American journal of clinical pathology
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Am. J. Clin. Pathol. · Oct 1995
Case ReportsAggressive fibromatosis of the spermatic cord. A typical lesion in a "new" location.
The authors describe a 31-year-old man with a 7 cm aggressive fibromatosis (desmoid tumor) of the spermatic cord presenting as a swelling in the left inguinal area that was excised along with the testis and cord. The desmoid tumor is histologically typical, but such tumors arising primarily from the paratesticular structures have apparently not been previously reported and the diagnosis would not be questioned if it not for the unusual site. ⋯ Paratesticular fibrosarcoma and leiomyosarcoma should also be differentiated from desmoid tumor that does not have the metastatic potential of sarcomas. Thirty-four months post-operatively, an 8 cm local recurrence in the remaining portion of the left vas deferens causing left hydroureter and hydronephrosis was detected.
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Am. J. Clin. Pathol. · Oct 1995
ReviewPoint-of-care testing in the intensive care unit. The intensive care physician's perspective.
Technological advancements have, for the first time, made the entire laboratory testing process feasible at the bedside. Physicians working in the intensive care unit have always had immediate access to patients' medical history, physical examination, and physiologic monitoring data, but had to wait for laboratory results. ⋯ The concept of point-of-care testing in the intensive care unit is relatively new, but as technology progresses, physicians will undoubtedly become aware and use it in the intensive care unit. This article focuses on the intensive care physician's perspective on laboratory testing, the evolution of the intensive care unit laboratory, advantages of point-of-care testing in that setting, new developments in arterial blood gas analyzers and monitors, and cost-effectiveness and incorporation of point-of-care testing.
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Am. J. Clin. Pathol. · Oct 1995
Comparative StudyComparison of the kinetic fibrinogen assay with the von Clauss method and the clot recovery method in plasma of patients with conditions affecting fibrinogen coagulability.
A Kinetic Fibrinogen Assay (KFA), a method based on the kinetic reaction of the developing fibrin clot, was used to determine fibrinogen concentration in plasma. Two other methods employing different quantification principles were used for comparison: the von Clauss method and the procedure measuring protein concentration in an isolated and washed plasma clot (World Health Organization [WHO] method). All three methods quantified functional thrombin-coagulable fibrinogen. ⋯ In assessing the clinical utility of each method, the WHO method was found to be labor intensive and time consuming; therefore, not suitable for routine use in a clinical laboratory. The von Clauss method required a trained laboratory technician and some laboratory manipulations. The KFA method was not only reliable and accurate, but also fully automated, making it the easiest and the fastest to perform routinely.
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Am. J. Clin. Pathol. · Oct 1995
Case ReportsSevere intravascular hemolysis associated with brown recluse spider envenomation. A report of two cases and review of the literature.
Envenomation by the brown recluse spider (loxoscelism) is classically associated with a necrotic ulcer. Systemic manifestations occur in a minority of cases, but are generally mild and self-limited. The hematologic complications of brown recluse spider bite range from mild hemolysis to fulminant intravascular hemolysis with or without evidence of disseminated intravascular coagulation. ⋯ This article presents two cases of severe hemolysis associated with loxoscelism occurring in two young women in Memphis, Tennessee. The second documented death in an adult from severe hemolysis due to a brown recluse spider bite is reported. A review of the literature emphasizing the pathogenic mechanisms of spider bite hemolysis is also included.