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Biomedical subjects

D Hayes

Publications and source records attributed to D Hayes.

At least 73 records · Page 4Linked to original sources

An investigation of vanishing bone disease.

Vanishing bone disease is a rare condition producing local deformity and instability. Fibrovascular tissue replaces bone completely but the mechanism of bone destruction and resorption is unknown and there is controversy regarding the presence or absence of osteoclasts in the disease. Radiography, clinical chemistry, light microscopy, transmission electron microscopy (TEM) and cytochemistry were used to investigate the condition of a young woman presenting early in the disease process. We detected atypical ultrastructure in osteoblasts and endothelial cells. The rare osteoclasts, numerous mononuclear phagocytes and vascular endothelium found in the condition reacted positively for the enzyme acid phosphatase. Aggressive local excision of diseased tissue and insertion of a free vascularized bone graft at an advanced stage of the disease, accompanied by subsequent radiotherapy for residual disease only were successful in rehabilitating the affected forearm and hand.

Adult↗

Tartrate resistant acid phosphatase positive splenic lymphoma: a relatively benign condition occurring in a time-space cluster?

Conventional light and electron microscopic studies, together with cytochemical and immunocytochemical staining procedures, were carried out to ascertain whether the lymphomata of four elderly female patients living within 10 kilometers of each other, who presented within a short space of time with massive splenomegaly and varying cytopenia, belonged to any particular subgroup of lymphoma. In each case the lymphoma had a diffuse pattern and mature B cell phenotype. The malignant cells were of uniform cell type, slightly larger than admixed polymorphonuclear leucocytes, and showed minimal nuclear irregularity and positivity for tartrate resistant acid phosphatase (TRAP) staining. Their clinical and morphological features were compared with those of other lymphoproliferative disorders, but while sharing some features in common with each condition, this small group of patients seemed to have a unique combination of findings. The cytopenias of all four responded well after removal of the spleen and their disease has not been aggressive. It is concluded that these patients have a distinct subgroup of lymphoma, which it is important to recognise so that inappropriate use of aggressive cytotoxic drugs can be avoided.

Acid Phosphatase↗

Teaching first-year students the interpersonal recall process for patient interviews.

The authors investigated how well 52 internal medical residents understood the four modes of the interpersonal process recall (IPR) system after the students had received training in this system, and also investigated whether the students taught by instructors trained in the IPR system had a greater understanding of the system than those taught by nontrained instructors. Students were tested before and after the course, which involved extensive use of videotapes of interviews. With some reservations, the data as a whole suggest that the IPR system can be taught effectively by an enhancement of the methods used for this study and that the instructors do not have to receive training in the system to teach it effectively.

Humans↗

Acute effects of carbon monoxide exposure on individuals with coronary artery disease.

The purpose of this study was to determine, using more objective evidence than that reported in previous studies, whether or not exposures to carbon monoxide that produce approximately 2% or 4% blood carboxyhemoglobin levels cause an exacerbation of myocardial ischemia during a progressive exercise test. The objective measurements were based on the development of electrocardiographic evidence of ischemia. In addition, time to onset of angina pectoris was studied. Male subjects, ages 35 to 75, with stable exertional angina pectoris and positive exercise treadmill tests with reproducible ischemic ST-segment changes in their electrocardiograms, were studied. In addition, each subject fulfilled at least one of the following criteria of coronary artery disease: angiographic evidence of at least a 70% occlusion of one or more major coronary artery; prior documented myocardial infarction; or a positive exercise thallium test. Each subject was evaluated on four separate occasions, a qualifying visit and three blinded test visits, which involved exposure (in random order) to air without added carbon monoxide and to air that contained carbon monoxide concentrations calculated to produce approximately 2.2% or 4.4% carboxyhemoglobin, measured by gas chromatography, at the end of the exposure period. These immediate postexposure target levels were set 10% higher than the desired postexercise carboxyhemoglobin levels of 2.0% and 4.0% because exercise while breathing room air results in loss of carbon monoxide. The actual one-minute postexercise levels reached were 2.0% +/- 0.1% (mean +/- standard error of the mean) and 3.9% +/- 0.1%. On each test day, the subject performed a symptom-limited exercise test on a treadmill, was exposed for approximately one hour to air or to one of two levels of carbon monoxide in air, and then performed a second exercise test. Time to the onset of ischemic ST-segment changes and time to the onset of angina were determined for each exercise test. The percent difference for these endpoints on the pre- and postexposure exercise tests was determined, and then the results on the 2%-COHb-target day and the results on the 4%-COHb-target day were compared to those on the control day. Data from the 63 subjects who completed the three test visits and met all protocol criteria were analyzed. There were 5.1% (p = 0.01) and 12.1% (p less than or equal to 0.0001) (trimmed mean) decreases in the time to development of ischemic ST-segment changes after the 2%- and 4%-COHb-target exposures, respectively, compared to the control day.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Isolation and sequencing of a cDNA coding for the human DF3 breast carcinoma-associated antigen.

