Treatment of a saphenous vein graft to right ventricle fistula with a PTFE-covered stent: a case report.

This report demonstrates the use of a covered stent for the correction of a fistula from a saphenous vein graft to the right ventricle. The use of this stent resulted in complete obliteration of the fistulous tract and restoration of flow into the sequential limb of the graft.

Five French (5 Fr) guiding catheters for percutaneous coronary angioplasty and stent placement: An initial feasibility study.

Thirty patients were treated with percutaneous coronary intervention (PCI) using a 5 Fr guiding catheter. A recently developed, mechanically advantaged hand injector was used to deliver contrast and achieved excellent visualization through the 5 Fr system. Stent sizes ranged from 2.25 to 4.00 mm in diameter and from 8 to 24 mm in length. All primary lesions were successfully treated. The average contrast use was 70 cc per case. There were no major complications and only one minor femoral hematoma. In selected patients, a balloon angioplasty and stent placement can be performed safely and successfully with 5 Fr guiding catheters using currently available products. This technique creates a smaller arterial puncture site, which may obviate the need for a closure device and allow early and safe ambulation. With 5 Fr systems, it appears that contrast usage is reduced, thereby potentially decreasing cost and morbidity. Cathet. Cardiovasc. Intervent. 51:352-357, 2000.

Hantavirus pulmonary syndrome.

We present the first case of Hantavirus pulmonary syndrome in the Dallas/Fort Worth area. The patient was a 50-year-old previously healthy white man, who had adult respiratory distress syndrome (ARDS) and hypotensive shock after 1 week of nonspecific "viral" symptoms. Despite supportive care, the patient died within several hours of presentation. This case illustrates several of the classic hallmarks of hantavirus infection such as hemoconcentration, thrombocytopenia, ARDS, and shock.

Intermittent fever and pancytopenia in a young Mexican man.

We report a case of brucellosis in a young Mexican man who had weight loss, fever, and nausea. Physical examination revealed hepatosplenomegaly, and examination of the blood showed pancytopenia. This case illustrates the need for a high index of suspicion when patients living in the southern United States have these symptoms.

Low Water Potential Disrupts Carbohydrate Metabolism in Maize (Zea mays L.) Ovaries.

Water deficit during pollination increases the frequency of kernel abortion in maize (Zea mays L.). Much of the kernel loss is attributable to lack of current photosynthate, but a large number of kernels fail to develop on water-deficient plants even when assimilate supply is increased. We examined the possibility that assimilate utilization by developing ovaries might be impaired at low water potential ([Psi]w). Plants were grown in the greenhouse in 20-L pots containing 22 kg of amended soil. Water was withheld on the first day silks emerged, and plants were hand-pollinated 4 d later when leaf [Psi]w decreased to approximately - 1.8 MPa and silk [Psi]w was approximately -1.0 MPa. Plants were rehydrated 2 d after pollination. The brief water deficit inhibited ovary growth (dry matter accumulation) and decreased kernel number per ear by 60%, compared to controls. Inhibition of ovary growth was associated with a decrease in the level of reducing sugars, depletion of starch, a 75-fold increase in sucrose concentration (dry weight basis), and inhibition of acid invertase (EC 3.2.1.26) activity. These results indicate that water deficits during pollination disrupt carbohydrate metabolism in maize ovaries. They suggest that acid invertase activity is important for establishing and maintaining reproductive sink strength during pollination and early kernel development.

Relationship of endogenous abscisic Acid to sucrose level and seed growth rate of soybeans.

It has been proposed that abscisic acid (ABA) may stimulate sucrose transport into filling seeds of legumes, potentially regulating seed growth rate. The objective of this study was to determine whether the rate of dry matter accumulation in seeds of soybeans (Glycine max L.) is correlated with the endogenous levels of ABA and sucrose in those sinks. The levels of ABA and sucrose in seed tissues were compared in nine diverse Plant Introduction lines having seed growth rates ranging from 2.5 to 10.0 milligrams dry weight per seed per day. At 14 days after anthesis (DAA), seeds of all genotypes contained less than 2 micrograms of ABA per gram fresh weight. Levels of ABA increased rapidly, however, reaching maxima at 20 to 30 DAA, depending upon tissue type and genotype. ABA accumulated first in seed coats and then in embryos, and ABA maxima were higher in seed coats (8 to 20 micrograms per gram fresh weight) than in embryos (4 to 9 micrograms per gram fresh weight. From 30 to 50 DAA, ABA levels in both tissues decreased to less than 2 micrograms per gram fresh weight. Levels of sucrose were also low early in development, less than 10 milligrams per gram fresh weight at 14 DAA. However, by 30 DAA, sucrose levels in seed coats had increased to 20 milligrams per gram fresh weight and remained fairly constant for the remainder of the filling period. In contrast, sucrose accumulated in embryos throughout the filling period, reaching levels greater than 40 milligrams per gram fresh weight by 50 DAA. Correlation analyses indicated that the level of ABA in seed coats and embryos was not directly correlated to the level of sucrose measured in those tissues or to the rate of seed dry matter accumulation during the linear filling period. Rather, the ubiquitous pattern of ABA accumulation early in development appeared to coincide with water uptake and the rapid expansion of cotyledons occurring at that time. Whole tissue sucrose levels in embryos and seed coats, as well as sucrose levels in the embryo apoplast, were generally not correlated with the rate of dry matter accumulation. Thus, it appears that, in this set of diverse soybean genotypes, seed growth rate was not limited by endogenous concentrations of ABA or sucrose in reproductive tissues.

