Role of cytology in the diagnosis of cystic and intradcutal papillary mucinous neoplasms.

Cytology may provide valuable information and is diagnostic in many cases, but it is limited by sampling difficulties. Performance of mucin stains and analysis of the cyst fluid for tumor markers, as described in the article on histology of cystic neoplasms elsewhere in this issue, increase detection of MCNs and IPMNs; however, as with any other laboratory test, the results of the cyst fluid cytologic analysis need to be assessed in light of the clinical and radiologic findings, particularly when the cytology is not completely diagnostic.

Right ventricular function in the human fetus.

Fetal RV function is critical for survival and normal cardiovascular development. Doppler can be used to assess function. Combined with wise use of imaging techniques, the cause of abnormalities can be assessed.

Comparison of calcium-binding proteins expressed in cultured hNT neurons and hNT neurons transplanted into the rat striatum.

An alternative source of cells for neural transplantation and brain repair that has many characteristics of immature neurons is the hNT neuron, derived from an embryonal human teratocarcinoma (NTera2) cell line that is terminally differentiated in vitro with retinoic acid. The majority of hNT neurons are GABAergic in cell culture. We have determined the calcium-binding protein (CBP) phenotypes of hNT neurons for three CBPs, calretinin (CR), calbindin D-28K (CB), and parvalbumin (PV), in cell culture and after transplantation into the rat striatum.

Innovations in the management of vulvar carcinoma.

Radical surgery has resulted in impressive cure rates in women with locally advanced vulvar carcinoma. Unfortunately, morbidity mostly related to inguinofemoral lymphadenectomy, is common. The present review discusses innovations in the management of vulvar disease with attempts to reduce attendant morbidity.

Leg edema from intrathecal opiate infusions.

Despite the increasing popularity of intrathecal infusions to treat patients with long-term non-cancer-related pain, this therapy is not without serious side-effects. Five out of 23 patients who had intrathecal infusions of opiates for longer than 24 months developed leg and feet edema. As predisposing factors, cardiovascular disease, deep venous thrombosis, peripheral vascular disease, and venous stasis of the lower extremities were considered.

Purpuric irritant contact dermatitis induced by Agave americana.

The sap of Agave americana, a popular ornamental plant, may cause irritant contact dermatitis. This rare eruption is typically vesiculopapular; however, a new purpuric variant with evidence of leukocytoclastic vasculitis has recently been reported. We report an additional case of a purpuric eruption associated with severe constitutional symptoms further supporting a possible vasculitic component.

The role of airway stents in the management of pediatric tracheal, carinal, and bronchial disease.

Objective: A variety of stents are available to aid in the management of complex tracheal, carinal and bronchial stenoses. We reviewed our multi-institutional experience with airway stents in children.

Methods: Thirty-three children (age, 13 days-18 years) from four institutions have had a total of 40 stents placed to aid in the management of complex airway stenoses.

Congenital Heart Surgery Nomenclature and Database Project: aortopulmonary window.

The extant nomenclature for aortopulmonary window (AP window) and pulmonary artery origin from ascending aorta (hemitruncus) is reviewed for the purpose of establishing a unified reporting system. The subject was debated and reviewed by members of the STS-Congenital Heart Surgery Database Committee and representatives from the European Association for Cardiothoracic Surgery. All efforts were made to include all relevant nomenclature categories using synonyms where appropriate.

Congenital Heart Surgery Nomenclature and Database Project: atrioventricular canal defect.

The extant nomenclature for atrioventricular (AV) canal/atrioventricular septal defect is reviewed for the purpose of establishing a unified reporting system. The subject was debated and reviewed by members of the STS-Congenital Heart Surgery Database Committee and representatives from the European Association for Cardiothoracic Surgery. All efforts were made to include all relevant nomenclature categories using synonyms where appropriate.

Congenital Heart Surgery Nomenclature and Database Project: ventricular septal defect.

The extant nomenclature for ventricular septal defect (VSD) is reviewed for the purpose of establishing a unified reporting system. The subject was debated and reviewed by members of the STS-Congenital Heart Surgery Database Committee and representatives from the European Association for Cardiothoracic Surgery. All efforts were made to include all relevant nomenclature categories using synonyms where appropriate.

Congenital Heart Surgery Nomenclature and Database Project: atrial septal defect.

The extant nomenclature for atrial septal defect (ASD) is reviewed for the purpose of establishing a unified reporting system. The subject was debated and reviewed by members of the STS-Congenital Heart Surgery Database Committee and representatives from the European Association for Cardiothoracic Surgery. All efforts were made to include all relevant nomenclature categories using synonyms where appropriate.

Tracheal allograft reconstruction: the total North American and worldwide pediatric experiences.

Background: We reviewed both the North American and the total worldwide pediatric experience with tracheal allograft reconstruction as treatment for patients with long segment and recurrent tracheal stenosis.

Methods: The stenosed tracheal segment is opened to widely patent segments. The anterior cartilage is resected and the posterior trachealis muscle or tracheal wall remains.

Minimally invasive radioguided parathyroidectomy.

The last decade has been characterized by an emphasis on minimizing interventional techniques, hospital stays, and overall costs of patient care. It is clear that most patients with sporadic HPT do not require a complete neck exploration. We now know that a minimal approach is appropriate for this disease.

Lymphatic mapping in gynecologic malignancies.

Gynecologic malignancies account for 15% of all cancer diagnosis in women. Primary lymphatic spread is well recognized in vulvar, cervical, uterine, and ovarian carcinomas. Vulvar carcinoma spreads locally to the inguinofemoral lymph nodes in a relatively predictable fashion similar to the local spread of breast carcinoma.

Does methotrexate increase the risk of infection or malignancy?

Most patients do not exhibit overt signs of immunosuppression. Studies cited in this article support a modest increase in the rate of bacterial respiratory and skin infections. Opportunistic infections occur rarely, however, and may be life threatening.

Organ preservation. An effective and safe form of cancer treatment.

In this article we review the current strategies for organ preservation in the treatment of cancer. Organ preservation with functional integrity is particularly beneficial for older patients because the need for complex functional rehabilitation and for the care of permanent stomas may be avoided.

Cancer in the elderly. Epidemiologic and clinical implications.

Cancer is a major problem for the older population. The incidence of most malignancies increases with age, with cancer being the second most common cause of death in persons older than 65. With the decline in deaths related to cardiovascular diseases, cancer is becoming an even more prominent cause of death among the elderly.

Antidepressant noncompliance as a factor in the discontinuation syndrome.

Compliance is generally defined as the extent to which a patient adheres to a treatment regimen and, specifically, takes medication as prescribed. While little research is available about the number of patients who consistently skip antidepressant doses, the literature indicates that about 30% of patients discontinue treatment suddenly within the first month. Both missed doses and abrupt stoppage of treatment place a patient at risk for experiencing discontinuation symptoms.