The murine monoclonal antibody (mAb) DF3 reacts with a high molecular weight glycoprotein detectable in human breast carcinomas. DF3 antigen expression correlates with human breast tumor differentiation, and the detection of a cross-reactive species in human milk has suggested that this antigen might be useful as a marker of differentiated mammary epithelium. To further characterize DF3 antigen expression, we have isolated a cDNA clone from a lambda gt11 library by screening with mAb DF3. The results demonstrate that this 309-base-pair cDNA, designated pDF9.3, codes for the DF3 epitope. Southern blot analyses of EcoRI-digested DNAs from six human tumor cell lines with 32P-labeled pDF9.3 have revealed a restriction fragment length polymorphism. Variations in size of the alleles detected by pDF9.3 were also identified in Pst I, but not in HindIII, DNA digests. Furthermore, hybridization of 32P-labeled pDF9.3 with total cellular RNA from each of these cell lines demonstrated either one or two transcripts that varied from 4.1 to 7.1 kilobases in size. The presence of differently sized transcripts detected by pDF9.3 was also found to correspond with the polymorphic expression of DF3 glycoproteins. Nucleotide sequence analysis of pDF9.3 has revealed a highly conserved (G + C)-rich 60-base-pair tandem repeat. These findings suggest that the variation in size of alleles coding for the polymorphic DF3 glycoprotein may represent different numbers of repeats.

Antibodies, Monoclonal↗

Exercise and psychologic well-being in the community.

In a representative sample of 401 adults in Illinois in 1984, the authors found that increased participation in exercise, sports, and physical activities is associated with improved psychologic well-being. Part of this association is through improved subjective physical health. The authors controlled for potentially confounding factors, including sociodemographic characteristics, instrumentalism, and overweight. They concluded that exercise is associated with decreased symptoms of depression (feelings that life is not worthwhile, low spirits, etc.), anxiety (restlessness, tension, etc.), and malaise (rundown feeling, trouble sleeping, etc.) in the general population, most of which is not severely depressed, and in which many persons are engaged in moderate, nonaerobic exercise.

Adolescent↗

Chronic eosinophilic pneumonia (Carrington's) with increased serum IgE levels. A distinct subset?

We report our second case of chronic eosinophilic pneumonia (CEP) (Carrington's pneumonia) with elevated serum IgE values and present a review of the literature on this subject. Our present patient, a 55-year-old woman, had classic symptoms of dry cough, weight loss, malaise, dyspnea, night sweats, and fevers. Significant peripheral blood eosinophilia and a right upper lobe infiltrate were present. Glucocorticoid therapy caused prompt resolution of symptoms, as well as disappearance of blood eosinophilia, elevated serum IgE levels, and pulmonary shadowing. The diagnosis of CEP should not be neglected in the classification of the eosinophilic pneumonias with increased serum IgE levels. The increased serum IgE levels, when present in CEP, seem nonspecific and thus may not be useful as a diagnostic adjunct. However, measurement of IgE may be helpful in CEP, as it has been in allergic bronchopulmonary aspergillosis, to guide the dosage and duration of corticosteroid therapy.

Female↗

Elevated pulmonary artery systolic storage volume associated with redistribution of pulmonary perfusion.

The possibility that an increased pulmonary arterial systolic storage volume (PASSV) correlates with a significant redistribution of pulmonary perfusion was examined in 30 surgical patients. Right ventricular stroke work index (RVSWI) was used as an index of distribution of pulmonary perfusion. The systolic storage volume was calculated from the pulmonary arterial compliance and mean pulmonary arterial distending pressure. Pulmonary arteriolar pressures were computed by Fourier analysis. Pulmonary arterial compliance was derived from the pulmonary arterial time constant and pulmonary arterial resistance. There was a linear relationship between PASSV and RVSWI (r = .81, p less than .001). Also, a direct correlation was found between RVSWI and pulmonary arterial time constant (r = .45, p less than .01). When the patients were divided into three groups according to the severity of pre-existing disease, linear relationships between PASSV and RVSWI were present in all groups, and the slopes were not different among the three groups. The patients were also divided into two groups based on a storage volume fraction of stroke volume index, to evaluate the effect of other hemodynamic data on the PASSV. Comparison of the two groups revealed that pulmonary arterial pressure and pulmonary arterial compliance were significantly higher in the group with a high storage volume fraction (p = .05 and p = .01, respectively). RVSWI and time constant were also significantly different between the groups (p less than .01 and p less than .01, respectively). We conclude that the pressure work generated by the right ventricle improved the distribution of pulmonary perfusion by increasing PASSV.

Capillary Permeability↗

Chondrosarcoma developing in synovial chondromatosis. A case report.

Synovial chondromatosis is a rare condition in which osteocartilaginous nodules are formed by synovial metaplasia and become intra-articular loose bodies. It is usually monarticular, most commonly affecting the knee and is regarded as invariably benign. There are reports of malignant change, but only the two case studies of Mullins, Berard and Eisenberg (1965) and of Dunn et al. (1974) fully document the development of chondrosarcoma in this condition. We report a patient with a long history of histologically proven synovial chondromatosis in whom the condition became clinically aggressive and underwent malignant transformation to chondrosarcoma.

