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Biomedical subjects

C Reynolds

Publications and source records attributed to C Reynolds.

At least 73 records · Page 4Linked to original sources
PubMed1997

Calcified amorphous tumor of the heart (cardiac CAT).

Eleven cases of poorly characterized nonneoplastic endocardially based intracavitary cardiac masses have been seen at the Mayo Clinic between 1965 and 1994. They occurred in 7 women and 4 men from age 16 to 75 years (mean, 52 years). The patients presented with a wide variety of symptoms and underlying diseases. The lesions were diagnosed as a primary cardiac neoplasm in 6 of 8 patients having echocardiography. Surgical excision was the treatment of choice in 10 patients; the 11th patient died of noncardiac causes 30 days after the mass was discovered. Grossly, the lesions were firm, yellow-white, and partially calcified, and arose in any of the four chambers. Microscopically, all lesions were characterized by nodular calcium in a background of degenerating blood elements and chronic inflammation. All patients had a benign course relative to their cardiac lesion. Repeat echocardiogram in two patients showed residual calcium in the region of the initial tumor. Although these lesions may represent calcified thrombi, the clinical presentation did not suggest thrombosis as the most likely explanation for their occurrence. Based on the combined clinical presentation and microscopic appearance, the authors propose the descriptive name calcified amorphous tumors (cardiac CAT) to describe this group to nonneoplastic cardiac masses.

Adolescent↗
PubMed1997

MR imaging of ductal carcinoma in situ.

PURPOSE: To investigate the ability of magnetic resonance (MR) imaging to depict ductal carcinoma in situ (DCIS). MATERIALS AND METHODS: Between January 1992 and April 1996, 330 women underwent MR imaging before excisional biopsy. Of these, 101 women had carcinoma, 19 of whom had DCIS. The MR imaging findings in the 19 women were reviewed. RESULTS: Thirteen of 19 patients had pure DCIS. The mean lesion diameter was 10 mm (range, 2-22 mm). MR imaging enabled identification of DCIS in 10 (77%) of the 13 cases as ductal enhancement (n = 6), regional enhancement (n = 3), or a peripherally enhancing mass (n = 1). The three lesions not identified had a mean diameter of 3.7 mm. Six of 19 patients had both DCIS and an invasive cancer. In four of these patients, DCIS was identified only at MR imaging (mean diameter, 3 mm). In two of six patients, DCIS was not identified at MR imaging. CONCLUSION: MR imaging can depict mammographically visible and occult foci of DCIS. Some small foci of DCIS detected at mammography and histologic examination, however, may be occult at MR imaging.

Adult↗
PubMed1997

Breast carcinoma: MR imaging before re-excisional biopsy.

PURPOSE: To investigate the role of magnetic resonance (MR) imaging in the examination of patients after excisional biopsy of breast carcinoma before re-excision. MATERIALS AND METHODS: Forty-seven patients underwent contrast material-enhanced MR imaging after initial excisional biopsy of breast carcinoma before further surgery. RESULTS: The positive predictive value of MR imaging for predicting residual disease was 82%; the negative predictive value was 61%. Fourteen patients had multifocal (n = 6) or diffuse (n = 8) carcinoma. The extent of tumor was correctly identified with MR imaging alone in nine of the 14 patients, with both mammography and MR imaging in three patients, with mammography alone in one patient, and with no imaging modality in one patient. In four of the 14 patients, management was altered from re-excision to mastectomy (n = 3) or from breast-conservation therapy to mastectomy (n = 1). CONCLUSION: MR imaging has a high positive predictive value for predicting residual tumor after excisional biopsy. The identification of mammographically and clinically unsuspected multifocal or extensive residual tumor may lend support for mastectomy rather than re-excision. However, false-negative findings due to postsurgical changes and false-positive findings due to enhancement of granulation tissue and benign breast tissue remain limitations.

Adult↗
PubMed1997

Expression of prolactin and its receptor in human breast carcinoma.

