Serous effusion cytology in gynecologic malignant mixed müllerian tumors.

We reviewed 51 serous effusions (50 peritoneal/one pleural) from 38 patients with uterine (30 cases) and ovarian (eight cases) malignant mixed Müllerian tumors (MMMT). There were 16 patients (42%) with positive effusion cytology specimens; 13 cases (81%) were diagnosed as adenocarcinoma with three cases (19%) interpreted as having a sarcomatous component. Eight of 16 positive effusion specimens had cell block material available for immunoperoxidase (IP) study that included cytokeratin (AE1/3), vimentin, muscle specific actin (HHF) and S-100 protein to determine if unsuspected mesenchymal components were present in the cases originally diagnosed as carcinoma (six cases), or sarcomas (two cases). In the six cases originally interpreted as carcinoma, three were diagnosed as adenocarcinoma and three as poorly differentiated carcinoma. All three of the cases considered adenocarcinoma and two of those diagnosed as poorly differentiated carcinoma reacted only with AE1/3 and vimentin. The remaining case, considered a poorly differentiated carcinoma, stained only with vimentin. In the two cases having cell blocks interpreted as having a sarcomatous component, only vimentin was positive in one while AE1/3, vimentin, HHF, and S-100 were positive in the other. The case where all immunohistochemical stains were reactive contained both carcinomatous and sarcomatous components. In the three cases considered sarcomatous, the cytomorphologic features helpful in the recognition of a mesenchymal component included a dissociated smear pattern of pleomorphic round to oval cells and/or spindle cells. In retrospect, the IP stains did not alter any of the original diagnoses.(ABSTRACT TRUNCATED AT 250 WORDS)

Staphylococcus aureus ventriculitis treated with single-dose intraventricular vancomycin or daptomycin (LY146032): bacterial and antibiotic kinetics in hydrocephalic rabbits.

Vancomycin and a new antibiotic, daptomycin (LY146032), were tested in vitro and in vivo against Staphylococcus aureus. In vivo tests were performed with rabbits with kaolin-induced hydrocephalus. Five groups of rabbits were studied: untreated ventriculitis, intraventricular vancomycin only, and ventriculitis treated with intraventricular vancomycin (30 micrograms or 120 micrograms) or daptomycin (7.5 micrograms). Results of this study were as follows. (i) S. aureus demonstrated static growth in cerebrospinal fluid in vitro and in ventriculitis at a maximum titer of 10(5) to 10(6) CFU/ml. (ii) In vitro time kill curves in cerebrospinal fluid matched those in vivo. (iii) Single-dose intraventricular vancomycin did not lower S. aureus concentrations over 8 h, whereas daptomycin did. (iv) Ventriculitis did not significantly alter the clearance of intraventricular vancomycin. (v) Intraventricular half-lives were approximately 2.8 h (maximum) for vancomycin and 4.5 h for daptomycin. (vi) Vancomycin was detectable in the periventricular white matter only in the presence of ventriculitis. Daptomycin was also detectable in the periventricular white matter of rabbits with ventriculitis, but in amounts too small to quantitate. We concluded that daptomycin achieved greater bactericidal activity, more rapid killing kinetics, and a longer half-life in the ventricle than vancomycin did in this model.

Efficacy of verapamil in the salvage of failing random skin flaps.

Verapamil is a calcium channel blocker that inhibits mast cell degranulation, platelet aggregation, and neutrophil function and is a potent vasodilator. The efficacy of verapamil (20 mg/kg/day) to salvage a standard failing random skin flap in the rat was studied. In this study verapamil failed to benefit skin flap survival. The results are analyzed and presented.

Augmentation of critical skin flap survival following ibuprofen therapy.

Much research effort has attempted to identify pharmacological agents that will augment random skin flap survival. Unfortunately, the vast majority of these agents have been administered preoperatively, and as such their routine use is not often justified. Ibuprofen administered in the postoperative period significantly augments random skin flap survival in the rat.

Efficacy of topical nitroglycerin for random-pattern skin-flap salvage.

The efficacy of topical nitroglycerin in the augmentation of random-pattern skin-flap survival was studied. Our model consisted of a standardized cranially based random skin flap on the dorsum of Sprague-Dawley rats. Nitroglycerin was delivered transdermally through a semipermeable membrane from a constant delivery system. The four study groups included preoperative and postoperative nitroglycerin, postoperative nitroglycerin, semipermeable membrane alone, and a control flap. Surviving flap areas were measured by a computer-assisted system, and groups were statistically analyzed for significance. In the rat model, treatment of a compromised random skin flap by topical nitroglycerin demonstrates no improvement in survival. In light of previous studies, this suggests a fundamental drug response difference between axial- and random-pattern skin flaps. Moreover, the use of a semipermeable membrane dressing alone showed a clear benefit (p less than 0.05) over nitroglycerin-treated and control animals.

Quantitation of skin-flap survival: a computer-based method.

We have proposed a standard scheme for presenting data on experimental skin flap survival in pharmacologic studies that will aid in comparing results. In addition, we have presented a method using desktop computer accessories for accurately measuring the area of any flap.