A comparison between digital images viewed on a Picture Archiving and Communication System diagnostic workstation and on a PC-based remote viewing system by emergency physicians

Picture Archiving and Communication Systems (PACS) make possible the viewing of radiographic images on computer workstations located where clinical care is delivered. By the nature of their work this feature is particularly useful for emergency physicians who view radiographic studies for information and use them to explain results to patients and their families. However, the high cost of PACS diagnostic workstations with fuller functionality places limits on the number of and therefore the accessibility to workstations in the emergency department. This study was undertaken to establish how well less expensive personal computer-based workstations would work to support these needs of emergency physicians. The study compared the outcome of observations by 5 emergency physicians on a series of radiographic studies containing subtle abnormalities displayed on both a PACS diagnostic workstation and on a PC-based workstation. The 73 digitized radiographic studies were randomly arranged on both types of workstation over four separate viewing sessions for each emergency physician. There was no statistical difference between a PACS diagnostic workstation and a PC-based workstation in this trial. The mean correct ratings were 59% on the PACS diagnostic workstations and 61% on the PC-based workstations. These findings also emphasize the need for prompt reporting by a radiologist.     

Djibouti, history of 2 epidemics of cholera: 1993-1994

When two cholera epidemics broke out in Djibouti, respectively in 1993 and 1994, Bioforce was obliged to intervene. The first time, three goals were pursued: setting up a rehydration centre in a tent, organizing epidemiological surveillance and training local personnel in treatment and diagnosis techniques. The next year, the epidemic followed serious flooding. The epidemiological analysis showed that cholera had become endemic in the poor neighbourhoods of the town and that epidemic break-outs were favoured by contaminated surface water and disturbances in the distribution of drinking water. The epidemic of 1997, likewise following flooding, only confirmed this point of view.     

Induction of T cell proliferation with anti-CD3 switch-variant monoclonal antibodies: effects of heavy chain isotype in monocyte-dependent systems

Monoclonal antibodies (mAb) directed against the CD3 (T3), antigen are able to induce proliferation in resting human T lymphocytes. T cell proliferation only occurs in the presence of monocytes that carry the proper Fc receptor for the mAb used. To further analyze the role of the Fc portion of anti-CD3 mAb in proliferation induction, we isolated, starting from a gamma 1 anti-CD3-producing hybridoma, four heavy-chain isotype switch-variant antibody-secreting clones, producing gamma 2b, gamma 2a, epsilon and alpha, respectively. All variant antibodies recognize the CD3 antigen as determined by immunoprecipitation and cross-blocking experiments. With this series of isotype variant antibodies we were able, in proliferation induction experiments, to confirm the Fc receptor polymorphism for murine IgG2a, IgG2b and IgG1 on human monocytes. Moreover, we found that all 30 donors tested responded to the IgE anti-CD3 antibody, while no IgA responders could be identified. The induction of proliferation by the IgE variant antibody does not require the 72-kDa Fc receptor which is responsible for the interaction with mouse IgG2a. Nonresponsiveness to the IgG1 antibody, but not to the IgG2b or IgA variant antibodies, could be overcome by the addition of exogenous interleukin 2 to the cultures. When the switch-variant antibodies were used to induce IgM synthesis in peripheral blood mononuclear cells only low IgM synthesis was found, with the exception of the IgE variant, which induced excellent T cell help for IgM production.     

Distribution of lymphocyte subsets in a case of angiofollicular lymph node hyperplasia

A series of monoclonal and polyclonal antibodies was used to determine the distribution of lymphocyte subsets in frozen tissue sections of a case of angiofollicular lymph node hyperplasia (ALNH), intermediate type. Primary follicles and mantle zones of secondary follicles consisted of BA1+OKIa1+-C3RTo5+sIgM+sIgD+ lymphocytes. Poorly developed follicular centers reacted with OKIa1, C3RTo5, DRC-1 and anti-IgM but contained no OKT4+Leu-3a+ or Leu-7+ cells. Mantle zones and primary follicles contained more OKT4+Leu-3a+ and less OKT8+ cells than normally observed. The interfollicular area consisted mainly of OKT4+Leu-3a+OKIa1- helper/inducer T-cells, admixed with some OKT8+ suppressor/cytotoxic T-cells and OKIa1+ interdigitating reticulum cells. Polyclonal plasma cells were found both in follicular centers and interfollicular areas. Based on the analogy to the peripheral lymphoid tissue in nude mice and in children with variable thymic dysfunction, it is suggested that the abnormal distribution of immunoregulatory T-cells may be of pathogenetic significance and may account for the morphology of the lymphoid follicles in ALNH.     

