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We prospectively studied 64 consecutive patients on whom computerized tomography-guided fine needle aspirations (CT-FNA) of pulmonary lesions were performed to determine whether obtaining a delayed chest radiography (CXR) after CT-FNA is helpful in the diagnosis of post-procedure pneumothorax (PTX). Two of the 64 patients developed a delayed PTX. Only one of the patients with a delayed PTX required chest tube drainage. If patients have no evidence of a PTX immediately after a CT-FNA by CT scan then a delayed CXR adds little to care of these patients.

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Household exposures may result in a variety of respiratory illnesses. Most of these inhalation injuries are benign and self-limited. However, an acute injury that results in exacerbation of asthma or chronic fibrosing processes may be life-threatening. We report the case of a patient who suffered a massive household dust exposure when the bag of his upright vacuum cleaner exploded. Inhalation of the dust resulted in respiratory distress characterized by non-cardiogenic pulmonary edema. We believe this is the first report of acute respiratory distress syndrome (ARDS) as a result of endotoxin exposure from the inhalation of household dust.

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Sera from patients with systemic lupus erythematosus were tested for the simultaneous presence of antibodies to intermediate filaments (vimentin) and to DNA, using radioimmunoassay and immunofluorescence techniques. Our results indicate that 3 of 17 sera tested contain an IgM population which recognizes an antigenic determinant common to vimentin and DNA by a solid phase immunoassay.

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In a review of 100 consecutive patients with adult rheumatoid arthritis (RA), clinical evidence of liver disease was absent, whereas minor abnormalities of liver biochemistry, mainly a raised alkaline phosphatase, were present in 32 cases. Liver biopsies were obtained in eight patients; the most striking finding was the presence of sinusoidal dilation in all samples, with a normal central vein and preservation of hepatic architecture. The mechanism of this nonspecific histological change is not known, though it could be speculated to be secondary to a humoral factor related to RA. We conclude that hepatic involvement in adult RA is common but trivial and that routine liver biopsy is not indicated.

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We used flow cytometry and immunoprecipitation techniques to study the expression of the activation molecules transferrin receptor, interleukin-2 receptor, HLA-DR, and very late activation antigen 1 (VLA-1) on purified T lymphocytes from peripheral blood and synovial fluid of 9 patients with rheumatoid arthritis and 7 patients with other rheumatic diseases. We found a T cell subset bearing VLA-1 in synovial fluid from 8 rheumatoid arthritis patients and 4 patients with other rheumatic diseases. VLA-1 was not found in peripheral blood T lymphocytes from either group.

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Anticentromere antibodies (ACA) present in a high percentage of patients with complete or incomplete CREST scleroderma, and which are presently used in the diagnosis of this disease, also appear in some primary Raynaud's phenomenon patients. Three principal centromeric antigens, CENP-A, CENP-B and CENP-C, have been described as reacting with the sera of these individuals. We attempt to determine whether or not a correlation between the presence of ACA and serum reactivity against one or more of these peptides could be established, and have observed that CENP-A, but not CENP-B or CENP-C, is specifically recognized by all patients sera tested. The fact that this reactivity is clearly detectable at very high serum dilutions, thus eliminating other non-specific interference, suggests that anti-CENP-A activity might be useful in the diagnosis of patients with CREST-associated Raynaud's phenomenon.

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Severe aplastic anemia is the most serious complication of chrysotherapy. No treatment for this condition has been demonstrated effective. We report 3 patients with gold induced severe aplastic anemia treated with antithymocyte globulin. Complete marrow recovery was obtained in 1 case and a partial but satisfactory response in the other. All the patients remain alive without requiring blood transfusion after followup of longer than 16 months.

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The characterization of a homogeneous non-adherent synoviocyte (Type A) cell population (greater than or equal to 95%) from non-rheumatoid patients by culturing the cells in the presence of forty percent foetal calf serum is reported. These cells were able to phagocyte latex beads, iron particles, fluoresceinated zymosan and yeast. Furthermore, non-adherent synoviocytes were capable of being infected by the obligate intracellular parasite of peripheral monocytes Leishmania donovani. Indirect immunofluorescence experiments with specific anti-human monocyte (OKM1) antibody and specific antisynoviocyte serum, showed the presence of common surface structures between synoviocytes A cells and peripheral monocytes. Fifty five percent of the synoviocytes were also positive for HLA Dr antiserum. Analysis by two dimensional gel electrophoresis showed that peripheral monocytes and synoviocytes secreted identical polypeptides in vitro. These results strongly suggest a relationship between synoviocytes A and mononuclear phagocyte system.

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La posibilidad de presentación colposcópica del papiloma cervical es variadísima, predominando la variedad plana. La imagem más frecuente ha sido la base seguida del mosaíco. Dominan las lesiones multifocales, sobretodo localizadas en el labio anterior. Asimismo, se acompañan de un aumento del calibre vascular. Autorradiográficamente, se ha comprobado que la actividad de sínteses de ADN, ARN y proteínas, es exactamente igual para los papilomas que para el epitelio poliestratificado normal del ectocérvix, predominando a nível de la primera línea de células parabasales

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La posibilidad de presentación colposcópica del papiloma cervical es variadísima, predominando la variedad plana. La imagem más frecuente ha sido la base seguida del mosaíco. Dominan las lesiones multifocales, sobretodo localizadas en el labio anterior. Asimismo, se acompañan de un aumento del calibre vascular. Autorradiográficamente, se ha comprobado que la actividad de sínteses de ADN, ARN y proteínas, es exactamente igual para los papilomas que para el epitelio poliestratificado normal del ectocérvix, predominando a nível de la primera línea de células parabasales (AU)

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Three biologic effects were clearly associated with C. parvum infusions: a) granulocytosis with lymphomonocytopenia, b) increase in responsiveness to phytohemmagglutinin and c) increase of specific antibodies to C. parvum antigens. Addition of dexamethasone moderately altered the kinetics of leukocyte changes without affecting other properties. Side effects after intravenous administration of C. parvum (2.5 mg/m2) consisted primarily of chills and fever which lasted for periods of 6-24 hours. Side effects occurred in 77% of the infusions. Addition of dexamethasone (4 mg IVP) reduced significantly the frequency (only 22% of patients) and intensity (fever 102 F and chills for only 30-60 minutes) of side effects. Clearly, dexamethasone of the dosage employed did not abrogate C. parvum effects while reducing significantly its toxic properties.

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