Lipoblastoma of the foot.

Lipoblastoma is an uncommon benign lipomatous soft tissue mass of childhood, occurring most commonly in children less than 3 years of age. We present a case of lipoblastoma occurring in the foot of a 14-year-old boy and review the literature. The appearance of the mass on magnetic resonance imaging (MRI) is illustrated and is correlated with the findings at gross and microscopic pathological examination.

Closing the clinical laboratory testing loop with information technology.

Information technology can enhance the effectiveness of the part of the laboratory testing loop that occurs outside of the clinical laboratory. That external component involves the presentation of laboratory results and related information to physicians and the reception of physician requests for follow-up testing. Improvements made in the clinician-computer interface can conceivably enhance the quality of information transfer of this part of the testing loop and thereby improve the effectiveness of the entire loop.

Medical examination of the internationally adopted child: screening for infectious diseases and developmental delay.

Because of the number of internationally adopted children with undiagnosed disease, a defined set of screening tests for medical evaluation is now recommended. By and large, these tests are directed toward infectious diseases that are more common abroad than in the United States. In this article, the authors examine various aspects of screening and highlight tests that are useful in children from specified areas.

Hypertension from carotid occlusion decreases renal papillary plasma flow, hypotension from hemorrhage increases it, an autoregulatory paradox.

Renal papillary plasma flow was tested during acute increases and decreases of perfusion pressure using the 125I-labelled albumin technique. Increases of pressure were attained through ligation of carotid arteries; decreases of pressure through modest hemorrhage. In 12 control rats with blood pressure of 144 mmHg, the papillary plasma flow averaged 21.

Perforation of the right ventricle by transvenous defibrillator leads: prevention and treatment.

A series of 78 consecutive implants of the transvene PCD (Medtronic, Inc.) defibrillator system is presented and the occurrence of right ventricular perforation in 4 patients reported (5.2%).

Hematuria in a newborn infant caused by bladder hemangioma.

A newborn boy had gross hematuria caused by hemangiomas of the bladder. The sonographic examination and the voiding cystourethrogram showed an irregular and thick bladder wall with a lesion extending into the vesical lumen. Cystoscopic examination and biopsy of the lesions were diagnostic of hemangioma.

Synchronous bilateral Wilms' tumor in a neonate.

Objectives: Wilms' tumor is the most common solid abdominal tumor of childhood. Wilms' tumor is extremely rare in the neonate, with less than 20 well-documented cases. No bilateral lesions in neonates have been described in the literature.

Delivering clinical laboratory services to intensive care units.

In response to the pressures of cost reduction, we established and evaluated a carefully integrated program to deliver clinical laboratory services more promptly and efficiently to the intensive care units (ICUs). The new protocol reduced the steps and turnaround time from ordering tests by physicians to reporting results by as much as 80% on all ICUs, permitting significant reductions in personnel (exceeding $400,000 per year). For the surgical ICU there were also fewer blood collections (mean preprotocol: 7.

Lack of GVHD across classical, single minor histocompatibiliTy (miH) locus barriers in mice.

To determine whether a disparity at a single miH genetic loci are sufficient to generate GVHD in mice, we focused on well-known genetic alleleic differences at the miH gene loci, H3 and H4. For H3 congenic GVHD studies, C57BL/10 (H2b) mice were used as recipients of miH-disparate B10.LP-H3b donor cells.

Antisense oligonucleotides for central nervous system tumors.

The poor prognosis associated with malignant primary brain tumors has led investigators to seek and develop new, innovative treatment modalities. Current adjuvant therapies lack tumor specificity, which can lead to toxic central nervous system side effects. Advances in molecular biology now allow specific gene sequences to be inserted or targeted in the malignant cell genome.

Cost-effectiveness of carotid endarterectomy.

Carotid endarterectomy (CEA) reduces the risk of stroke in symptomatic patients with high-grade carotid stenosis. In this study, we evaluated the long-term, societal cost-benefit ratio of endarterectomy using a decision analysis model. We reviewed the results of 150 CEAs performed at an academic center and established a Markov model comparing cohorts of patients who experienced transient ischemic attacks and then underwent observation, aspirin therapy, or CEA.

Chloramphenicol-dependent antibody: a case report.

Background: Chloramphenicol-dependent antibodies are a rare cause of interference in pretransfusion serologic testing. Their presence can be confirmed by the testing of red cells in both the presence and absence of chloramphenicol.

Case Report: A 29-year-old, group A, Rh-positive man with no history of chloramphenicol exposure was found to have a chloramphenicol-dependent panagglutinin in his serum.

Composition of mammographic phantom materials.

Purpose: To determine the composition of a breast phantom that is most suitable for phototimer testing.

Materials And Methods: Kilovolt peak and milliampere second values were analyzed for phototimed exposures of phantoms containing 0%, 30%, 50%, 70%, and 100% simulated glandular material at thicknesses of 2, 4, 6, and 8 cm. Data also were analyzed from 1,578 mammograms in 417 patients.

Pediatric gastroenterology. Update on metabolic liver disease.

Wilson's disease, genetic and neonatal hemochromatosis, protoporphyria, tyrosinemia, and alpha1-antitrypsin deficiency are updated. Cost effectiveness of screening is discussed. Current therapies are evaluated, including the role of transplantation.

Lethal murine graft-versus-host disease induced by donor gamma/delta expressing T cells with specificity for host nonclassical major histocompatibility complex class Ib antigens.

Although T-cell receptor (TCR) alpha/beta expressing cells have a well-known role in graft-versus-host disease (GVHD) generation, the role of TCR gamma/delta expressing cells in this process has remained unclear. To elucidate the potential function of TCR gamma/delta cells in GVHD, we have used transgenic (Tg) H-2d mice (termed G8) that express gamma/delta heterodimers on a high proportion of peripheral T cells. In vitro, G8 Tg gamma/delta T cells proliferate to and kill C57BL/6 (B6) (H-2b) which express gene products (T10b and T22b) from the nonclassical major histocompatibility complex (MHC) class Ib H-2T region.

The role of operative laparoscopy in gynecologic oncology.

The potential applications of operative laparoscopy have expanded with improvements in technology and instrumentation. With newly developed techniques to complete both pelvic and paraaortic lymph node dissection, the use of the laparoscope has increased in patients with pelvic malignancies. Gynecologic oncologists are currently incorporating the techniques of operative laparoscopy in the management of patients with cervical, endometrial, and ovarian cancer.

Imaging of small airways disease.

High-resolution computed tomography (HRCT) is the most useful modality for imaging of small airways disease. Direct signs of small airways disease that appear on HRCT scans are the result of changes in the airway wall or lumen. Abnormal small airways can be seen as tubular, nodular, or branching linear structures on HRCT scans.

Counseling issues with gay and lesbian adolescents.

Few resources have been available to counselors working with lesbian and gay adolescents. This article seeks to bridge the gulf between the life experiences of these teens and those of the counselor by providing information on sexual identity formation, increased mental health risk factors for gay and lesbian youth, "coming out" issues, and barriers to supportive intervention given the hidden nature of much of this population within the schools and the world at large. Specific suggestions regarding how mental health counselors can assist these adolescents are provided.

Studies of ventilation efficiency in a protective isolation room by the use of a scale model.

Objective: To assess the ability of a protective isolation room ventilation system to reduce patient exposure to airborne infectious agents, using a small-scale model that permits cost-effective and unobtrusive study of relevant indices of performance.

Design: A one-half scale model of a protective isolation room at the University of Minnesota Hospital was constructed and equipped for tracer gas experiments to assess ventilation efficiency.

Measurements: Tracer gas (SF6) was injected into the model supply air.