Growth and metabolic alterations after submandibular sialadenectomy in male mice

Because the submandibular salivary glands of male mice are rich in growth factors such as epidermal growth factor and nerve growth factor, and because there are sporadic reports of sialadenectomized mice showing growth retardation and endocrine abnormalities, we studied oxidative metabolism and fertility after submandibular sialadenectomy. Despite similar intake of food, male mice (n = 60) deprived of submandibular saliva, either by duct ligation or gland excision, initially weighed 12-13% less than the sham controls and had a slower rate of growth (P less than 0.001). After 5 mo, mice with duct ligation caught up with the sham-operated mice, but the differences compared with submandibular-sialadenectomized mice were still apparent at 32 wk (P less than 0.001). The mean respiratory quotient of submandibular-sialadenectomized and duct-ligated mice was 0.71 instead of 0.88 as in the shams at 10, 20, and 30 wk after operation (P less than 0.01). No effect on fecundity was observed in either male or female mice following submandibular sialadenectomy.     

Microvasculature of the buffalo epididymis

The microvasculature of the water buffalo (Bubalus bubalis) epididymis was investigated using light (LM), scanning electron (SEM), and transmission electron (TEM) microscopy techniques. SEM analysis of the buffalo epididymis showed fenestrations that occupied ovoid inside the endothelium of the postcapillary venules located in the caput, corpus, and cauda. They varied in shape and dimension, but more importantly, they connected the venules of the blood vascular system to the capillaries of the peripheral lymphatic vascular system. Morphofunctional analysis of these connections suggests that the microvasculature of the buffalo epididymis plays a role in facilitating the circulation of biologically active substances, and the absorption and secretion processes necessary for the survival and maturation of spermatozoa. The lymphatic capillaries at the connection points formed a network of variously sized polygonal links. These capillaries then converged to form the precollector lymphatic vessels, which in turn converged with the larger vessels originating from the testis. It was further noted that in the capillary endothelium there were no fenestrations, and in the large veins there were many diverticula. These diverticula appear to play a role in the regulation of the seasonal variations of the blood reflux. In general, the microvascular architecture of the buffalo epididymis, particularly its connection to the lymphatic vascular system, appears to play an important role in the absorption and secretion processes of the epididymal epithelium. Anat Rec 266:58–68, 2002. © 2002 Wiley‐Liss, Inc.     

Evaluation of the WIDER I system for antimicrobial susceptibility testing of clinical isolates of Haemophilus influenzae and Streptococcus pneumoniae

The aim of this study was to evaluate the WIDER I system for susceptibility testing of Haemophilus influenzae and Streptococcus pneumoniae . MICs of 12 antimicrobials against 42 H. influenzae and 58 S. pneumoniae strains were determined using 1W MIC panels and compared with those obtained by microdilution. Overall essential agreements were >99%. Very major errors were not detected. Major errors occurred with ampicillin (1.7% H. influenzae ). Minor errors were 2.3% (amoxicillin–clavulanate, cefuroxime, chloramphenicol), 7.1% (ampicillin) and 16.7% (clarithromycin) for H. influenzae , and 1.7% (chloramphenicol, erythromycin, meropenem), 3.4% (amoxicillin–clavulanate, cefuroxime, tetracycline) and 8.6% (levofloxacin) for S. pneumoniae . The WIDER I system is a reliable method for susceptibility testing of H. influenzae and S. pneumoniae .     

Paratesticular congenital malignant rhabdoid tumor diagnosed by fine-needle aspiration cytology. a case report

We report the FNA features of a congenital malignant extrarenal rhabdoid tumor (MERT) located in the right paratesticular area of a newborn full-term boy (39 wk gestation), with disseminated metastases in the liver and right parietal region. The diagnosis was suggested two days after birth by fine-needle aspiration biopsy (FNAB) of the parietal mass, which demonstrated an atypical large cell proliferation with vesicular nuclei, prominent nucleoli, and abundant cytoplasm exhibiting paranuclear dense inclusions. The diagnosis was confirmed by histopathologic and immunohistochemical examination of the primary paratesticular tumor. To the best of our knowledge, this is the third MERT reported in the paratesticular region, one of the few congenital extrarenal non-central nervous system cases, and the third congenital case (renal or extrarenal) primarily diagnosed by FNAB. We emphasize the characteristic cytologic features of a congenital rhabdoid tumor, which must be known by pathologists because of the clinical and prognostic implications. Diagn. Cytopathol. 2004;30:46-50.     

Increasing transplant mass results in long-term allograft survival and recovery from transplant vasculopathy

Late allograft rejection due to transplant vasculopathy continues to be a major clinical problem. Increasing the ratio of donor transplant size to recipient weight has been shown to reduce the incidence of late allograft failure. Using a murine pancreas transplant model we have tested the hypothesis that increasing the donor transplant size in a recipient can promote long-term allograft survival by promoting recovery from transplant vasculopathy. Recipients of an allograft that showed extensive vasculopathy were transplanted with a second donor transplant. The effect of the second allograft on the vasculopathy present in the first graft was measured. Transplanting a second allograft reversed all signs of ongoing rejection, including transplant vasculopathy, resulting in long-term survival of the first graft. Vasculopathy was only reversed if the first and second grafts were from the same mouse strain, suggesting an antigen-specific mechanism. However, the recovery of the first graft was not associated with antigen-specific peripheral tolerance.