The growth regulatory effects of PRL on the human breast are mediated by its receptor (PRLr), a member of the cytokine receptor family. Recent reverse transcriptase-PCR studies by our laboratory and others have shown PRL expression within breast tissues at the RNA level. To confirm the role of this growth factor-receptor complex in normal and malignant breast tissues, the expression of PRL and PRLr was examined in parallel with the estrogen receptor (ER) and progesterone receptor (PR). Sixty-nine cases of primary invasive breast carcinoma were examined for PRL and PRLr expression by in situ hybridization and immunohistochemical technique, respectively. These data revealed widespread expression of PRL and its receptor in the breast cancers studied (>95%) and in the normal breast tissues (>93%), with no association between the expression of PRL-PRLr and ER or PR. These findings stand in contrast to prior RIA-based studies that detected the PRLr in only 20-60% of breast carcinomas, most commonly in ER-PR-positive cells. These results confirm prior data indicating the presence of an autocrine/paracrine loop for the PRL-PRLr complex within human breast tissues. Given the widespread expression of PRL-PRLr in breast cancer, pharmacological interventions aimed at the inhibition of function of this growth regulatory receptor complex may be of considerable utility in the therapy of this disease.

Adult↗
PubMed1996

High-resolution MR imaging of the breast: clinical context.

Preliminary investigation into magnetic resonance (MR) imaging as a breast imaging technique has demonstrated several promising roles for this modality when used as an adjunct to mammography for the detection and diagnosis of breast cancer. There are many technical factors that must be considered, including high resolution, rapid imaging, fat suppression, and localization and biopsy capability. Potential clinical applications include differentiating benign from malignant lesions, detecting cancer when results of clinical examination or conventional imaging are equivocal, detecting cancer recurrence after breast conservation treatment, staging newly diagnosed breast cancer, and detecting occult cancer in patients presenting with axillary node metastasis. Pitfalls include false-positive and false-negative results. Awareness of the strengths and limitations of MR imaging of the breast will facilitate integration of this technique into the work-up of patients with suspicious breast lesions.

Adult↗
PubMed1996

The measurement of complexity in surgical pathology.

The quantitation of effort both within and among surgical pathology laboratories is data which is being increasingly sought by physician managers, hospital administrators and managed care organizations. Simple measurement of case numbers fails to adequately represent the work of a laboratory. The complexity of the cases reviewed is likely to explain a significant portion of the variance in the time required to bring a case to final diagnosis. Measures which adequately reflect complexity in surgical pathology cases have not been developed. We have studied a variety of extractable report features and correlated these with the time required for case sign-out. Numbers of slides reviewed and total lines of factual data provided were strong correlates of the time required to complete case review, report construction and verification. Such data suggests that models can be constructed based on data that can be gleaned from case reports and records which will relate such data to actual work time.

Analysis of Variance↗
PubMed1995

Frequent loss of heterozygosity at the TEL gene locus in acute lymphoblastic leukemia of childhood.

TEL is a new member of the ETS family of transcription factors which is rearranged in a number of hematologic malignancies with translocations involving chromosome band 12p13. In some cases, both TEL alleles are affected, resulting in loss of wild-type TEL function in the leukemic cells. In addition, 5% of children with acute lymphoblastic leukemia (ALL) have 12p12-p13 deletions, suggesting that a tumor suppressor gene resides on 12p. These observations led us to consider whether TEL loss of function may contribute to the pathogenesis of ALL. In this report we show that the TEL gene maps between the polymorphic markers D12S89 and D12S98, and we use these flanking markers to screen paired diagnosis and remission samples from 81 children with ALL for loss of heterozygosity (LOH) at the TEL gene locus. Fifteen percent of informative patients showed TEL LOH which was not evident on cytogenetic analysis. Detailed examination of patients with LOH at this locus showed that the critically deleted region included two candidate tumor suppressor genes: TEL and KIP1, the gene encoding the cyclin-dependent kinase inhibitor p27. These studies show that LOH at the TEL locus is a frequent finding in childhood ALL.

