Esophageal squamous carcinoma

Squamous cell carcinoma of the esophagus is a tumor with poor prognosis; it is usually in an advanced state when first diagnosed. Because a multimodal treatment approach is currently used, proper tumor staging is essential to determine whether therapy should be directed toward cure or palliation. Important prognostic features of squamous cell carcinoma include the depth of tumor infiltration into or through the esophageal wall and the presence of distant metastases. Imaging strategies should not be limited to visualization of the tumor but also should be directed toward accurate pretreatment staging. In this article, the authors review the use of barium swallow, CT scans, and endoscopic ultrasonography both alone and in combination to visualize and stage esophageal carcinoma. The strengths and limitations of each modality are also discussed.     

Rat testicular extracellular superoxide dismutase: its purification, cellular distribution, and regulation

Rehabilitative measures for stroke are not generally based on basic neurobiological principles, despite evidence from animal models that certain anatomical and pharmacological changes correlate with recovery. In this report, we use functional magnetic resonance imaging (fMRI) to study in vivo human brain reorganization in a right handed patient with an acquired reading disorder from stroke. With phonological dyslexia, her whole-word (lexical) reading approach included inability to read nonwords and poor reading of function words. Following therapy, she was able to read nonwords and function words, and preferred a decompositional (sub-lexical) strategy in general. fMRI was performed during a reading task before and after treatment. Prior to therapy, her main focus of brain activation was in the left angular gyrus (area 39). After therapy, it was instead in the left lingual gyrus (area 18). This result suggests first that it is possible to alter brain physiology with therapy for acquired language disorders, and second, that two reading strategies commonly used in normal reading use distinct neural circuits, possibly reconciling several conflicting neuroimaging studies of reading.     

The usefulness of screening for chlamydial trachomatis infection with cervical mucus leukocyte esterase

OBJECTIVE: This study was conducted to evaluate the psychological distress in patients with tinnitus that is often correlated with sleeping disorders, difficulties in concentration, and compromized social relations. METHODS: Eighty-four patients were studied using preliminary clinical and audiologic evaluations, and successive psychological tests. RESULTS: The cluster analysis indicated two essential groups composed of 45 patients (CLST-1) and 38 patients (CLST-2), respectively. The CLST-1 group had higher scores for depression, anxiety, and neuroticism. The IBQ CLST-1 revealed a greater degree hypochondria, conviction of disease dysphoria, and irritability. CONCLUSIONS: Our results indicate that the relationship between the intensity of the tinnitus and the extent of the distress is supported by the larger number of patients with more intense tinnitus in the first cluster. The CLST-2 with its normal psychological test results, apart from marked denial, would support the hypothesis of a somatic expression of the distress.     

A computer program for the geographic distribution of fluvial mollusks of medical interest in Cuba

The need to know the distribution of mollusks considered to play an important medical role in Cuba through a geographic representation motivated us to develop a software capable of acting as a system for the retrieval of geographic information in which the requested data would be presented in maps. The system has been called DMIM and it is a useful tool for malacological studies, and assessment and planning of programs for the control of intermediate host mollusks, as well as for teaching purposes.     

Transient up-regulation of ciliary neurotrophic factor receptor-alpha mRNA in axotomized rat septal neurons

PURPOSE: To determine prospectively the feasibility, complications, and mid- and long-term advantages of peripheral insertion of central catheters in infants and children. MATERIALS AND METHODS: During a 15-month period between March 1995 and June 1996, a total of 285 catheter placement attempts were made to peripherally insert central catheters in 183 pediatric patients (89 boys, 94 girls). Phlebographic guidance was used, and the catheters were inserted below the elbow in 99% of cases. Catheter insertion was indicated for prolonged antibiotic therapy in 108 patients (158 catheter placement attempts), hematologic or oncologic care in 24 patients (40 attempts), total parenteral nutrition in 16 patients (46 attempts), and venous access for fluid or blood in 35 patients (41 attempts). The success rate and complications were recorded along with the indication, patient age, and duration of catheter placement. RESULTS: One hundred fifty-two of 158 (96%) catheter placement attempts were successful in outpatients (n = 108), 124 of 127 (98%) in hospitalized patients (n = 75), and 70 of 73 (96%) in patients aged less than 1 year. Infection and pericatheter venous thrombosis were the main complications and were seen in 17 of 276 (6%) and one of 276 (0.3%) catheter placement attempts, respectively. Catheter occlusion occurred in 23 of 276 (8%) catheter placement attempts. CONCLUSION: Peripheral insertion of central catheters was highly feasible in infants and children with this protocol. Such catheters were well tolerated in the pediatric population with a low frequency of complications.     

The use of intravenous immunoglobulin in Miller Fisher syndrome

We report a patient with Miller Fisher syndrome who was treated with an intravenous high-dose of immunoglobulin. This syndrome is considered to be a benign variety of acute inflammatory demyelinating polyneuropathy (Guillain-Barré syndrome). However, there have been several reports of the need for ventilatory support and a few cases have had a fatal outcome. We observed a case of progressive Miller Fisher syndrome in a 3-year-old boy. Following 2 episodes of apnea lasting about 50 s each, he was treated with intravenous immunoglobulin (400 mg/kg/day) for 5 consecutive days. His respiratory state, general muscle strength, truncal ataxia and emotional state improved remarkably after this therapy.