Hepatic parenchymal gas after blunt trauma

Hepatic parenchymal gas was demonstrated by computed tomography in a boy who had sustained severe blunt trauma to the abdomen 12 hours earlier. There was no clinical evidence of infection. Although previous reports have suggested that hepatic parenchymal gas indicates the presence of infection, such gas may also be a manifestation of severe blunt trauma without infection.     

Breast Fine-Needle Aspiration in the Socialist Republic of Vietnam: First-Year Experience in the Ho Chi Minh City Cancer Center

Abstract: In the Socialist Republic of Vietnam, breast cancer is the second leading cause of cancer death in women. Prior to 1994, in certain regions of Vietnam, such as the South, the only diagnostic modalities for breast lesions were clinical examination and open surgical biopsy, a procedure prohibitively expensive for many women. In January 1994, two American cytopathologists conducted a 3-day breast fine needle aspiration (FNA) seminar at the Ho Chi Minh City Cancer Center, Ho Chi Minh City. After the seminar, 754 breast FNAs were performed from January 1994 to January 1995. The sensitivity and specificity of breast FNA were 96% and 83%, respectively, and there were nine false positive and seven false negative diagnoses. The overall diagnostic accuracy of breast FNA is within the range of previously reported accuracies, indicating that breast FNA can be learned quickly and practiced proficiently. A main role of breast FNA in Vietnam is in the diagnosis of high-stage, inoperable breast tumors. The relative af-fordability of breast FNA enables many women with breast lesions to undergo a diagnostic procedure. The introduction of inexpensive, diagnostically accurate procedures, such as breast FNA, may prove to be of great benefit in countries with scant medical resources.     

Cystic fibrosis and the phenotypic expression of autosomal dominant polycystic kidney disease

Recent experiments in cultured cyst epithelial cells from kidneys of patients with autosomal dominant polycystic kidney disease (ADPKD) have shown that the cystic fibrosis (CF) transmembrane conductance regulator (CFTR) is present in the apical surface of these cells and mediates chloride (Cl-) and fluid secretion in vitro. To determine whether the presence of CF with the expression of mutated CFTR proteins modifies cyst formation in ADPKD, we studied a large family with both inherited diseases. ADPKD in this family is linked to PKD1. The family is composed of 26 members; 11 members with ADPKD, 4 members with CF, and 2 members with both diseases. Renal volumes measured by computerized tomography (CT), calculated creatinine clearances, and other clinical parameters in the family members with ADPKD and CF were compared with those in the family members with ADPKD alone, as well as to a large population of patients with ADPKD. The patients with CF and ADPKD, but not the CF heterozygote carriers with ADPKD, had less severe polycystic kidney and liver disease, as indicated by normal renal function; smaller renal volume, even when corrected for height and body surface area; and the absence of hypertension and liver cysts. These observations suggest that the coexistence of CF may reduce the severity of ADPKD.     

HIV/AIDS infection control enforcement: a comparison between Nigeria and the United States

We examined differences in approaches to HIV-related infection control practices in two university teaching hospitals in the United States and Nigeria. Health care workers (n = 202 in Nigeria and 186 in the USA) responded to a previously validated measure of infection control practices. There were significant differences in the estimated probability of treating a person with HIV disease (higher in USA), and a greater probability of peer ridicule as a way of enforcing group norms on infection control in Nigeria. Peer enforcement of norms was significantly lower in the USA. In both countries, more precautions would be taken if it was known that the patient was HIV infected. Infection control practices were more likely to be followed in the USA compared with Nigeria if they were praised for this activity, if appropriate facilities (sharps containers, gloves, etc.) were nearby, and if they felt that infection control procedures were effective. These data point to the importance of normative social pressures in Nigeria and of knowing the patient is HIV infected in the USA and feeling that infection control procedures are effective ways of avoiding occupational HIV infection. The role of normative pressures and assumptions about HIV infection status as well as cues and availability of facilities for infection control appear to differ between these health care workers in Nigeria and the USA.     

Iopamidol and meglumine diatrizoate: comparison of effects on patient discomfort during aortofemoral arteriography

Iopamidol was compared with Renografin-60 (meglumine diatrizoate, Squibb) in a controlled, randomized double-blind study of 40 patients undergoing peripheral arteriography for arteriosclerotic occlusive disease to determine which agent caused less discomfort. Each patient was evaluated for objective signs of discomfort and subjective feelings of pain and heat. Monitoring was achieved by multiple physical examinations, chemical tests, electrocardiograms, and intra-arterial pressure recordings. It is concluded that iopamidol is safe and causes significantly less patient discomfort than Renografin-60.     

On the reactivity of corneal collagen and subcomponent C1q of the complement system with human platelets and IgG-coated latex particles

Collagen was isolated from bovine cornea and tested for reactivity towards platelets and IgG-coated polystyrene latex particles. The corneal collagen caused a dose- and temperature-dependent platelet aggregation in all human platelet-rich plasmas studied. As little as 0 . 31 micrograms of purified corneal collagen could trigger platelet activation. Human C1q, a subcomponent of the first complement component (C1), which shares extensive chemical-structural similarities with collagen, was able to inhibit the platelet aggregation provoked by corneal collagen. This blocking effect could be, however, overcome by increasing collagen doses. In a slide method or in aggregometry both corneal collagen and C1q agglutinated IgG-coated latex particles in a dose-dependent manner. Addition of such latex particles to platelet-rich plasmas or preincubation of the particles with collagen reduced or prevented the platelet action of collagen, suggesting that due to their reactivity with collagen immune complexes may play an inhibitory role in collagen-caused platelet aggregation. The results are discussed in relation to pathological events that lead to collagenolysis and also with respect to wound healing in the injured cornea.