Coccidioidomycosis of the knee diagnosed by fine-needle aspiration: a case report.

A case of septic arthritis from coccidioidomycosis in a 62-year-old man is described. The diagnosis was made by fine-needle aspiration and supported by positive cultures and exoantigen testing. Coccidioidomycosis can infect bones and joints, especially the knee. This case is presented to increase awareness of involvement of the knee by this organism, and to demonstrate the feasibility of diagnosis by fine-needle aspiration. The cytologic findings of coccidioidomycosis of the knee are described and discussed.

Diagnosis of dermoid cyst of the floor of the mouth by fine-needle aspiration cytology: a case report.

A case of a dermoid cyst in the floor of the mouth in a 17-yr-old male is described. The diagnosis was made by fine-needle aspiration cytology and supported by histologic examination of the subsequently excised tissue. Dermoid cysts are benign lesions that can occur in the floor of the mouth. This case is presented to increase awareness of this entity and its occurrence in this location, and to demonstrate the feasibility of diagnosis by fine-needle aspiration. The cytologic and histologic features of dermoid cysts are described and discussed.

Sputum cytology in measles infection. A case report.

A resurgence of measles, a highly infectious viral infection, has occurred in the United States. In this report the sputum cytology from a case of measles pneumonia is described and discussed. Only a few recent reports have described the cytopathologic changes of measles. Familiarity with the typical cytologic changes of measles will assist in the diagnosis of this infection.

A medical follow-up of the health effects of long-term exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin.

The human health effects of long-term exposure to low levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) have not been well established. The results of a prior study showed that persons exposed to TCDD had depressed cell-mediated immunity, and 18 of 51 persons had anergy or relative anergy on skin testing. This paper presents the results of a medical follow-up on participants who were reported to be anergic or relatively anergic in the earlier study. None of the participants in the follow-up study was anergic, and only one exposed and one unexposed participant were relatively anergic. Several technical and biological possibilities for the difference in results of the two studies are presented. The possibility that recovery from the effects of TCDD exposure caused the differing results is the least plausible explanation for the changes in the skin test results.

Visualization of aerodynamic flow fields using photorefractive crystals.

Interferometry based on double exposure Fourier transform holography in photorefractive crystals is applied for visualization of aerodynamic flow fields. The interferograms obtained are of similar quality as those produced using holographic film but with greatly simplified procedures. The results presented are obtained using a high-power cw argon laser and iron doped lithium niobate crystals. The angular characteristics of the Fourier transform data holograms are studied.

Occupational risk of prostate cancer: a cancer registry-based study.

Previous studies have suggested that certain occupational groups may be at increased risk for prostate cancer. A cancer registry-based case-control study was conducted to investigate possible associations between various occupations and the risk of prostate cancer among 1,239 case subjects and 3,717 age-matched control subjects. Elevated relative risk estimates were observed for farmers, mechanics, sheet metal workers, separating machine operators, and for men employed in several manufacturing industries. These findings are discussed in the context of previous studies, and suggestions for future research are provided.

Increased concentrations of homocysteine in the cerebrospinal fluid in patients with fibromyalgia and chronic fatigue syndrome.

Twelve outpatients, all women, who fulfilled the criteria for both fibromyalgia and chronic fatigue syndrome were rated on 15 items of the Comprehensive Psychopathological Rating Scale (CPRS-15). These items were chosen to constitute a proper neurasthenic subscale. Blood laboratory levels were generally normal. The most obvious finding was that, in all the patients, the homocysteine (HCY) levels were increased in the cerebrospinal fluid (CSF). There was a significant positive correlation between CSF-HCY levels and fatiguability, and the levels of CSF-B12 correlated significantly with the item of fatiguability and with CPRS-15. The correlations between vitamin B12 and clinical variables of the CPRS-scale in this study indicate that low CSF-B12 values are of clinical importance. Vitamin B12 deficiency causes a deficient remethylation of HCY and is therefore probably contributing to the increased homocysteine levels found in our patient group. We conclude that increased homocysteine levels in the central nervous system characterize patients fulfilling the criteria for both fibromyalgia and chronic fatigue syndrome.

A public health response to cancer clusters in Missouri.

A protocol was developed in 1984 by the Missouri Department of Health to provide a systematic method for responding to citizen reports of cancer clusters. This protocol integrates public health and environmental expertise and includes two stages: the preliminary review and the investigation. The preliminary review is focused on problem definition and hypothesis generation. Cancer mortality and incidence data are reviewed. Information is gathered and verified through the efforts of citizens, local health officials, environmental staff, and the cancer program staff. Epidemiologic factors evaluated include type of cancer, temporal and spatial relations, population at risk, community profile, and possible environmental and occupational factors. The investigation is an expanded analytic study. Resources are focused on cancer inquiries that appear most likely to involve manageable common exposures. Program experience and protocol development highlights, including surveillance system improvement and educational programming, are described.

A study of the accuracy of cancer risk factor information reported to a central registry compared with that obtained by interview.

Sources of readily available data for cancer surveillance are frequently sought. To assess the validity of information on cancer risk factors that is routinely collected in conjunction with cancer incidence reporting, the authors completed interviews for 441 patients identified through the Missouri Cancer Registry from June 1986 to May 1987. Interviews elicited information on employment history, smoking, and alcohol consumption. Data collected from interviews were compared with those previously reported to the Registry by participating hospitals. Exact agreements of three-digit US Census codes were 70% for occupation and 72% for industry. Concordance for never- versus ever-smoking status was 83%, and a high correlation (r = 0.93) was observed for level of smoking. Agreement on alcohol consumption was lower (65%), largely because of the presence of false negatives. Misclassification occurred in a random manner for occupational variables; however, differential misclassification was present for smoking and alcohol histories. Despite the limitations of registry-collected data, these findings suggest that cancer registries that obtain information on cancer risk factors may be suitable for exploratory studies, especially those involving occupational cancer surveillance.

Report of an illness outbreak at the Harry S Truman State Office Building.

An acute epidemic of headache, mucosal irritation, fatigue, odd taste, and dizziness involving several hundred state government employees occurred in June 1986 in an office building in Missouri that housed 2,500 employees. A survey of 305 ill and 131 well employees demonstrated that ill employees were more likely to have perceived unusual odors and inadequate air flow in their work areas. The building has eight floors, seven of which are divided in half by an atrium, and 17 separate air handling systems. A total of 87% of the ill employees were concentrated in only three of the "half floors." Extensive investigation revealed no toxic substances or other direct causes for the illnesses, but several factors were identified that may have reduced air quality in the affected areas. These included a low proportion of outside air, associated with crowding, blocked vents, smoking, and use of office chemicals. This pattern of illness suggests epidemic anxiety state triggered by poor air quality.

2,3,7,8-Tetrachlorodibenzo-p-dioxin levels in adipose tissue of exposed and control persons in Missouri. An interim report.

The compound 2,3,7,8-tetrachlorodibenzo-p-dioxin, commonly known as dioxin, was measured in the adipose tissue of 39 persons with a history of residential, recreational, or occupational exposure in Missouri and in 57 persons in a control group. All participants had detectable levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin in their adipose tissue, but the exposed group had significantly higher levels. Levels of six of the exposed persons were more than five times greater than the level of the highest control. Measuring 2,3,7,8-tetrachlorodibenzo-p-dioxin in adipose tissue provides a much improved index of exposure, an important advance for research studies evaluating the possible health effects of this compound.