Molecular basis of fish-eye disease in a patient from Spain. Characterization of a novel mutation in the LCAT gene and lipid analysis of the cornea.

The genetic and biochemical basis of fish-eye disease (FED) was investigated in a 63-year-old female proband with low plasma HDL cholesterol. Analyses of corneal and plasma lipids of the proband were consistent with impaired lecithin:cholesterol acyltransferase (LCAT) activity. Free cholesterol and phospholipid levels were elevated relative to control values, whereas cholesteryl ester levels were greatly reduced.

Angiosarcoma at unusual sites. A report of two cases with aspiration cytology and diagnostic pitfalls.

Background: Angiosarcomas are uncommon soft tissue neoplasms with a predilection for skin and superficial soft tissues.

Cases: Two cases of angiosarcoma occurred at unusual sites, the parotid gland and lung. The parotid lesion was characterized by malignant cells present singly, in loose groups, in tight three-dimensional aggregates and in acinar formation initially misinterpreted as an adenocarcinoma.

Pitfalls in interpreting prostate specific antigen velocity.

Purpose: The concept of prostate specific antigen (PSA) velocity as an improved marker for prostate cancer detection is intriguing. However, before this concept is applied to individual patients several confounding parameters must be addressed. We determined the variability of serum PSA levels in men without prostate cancer.

Ruptured abdominal aortic aneurysms in a private hospital: a decade's experience (1980-1989).

Despite refinements in elective resection of abdominal aortic aneurysms, morbidity and mortality rates for ruptured abdominal aortic aneurysms (RAAAs) remain high. Between January 1, 1980 and December 31, 1989, we treated 208 patients with RAAAs whose mean age was 70 years. The overall mortality rate was 49.

Causes of false results in transthoracic fine needle lung aspirates.

To evaluate the causes of false-negative and false-positive results in transthoracic fine needle aspirates (TFNAs), we reviewed our experience with this technique over the 20-year period from 1972 to 1991. For 488 TFNAs satisfactory for cytologic interpretation, tissue diagnoses were subsequently obtained by biopsy, resection or autopsy in 218 cases (56 benign and 162 malignant). In 11 cases, TFNA was positive for malignancy, and the biopsy was negative.

A prospective study of respiratory failure after high-risk surgery on the thoracoabdominal aorta.

From June 1960 to September 1990, 1414 patients underwent repair of thoracoabdominal aortic aneurysms, of whom 112 (8%) had pulmonary complications requiring respiratory support with tracheostomy; subsequently 45 (40%) died in the hospital. We determined by stepwise logistic regression analysis, in a prospective study of high-risk type I and II thoracoabdominal aortic aneurysms repairs, the independent predictors of respiratory failure, defined as respiratory ventilation exceeding 48 hours after operation. In 98 patients studied, 38 (39%) were women, 60 (61%) were men, 54 (55%) had type II thoracoabdominal aortic aneurysms, 34 (35%) had aortic dissection, 19 (19%) were nonsmokers, 40 (41%) exsmokers, and 39 (40%) active smokers.