Adolescent↗
PubMed1995

An empirical test of telephone screening to identify potential dementia cases.

Thirty-seven subjects, 15 with a clinical diagnosis of Alzheimer's disease and 22 normal controls, participated in a study of the accuracy of telephone screening in identifying potential dementia cases. The telephone protocol and scoring algorithm resulted in 100% sensitivity and 91% specificity. The findings suggest that a brief telephone interview can serve as an efficient screening device to locate dementia cases in the context of a large-scale community-based investigation.

Aged↗
PubMed1995

Comparison of PF4/heparin ELISA assay with the 14C-serotonin release assay in the diagnosis of heparin-induced thrombocytopenia.

The diagnosis of heparin-induced thrombocytopenia (HIT) may be affirmed by demonstrating heparin-dependent anti-platelet antibodies using the 14C-serotonin release assay (SRA). In this study, results of the SRA was compared with the recently described platelet factor 4 (PF4)/heparin enzyme-linked immunosorbent assay (ELISA). Compared with the SRA, the sensitivity and specificity of a PF4/heparin ELISA was 87% and 92%, respectively, using an assay developed in our laboratory; and 90% and 98%, respectively, using a commercially developed kit (Diagnostica Stago, Asnieres, France). However, antibodies to PF4/heparin were also detected in up to 8% of patients whose plasma was negative by SRA, and 23% of patients receiving heparin who were not thrombocytopenic. These data indicate that results obtained with the PF4/heparin ELISA and the SRA are generally in accord in patients with a clinical diagnosis of HIT. However, discrepant results occur in approximately 20% of cases because of the greater sensitivity of ELISA and the possible involvement of other heparin-binding proteins. The fact that each assay contributes independent information in some cases must be considered in the sequence of test performance and in providing consultation to the practicing hematologist.

Adult↗
PubMed1995

Public health and the Australian Constitution.

The powers vested in the Commonwealth Government by the Constitution contain the basis of much public health law in Australia. Yet this is not often recognised; public health law is generally, and historically, seen as the states' responsibility. This article surveys the broad range of constitutional powers that the Commonwealth Government can rely upon to make public health laws. It considers areas of power specified in the Constitution, such as those with respect to external affairs and corporations. Decisions of the High Court have interpreted the various heads of power very broadly and have significantly enhanced the potential of the Commonwealth to pass detailed and far-reaching public health law. To this fact must be added the taxation arrangements in Australia and, with these, the very extensive control that the Commonwealth can exercise through its monopoly of major taxation sources. Its power to make financial arrangements can tie dependent states into specific policies (including public health policies) as a condition of the grants made to them. However, these broad powers may be limited in some important respects: the High Court is increasingly identifying rights and freedoms in the Constitution that may increasingly bring both state and Commonwealth public health law under challenge. Despite this possibility, the Commonwealth may prove to be our most significant source of public health law, and public health policy makers should recognise the full potential of its power to make such laws.

Australia↗
PubMed1995

Malignant triton tumour of the spine: a case report.

A malignant triton tumour is a malignant schwannoma with rhabdomyoblastic differentiation, and is a very rare occurrence. We describe the case of a 33-year-old man with neurofibromatosis type 1 who presented with paraplegia. Pathological examination of an intradural, extramedullary tumour excised at lumbar laminectomy demonstrated a malignant schwannoma with rhabdomyoblastic differentiation. We believe this is the first documented case of a malignant triton tumour of the spine.

Adult↗
PubMed1994

Social rhythm in anxiety disorder patients.

