Thrombomodulin staining of mesothelioma cells.
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Adenocarcinoma↗
Biomedical subjects
C L Collins
Publications and source records attributed to C L Collins.
Thrombomodulin expression in malignant pleural mesothelioma and pulmonary adenocarcinoma.
Thrombomodulin (TM) is a glycoprotein of molecular weight 75,000 kd that is normally present in restricted numbers of cells, including endothelial and mesothelial cells. In this study, the authors tested the possibility of using anti-TM to facilitate the diagnosis of mesothelioma. All of the 31 mesotheliomas and the two mesothelioma cell lines (MS-1 and MS-2) tested were stained positively with anti-TM. The specificity of anti-TM staining in mesothelioma cells was further confirmed by in situ hybridization of MS-1 cells with a TM-specific probe. The expression of TM in MS-1 cells was increased markedly when these cells were induced by 12-0-tetradecanyl phorbol 13-acetate (TPA) to differentiate. The expression of TM in mesothelioma cells, however, did not correlate with any particular phase of the cell cycle. In an attempt to differentiate pleural mesothelioma from pulmonary adenocarcinoma, the authors compared the expression of TM, carcinoembryonic antigen (CEA), and Leu M1 in these two types of tumors. Only four of 48 (8%) pulmonary adenocarcinomas were stained positively by antibodies to TM. Therefore, immunohistochemical staining with antibodies to TM yielded 100% sensitivity and 92% specificity for diagnosis of mesothelioma. All of the mesotheliomas stained negatively for CEA and Leu M1, except for one, which showed minimal focal positivity for Leu M1. In contrast, 79% and 60% of adenocarcinomas stained positively for CEA and Leu M1, respectively. These findings suggest that immunocytochemical staining with anti-TM should be added to the battery of tests to increase the diagnostic sensitivity and specificity for differentiating mesothelioma from pulmonary adenocarcinoma.
Adenocarcinoma↗
Nuchal cord: a definition and a study associating placental location and nuchal cord incidence.
The umbilical cord around the neck of the fetus at the time of birth has been referred to in the literature by many different terms, including the term nuchal cord. A standardized definition of nuchal cord is proposed in order to allow for more accurate study of this problem. A prospective study is undertaken applying this specific definition. The results suggest a statistically significant relationship between nuchal cord incidence and placental location. A relationship between fetal heart rate decelerations and placental location also surfaced.
Delivery, Obstetric↗
Comparison of home occult blood tests and interaction of tests with ibuprofen.
The interaction of ibuprofen with home tests for occult blood was evaluated, and the accuracy of these tests was determined by validating the results with a specific quantitative assay of stool blood. Three home occult blood tests were evaluated: Early Detector, Fleet Detecatest, and CS-T Coloscreen Self Test. Fourteen men 19 to 35 years of age were instructed on how to use the tests and to record each day their dietary intake and stool consistency, the color of test control areas, the results, and the times of ibuprofen administration. The study consisted of a control period (days 0-5) and short-term (days 6-9) and long-term (days 10-14) ibuprofen periods. Each subject took two 200-mg tablets of ibuprofen three times daily beginning on day 6 and ending on day 14. During each study period, one stool sample was collected on each of three consecutive days. All three tests were performed on each sample, in addition to specific quantitative analysis with HemoQuant. All samples in the control period were negative for occult blood. Three positive results were reported by subject 4 in the short-term ibuprofen period, one with Fleet Detecatest and two with Early Detector. Subject 6 reported two positive Fleet Detecatest results and three positive Early Detector results during the long-term drug period. No positive results were detected with CS-T Coloscreen Self Test. The HemoQuant values showed that Early Detector produced one false-negative and two false-positive results.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
The effect of oral contraceptives on lumbar bone density in premenopausal women.
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Adult↗
The in vivo performance of 250 internal fixation devices: a follow-up study.
The in vivo performance of 250 retrieved internal fixation plates was evaluated. The corrosion characteristics and metallurgical properties of each implant were assessed and correlated with respective clinical performance. Screw-plate interface corrosion and screw surface corrosion were graded; Rockwell hardness, grain size, thin inclusion content, and heavy inclusion content measurements were made. The devices studied included 169 bone plates, 59 Richards type hip screw-plates and 22 Jewett type hip nail-plates. The devices remained in situ for an average of 26.3 months, with in situ periods ranging from 1 to 192 months. The majority of the plates (50.4%) were removed due to cause-related reasons, while the remaining devices (49.6%) were removed on a routine asymptomatic basis. The primary symptomatic removal reasons consisted of implant related pain, nonunion or malunion, infection, loosening and implant breakage. Upon stereomicroscopic examination, 89% of all plates exhibited some degree of interface crevice corrosion, and 88% of all screws exhibited some degree of surface corrosion. Statistical analysis of corrosion gradings and metallurgical data revealed significant correlations between the two. As was suggested in our previous study of a limited number of implants, this study demonstrates that stricter manufacturing standards for metallurgical properties would serve to enhance corrosion resistance and improve the in vivo performance of stainless steel internal fixation devices. It is also suggested that the routine removal of all internal fixation plates after fracture healing has been achieved would reduce the occurrence of symptomatic complications, such as implant breakage, implant loosening and implant related pain.
Bone Plates↗
A clinical and metallurgical analysis of retrieved Jewett and Richards hip plate devices.
