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Biomedical subjects

B McKinley

Publications and source records attributed to B McKinley.

11 recordsLinked to original sources
PubMed2001

Malignant fibrous histiocytoma: an institutional review.

BACKGROUND: A thorough understanding of malignant fibrous histiocytoma (MFH), the most common subtype of soft tissue sarcoma, will lead to improved histologic-specific protocols. METHODS: 126 patients with histologically confirmed MFH were analyzed. The median follow-up was 42 months (range 1-233 months). RESULTS: Overall survival was 58% at 5 years and 38% at 10 years. Grade significantly influenced prognosis, with 10-year survival of 90%, 60%, and 20% for low, intermediate, and high grade tumors, respectively (p = 0.0007). Distant metastases at initial presentation (p = 0.0002) and size of the primary tumor (p = 0.0007) influenced outcome. Neither anatomic site nor depth of the primary tumor were significant prognostic factors. Positive microscopic margins were associated with a decreased disease-free survival (p = 0.006). CONCLUSIONS: Tumor grade, size, and distant metastases at initial presentation remain the most important prognostic factors for MFH. Resection with negative microscopic margins decreased the incidence of local recurrence.

Disease-Free Survival↗
PubMed1999

Patient's lists.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1999

Efficacy of computerized decision support for mechanical ventilation: results of a prospective multi-center randomized trial.

200 adult respiratory distress syndrome patients were included in a prospective multicenter randomized trial to determine the efficacy of computerized decision support. The study was done in 10 medical centers across the United States. There was no significant difference in survival between the two treatment groups (mean 2 = 0.49 p = 0.49) or in ICU length of stay between the two treatment groups when controlling for survival (F(1df) = 0.88, p = 0.37.) There was a significant reduction in morbidity as measured by multi-organ dysfunction score in the protocol group (F(1df) = 4.1, p = 0.04) as well as significantly lower incidence and severity of overdistension lung injury (F(1df) = 45.2, p < 0.001). We rejected the null hypothesis. Efficacy was best for the protocol group. Protocols were used for 32,055 hours (15 staff person years, 3.7 patient years or 1335 patient days). Protocols were active 96% of the time. 38,546 instructions were generated. 94% were followed. This study indicates that care using a computerized decision support system for ventilator management can be effectively transferred to many different clinical settings and significantly improve patient morbidity.

Adult↗
PubMed1990

A simple and sensitive microtiter plate estrogen bioassay based on stimulation of alkaline phosphatase in Ishikawa cells: estrogenic action of delta 5 adrenal steroids.

We have developed an estrogen bioassay using the Ishikawa human endometrial adenocarcinoma cell line growing in 96-well microtiter plates. Alkaline phosphatase enzyme activity (AlkP) in these cells is markedly stimulated by estrogens, and this enzyme can be easily quantified in situ using a chromogenic substrate. These cells are very sensitive to estrogens; estradiol induces AlkP at levels as low as 10(-12) M. Antiestrogens completely block the action of estradiol. Various estrogens stimulate AlkP with potencies comparable to those achieved in vivo. The induction of AlkP is specific for estrogens; no other type of steroid, including androgens, progestins, mineralocorticoids, or glucocorticoids produce this effect. The stimulation of AlkP in Ishikawa cells is specific for estrogens, is highly reproducible and sensitive, and permits large numbers of samples to be assayed with ease. We have used this assay to investigate the estrogenic action of the adrenal delta 5-3 beta-hydroxysteroids. While pregnenolone is inactive, dehydroepiandrosterone and its sulfate ester induce AlkP slightly. However, the C19 steroid, 5-androstene-3 beta, 17 beta-diol is considerably more estrogenic in this assay, although it stimulates Ishikawa AlkP with a potency of 1/30,000 that of estradiol. The stimulation by 5-androstene-3 beta,17 beta-diol is inhibited by antiestrogens, but it is not blocked by the delta 5-3 beta-hydroxysteroid isomerase/dehydrogenase inhibitor, cyanoketone, or by the aromatase inhibitor, 4-hydroxy-androstenedione. Thus, neither conversion to a delta 4-3-ketone nor aromatization is required for the action of this unusual estrogen.

Adenocarcinoma↗
PubMedDate not supplied

Impact on survival by method of recurrence detection in stage I and II cutaneous melanoma.

BACKGROUND: The impact on survival by components of a surveillance program (physical examination, blood tests, and chest radiograph) used to detect recurrences in patients with cutaneous melanoma was assessed. METHODS: Data were collected from medical records and tumor registry information on a historical cohort of 1004 patients who presented with AJCC Stage I or II cutaneous melanoma at Roswell Park Cancer Institute from 1971 through 1995. RESULTS: Information on method of detection was available on 154 out of 174 identified first recurrences (89%). Physical examination detected 72% of recurrences, constitutional symptoms indicated 17% of recurrences, and chest radiograph revealed 11% of recurrences. Blood tests did not predict any recurrence. Only 9 of 17 patients with recurrences detected by chest radiograph alone underwent curative surgical resection. These patients had a statistically significant prolonged survival after diagnosis of recurrence compared to those surgical candidates who did not undergo resection. There was no statistically significant difference in overall survival between patients with asymptomatic pulmonary recurrences and those whose pulmonary recurrences were detected after symptoms of metastatic disease had developed. CONCLUSIONS: Most recurrences are detected on physical examination. Blood tests have no role in surveillance programs. Chest radiographs can detect pulmonary recurrences in a small number of asymptomatic patients at a stage when surgery may prolong survival.

Adult↗
PubMedDate not supplied

Direct detection of drugs of abuse in whole hemolyzed blood using the EMIT d.a.u. urine assays.

A simple, rapid, and sensitive method for the direct detection of a broad spectrum of drugs of abuse in hemolyzed whole blood by the enzyme multiplied immunoassay technique (EMIT) is described. A methanolic extract of 1 mL of whole blood is directly analyzed with EMIT urine assays. The proposed method is very sensitive and can detect drug concentrations in low therapeutic to subtherapeutic concentration ranges for all ten assays used. The EMIT urine assays used in this study included those for opiates, amphetamines, methadone, barbiturates, phencyclidine (PCP), methaqualone, propoxyphene, cocaine metabolite, benzodiazepine metabolite, and cannabinoids. This method should be most useful for screening forensic cases by EMIT when no urine is available, such as in impaired driving cases.

Amphetamines↗