Effect of Water Deficits on Seed Development in Soybean : II. Conservation of Seed Growth Rate.

Water deficits during seed filling decrease seed size in soybean (Glycine max L.). This may result from a reduction in the supply of assimilates from the maternal plant and/or an inhibition of seed metabolism. To determine whether maternal or zygotic factors limited seed growth, we examined the effects of a plant water deficit on the supply of sucrose to and its utilization by developing embryos. Plants were grown in the greenhouse, and water deficits were imposed by withholding water for a period of 6 days during linear seed fill. When water was withheld, leaf water potential decreased rapidly, inhibiting canopy photosynthesis completely within 3 days. However, seed dry weight (nodes 7-11) continued to increase at or near the control rate. The level of total extractable carbohydrates in leaf, stem, and pericarp tissue decreased by 70, 50, and 45%, respectively, indicating that reserves were mobilized to support seed growth. Cotyledon sucrose content decreased from about 60 milligrams per gram dry weight to 30 milligrams per gram dry weight. Similarly, the concentration of sucrose in the interfacial apoplast of the cotyledons decreased from approximately 100 millimolar to 50 millimolar. However, the rate of sucrose accumulation by excised embryos, measured in a short-term in vitro assay, increased in response to the water deficit. These results indicate that both source and sink activity in soybean are altered by water deficits to maintain the flux of assimilates to the developing embryos. This may explain why seed growth is maintained, albeit for a shorter duration, when soybean is exposed to water deficits during the seed filling period.

[Hypoplastic left heart syndrome--clinical and pathologico-anatomic findings]. / Das hypoplastische Linksherzsyndrom--klinische und pathologisch-anatomische Befunde.

In twenty-two cases with hypoplastic left heart syndrome the anamnestic criterias and the clinical features were analysed. The pathologic specimens were examined in thirteen cases. The relations of the left heart to the right heart were measured. The same information is to be measured by two-dimensional echocardiography intra vitam. It should be discussed whether it is possible to perform an operative procedure in some rare cases of hypoplastic left heart syndrome.

Abscisic Acid and its relationship to seed filling in soybeans.

The effect of exogenous abscisic acid (ABA) on the rate of sucrose uptake by soybean (Glycine max L. Merr.) embryos was evaluated in an in vitro system. In addition, the concentrations of endogenous ABA in seeds of three soybean Plant Introduction (PI) lines, differing in seed size, were commpared to their seed growth rates. ABA (10(-7) molar) stimulated in vitro sucrose uptake in soybean (cv ;Clay') embryos removed from plants grown in a controlled environment chamber, but not in embryos removed from field-grown plants of the three PI lines. However, the concentration of ABA in seeds of the three field-grown PI lines correlated well with their in situ seed growth rates and in vitro [(14)C] sucrose uptake rates.Across genotypes, the concentration of ABA in seeds peaked at 8.5 micrograms per gram fresh weight, corresponding to the time of most rapid seed growth rate, and declined to 1.2 micrograms per gram at physiological maturity. Seeds of the large-seeded genotype maintained an ABA concentration at least 50% greater than that of the small-seeded genotype throughout the latter half of seed filling. A higher concentration of ABA was found in seed coats and cotyledons than in embryonic axes. Seed coats of the large-seeded genotype always had a higher concentration of ABA than seed coats of the small-seeded line. It is suggested that this higher concentration of ABA in seed coats of the large-seeded genotype stimulates sucrose unloading into the seed coat apoplast and that ABA in cotyledons may enhance sucrose uptake by the cotyledons.

Immunological characterization of mononuclear cells and morphological findings in patients with mammary carcinoma.