The metallurgical properties of 61 retrieved 316L stainless steel (ASTM F138-76) hip plate devices used for the treatment of intertrochanteric fractures were examined. Surface and screw-plate interface corrosion characteristics were graded, and grain size, inclusion content, and hardness values were measured. These measurements were then correlated with the clinical performance of the devices. The devices studied included 21 Jewett nail-type and 40 Richards compression screw-type hip plates. The devices had been in situ an average of 26.7 months, with in situ periods ranging from 2.0 to 156.0 months. Cause-related reasons represented the majority of removals (89.8%), while only 10.2% of the hip plates were removed on a routine asymptomatic basis. The data suggest that surgeons consider this type of device as a permanent implant, with removal undertaken only for causative factors. Of all devices removed, 30.6% were retrieved from patients who presented with fracture nonunion. Upon microscopic examination, 97% of the retrieved implants exhibited some degree of either surface of interface corrosion. Statistical analysis revealed significant correlations between corrosion scores and the metallurgical properties of grain size and nonmetallic inclusion content. No statistically significant metallurgical or corrosion differences were discerned between the two types of devices studied. However, four implants of the Jewett design and four of the Richards design were found to be out of ASTM specification F-138-76. It should also be noted that four devices of the Jewett design (19%) fractured in situ, while none of the retrieved Richards designs had fractured. No correlation was observed between the plates' corrosion scores and in situ time.(ABSTRACT TRUNCATED AT 250 WORDS)
Bone Plates↗
Thin-layer chromatography of substituted glycosides.
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Alkylation↗
HIV safety guidelines and laboratory training. NIOSH.
At the Centers for Disease Control (CDC), educational activities concerning acquired immunodeficiency syndrome (AIDS) are directed to many target audiences; important among these are health care and public safety workers. Several CDC programs are designed to address the specific education and training needs of these groups. The National Institute for Occupational Safety and Health (NIOSH) has developed a set of occupational safety guidelines directed to fire service personnel, emergency medical technicians, paramedics, and law enforcement and correctional facility personnel. These guidelines provide information on modes of transmission of human immunodeficiency virus (HIV) in the workplace, the risk of transmission, the control of risk, and specific risk-control recommendations. NIOSH also has developed a model curriculum, based on the principles and practices discussed in the guidelines, for use in training workers. The Hospital Infections Program (HIP) at CDC's National Center for Infectious Diseases is responsible for assessing the risk of HIV infection for both health care workers and patients. As part of this effort, HIP has developed guidelines to prevent transmission of HIV and other bloodborne pathogens in health care settings, as well as statements regarding management of occupational exposure to HIV. The Public Health Practice Program Office provides laboratory training to health care workers who are performing HIV- and AIDS-related testing. This training is delivered through the National Laboratory Training Network and through courses given at CDC headquarters in Atlanta. The delivery of laboratory training is supported by the development of training materials and by performance evaluation programs.
AIDS Serodiagnosis↗
Methylprednisolone pulsing of heart transplant patients in the home.
Methylprednisolone pulsing is the first form of treatment used to reverse acute moderate rejection in heart transplant patients at the University of Michigan, Ann Arbor. Before May 1986, patients who needed administration of medications to be pulsed were admitted to the hospital. With our increasing number of transplant patients, lack of hospital beds, and efforts toward cost containment, a new system was established. From June 1986 to April 1988, 53 heart transplantations were performed in 40 adults and 13 children. Home care agency nurses received in-service training by the heart transplant clinical specialist. Insurance companies were contacted directly to obtain financial approval when it was not considered a covered benefit. Of 47 episodes of rejection, 45 were successfully treated in the home with resolution, whereas hospital admission was required in two cases of rejection episodes for successful resolution. There were marked financial savings, increased patient satisfaction, no patient infections, and minimal side effects, which included hypertension in five patients, headaches in two patients, and difficulty gaining venous access in two patients. Most problems were easily handled by telephone communication. Therefore, after a 22-month experience with administration of methylprednisolone pulses in the home, we believe that this is a satisfactory method of treating patients. It is cost-effective, has minimal side effects, and leads to increased patient satisfaction.
Costs and Cost Analysis↗
Efficacy of patient-controlled versus conventional analgesia for postoperative pain.
Patient-controlled i.v. administration and intramuscular administration of morphine sulfate were compared in a crossover study to determine their relative effectiveness in relieving postoperative pain. Twenty adult patients scheduled for abdominal surgery were randomly assigned to one of two groups; one group received i.v. morphine sulfate for 24 hours using a patient-controlled analgesia (PCA) device, after which they were given morphine sulfate i.m. for 24 hours. The treatment order was reversed for the other group. Amount of narcotic administered, respiratory rate, and levels of discomfort, activity, and sedation were assessed by the nursing staff every two hours. At the end of each 24-hour treatment phase, patients ranked their level of pain, amount of pain relief, level of sedation, ability to sleep, and ability to perform pulmonary toilet. Patients were also asked whether they preferred PCA or i.m. analgesic therapy for future surgery. Patients reported significantly less discomfort while using PCA than during i.m. morphine administration. No significant differences in amount of narcotic used, respiratory rate, nausea and vomiting, or levels of activity or sedation were noted for the two regimens. Patients' rankings of the two treatment modes did not differ significantly, but a majority of patients indicated a preference for future use of PCA. In these postoperative patients, administration of i.v. morphine sulfate by PCA was as safe as i.m. administration and possibly more effective in relieving pain.
Adult↗