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Biomedical subjects

C Caldwell

Publications and source records attributed to C Caldwell.

At least 55 records · Page 3Linked to original sources
PubMed1992

Pseudomyxoma peritonei of appendiceal origin. The Memorial Sloan-Kettering Cancer Center experience.

BACKGROUND: Pseudomyxoma peritonei is a rare clinical entity in which the peritoneal surfaces and omentum are involved with diffuse gelatinous mucinous implants. It originates from ruptured mucinous tumors of the appendix or ovary. METHODS: The authors examined the experience with 34 patients with pseudomyxoma peritonei seen at Memorial Sloan-Kettering Cancer Center from 1952-1989. Of these, 17 cases were identified to be of appendiceal origin. RESULTS: All patients underwent celiotomy and cytoreduction. The median survival time from diagnosis was 75 months. It was found that long-term survival can be achieved by operation alone. When conditions do recur, chemotherapy may be valuable. CONCLUSIONS: Pseudomyxoma peritonei of appendiceal origin is a rare low-grade malignancy. Initial treatment consists of cytoreduction in an attempt to render the patient locally disease-free. Long-term survival can be obtained by operation alone, even if gross disease is present at the end of the procedure. Systemic chemotherapy should be reserved for patients with proven recurrence.

Adenocarcinoma, Mucinous↗
PubMed1992

Depression and reduced natural killer cytotoxicity: a longitudinal study of depressed patients and control subjects.

Cross-sectional studies have demonstrated that natural killer (NK) cell activity is reduced in depression. To extend these observations and examine further the association between severity of depressive symptoms and values of NK activity, this study used a longitudinal case-control design and assessed NK cytotoxicity at intake and at follow-up 6 months after discharge from the hospital in depressed patients and control subjects. From acute hospitalization to follow-up, depression scores significantly (P < 0.01) decreased following treatment in the depressed patients but did not change in the control subjects. NK activity significantly (P < 0.05) increased from intake to follow-up in the depressives while lytic activity did not change in the controls. At intake NK activity was significantly (P < 0.01) reduced in the depressed patients as compared to values in the controls, while at follow-up cytotoxicity was similar between the two groups. These longitudinal data suggest that a reduction of NK cytotoxicity is temporally associated with the state of acute depression.

Adult↗
PubMed1992

Phosphorus 31-nuclear magnetic resonance spectroscopy of rat liver during simple storage or continuous hypothermic perfusion.

The adenosine triphosphate (ATP) content and intracellular pH (pHi) of isolated rat liver before, during, and after cold preservation in either University of Wisconsin lactobionate solution (UW) (n = 10) or Euro-Collins solution (EC), (n = 8) were monitored with phosphorus 31 nuclear magnetic resonance. The 31P nuclear magnetic resonance spectra were obtained on a 4.7 T system operating at 81 MHz. Fructose metabolism, liver enzyme release, oxygen consumption, and rat survival after liver transplantation were also evaluated. During simple cold storage (SCS) the ATP level declined to undetectable levels with both preservation solutions whereas the pHi declined to approximately 7.0. In contrast, during continuous hypothermic perfusion (CHP), hepatic ATP levels remained measurable during the 24-hour EC preservation and actually increased significantly (p > 0.01) during UW preservation. After reperfusion at 37 degrees C with Krebs lactate, the livers in SCS treated with EC differed significantly from the UW-treated livers in terms of their ATP level and pHi and their response to a fructose challenge. In contrast, livers undergoing CHP demonstrated similar behaviors with both solutions. These results demonstrate an increase in the hepatic ATP content during CHP, which occurs with UW but is not seen with EC. On the other hand, only livers that were simply stored with UW achieved significant survival after transplantation, whereas CHP livers were affected by vascular damage as demonstrated by fatal thrombosis after transplantation. These data suggest that ATP content is not the only determinant of good liver function. A system of hypothermic perfusion might further improve liver preservation efficacy should injury to the vascular endothelium be avoided.

Adenosine↗
PubMed1991

Vascular soft-tissue sarcomas. An analysis of tumor-related mortality.

Between 1982 and 1990, 69 adult patients were admitted to Memorial Sloan-Kettering Cancer Center with a diagnosis of angiosarcoma, lymphangiosarcoma, or malignant hemangiopericytoma. The existing literature regarding sarcomas focuses on individual histologic conditions or site-specific activity and includes pediatric patients, which makes estimates of survival difficult. We describe the clinical course of all vascular sarcomas, the survival without distant recurrence of patients with vascular sarcomas, and the overall survival of patients with vascular sarcomas. Using Cox's stepwise regression model, histologic characteristics of the tumors, tumor grade, tumor size, and other factors were assessed to determine their prognostic significance. Noncurative treatment and the presence of metastases were the only two factors influencing survival. Tumor grade approached significance. Disease recurrence was common among curatively treated patients (37% of such patients), and more than half of these recurrences involved distant sites. The survival of these patients depends on complete surgical resection and is independent of individual histologic characteristics of the tumor.

