Bony metastases in desmoplastic pleural mesothelioma

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A rocky financial road for many HMOs

For years, HMOs have made life difficult, economically, for hospitals and other healthcare providers, with their relentless price pressures. Now, new data suggest that HMOs, themselves, are facing economic difficulties, and the inherent financial weakness of this industry may threaten its viability, both as a market for suppliers and as a provider of services to consumers.

Home healthcare--who will dominate?

Increasing interest by hospitals and HMOs and PPOs is bringing yet more changes to one of healthcare's most volatile market segments, home healthcare. Although home healthcare is expected to grow over the next several years, changes in market dynamics and in reimbursement will force suppliers to target their marketing efforts if they are to realize any of the potential of this segment.

The effect of unilateral testicular torsion on the contralateral testicle in prepubertal Chinese hamsters

Recent studies of experimental testicular torsion in rats, rabbits, and guinea pigs have demonstrated conflicting evidence regarding contralateral testicular damage. Those studies in which cellular damage has been found are postulated to result from an immunological mechanism whereby the blood-testis barrier is disrupted with subsequent autoantibody formation. In this study, the histologic and immunologic effects of testicular torsion on the contralateral testicle were investigated in prepubertal Chinese hamsters. Four study groups were established; (1) Left orchiectomy only, (2) sham surgery (scrotal incision), (3) 720 degrees left testicular torsion with left orchiectomy 24 hours later, (4) 720 degrees torsion of left testicle with detorsion after 24 hours. The initial procedure was performed at 1 month of age with subsequent biopsies of the contralateral testicle at 1 week, 1 month, and 6 months after the initial procedure. Testicular tissue was examined for immunofluorescent activity using fluorescent labeled goat anti-hamster IgG. Positive controls were established by rabbit immunization (rabbit anti-hamster immunoglobulin) which was subsequently combined with fluorescent labeled goat antirabbit IgG. There was no appreciable difference in immunologic activity between control and experimental animals. Representative sections were examined histologically and no tubular damage was demonstrated and active spermatogenesis was noted at 6 months in all groups. We believe that our results support the premise that testicular torsion in the prepubertal period has no effect on the contralateral testicle.

Gas plant (Dictamnus albus) phytophotodermatitis simulating poison ivy

A 48-year-old man presented with an itchy rash that resembled superficial burns or cane marks on his left forearm; similar lesions had appeared every summer for 5 years. Poison ivy dermatitis had been the initial diagnosis, but the patient knew that this plant was absent from his well tended garden. A visit to the garden revealed the gas plant Dictamnus albus, and occlusive patch testing with leaf cuttings produced a reaction after the skin was exposed to sunlight. Gas plant phytophotodermatitis was diagnosed.

Effect of methotrexate on the response of rat lymphocytes to phytohaemagglutinin

The proliferative responses of rat peripheral blood lymphocytes (PBL) and spleen cells to phytohaemagglutinin (PHA) were studied following either single or multiple (daily for 4 days) doses of methotrexate (MTX). Lymphopenia developed 72 hr after a single dose of MTX. Multiple doses of MTX caused a dose-limited lymphopenia. In vitro, MTX depressed the response of PBL but enhanced the response of spleen cells to PHA. The administration of single or multiple doses of MTX led to increased responses of the remaining PBL and spleen cells. Folinic acid protected against the toxicity of multiple doses of MTX and the previously enhanced spleen cells were less responsive. In some conditions MTX treatment led to the enhancement of PBL responses by the serum of treated rats; in other conditions serum became inhibitory. MTX inhibited the primary antibody response to sheep erythrocytes. These studies demonstrate that MTX treatment initially enhances the proliferative response of lymphocytes to PHA and then causes depression at the onset of lymphopenia; that serum after MTX treatment has a variable effect on lympho-proliferative responses; and also that MTX is selectively more depressive of antibody formation than of responsiveness to PHA.

Xeroradiography and otolaryngology

As a diagnostic tool, a new horizon in otolaryngology has become apparent in the past several years. It is known as xeroradiography and is a convenient technique requiring minimal patient cooperation and enjoying excellent acceptability for both patients and physicians. Speed, efficiency and consistently high image quality make xeroradiography suitable for otolaryngologic applications in the office, as well as in operating and emergency rooms. All tissue densities are represented in a single image, eliminating the need for taking two films of different densities, while radiation exposure in the same. Now popular for use in mammography, the technique is especially useful for detailed studies of the areas of interest to otolaryngologists. Certain inherent disadvantages in the technique are mentioned and guidelines are given to make these disadvantages an acceptable trade-off in actual application.