Massive hemoptysis resulting from a fistula between the bronchus intermedius and pulmonary artery: a novel clinical presentation.

This is a case of a woman with massive hemoptysis, associated with a pulmonary artery pseudoaneurysm, and a fistula between the right pulmonary artery and bronchus intermedius. Bronchoscopic evaluation revealed an endobronchial mass in the right bronchus intermedius, suspicious for a tumor. Upon biopsy of the mass, massive bleeding occurred. The right lung was surgically resected. No specific etiology for the fistula was identified on pathologic examination. To our knowledge, this is the first report of a pulmonary artery-bronchial fistula presenting without typically known predisposing factors.

Patterns of cell division in the filamentous Desmidiaceae, close green algal relatives of land plants.

Patterns of cell division and cross wall formation vary among the charophytes, green algae closely related to land plants. One group of charophytes, the conjugating green algae (Zygnematophyceae), is species-rich and is known to vary substantially in the mode of cell division, but the details of these cell division patterns and their phylogenetic distribution remain poorly understood. We studied cross wall development in filamentous Desmidiaceae (a clade of conjugating green algae) using differential interference contrast and fluorescence light microscopy. All strains investigated had centripetal encroachment of a septum, but with several different developmental patterns. In most cases, cell wall formation was delayed with respect to the Cosmarium-type of cell division, and the cross wall was modified considerably after deposition in a manner specific to the particular clade of filamentous desmids. These characteristics were mapped on a phylogeny estimated from a data set of two organellar genes, and the evolutionary implications of the character state distribution were evaluated. The data suggest a complex history of evolution of cell division in this lineage and also imply that Desmidium and Spondylosium are polyphyletic. These results indicate that many features of the cell shape are determined at the time of cell division in conjugating green algae.

PHYLOGENY OF THE CONJUGATING GREEN ALGAE BASED ON CHLOROPLAST AND MITOCHONDRIAL NUCLEOTIDE SEQUENCE DATA(1).

The conjugating green algae represent a lineage of charophyte green algae known for their structural diversity and unusual mode of sexual reproduction, conjugation. These algae are ubiquitous in freshwater environments, where they are often important primary producers, but few studies have investigated evolutionary relationships in a molecular systematic context. A 109-taxon data set consisting of three gene fragments (two from the chloroplast and one from the mitochondrial genome) was used to estimate the phylogeny of the genera of the conjugating green algae. Maximum likelihood (ML), maximum parsimony (MP), and Bayesian inference (BI) were used to estimate relationships from the 4,047 alignable nucleotides. This study confirmed the polyphyly of the Zygnemataceae and Mesotaeniaceae with respect to one another. The Peniaceae were determined to be paraphyletic, and two genera traditionally classified among the Zygnematales appear to belong to the lineage that gave rise to the Desmidiales. Six genera, Euastrum, Cosmarium, Cylindrocystis, Mesotaenium, Spondylosium, and Staurodesmus, were polyphyletic in this analysis. These findings have important implications for the evolution of structural characteristics in the group and will require some taxonomic changes. More work will be required to delineate lineages of Zygnematales in particular and to identify structural synapomorphies for some of the newly identified clades.

Effects of a culturally sensitive education program on the breast cancer knowledge and beliefs of Hispanic women.

PURPOSE/OBJECTIVES: To determine the effectiveness of a multifaceted, culturally sensitive, and linguistically appropriate breast cancer education program for Hispanic women. DESIGN: Experimental (post-test only, control-group design). SETTING: The parish hall of a Roman Catholic Church in northeastern Arkansas. SAMPLE: 31 Hispanic women aged 25-56 residing in northeastern Arkansas. METHODS: The experimental group received a multifaceted, culturally sensitive, and linguistically appropriate breast cancer education program; the control group received general nutritional information. Both groups completed the Breast Cancer Knowledge Test and Breast Cancer Screening Belief Scales so that the researchers could measure dependent variables. Data were analyzed with t tests. MAIN RESEARCH VARIABLES: Knowledge of and beliefs about breast cancer. FINDINGS: The experimental group scored significantly higher on the Breast Cancer Knowledge Test than did the control group. The control group scored significantly higher than the experimental group on the barriers to mammography scale and the benefits of breast self-examination scale of the Breast Cancer Screening Belief Scales. CONCLUSIONS: The multifaceted, culturally sensitive, and linguistically appropriate breast cancer education program appeared to be responsible for increased knowledge of breast cancer and reduced barriers to mammography. IMPLICATIONS FOR NURSING: Education may change Hispanic women's knowledge and beliefs about breast cancer. An intervention designed and implemented by nurses can play a significant role in meeting the strong need for culturally sensitive and linguistically appropriate breast cancer educational programs for Hispanic women. Such programs should focus on helping Hispanic women understand their personal risks related to breast cancer and reduce barriers they perceive to early screening and detection.

Teaching breast cancer screening to African American women in the Arkansas Mississippi river delta.

PURPOSE/OBJECTIVES: To determine the effectiveness of a multifaceted, culturally sensitive breast cancer education program for African American women in the Arkansas Mississippi River Delta. DESIGN: Experimental (i.e., posttest only, control group design). SETTING: African American churches and a county Extension Homemakers Club sponsored through the Arkansas Extension Homemakers council. SAMPLE: 53 African American women. The experimental group included 30 participants who had a mean age of 56 years, and the control group consisted of 23 participants with a mean age of 51 years. METHODS: After the presentation of a multifaceted, culturally sensitive breast cancer education program, a variety of instruments were administered to participants in the experimental group that measured dependent variables. Subjects in the control group completed the same instruments in the absence of a viable intervention. Data were analyzed using t tests. MAIN RESEARCH VARIABLES: Knowledge and beliefs about breast cancer. FINDINGS: The experimental group's mean scores were significantly higher than the control group's on the Breast Cancer Knowledge Test and the susceptibility scale of the Breast Cancer Screening Belief Scales. The experimental group also scored significantly higher than the control group on the confidence scale of the Breast Cancer Screening Belief Scales. CONCLUSIONS: The multifaceted, culturally sensitive breast cancer education program appeared to be responsible for the differences in scores between the experimental and control groups. IMPLICATIONS FOR NURSING: Culturally sensitive group educational programs aimed at helping African American women in the rural South become more knowledgeable about breast cancer and early detection clearly are needed. Such efforts also must focus on increasing women's confidence in effectively performing regular breast self-examination as well as their understanding of personal risk. Healthcare professionals play a major role in the development and implementation of these programs.