Blue angioedema of eyelip after patent blue injection for lymphatic mapping procedure.

Sentinel node biopsy using patent blue dye in breast cancer is a well-documented procedure to assess the axillary status. We presented an unusual and previously unreported complication of simple blue angioedema over bilaterally periorbital tissue after blue dye injection.

Human ovary and placenta express messenger RNA for multiple activin receptors.

In the present study, we examined the expression of activin receptor (ActR) mRNAs in human ovary and placenta. Primers specific for two type I and two type II activin receptors (ActR-I, ActR-IB, ActR-II, and ActR-IIB) were used in polymerase chain reaction (PCR) to amplify cDNAs prepared from granulosa-luteal cells, placental tissues and isolated trophoblast cells. PCR products with the expected sizes for ActR-I, ActR-IB, ActR-II, and ActR-IIB mRNAs were detected in freshly dissociated and 5-day cultured granulosa-luteal cells; and in trophoblast cells from both first trimester and term placentas. The identity of these PCR products were confirmed by Southern blot hybridization, as well as cloning and sequencing. These results suggest that multiple activin receptors are present in human ovary and placenta and may mediate activin function in these tissues. The demonstration of activin receptor mRNAs in granulosa-luteal and trophoblast cells further supports the notion that activin is an important local regulator in the human ovary and placenta.

Use of National Practitioner Data Bank disclosure information for decision making.

Hospital, state licensing boards, and managed care organizations query the National Practitioner Data Bank to receive malpractice payment and adverse licensure or clinical privileges reports concerning licensed health care practitioners. The results of a national survey of queriers strongly suggest that Data Bank reports impart valuable information that affects licensing and credentialing decisions. Thus, the Data Bank is fulfilling the role lawmakers intended in improving the quality of health care.

Malpractice in the lower Rio Grande Valley.

Data from the National Practitioner Data Bank were examined to assess malpractice payments in the Lower Rio Grande Valley in comparison with those for Texas and the United States as a whole. The Valley was found to have a high rate of malpractice payments when considered on a per physician basis and on a per unit of utilization basis, but an average rate when considered on a population basis. A number of possible explanations (such as the "bad apple" theory, the "settlement for convenience" theory, the case distribution theory, the physician qualifications theory, and the foreign medical graduate theory) were examined to explain the Valley's observed rate of malpractice payments per physician. No explanations are particularly satisfactory. More research is needed, but indications suggest that the observed rate may be driven more by the activities of some attorneys than by the actions of Valley physicians.

Technical considerations in the selection and performance of walkers.

The walker is a mobility aid that provides a portable base of support. People of all ages use different kinds of walkers for a variety of reasons. With the correct walker, many people stroll along at the same pace as their companion. Today, walkers are available in a variety of styles and colors and have numerous accessories. It is the purpose of this article to describe the various types and models of walkers and accessories that are available. Our goal is not to recommend or rate the walkers but to help you find the right walker. The ultimate selection of a walker will depend on a cooperative effort between the physiatrist, physical therapist, and medical equipment supplier. Before you purchase a walker you should test it out to decide if it is the right one for you. The physical therapist who supplies your walker should adjust for your height and should check the physical fit of the equipment. Moreover, the physical therapist should demonstrate the proper gait for walking. During the past few years radical changes have occurred in the design and style of walkers. We expect this trend to continue with more attractive, easier-to-use products to be introduced regularly. If you think that your walker is outdated and is not adapting to your lifestyle, talk with your physiatrist regarding alternatives. Today, walkers are as different as their users. Find the best one for you by taking a test walk in your home and community.

A new procedure for management of extrahepatic portal obstruction. Proximal splenic-left intrahepatic portal shunt.

For management of obstruction of the extrahepatic portal trunk in patients with healthy livers, we designed an end-to-side anastomosis between the proximal splenic vein and the umbilical portion of the left intrahepatic portal vein and performed a splenectomy to relieve portal hypertension, treat hypersplenism, and restore hepatic portal flow. To our knowledge, no other procedure more adeptly restores original hepatic blood flow. Creation of an anastomosis between the coronary vein and umbilical portion of the left intrahepatic portal vein is an alternative method.

Carcinoid tumor localized in the liver--two cases report: immunohistochemical and ultrastructural studies.

Two cases of carcinoid tumors, considered to be probably hepatic in origin, occurring in a 53-year-old man and a 69-year-old woman are reported. In both cases no endocrine syndrome appeared, and an alternative primary source of the tumor was not found in case two, despite an intensive search at operation. The neoplasms in both cases were soft, firm, brown-pink and well-encapsulated. They were composed of small uniform cells, that had distinct borders and grew in insular, nests, trabeculae and strands that were separated by a delicate fibrous stroma. Stains of argentaffin and argyrophil showed strong positivity in both cases. The immunohistochemical and ultrastructural studies all demonstrated characteristics of a carcinoid. The postoperative recovery was good. They have remained well 5 years later in case 1 and 3 years in case 2 after surgical treatment. Literature concerning this rare condition is also reviewed.

A system for adaptive transportation.

In our society, we take for granted the ability to travel with few restrictions. For most travelers, the major factor that limits travel is cost. However, for a significant number of Americans, the phrase "freedom to travel" is meaningless. These are the physically handicapped, a group with special needs that has long been denied what every American assumes to be a natural right.

Inflammatory pseudotumor of the liver with occlusive endophlebitis: report of a case.

Inflammatory pseudotumor (IPT) of the liver is an extremely rare benign tumor. Only 12 cases have so far been reported in the English literature. The etiology and pathogenesis of IPT remain obscure. We herein present an additional case of IPT of the liver with occlusive endophlebitis in a 36-year-old female. Immunohistochemical studies demonstrated the polyclonal nature of the plasma cells in the tumor, including IgA, IgM, IgG, kappa and lambda. The inflammatory pseudotumor should be kept in mind in the differential diagnosis of hepatic space-occupying malignant lesions.

Adaptive housing: remodeling considerations for the disabled.

The disabled are handicapped only to the extent that they are prevented from being normal. The process of normalization is hampered by physical barriers in the home that make life difficult for disabled persons. Staff can be trained to eliminate these architectural barriers in the home, focusing primarily on accessibility, the bathroom, the bedroom, and the kitchen. Completion of the barrier-free design of the home should provide a cost-effective means for improving the quality of life for disabled persons and their families.

Inflammatory pseudotumor of the spleen--case report and literature review.

Inflammatory pseudotumor (IPT) of the spleen is an extremely rare benign lesion. We herein report an additional case of a 64-year-old man with IPT of spleen to compare with seven cases previously reported in the literature. However, the immunohistochemical studies has demonstrated to polyclonality of plasma cells which was comparable to these seven previously reported cases. The clinical and pathological findings, as well as the possibilities of etiology and pathogenesis are also described.

Dislocation of the carpometacarpal joint of the thumb.

A case is reported of traumatic dislocation to the carpometacarpal joint of the left thumb, treated by ligament reconstruction.

Dislocation of carpometacarpal joint of the little finger.

A case is reported of late ulno-volar carpometacarpal dislocation of the left little finger, treated by open reduction and internal fixation.

Maffucci's syndrome.

A case is reported of Maffucci's Syndrome with multiple enchondromata involving the left ring finger and subcutaneous haemangiomata in the left thenar eminence, treated by surgical excision.