Mononuclear cells from peripheral blood and draining lymph nodes of 40 patients with invasive mammary carcinoma were examined for various immunological cell surface markers including surface membrane immunoglobulins and rosetting properties (E, EA, EAC). No significant relationship could be established to anyone of the following criteria for which the literature reports varying prognostic values: Clinical staging of the disease , histological tumor type, grading, nuclear differentiation, round cell infiltration, perivenous infiltration, sinus histiocytosis, and lymph node reaction patterns (lymphocyte predominance, germinal center predominance, lymphocyte depletion, unstimulated nodes). From the reported results it is concluded that the analysis of lymphocyte cell surface markers in mammary carcinoma is not a suitable parameter for supporting the existence of specific or unspecific anti-tumor immune reactions which may be suspected from certain histological reaction patterns.

[Plasma levels of PGE2, PGA2 and PGF2 alpha during spontaneous labour]. / Plasmaspiegel von PGE2, PGA2, und PGF2 alpha im Verlauf der Spontangeburt.

Plasma levels of PGE2, PGA2 and PGF2 alpha were determined by radioimmunoassay in maternal venous blood during different phases of uterine contractions. Mean prostaglandin levels during labor were: PGE2 = 2,25 +/- 1,3 ng/ml (mean +/- SD), PGA2 = 2,86 +/- 1,55 ng/ml and PGF2 alpha = 0,58 +/- 0,37 ng/ml. The approximate ratios between the prostaglandin concentrations were: PGE2:PGA2: PGF2 alpha = 1:1-3:0,3. No changes of PGE2 levels were found in the course of concentrations during the first and second stage of labor. At delivery and at the contraction followed by the expulsion of the placenta, PGE2 concentrations rose from the beginning of the contraction (2,21 +/- 0,07 ng PGE2/ml) to the maximum of the contraction (4,31 +/- 0,56 ng PGE2/ml). PGA2 levels did neither show a correlation to the course of contractions nor to the different stages of labor, but were considerably different between patients during the first stage of labor (e.g. 1,9 +/- 1,1 ng PGA2/ml) and during the second stage of labor (3,36 +/- 2,8 ng PGA2/ml). Mean PGF2 alpha concentrations were between 0,21 +/- 0,12 ngPGF2 alpha/ml (1st stage) and 0,81 +/- 0,11 ng PGF2alpha/ml (highest value obtained, 1st stage of labor, too). There was no correlation between PGF2 alpha concentrations and the course of contractions during the different stages of labor.

Immunological characterization of mononuclear cells in peripheral blood and regional lymph nodes of breast cancer patients.

Mononuclear cells from peripheral blood and draining lymph nodes of 40 patients with invasive locoregional breast cancer were examined for immunological cell surface markers (E, EAhuman, EAox, EAC, SIg pos.). Concomitantly, blood lymphocytes from 36 healthy women and axillary and mesenteric lymph-nodes from patients without malignant diseases were tested as controls. In peripheral blood of tumor patients E rosette-forming cells were slightly diminished as compared to the control group, whereas EAox and EAC rosette-forming cells were increased. These differences may be age-dependent rather than tumor-related. In the draining lymph nodes of breast cancer patients as well as in the control lymph nodes, the percentages of EAC rosette-forming cells and SIg positive lymphocytes were significantly increased compared to peripheral blood, whereas E and EAhuman rosette values remained unchanged. Percentages of EAox rosettes on the other hand were strongly diminished in the draining lymph nodes, suggesting that the EAhuman and EAox rosetting techniques detect 2 types of Fc-receptor bearing cells. No significant differences were found between the cell surface marker analysis of tumor-free and metastatic lymph nodes of breast cancer patients and the control lymph nodes.

[Imprint cytology of axillary lymph nodes in breast neoplasms for intraoperative rapid diagnosis]. / Imprint-Zytologie der axillären Lymphknoten bei Mammakarzinom zur intraoperativen Schnelldiagnostik.

A total of 385 lymph nodes of patients suffering from breast cancer were examined intraoperatively for the presence of metastases. We applied imprint cytology and stained using the "Diff-Quick" set (3 times 30 seconds). The percentage of correct identifications following instant cytological examination amounted to 94.5 if compared with subsequent paraffin histology. The 21 diagnostic failures were composed of 3 false negative and 18 false positive results. These data make the advantages for routine clinical application quite obvious.

[The problem of the ploidy reduction in carcinogenesis of the uterine cervix: numerical chromosome anomalies in carcinoma in situ (author's transl)]. / Zur Frage der Ploidiereduktion bei der Carcinogenese an der Cervix uteri: Numerische Chromosomenanomalien beim Carcinoma in situ.

