Metastatic renal cell carcinoma presenting as an aural polyp

Renal cell carcinoma may metastasize to the head and neck region at different stages of its evolution. We present a case of an undiagnosed renal cell carcinoma presenting as an ear polyp, and discuss the difficulties of the diagnosis and the management of these tumours.     

Retained fetal lung liquid in congenital lobar emphysema: a possible predictor of polyalveolar lobe

The purpose of this study was to determine whether retention of fetal lung liquid is more prevalent in polyalveolar congenital lobar emphysema than in conventional congenital lobar emphysema. Two patients with congenital lobar emphysema were prospectively identified in a 3-year period. Twenty-five such patients were identified in a retrospective study covering 39 years. Medical records were available for 22 patients who had 23 emphysematous lobes. Both babies from the prospective study and six subjects from the retrospective group had respiratory symptoms and underwent chest X-ray in the first day of life. Six of the eight babies with respiratory symptoms and chest imaging in the first day of life had retention of fetal lung liquid in an emphysematous lobe. All six of these lobes were polyalveolar. The lobe in one child was a polyalveolar lobe but without retained fetal lung liquid, and one child exhibited conventional lobar emphysema also without retained fetal lung liquid. One polyalveolar lobe caused no neonatal symptoms and was not imaged until the child was 3 months old. No baby with conventional lobar emphysema was shown to have retained fetal lung liquid. There seems to be a correlation between polyalveolar lobe and onset of respiratory symptoms in the first day of life. Retention of fetal lung liquid within the affected lobe was documented only in cases of polyalveolar lobe.     

Teleconferencing: A Better Way to Meet

As most IS managers know, time is often wasted during most business meetings. As technological advances in the various types of teleconferencing systems continue, teleconferencing will serve as the preferred method of conducting meetings because of the resulting time and cost savings.     

CORPORATE NETWORK INFRASTRUCTURE Pulblic, Private, or Hybrid?

Designing a geographically extensive corporate network at the lowest cost means dealing with the vagaries of handling multiple carriers and widely varying levels of service. Further complicating matters are tariff structures that often dictate optimum corporate network infrastructures. This column reviews some of the available and emerging services and the best network structure options.     

H2S optimization for lignite liquefaction

Two lignite samples, Beulah No. 3 and Big Brown No. 1, were liquefied at 420 °C using H₂ and synthesis gas to determine the optimum beneficial amount of H₂S in the batch autoclave reactor. Under the conditions employed, 50–100 psi partial pressure of H₂S, nominally 4–10 wt% of daf lignite, was optimum for both samples. Synthesis gas outperformed H₂ with and without H₂S for the liquefaction of the two coals.     

Transmission electron microscopic analysis of kidney glomeruli obtained by fine-needle aspiration

Aspiration biopsy of tumors and transplanted organs is a popular atraumatic method for diagnosis and also for the management of patients. Apart from the cytological analyses, it is clear that large aggregates of cells are obtained and these may be examined by electron microscopy. A study was carried out with dogs to assess the yield of intact glomeruli and tubules, resulting from a standard fine-needle aspiration procedure. Employing a 20-gauge needle, yields of approximately ten intact glomeruli were obtained with a tissue processing protocol that utilized filtration through a nylon mesh and backwashing, to resuspend the trapped aggregates. Processing for electron microscopy was carried out in microcentrifuge tubes. The ultrastructural preservation was excellent and the extension of these studies to investigations of not only renal transplantation, but also for diagnosis in human renal diseases of a broad spectrum, is suggested.     

Non-functional variants of yeast mitochondrial ATP synthase subunit 8 that assemble into the complex

Myocardial and pulmonary beta-adrenoceptors can be imaged with 2-(S)-(-)-(9H-carbazol-4-yl-oxy)-3-[1-(fluoromethyl)ethyl]amino-2- propanol (S-1'-[18F]fluorocarazolol, I). Quantification of unmodified fluorocarazolol in plasma is necessary for analysis of PET images in terms of receptor densities. We have determined I and its radioactive metabolites in rat, sheep and human plasma, using (1) solid-phase extraction (C18) followed by reversed-phase HPLC and (2) direct injection of untreated plasma samples on an internal-surface reversed-phase (ISRP) column. The two methods were in good agreement. Unmodified I decreased from over 99% initially to less than 5%, 5-10% and 20% at 60 min post-injection in rats, sheep and human volunteers, respectively. Protein binding in sheep and human plasma was determined by ultrafiltration. The fraction of total plasma radioactivity bound to protein and the fraction representing unmodified radioligand were linearly correlated, suggesting that fluorocarazolol was more than 70% protein-bound, whereas its metabolites showed negligible protein binding. Direct injection of plasma on an ISRP column seems a convenient method for quantification of lipophilic radioligands such as fluorocarazolol.     

Value of transcranial Doppler indices in predicting raised ICP in infantile hydrocephalus. A study with review of the literature

Cerebral hemodynamic changes in infants with progressive hydrocephalus have been studied with the transcranial Doppler (TCD) technique. Several authors have referred to the correlation between the hemodynamic changes and increased intracranial pressure (ICP). Despite conflicting conclusions on the value of pulsatility index (PI) and resistance index (RI) measurements for monitoring infantile hydrocephalus, these pulsatility indices are the most commonly used for this purpose. Although clinical signs of raised ICP are highly variable and unreliable in infants, assumptions have been made in most of the studies about the presence of elevated ICP on the basis of the patient's clinical state. Few studies have reported on actual ICP values, however, and a direct relationship between ICP and TCD changes has never been adequately demonstrated. In the present study, this relationship was investigated in long-term simultaneous TCD/ICP measurements, in an attempt to develop a noninvasive method of monitoring the effect of ICP on intracranial hemodynamics. Two groups of data sets were established. Group I consisted of pre- and postoperative (shunt implantation) TCD/ICP measurements. Group II were long-term simultaneous TCD/ICP recordings showing significant ICP variations. In most of the postoperative measurements there was a decrease in the average PI and RI values. The correlation between PI or RI and ICP in the long-term simultaneous recordings, however, was generally poor. The risk of obtaining false positive or false negative PI or RI values in short-term measurements was also demonstrated. It can be concluded from our results, besides the wide range of reference values for the Doppler indices and extracranial influences upon them, that the present Doppler indices are inadequate for monitoring the complex intracranial dynamic responses in patients with raised ICP.