Posttransplant CD30+ (Ki-1) anaplastic large cell lymphoma: a case report and review of the literature

Posttransplant CD30(+) (Ki-1) anaplastic large cell lymphoma (ALCL) is rare. A review of the literature revealed only 3 such cases. All 3 cases were developed after single-organ transplantation. We describe CD30(+) (Ki-1) ALCL in a dual-organ (liver and heart) transplantation recipient. The patient was a 68-year-old white female who underwent an orthotopic heart transplantation in 1999 and a liver transplantation in 2000. She presented with nausea and was found to have CD30(+) (Ki-1) ALCL by pathologic examination of the gastric antrum biopsy specimen. To our knowledge, this patient represents the first reported case of posttransplant CD30(+) ALCL following a dual-organ transplantation.     

Cardiac Exposure History as a Determinant of Symptoms and Emergency Department Utilization in Noncardiac Chest Pain Patients

Although comparative studies differentiate noncardiac chest pain (NCCP), panic disorder, and coronary artery disease (CAD), little research has examined the defining features of NCCP, such as cardiac complaints, medical utilization, and learning history. We administered self-report measures to 80 Emergency Department (ED) patients with a primary complaint of chest pain who were subsequently found to not have CAD. Forty-eight percent of the ED utilization variance was accounted for by NCCP duration, age, cardiac distress symptoms, and prior exposure to both siblings' and friends' cardiac distress symptoms. In turn, 67% of the variance in cardiac distress symptoms was explained by education, age, NCCP duration, number of illnesses, noncardiac panic symptoms, prior exposure (friends), and prior observation of others' cardiac distress. No effects emerged for gender, ethnicity, avoidance, or depression. Results suggest that beyond the effects of age and distress intensity, prior exposure to other people's cardiac distress may influence NCCP.     

Comprehensive Assessment of Pain in Juvenile Rheumatoid Arthritis: An Empirical Model

A comprehensive assessment model of variables hypothesized toinfluence pediatric pain perception was empirically investigatedin 23 families who had a child with juvenile rheumatoid arthritis.To determine the effects of family environment, child psychologicaladjustment, and disease parameters on child pain perception,a developmentally appropriate model was developed. Childrenbetween the ages of 5 and 15 were found to be reliable judgesof their pain intensity. Several family environmental and childpsychological factors were found to interact with specific diseaseparameters in determining pediatric pain perception and report.A multidimensional age-appropriate assessment model is suggestedfor use in the further examination of pediatric chronic andrecurrent pain.     

Bulimia in male patients

Bulimia is not exclusively a disorder of women. Twelve men with bulimia were evaluated and found to have demographic variables and eating behaviors similar to those of female bulimia patients. Eleven of the 12 men were binge eating more than once a day, and ten of the 12 also self-induced vomiting on a regular basis. Three patients had initiated bulimic behavior in association with athletic training. Eight patients followed through with treatment referrals and responded favorably to therapy.     

Comparison of Diamond''s medium modified and Kupferberg medium for detection of Trichomonas vaginalis.

Diamond's medium modified, the commercially available version of the Klaas modification of Diamond's medium, was compared to Kupferberg medium and to direct wet-mount examination for detection of trichomonads in symptomatic patients. Diamond's medium was found to be superior to both Kupferberg medium (P less than 10(-4) and wet mount (P less than 10(-6].     

Adrenoleukodystrophy: Molecular Genetics, Pathology, and Lorenzo's oil

Knowledge about adrenoleukodystrophy (ALD), a disorder which was described first in 1923, has increased greatly during recent years. The principal biochemical abnormality, the presumed enzyme defect, and the gene defect, have been defined. A dietary therapy has been proposed and attracted world-wide attention through a motion picture. Nevertheless, many questions remain and cannot be answered without a more fundamental understanding of pathology and pathogenesis. This article will provide a review of the history, clinical features, pathology, biochemistry, and the gene defect, and then appraise current efforts to clarify pathogenesis and develop therapeutic approaches.     

Self-Regulated Facial Muscle Tension Effects on Intraocular Pressure

This study was designed to examine the relationship between orbicularis muscle tension around the eyes and fluctuations in intraocular pressure (IOP) in normal subjects. Using a biofeedback paradigm, 20 male and female subjects were asked to increase and decrease their EMG activity from the orbicularis muscle while receiving EMG feedback. Subjects received 3 alternating blocks of trials in which they attempted to increase and decrease muscle tension while maintaining the eyes open. A fourth trial consisted of a forceful closure of the eyes during the increase period. IOP was measured every 60 s throughout the entire sequence, and electrodes placed above and below the eye recorded eyeblinks. Results suggest that IOP increases with increases in facial muscle tension in normal subjects, a finding which cannot be accounted for by changes in eyeblink frequency. These results imply that increases in IOP occur during periods of increased muscle tension around the eye and suggest that muscle tension levels should be examined among individuals who have abnormally high IOP levels.     

Sensitivity of respiratory virus culture when screening with R-mix fresh cells

Use of R-Mix Fresh Cells has been shown to be a rapid and sensitive method for the detection and identification of respiratory viruses. We prospectively evaluated the impact of incorporation of R-Mix shell vials on the sensitivity and time to detection of seven respiratory viruses recovered in a comprehensive culture during the course of an entire respiratory season in a high-volume clinical laboratory. In this study, R-Mix shell vials were used as part of the culture of 3803 respiratory specimens. A total of 428 respiratory viruses were recovered. Staining of R-Mix vials after overnight incubation allowed initial detection of 274 of 279 influenza viruses, 33 of 38 parainfluenza viruses, 35 of 51 adenoviruses, and 52 of 60 respiratory syncytial viruses (RSVs). The time to reporting of all positive cultures after in-lab specimen receipt was 2.9 days on average and those initially detected in R-Mix cells were reported in 2.3 days on average. A combination of direct fluorescent-antibody (DFA) staining and virus culture was performed on a subset of 711 respiratory specimens. Of 152 viruses identified, 57 were observed only with DFA testing (55 RSV and 2 influenza A viruses) and 31 were recovered only in cell culture. After overnight incubation, R-Mix cells detected 87.1% of respiratory viruses not observed by DFA testing and 96.9% of viruses positive by both methods. The sensitivities of DFA testing and R-Mix cells for identification of influenza viruses were 70.5% and 96.7%, respectively. The R-Mix method detected influenza virus in 18 samples that were negative by DFA testing.