Adolescent↗
PubMed1991

Schizophrenia with secondary transsexualism.

We describe a patient with schizophrenia who developed transsexualism. The emergence of transsexualism and the patient's improvement paralleled those of the schizophrenic illness. The relationship between the diagnosis of the primary psychiatric illness in transsexualism has implications for prognosis and appropriate management.

Adult↗
PubMed1991

Gaining customer knowledge: obtaining and using customer judgments for hospitalwide quality improvement.

Customer knowledge is an essential feature of hospitalwide quality improvement. All systems and processes have customers. The aim is to use customer knowledge and voice of the customer measurement to plan, design, improve, and monitor these systems and processes continuously. In this way, the hospital stands the best chance of meeting customers' needs and, hopefully, delivering services that are so outstanding that customers will be surprised and delighted. There are many methods, both soft and hard, that can be used to increase customer knowledge. One useful strategy is to use a family of quality measures that reflect the voice of the customer. These measures can generate practical and powerful customer knowledge information that is essential to performing strategic planning, deploying quality policy, designing new services, finding targets for improvements, and monitoring those continuous improvements based on customers' judgments.

Consumer Behavior↗
PubMed1990

Reduction of immune function in life stress and depression.

Reduced cell-mediated immune function has been found in depressed patients and in distressed persons undergoing threatening life events. The present study examines the interaction between severe life stress and major depression to produce immune alterations in 36 matched pairs of hospitalized depressed patients and nondepressed controls. Both major depressive disorder and the presence of threatening life events in control subjects are independently associated with a 50% reduction of natural killer (NK) cytotoxicity. A decrease in natural cytotoxicity is significantly associated with depressive symptoms but not with age, alcohol consumption, or tobacco smoking. These findings of altered immunity provide further evidence that the physiological responses in chronic stress parallel those found in the syndrome of depression.

Adult↗
PubMed1990

Major depressive disorder, alcoholism, and reduced natural killer cell cytotoxicity. Role of severity of depressive symptoms and alcohol consumption.

Depression and alcohol abuse have been associated with alterations in cell-mediated immune function. This study directly compared the effects of depression, alcoholism, and their joint contribution to reduce natural killer cell cytotoxicity. Natural killer cell activity was significantly lower in both depressed (n = 18) and alcoholic (n = 19) patients compared with control subjects (n = 50). In addition, patients with a dual diagnosis of either alcohol abuse and secondary depression (n = 9) or depression with a history of alcohol abuse (n = 26) demonstrated a further decrease in natural killer cell activity compared with that found in patients with either depression or alcoholism alone. While both depression and alcoholism are separately associated with a reduction of natural killer cell activity, subgroups of patients in whom the diagnoses of alcoholism and depression coexist show a further decrement in natural killer cell function.

Adult↗
PubMed1981

An analysis of maternal transport within a suburban metropolitan region.

Data on 185 infants transported for perinatal and/or neonatal care from suburban metropolitan hospitals were analyzed. Following birth, 100 infants were transferred from community hospitals. A total of 85 infants were transported in utero and delivered at a tertiary (Level III) perinatal center. Survival rate was 90% for infants transported in utero contrasted with 81% for the infant transports. This difference was not significant. When hospitalization cost and length of stay were used as an index of morbidity, there was a significant difference between the two groups. The mean hospitalization cost of survivors was $6,473 for in utero transports compared to $12,208 for infant transports (p less than 0.005). The mean length of stay for in utero transports was 19 days contrasted to 27 days for infant transports (p less than 0.05). The findings of this study indicate that in utero transports resulted in reduced morbidity for infants of high-risk pregnancies.

Female↗
PubMed1978

Reliable sampling method for analysis of the ecology of the human alimentary tract.

An intubation method has been developed that allows removal of a sample of human intestinal fluid within a short period of time, that avoids contamination, and that minimizes exposure of the sample to air. Preliminary results obtained with this method have shown that the stomach and duodenum are essentially sterile and that the bacterial population present in the remainder of the small intestine is similar to that described by previous workers except that Veillonella species were encountered frequently and Haemophilus species were also detected in the lower jejunum and ileum of some individuals.

Bacteria↗