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Biomedical subjects

D A Clark

Publications and source records attributed to D A Clark.

455 records · Page 26Linked to original sources
PubMedDate not supplied

Psychologic predictors of psychosocial and medical outcomes in patients undergoing coronary angioplasty.

The relationship between psychologic variables (the match between repressive style and level of cardiac information, and anxiety level) and medical complications, re-stenosis (renarrowing), and psychosocial adjustment was studied in 97 patients undergoing percutaneous transluminal coronary angioplasty (PTCA) for treatment of narrowed coronary arteries. Three major findings emerged for outcomes measured 6 months after PTCA: repressors with a high level of cardiac information (coping style-information level mismatch) and no history of heart attack were at higher risk for late medical complications (p less than 0.001); sensitizers with a low level of cardiac information (coping style-information level mismatch) and whose PTCA was only moderately successful were at higher risk for re-stenosis of the artery previously widened during PTCA (p less than 0.01); and patients who were more anxious during hospitalization had poorer social functioning and more mood disturbance 6 months after PTCA (p less than 0.05). Thus, psychologic, information, and medical factors are important in predicting 6-month outcomes in patients undergoing PTCA.

Adaptation, Psychological↗
PubMedDate not supplied

Fine needle aspiration diagnosis of lymphomatoid granulomatosis. A case report.

The diagnosis of lymphomatoid granulomatosis (LG) of the lung depends on obtaining adequate histologic material to demonstrate the characteristic angioinvasive, polymorphous, lymphoid infiltrate and normally requires an open lung biopsy. Fine needle aspiration biopsy (FNAB), if only smeared directly, does not allow an assessment of the lymphoid infiltrate in relation to blood vessels. However, we report a case diagnosed by FNAB in which the specimen was processed by an alternative method that allows cell blocks to be made from all visible particles. Percutaneous FNAB of a nodular pulmonary infiltrate was performed after bronchoscopy and transbronchial needle biopsy failed to yield a diagnosis. The FNAB specimen was placed in 50% alcohol and submitted for processing. The specimen was then filtered through a fine sieve, and all visible tissue was embedded in bacteriologic agar and processed as a standard surgical specimen. The filtrate was processed as standard fluid cytology. The atypical, angioinvasive, lymphoid infiltrate was clearly demonstrated on the cell blocks, and the diagnosis of LG was made. This diagnosis was confirmed by subsequent open lung and skin biopsies.

Aged↗
PubMedDate not supplied

A novel suppressor cell develops in uterine decidua in response to fetal trophoblast-type cells.

In both murine and human pregnancy, a novel population of small lymphocytic cells with suppressive activity accumulates in the uterine decidua. In the mouse, these suppressor cells lack T cell markers, release an interleukin-2 blocking factor, are associated with cells with cytoplasmic granules, and are deficient in the decidua of mice showing increased abortion rates with loss of resistance to attack by maternal antipaternal transplantation immunity. Small granulated cells with immunosuppressive activity do not arise as a result of decidualization alone but can be induced using trophoblast-type cells and supernatants conditioned by trophoblast-type cells. Possible mechanisms of this induction and the importance of trophoblast-decidual interaction in generating localized immunosuppressive buffer zone (chemical barrier) about the implanted conceptus are discussed.

Animals↗
PubMedDate not supplied

Chemotactic factor induced neutrophil shape changes in whole blood. A comparison of adults and neonates.

To define further the nature of the decreased responsiveness of neonatal neutrophils to chemotactic factor stimulation, neutrophil shape change induced by various concentrations of N-formyl-methionyl-leucyl-phenyl-alanine (fMLP) was studied using a whole blood assay. Samples from 48 full term neonates and paired healthy adult controls were examined. The neutrophil response to the chemotactic peptide was assessed by the morphologic transformation from a spherical to a bipolar shape in monolayer blood smears made from fresh whole blood samples. Neonatal neutrophils were found to have increased responsiveness relative to adult controls at low concentrations of fMLP (10(-11) to 10(-9) M), resulting in a significantly lower calculated chemotactic peptide concentration necessary for a 50 percent maximal response (ED50) in neonatal cells (1.01 X 10(-9) M compared to 2.25 X 10(-9) M). The maximal response at higher concentrations of fMLP (5.0 X 10(-9) to 10(-6) M) showed no differences between neonatal and adult cells, thereby supporting the concept that the early cellular events of the chemotactic factor activation in neonatal neutrophils are functionally intact.

Adult↗