Successful cytologic diagnosis of cholangiocarcinoma from within a recently placed biliary Wallstent

A six year old boy with an epicardial pacing lead since infancy presented with thoracic pain triggered by movement. The pain was thought to be musculoskeletal, but two weeks later he collapsed and died in ventricular fibrillation. Necropsy showed strangulation of the ventricular apex by the epicardial lead.     

The myelotoxicity of chloramphenicol: in vitro and in vivo studies: I. In vitro effects on cells in culture

1 Chloramphenicol is used extensively in non-industrialized countries for the treatment of life-threatening infections because it is cheap and effective, despite its known hemotoxicity and linkage to fatal aplastic anaemia. It is important to define the mechanism of toxicity so that means can be devised to ameliorate the toxic effects in order to produce safer usage. 2 Chloramphenicol, at concentrations from 5 mM to 2 mM initiated apoptosis in dividing cells from a monkey kidney-derived cell line and in haematopoietic progenitor cells from human neonatal cord blood. 3 Growth of progenitor cells was suppressed at concentrations of chloramphenicol which would be considered less than therapeutic during patient treatment. 4 These effects could be ameliorated in progenitor cells by co-culture with the antioxidant mercaptoethylamine and in monkey kidney cells by co-culture with vitamin C. 5 This is the first report of apoptosis in chloramphenicol toxicity and suggests a possible link between a metabolic event i.e. the production of free radicals; a morphological effect, apoptosis; and a clinical effect, bone marrow suppression and aplastic anaemia.     

Kinematic analysis of shear displacement as a means for operating mechanotransduction channels in the contact region between adjacent stereocilia of mammalian cochlear hair cells

In sensory hair cells of the cochlea, deflection of the stereociliary bundle results in direct mechanical gating of mechanoelectrical transduction channels, a function generally attributed to the tip link running between the tips of short stereocilia and the sides of adjacent taller ones. However, immunocytochemical experiments indicate that the channels may not be associated with the tip link but occur just below it in a region of contact between the stereocilia. To determine whether transduction channels in this location could be operated during physiologically appropriate deflections as effectively by shear displacement as if they were associated with the tip link, a two dimensional kinematic analysis of relative motion between stereocilia has been performed assuming contact between stereocilia is maintained during deflection. Bundle geometry and dimensions were determined from transmission electron micrographs of hair cells from several frequency locations between 0.27 and 13.00 kHz in the guinea-pig cochlea. The analysis indicates that for a 10 nm deflection of the tallest stereocilia of both inner and outer hair cells, i.e. within the range of the maximum sensitivity of mammalian hair bundles, the average shear displacement in the contact region would be 1.6 nm, but that it increases systematically towards higher frequency regions for outer hair cells. This displacement is comparable in magnitude to tip-link elongation for individual stereociliary pairs.     

Factors influencing the determination of nisin in meat products

Recovery of nisin from minced meat and meat emulsions was poor and variable. The rate of recovery was little affected by the presence of NaCl and/or NaNO₂, particle size, or the meat to extractant (0.02N HCl) ratio, but was significantly affected by the fat content of the meat. For nisin added at 100 iu/g, recoveries at the optimal meat to extractant ratio, 10% wt/wt suspension, ranged from 26% at 3% fat to 76% at 83% fat. At addition levels of 200 iu/g and greater, nisin recovery efficiency was reduced.     

Marginal leakage of amalgam restorations pretreated with various liners

PURPOSE: To evaluate and compare the microleakage of amalgam restorations lined with four different liners. MATERIALS AND METHODS: Cylindrical occlusal cavities were prepared in extracted human molars and the teeth were then divided into four groups and lined with one of four liners: Amalcoden, AM (glass-metal ionomer), FujiDuet, FD (glass ionomer), Amalgambond, AB (adhesive resin), or copal varnish, CV. Each cavity was then restored with a high-copper amalgam alloy and aged for 7 days in 37 degrees C distilled water. The specimens were then thermocycled for 300 cycles followed by immersion in 0.5% basic fuchsin dye solution for 24 hours. The teeth were then embedded in resin, sectioned, and dye penetration at the tooth/amalgam interface evaluated microscopically at x 100 and scored from 0 to 4 (0 = no leakage and 4 = greatest leakage). RESULTS: The median values were: AM = 1.0; FD = 0.5; AB = 1.1; and CV = 4.0. Statistical analysis using Kruskal-Wallis and Mann-Whitney U indicated no significant differences between AM and AB or FD and AB. CV was however, significantly worse at P < 0.01.     

Diagnostic accuracy of a rural live video telepathology system

Accuracy of diagnoses rendered using a live video telepathology network was assessed for permanent sections of surgical pathology specimens. To determine accuracy, telepathology diagnoses were compared with those obtained by directly viewing the glass slide using a standard microscope. A total of 294 cases were read via both telepathology and glass slide by attending pathologists at a tertiary care medical center. Overall accuracy was defined as exact concordance between diagnoses. Clinically insignificant differences in diagnoses were excluded to determine clinically significant accuracy. For the 285 cases with complete data, the overall accuracy for telepathology was 0.912 (95% confidence interval [CI], 0.872-0.941), whereas the overall accuracy for glass slide readings was 0.968 (95% CI, 0.939-0.985). This difference is statistically significant (p = 0.009). When focusing on clinically significant discrepancies, where the difference in diagnosis might affect therapeutic decisions, the video accuracy was only slightly less than the glass slide accuracy (0.965 [95% CI, 0.934-0.982] vs. 0.982 [95% CI, 0.957-0.994], respectively), but this difference is not statistically significant (p = 0.302). Most of the cases with clinically significant differences involved lesions with inherently high interobserver variation. Certainty of diagnosis did not differ between video and glass slide readings (p = 0.911), but there was an association between certainty of diagnosis and diagnostic accuracy for video (p = 0.003 for clinically significant accuracies). Based on these findings, we recommend when using this telepathology system that only preliminary diagnoses should be given in the following situations: for diagnostic areas with known high interobserver variability; when the consultant has any degree of uncertainty about the presence or absence of the lesion in question; and when there is insufficient experience using telepathology as a diagnostic medium.