Adult↗

Comparison of two effervescent agents for double-contrast upper gastrointestinal tract radiography.

We prospectively evaluated the efficacy in 100 patients of two effervescent contrast agents commonly used in routine double-contrast upper gastrointestinal (GI) tract examinations: Baros and E-Z-Gas II granules. The study was double blinded. Two radiologists, who were not aware of which effervescent agent was being used, objectively evaluated the radiographic studies. Patient ease in swallowing and acceptance of the effervescent granules was 94% for Baros and 68% for E-Z-Gas II granules. The objective evaluation of the radiographs showed adequate gastric distension (Baros, 94%; E-Z-Gas II, 90%) and adequate to excellent mucosal coating for both agents (Baros, 92%, E-Z-Gas II, 94%). Areae gastricae were better seen with Baros (64% vs. 30%), and air bubbles were less of a problem with Baros. We conclude that Baros effervescent granules have certain distinct advantages over E-Z-Gas II granules regarding patient tolerance and acceptance, better visualization of the areae gastricae, and less degradation of the quality of the radiographs by air bubbles. The differences in mucosal coatings for the two agents was insignificant.

Adult↗

Differential reactivity of a novel monoclonal antibody (DF3) with human malignant versus benign breast tumors.

We have defined a human breast tumor associated antigen using a murine monoclonal antibody (MAb DF3) prepared against a membrane-enriched fraction of a human breast carcinoma. This antigen has a MW of 290 kD and is detectable on the cell surface of human breast carcinoma cells using a live cell radioimmunoassay and fluorescence flow cytometry. More important, immunoperoxidase staining with MAb DF3 clearly distinguishes malignant and benign breast lesions. A cytoplasmic staining pattern has been observed with 40 of 51 (78%) breast carcinomas, but only one of 13 fibroadenoma or fibrocystic disease specimens. In contrast, reactivity of benign breast lesions with MAb DF3 primarily occurs along apical borders on ductules. These results demonstrate that the DF3 antigen is present on apical borders of more differentiated secretory mammary epithelial cells and in the cytosol of less differentiated cells.

Adenofibroma↗

Constant ventricular drainage: pitfalls and variables. Technical note.

After observing the erratic performance of a commercially available ventricular drainage system, we examined the hydrostatic pressure exerted by the system as a function of the volume of fluid within the drainage bag (at a constant height). Initially, 3 to 4 cm more than the expected 27 cm of height was required to achieve a drainage pressure of 20 mm Hg. As the volume of fluid increased, there was an initial precipitous fall from the 20 mm Hg preset pressure to 14 to 16 mm Hg; this pressure differential increased as the volume of drained fluid increased. Removal of air from the drainage bag resulted in an additional decrement in the observed hydrostatic pressure. These decrements in pressure were not apparent with another commercially available bag used commonly for ventricular drainage. We therefore recommend that, if ventricular drainage is to be accomplished against a constant hydrostatic pressure head, the system should be configured so that the actual hydrostatic pressure against which drainage occurs can be measured quickly and easily. The system should be checked at frequent intervals as the ventricular drainage bag fills. We note additional pitfalls in use of constant ventricular drainage and suggest solutions.

Cerebral Ventricles↗

Latency of the acoustic reflex in eighth-nerve tumor.

We evaluated acoustic reflex morphologic features in four subjects with confirmed, unilateral acoustic neuroma. All four subjects showed marked reduction in absolute reflex amplitude and alteration in the reflex amplitude-intensity function in the ear with the eighth-nerve disorder. The early, fast-rising component of the normal reflex was also typically absent in the ears with tumor. Interaural latency comparisons were made in three ways. At equal reflex sensation levels and equal reflex sound pressure levels, latency ws substantially delayed in the ear with the eighth-nerve disorder. At equivalent reflex amplitudes, however, latency was equivalent in normal ears and ears with eighth-nerve disorder. Results suggest that delayed onset of the acoustic reflex in subjects with eighth-nerve disorder may reflect amplitude and wave-form morphologic effects rather than a latency prolongation per se.

Adult↗

Concerning the thermal stability of E. coli 23S ribosomal RNA.

Total RNA prepared from E. coli by several extraction procedures behaves as a mixture of covalently continuous heat stable 23S, 16S and 4-5S components. 16S rRNA remains heat stable after isolation from such preparations, whereas isolated 23S rRNA is heat labile but becomes heat stable after EDTA treatment. This and other evidence leads to the conclusion that heat lability of purified 23S rRNA is due, not to nuclease contamination of the type observed in earlier studies of the stability of this RNA, but to polyvalent cation catalyzed temperature-dependent scission of phosphodiester bonds. Heat stability of 23S rRNA in total RNA is due to the presence in these preparations of a contaminant which appears to act as a chelator of polyvalent cations. This material is similar or identical to the pyrogenic E. coli lipopolysaccharide described by Westphal and coll.

Edetic Acid↗