UNLABELLED: The social rhythm metric (SRM) is a self report diary instrument which generates a numerical measure of rhythmicity of daily life behaviors. Depression researchers have proposed that life events cause disruption of social rhythmicity and this leads to disturbance in the sense of well-being and to disruption of physiologic rhythmicity known to be related to depressive episodes. We hypothesized that low rhythmicity of daily activities might also be characteristic of anxiety disorder patients. SUBJECTS: Forty-eight patients who met DSM III-R criteria for an anxiety disorder were recruited and compared with 41 previously monitored normal controls. PROCEDURES: All patients and controls completed at least two weeks of daily monitoring with the SRM. Anxiety patients underwent structured diagnostic assessment and completed demographic and clinical rating scales. SRM was analyzed according to a previously developed algorithm. RESULTS: Anxiety disorder patients report significantly lower regularity of daily activities than normal controls. The low SRM scores were not accounted for by the presence of comorbid affective disorder. CONCLUSIONS: We identify a new type of abnormality in anxiety disorder patients which has potential clinical as well as theoretical interest.

Activities of Daily Living↗
PubMed1994

Cognitive-perceptual, interpersonal, and disorganized features of schizotypal personality.

While two factors are currently thought to underlie individual differences in schizotypal personality, three factors may best explain schizotypal traits. This study used confirmatory factor analysis to assess five competing models of schizotypal personality in the general population: null model, one-factor model, simple two-factor model, Kendler two-factor model, and three-factor model. The computer program LISREL was used to analyze Schizotypal Personality Questionnaire subscale scores that reflect the nine traits of schizotypal personality. The scores were obtained from (1) a sample of 822 undergraduates and (2) a replication sample of 102 subjects drawn from the community. Results indicate replicable support for a three-factor model reflecting cognitive-perceptual, interpersonal, and disorganized latent factors. Low intercorrelations between the first two factors and the lack of fit by a one-factor model are partially inconsistent with recent notions that a single vulnerability dimension underlies schizotypal personality. It is argued that future investigations should assess the correlates of all three schizotypal factors in clinical and nonclinical samples in addition to the two more traditional factors. It is hypothesized that three factors of schizophrenic symptomatology observed in recent studies may reflect an exaggeration of three analogous factors found in the general population.

Adolescent↗
PubMed1994

Clozapine therapy and clinical outcomes in Kentucky psychiatric hospitals.

We reviewed the protocol for determining patient eligibility to receive clozapine in Kentucky state psychiatric facilities. Results of a retrospective review of the clinical outcomes of the initial 42 patients who received clozapine under this protocol are reported. Patients receiving clozapine were severely ill patients with a mean duration of illness and mean length of current hospitalization of 11 years and 2 years, respectively. Symptomatic response was dramatic with a reduction in total Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) ratings of 48.4% and 36.3%, respectively. The time patients spent in restraints decreased significantly following clozapine initiation. Clozapine was well tolerated, with sedation being the most common adverse effect reported. One patient experienced a seizure and another developed leukopenia. Following 12 weeks of clozapine treatment, the patient discharge rate was 42.9%.

Adult↗
PubMed1993

Stimulation of human T-cell proliferation by specific activation of the 75-kDa tumor necrosis factor receptor.

TNF-alpha can enhance the proliferation of human thymocytes stimulated by the comitogen Con A. To determine which of the two different TNF receptors is responsible for signaling this cellular response, we investigated the proliferation of human thymocytes in response to agonistic antibodies specific for the two TNF receptor types. In contrast to previously examined TNF activities in human cells, thymocyte proliferation was stimulated in response to rabbit polyclonal antibodies directed against the 75-kDa TNF receptor (TNF-R2), but not those directed against the 55-kDa TNF receptor (TNF-R1). Lymphotoxin (TNF-beta) was also shown to stimulate human thymocyte proliferation, demonstrating that TNF-beta can initiate a biologic response that is mediated by TNF-R2. TNF-R2-mediated T-cell proliferation was not restricted to the immature T cells within the thymus, as the anti-TNF-R2 antibodies also stimulated the proliferation of peripheral T cells. As a first step toward identifying a specific agonist of TNF-R2 with therapeutic potential, 10 anti-TNF-R2 mAb were examined for potential agonist activity. Nine of these significantly stimulated human thymocyte proliferation with maximal responses ranging from twofold to significantly greater than that obtained with TNF-alpha by itself.

Antibodies, Monoclonal↗