Complications of laser therapy in the gynecological patient: a review of four patients

Complications of gynecological laser treatment for perineal disease have been seen with increasing frequency. This may be the result of more women undergoing therapy with this method. Four women presenting with unstable perineal scarring are discussed.

A promoter trap in embryonic stem (ES) cells selects for integration of DNA into CpG islands

An analysis of several G418-resistant ES cell lines produced by electroporation of a promoterless neo gene (NASTI), shows an enrichment for integrations within, or adjacent to, CpG islands. A detailed analysis of two of the cell lines reveals short regions of homology between the genomic target DNA and the construct ends, and that recombination may be mediated by DNA Topoisomerase I. The DNA flanking the insert detects transcription of endogenous genes, and in one cell line divergent transcripts are detected. This use of ES cells should provide an effective and efficient means of creating insertional mutations in mice.

Pressure Dependence of Elastic Wave Velocity for β-Mg 2 SiO 4 and the Composition of the Earth's Mantle

The pressure dependence of the elastic wave velocities for hot-pressed, elastically isotropic polycrystals of the beta (modified spinel) phase of magnesium orthosilicate (Mg(2)SiO(4)) has been determined at room temperature to 3 gigapascals (GPa) by ultrasonic pulse interferometry. Pressure derivatives of the bulk (dK/dP = 4.8) and shear (dG/dP = 1.7) moduli derived from the travel times of the compressional (P) and shear (S) waves clearly demonstrate that the velocity contrast between the olivine and beta phases of Mg(2)SiO(4) decreases with increasing pressure. When combined with plausible values for the (as yet unmeasured) temperature derivatives, these new data can be used to calculate the contrast in P and S wave velocities across an olivine-beta phase transformation occuaring at pressure-temperature conditions corresponding to about 400 kilometers depth in the earth. The seismologically observed contrasts DeltaV in both P and S wave velocities constrain the percentage of orthosilicate in a model mantle of uniform chemical composition for appropriate relative magnitudes of the temperature (T) derivatives of the bulk and shear moduli for the beta phase. Allowed combinations of orthosilicate content (percent), dK/dT, and dG/dT (both in gigapascals per Kelvin) for a pair of recent seismological models with DeltaV(p) = DeltaV(s) 4.6% include (65, -0.018, -0.020), (55, -0.015, -0.018), and (45, -0.012, -0.016).

The effect of tamoxifen and estrogen receptor status on survival in gastric carcinoma

One hundred patients were entered in a randomized, controlled study of adjuvant tamoxifen therapy in gastric carcinoma. Estrogen receptor status was established by an immunohistologic method (ERD5) and 55.8% of the tumors were positive. Tamoxifen had no overall effect on survival, but there was a significant decrease in the survival time of the patients with ERD5-positive tumors. Estrogen receptor status (by the ERD5 method) is an independent prognostic factor in gastric cancer. Tamoxifen therapy does not prolong survival, and new therapeutic strategies require investigation.

Immunoperoxidase examination of cutaneous infiltrates of mycosis fungoides and large-plaque atrophic parapsoriasis with OKT10

A monoclonal antibody (OKT10), which was developed recently, reacts with pro-thymocytes, T cell acute lymphoblastic leukemia (ALL) cells, cells in normal bone marrow (including plasma cells), and activated T cells. Tissues from patients with cutaneous T cell lymphoma were studied for the presence of OKT10-reactive cells with the use of an indirect immunoperoxidase technic. OKT10-reactive cells were identified in three of eight cases of mycosis fungoides, one of two cases of Sézary syndrome, with an equivocal reaction in one of ten cases of large-plaque parapsoriasis and in one of seven positive patch tests (allergic contact dermatitis). The biologic and possible clinical implications are discussed.

OKT 9 reactivity in mycosis fungoides and large plaque (atrophic) parapsoriasis

A monoclonal antibody OKT 9 which detects a determinant expressed by a variety of proliferating cell types has been recently developed. This antibody was used in conjunction with the immunoperoxidase technique to study the cutaneous lymphoid infiltrates of nine patients with mycosis fungoides, one patient with lymphomatoid papulosis, two patients with Sézary syndrome, and ten patients with large plaque atrophic parapsoriasis (a condition which may terminate in overt mycosis fungoides.) OKT 9 reactive cells were identified in all cases of mycosis fungoides examined, in one case of lymphomatoid papulosis, one of two cases of Sézary syndrome, and one of ten cases of large plaque atrophic parapsoriasis. These results suggest that further studies using OKT 9 should be performed to assess whether OKT 9 reactivity may be used as a prognostic marker in cutaneous lymphomas and prelymphomas.

Demonstration of cells bearing the OKT6 determinant in human tonsil and lymph node

An immunoperoxidase study was carried out on human tonsil (15 specimens) and human lymph node (5 specimens) using OKT6, a monoclonal antibody which was raised against a determinant on immature thymocytes. OKT6-positive cells were identified in the crypt epithelium of all tonsils examined and in occasional clusters in the interfollicular areas of two lymph nodes. OKT6 has recently been shown to react with epidermal dendritic cells (Langerhans' cells). This study confirms that OKT6-reactive cells may be found outside the thymus. The pattern of staining obtained suggests that OKT6 reactivity belongs to a dendritic subpopulation. The significance of the finding in relation to physiology and pathology is discussed. These physiological findings may also be relevant to the immunotherapy of T-cell lymphomas.

Case report: false aneurysm of the hand secondary to digital amputation

A false aneurysm in an amputation stump of the second metacarpal produced a pulsatile mass and throbbing pain. Operative findings disclosed a false aneurysm arising from the digital artery on the radial side of the middle finger, with entrapment of the nerve to the ulnar side of the index digit within the aneurysmal sac. Excision of the aneurysm, relocation of the traumatic neuromas, and amputation of the index ray relieved the symptoms.

Diagnosis of empty sella with CT scan

The diagnosis of empty sella was made correctly by CT scanning in 100% of 19 cases studied.

Management of diabetes insipidus in neurosurgical patients

The authors present a brief review of the problem of diabetes insipidus in neurosurgical patients, with particular emphasis on the differential diagnosis of postoperative and posttraumatic polyuria and the management of diabetes insipidus in these periods. A listing of drugs currently used in its treatment is given.

Cortisol secretion in Nelson syndrome: Persistence after "total" adrenalectomy for Cushing syndrome

In two patients who were severely pigmented (Nelson syndrome) following bilateral adrenalectomy for Cushing syndrome, symptoms of hyper-cortisolism developed while they were receiving only physiologic steroid replacement. Cortical assays proved that endogenous cortisol production had not been obliterated. Even after total adrenalectomy, steroid measurement should be performed to guard against adrenocortical excess.