Role of eye muscle antibody measurement in diagnosis of thyroid-associated ophthalmopathy: a laboratory update.

Objective: To review the current role of measurement of serum eye muscle antibodies in thyroid-associated ophthalmopathy (TAO).

Methods: We conducted laboratory studies to determine the prevalences of serum autoantibodies reactive with eye muscle antigens in patients with active and inactive TAO, Graves' hyperthyroidism, and Hashimoto's thyroiditis as well as in normal subjects.

Results: The two antigens most often recognized in immunoblotting with crude human or porcine eye muscle membranes by serum autoantibodies in patients with TAO are eye muscle membrane proteins of 55 and 64 kd.

Angiocentric CD3(+) T-cell infiltrates in human immunodeficiency virus type 1-associated central nervous system disease in children.

A significant proportion of brain tissue specimens from children with AIDS show evidence of vascular inflammation in the form of transmural and/or perivascular mononuclear-cell infiltrates at autopsy. Previous studies have shown that in contrast to inflammatory lesions observed in human immunodeficiency virus type 1 (HIV-1) encephalitis, in which monocytes/macrophages are the prevailing mononuclear cells, these infiltrates consist mostly of lymphocytes. Perivascular mononuclear-cell infiltrates were found in brain tissue specimens collected at autopsy from five of six children with AIDS and consisted of CD3(+) T cells and equal or greater proportions of CD68(+) monocytes/macrophages.

Morbidity, cost, and six-month outcome of minimally invasive direct coronary artery bypass grafting.

Background: Minimally invasive direct coronary artery bypass grafting (MIDCABG) promises to reduce the morbidity of coronary bypass, but this has not been proved.

Methods: This retrospective study compares the morbidity, mortality, cost, and 6-month outcome of patients less than 80 years old undergoing elective left internal mammary artery to left anterior descending artery bypass grafting via MIDCABG (n = 60) or sternotomy (n = 55) between January 1995 and December 1996. There were no differences between the groups in mean age, sex distribution, or preoperative risk level.

Teratoid Wilms tumor arising as a botryoid growth within a supernumerary ectopic ureteropelvic structure.

We report a case of a teratoid Wilms tumor arising within a supernumerary ectopic ureteropelvic structure in a 7-year-old boy. The tumor was near the right kidney but was completely separate from it. On the contralateral side, the child had a duplication of the ureteral system.

Cloning of the haemocin locus of Haemophilus influenzae type b and assessment of the role of haemocin in virulence.

The bacteriocin haemocin (HMC) is produced by most type b strains of Haemophilus influenzae, including strains determined to be genetically diverse, and is toxic to virtually all non-type b strains of H. influenzae, both encapsulated and non-encapsulated. Examination of the deduced amino acid sequences of several genes upstream of the previously identified HMC immunity gene (hmcI) revealed several features common to class II bacteriocins of certain Gram-positive bacteria.

Efficacy of radiofrequency catheter ablation for ventricular tachycardia in healed myocardial infarction.

Radiofrequency catheter ablation has been useful in the treatment of ventricular tachycardia (VT) in selected patients with healed myocardial infarction. Previous studies have demonstrated success rates of 60% to 96% for targeted VT morphologies; however, these studies included patients only after they have had successful mapping procedures and have received radiofrequency lesions. All patients referred for VT ablation from July 1992 to November 1996 were included in this analysis on an intention-to-treat basis.

Role of the eye muscles in thyroid eye disease: identification of the principal autoantigens.

Thyroid-associated ophthalmopathy (TAO) is a progressive orbital disorder associated with Graves' hyperthyroidism and, less often, Hashimoto's thyroiditis in which autoantibodies react with orbital antigens and lead to exophthalmos and eye muscle inflammation. Eye muscle (EM) membrane proteins initially reported as 55 and 64 kd are the best markers of ophthalmopathy. The "64-kd protein" is now shown to be the flavoprotein subunit of mitochondrial succinate dehydrogenase and to have a correct molecular weight of 67 kd.

New therapies for unstable angina and non-Q-wave myocardial infarction: recent clinical trials.

Thrombosis after the rupture of an atherosclerotic plaque often precipitates the acute coronary syndromes of unstable angina and myocardial infarction. The combination of aspirin and heparin has been shown to reduce the occurrence of both symptomatic and asymptomatic ("silent") ischemia, myocardial infarction, and death in patients with these syndromes. However, heparin and aspirin each have significant limitations as antithrombotic drugs.

Reevaluation of the prevalences of serum autoantibodies reactive with "64-kd eye muscle proteins" in patients with thyroid-associated ophthalmopathy.

Serum autoantibodies reactive with eye muscle proteins of "64 kilodaltons (kd)" are frequently found in patients with Graves' hyperthyroidism and thyroid-associated ophthalmopathy (TAO). Earlier, we cloned a 64-kd protein that was identified as calsequestrin, a calcium-binding protein localized in the sarcoplasmic reticulum of striated muscle and extensively studied another cloned 64-kd protein, called 1D, which is expressed in thyroid and eye muscle, and some other tissues. Using a monoclonal antibody against calsequestrin, a polyclonal antibody against 1D and a TAO patient serum reactive with the "64-kd protein," as probes, we performed Western blots of porcine eye muscle membrane.

Outcome after microdiscectomy: results of a prospective single institutional study.

Background: Although lumbar microdiscectomy is one of the most frequently performed spinal procedures, little consensus exists in the literature regarding results. Whereas retrospective reports boast success rates as high as 98%, prospective studies are less sanguine with statistics in the 73-77% range.

Methods: Prospective single-institution outcome study of all patients undergoing virgin unilateral single-level microdiscectomies by study surgeons November 1990 to March 1992.

Correlation between hemodynamic changes and tomographic sestamibi imaging during dipyridamole-induced coronary hyperemia.

Objectives: The purposes of this study were to examine the effects of dipyridamole infusion on hemodynamic variables and to compare these changes with myocardial perfusion.

Background: Dipyridamole stress testing with myocardial perfusion imaging is widely used in the assessment of patients with known or suspected coronary artery disease (CAD). Few studies, however, have correlated the hemodynamic effects of dipyridamole using invasive monitoring with perfusion patterns in patients with chest pain syndromes.

The pathology of fibrosing colonopathy of cystic fibrosis: a study of 12 cases and review of the literature.

The authors studied eight colectomy and eight biopsy specimens from 12 patients with cystic fibrosis who had developed fibrosing colonopathy, a complication observed in patients receiving high-strength enzyme replacement. The colectomies originated from five male and three female patients ranging in age from 18 months to 6 years. Five individuals had localized strictures of the right colon and three had stenosing fibrosis of the entire colon.