The authors report on cytogenetic studies of the uterine cervix in 11 carcinoma in situ. In six cases with intact epithelium the cells were no longer normal and five cases showed beginning stroma invasion. The numerical chromosome anomalies observed indicate the presence of ploidy reduction. In accord with cytogenetic findings in precancerous conditions and in carcinoma of the uterine cervix published in the literature, the ploidy reduction may be regarded as a probable causal principle for malignancy at the uterine cervix.

[Comparative cytogenetic studies of a primary squamous cell carcinoma of the uterine cervix and the local recurrence of the same tumor (author's transl)]. / Vergleichende zytogenetische Untersuchungen an Primärtumor und lokalem Rezidiv eines Plattenepithelkarzinoms der Cervix uteri

Comparative cytogenetic studies of a primary squamous cell carcinoma of the uterine cervix and the local recurrence of the same tumor following radio therapy are reported. The microscopic features of both tumors were identical. The cytogenetic features of both tumors were almost identical as to the degree of ploidy, the disturbances of the distribution of the chromosomes from Group A to Group G and the type and frequency of Marker chromosomes. It is therefore concluded that the primary tumor and its local recurrence are represented by the same cell lines. Apparently certain cell lines are of decisive importance in malignant growth.

[Cytogenetic studies of preinvasive lesions and invasive carcinomas of the cervix uteri. I. Numerical chromosome abnormalities (author's transl)]. / Cytogenetische Untersuchungen an Praecancerosen und Carcinomen der Cervix uteri. I. Numerische Chromosomenanomalien

Analysis of chromosome numbers of 9 dysplasias, 25 carcinomas in situ, 4 carcinomas in situ with microinvasion and 16 invasive squamous carcinomas (at least clinical stage I b) of the cervix uteri showed that the numerical deviations of the chromosome number cannot be differentiated in principle between the carcinoma in situ, carcinoma in situ with microinvasion and invasive squamous carcinoma groups. The only remarkable finding is that cells in the triploid region appear somewhat more frequently in the invasive squamous carcinoma group. The dysplasia group has in general less numerical chromosome deviations than the other three groups. Chromosome gains seldom occur in this group, chromosome losses appear to be a more frequent event.

[Cytogenetic studies of preinvasive lesions and invasive carcinomas of the cervix uteri. II. Structural chromosome abnormalities. Karyotype deviations (author's transl)]. / Cytogenetische Untersuchungen an Praecancerosen und Carcinomen der Cervix uteri. II. Strukturelle chromosomenanomalien. Veränderungen im Karyotypus

An analysis of karyotypes was possible in 17 preinvasive lesions (3 dysplasias, 14 carcinomas in situ) and 15 invasive lesions of the cervix uteri (3 carcinomas in situ with microinvasion, 12 invasive squamos carcinomas - at least clinical stage I b). With regard to the structural chromosome abnormalities or karyotype deviations in this study the preinvasive lesions analysed could not be differentiated in principle as a group from the invasive lesions. The question of whether the dysplasia group would be different on further investigation with more cases and could be differentiated like the numerical deviations cannot yet be answered, because of the small numbers, only preinvasive lesions and invasive lesions could be studied comparatively as groups.

Cytogenetic studies of preinvasive lesions and invasive carcinomas' of the cervix uteri. III. Survey and interpretation of the results reported in the literature.

Summary. Cytogenetic studies were performed of 54 preinvasive carcinomas and invasive squamous cervix carcinomas altogether. The chromosome number could be determined in 9 dysplasias, 25 carcinomas in situ, 4 carcinomas in situ with micro-invasion and 16 invasive squamous carcinomas (at least clinical stage Ib). It was shown that carcinomas in situ, carcinomas in situ with microinvasion and invasive squamous carcinomas could not be differentiated from each other in principle as groups with regard to numerical chromosome deviations...

[Vaginal cytology at the end of pregnancy (author's transl)]. / Vaginalzytologie am Ende der Gravidität

What information is permitted by cytodiagnosis was tested with reference to 2182 vaginal smear examinations in 882 pregnant women at the end of pregnancy. There is no cytological smear type from which the degree of fetal maturity can be determined beforehand with satisfactory certainty; in practice, one must work with diagnosis by exclusion, which, however, can be of great help: If a "before term" smear type is found, a genuine post-term birth can be excluded on the basis of the cytological examination alone with high degree of probability (98.3%). With an "at term" type of smear the birth of an immature child is nor very probable (1.7%); but an over-maturity may already exist (6.9%). A genuine post-term infant can only be expected in barely half of the cases (45.7%) with a "post-term" cell picture. A satisfactory assessment of the probable date of birth is only possible with the "at term" type of smear: in the great majority of cases (80.8%) a birth within 5 days can be counted on with this type of smear. The possibilities of "term cytology" in "programmed births" are referred to.