating complications of percutaneous interventional vascular procedures. Complications including hematoma, pseudoaneurysm, arteriovenous fistula, thrombosis, stenosis, and vessel occlusion are routinely diagnosed with Doppler sonography. Hematomas exhibit variable echogenicity and internal complexity but never demonstrate internal blood flow.

Activation of c-erbB-2 and prognosis in ovarian carcinoma. Comparison with histologic type, grade, and stage.

Background: Prior reports suggested that measuring c-erbB-2 activation in ovarian carcinomas might be valuable in predicting prognosis. The authors attempted to confirm these studies while specifically excluding tumors of low malignant potential.

Methods: The clinical and pathologic significance of c-erbB-2 oncogene activation was assessed in 56 ovarian carcinomas, none of which met histologic criteria for tumor of low malignant potential.

Immunohistochemical characterization of teratomatous and fetal neuroendocrine pancreas.

Six extragonadal teratomas that contained pancreatic tissue were retrieved from archival material at the University of Minnesota Hospital, Minneapolis. The neuroendocrine cells were studied immunohistochemically for insulin, glucagon, somatostatin, pancreatic polypeptide, vasoactive intestinal polypeptide, gastrin, chromogranin, and synaptophysin. Pancreatic tissue from autopsies of 10 stillbirths (20 to 40 weeks' gestational age) was evaluated similarly.

Surveillance of infrainguinal vein grafts with duplex sonography.

This review considers the relative roles of traditional noninvasive vascular tests and conventional duplex and color flow Doppler sonography in the surveillance of infrainguinal autologous vein grafts. The purpose of surveillance is to identify significant anatomic or flow abnormalities that predispose to thrombosis, but can be repaired before graft thrombosis occurs. Although a few authors believe that serial measurements of the ankle-brachial index and other noninvasive vascular tests can serve as the primary method of surveillance for infrainguinal grafts, most authors do not concur.

Renal rupture after the Credé maneuver.

We report a case of renal rupture with development of a large perinephric urinoma and deterioration of renal function after the Credé maneuver in a girl with neurogenic bladder and detrusor sphincter dyssynergia without vesicoureteral reflux. After percutaneous drainage of the urinoma, management was changed to clean intermittent catheterization, and renal function returned to normal. We recommend that the Credé maneuver not be used in children with neurogenic bladder and nondenervated urethral sphincter.

Rhinocerebral mucormycosis: changing patterns of disease.

Eleven cases of rhinocerebral mucormycosis (RM) encountered over a 13-year period were reviewed. Predisposing factors included leukemia (36%), diabetes mellitus (27%), aplastic anemia (9%), myelodysplastic syndrome (9%), and treatment with immunosuppressive medications necessary to maintain solid organ or bone marrow graft viability (64%). Two patients had no predisposing factors.

Severe penile erosion after use of a vacuum suction device for management of erectile dysfunction in a spinal cord injured patient. Case report.

We report a case of severe erosion and cellulitis at the base of the penis as a result of vacuum suction device constriction bands left on for 4 hours in a spinal cord injured patient with paraplegia and hypesthesia of the genital area. All patients using vacuum suction devices need to be properly educated regarding usage and risks with adequate follow up; patients with hypesthesias and spinal cord injuries need information specifically related to their decreased or absent level of sensation. Only two out of seven vacuum suction device brochures reviewed warn of the risk to patients with decreased sensation in the penis, but none specifically address usage or risks to men with spinal cord injuries.

Rapamycin, a potent inhibitor of T-cell function, prevents graft rejection in murine recipients of allogeneic T-cell-depleted donor marrow.

We investigated the ability of the macrolide antifungal agent rapamycin (RAPA) to inhibit the rejection of T-cell-depleted (TCD) donor bone marrow (BM) transplanted into major histocompatibility complex (MHC)-disparate irradiated recipients. RAPA (1.5 mg/kg) was administered for 14 days beginning on the day of transplant.

Radiologic diagnosis, staging, and follow-up of adult central nervous system primary malignant glioma.

Glioma represents the most common primary intra-axial brain tumor. Currently, magnetic resonance (MR) imaging is the study of choice for the radiographic evaluation of patients with primary central nervous system glioma prior to and following therapeutic intervention. Computed tomography and MR imaging are frequently used for stereotactic biopsy and mapping.

Radiologic diagnosis and staging of head and neck squamous cell carcinoma.

The predominant extracranial head and neck cancer in adults is squamous cell carcinoma. The purpose of this article is to discuss the radiographic evaluation of these patients with computed tomography (CT) or magnetic resonance (MR) imaging prior to therapeutic intervention. Specific focus is given to the efficacy of CT and MR imaging, as an adjunct to clinical staging, for evaluation of the primary tumor, and metastatic adenopathy.

Staging of musculoskeletal tumors.

Staging of musculoskeletal neoplasms is important for planning chemotherapy and surgical procedures. Accurate staging has increased in importance with advancements in limb salvage procedures. This article outlines concepts, techniques, and potential problems with staging of neoplasms.

How accurate is the pelvic examination as compared to transvaginal sonography? A prospective, comparative study.

Findings at pelvic examination in 120 patients were compared to those obtained by transvaginal sonography (TVS). Overall, 102 of 472 (22%) pelvic examination assessments did not agree with the TVS findings. Twenty-nine (36%) uterine assessments differed, while 46 (32%) ovarian assessments differed.

Hemolytic effect of the Amplatz thrombectomy device.

Purpose: The hemolytic effect of the Amplatz thrombectomy device (ATD) was evaluated in nine dogs and in nine patients.

Materials And Methods: The device was activated for 1-2 minutes in the abdominal aorta, inferior vena cava, or femoral artery of nine dogs. The device was activated for 1-4 minutes in the nine patients in occluded lower extremity bypass grafts (n = 5), native superficial femoral artery (n = 1), a pulmonary artery embolus (n = 1), a portocaval shunt (n = 1), and an iliac vein stent (n = 1).