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E Montgomery

Publications and source records attributed to E Montgomery.

At least 37 records · Page 2Linked to original sources
PubMed2000

Fibromatoses of the extremities: clinicopathologic study of 36 cases.

BACKGROUND AND OBJECTIVES: Fibromatoses of the extremities are rare and often recalcitrant to treatment. We evaluated the clinical and pathologic features of a group of extremity fibromatoses treated by surgical excision with or without adjuvant therapy to determine if any clinical or pathologic parameters were predictive of clinical outcome. METHODS: Thirty-six extremity fibromatoses were evaluated. A number of clinical and histologic features were correlated with risk of local recurrence. RESULTS: The cohort included 19 females and 17 males with ages ranging from 11-72 years (mean: 35 years), with 12 tumors of the upper and 24 tumors of the lower extremity. Tumors ranged in size from 1.5-15.5 cm (mean: 7.5 cm).Histologically, 26 were infiltrative, 3 had pushing borders and 7 had both. Mitotic counts ranged from 0-5/50 high-power fields (mean: 0.74). Surgical margins were positive in 22 cases. Seventeen patients were treated with postoperative adjuvant therapy including radiation therapy and tamoxifen. Follow-up information was available in 34 cases (from 1-202 months; mean: 83 months). Nineteen patients (56%) had recurrences, including 11 with multiple recurrences (range to first recurrence: 5-61 months; mean 23 months). Seventy-one percent of patients with a positive surgical margin and clinical follow-up had a local recurrence, compared to 31%with a negative surgical margin (P < 0.05). None of the other clinical or histologic parameters correlated with the risk for local recurrence. CONCLUSIONS: Local control in fibromatoses of the extremities remains problematic. Aside from positive surgical margins, none of the other clinical or histologic parameters evaluated in this study were useful in predicting the risk of local recurrence.

Adolescent↗
PubMed2000

Myofibromas presenting in the oral cavity: a series of 9 cases.

OBJECTIVES: Solitary myofibromas are well described in the head and neck, but oral examples are less well known, and jaw lesions are rare. We studied the clinicopathologic features of a series of such lesions. DESIGN: Nine cases of oral myofibromas were retrieved from archives and studied. RESULTS: Two cases involved the mandible (intraosseous), 3 involved the gingiva, 2 involved the tongue, and 2, the hard palate. There were 4 men and 5 women, aged 9 months to 50 years (mean, 24 years; median, 27 years). Deep lesions showed typical histology, with paucicellular lobules and intervening hemangiopericytoma-like zones. In ulcerated submucosal lesions, these features blended superficially with cellular fascicles. The tumors expressed smooth muscle actin but lacked desmin and S100 protein. None of the tumors recurred or metastasized. CONCLUSION: Myofibromas appear in osseous, intramuscular, and submucosal aspects of the oral cavity. Ulceration imparts a fascicular appearance that makes superficial biopsy specimens difficult to interpret.

Actins↗
PubMed2000

Combinatorial chemoprevention of intestinal neoplasia.

A combination of two drugs afforded remarkable protection from intestinal neoplasia in APC(Min/+) mice, a murine model of human familial adenomatous polyposis (FAP). One of the drugs was sulindac, a prototypical non-steroidal anti-inflammatory drug with established chemopreventative activity. The second drug was EKI-569, a newly developed, irreversible inhibitor of the epidermal growth factor receptor kinase. Although 100% of the untreated APC(Min/+) mice developed approximately 20 polyps, nearly half the mice treated with these two agents developed no polyps at all. These results suggest a powerful strategy for the chemoprevention of human colonic neoplasia.

Adenomatous Polyposis Coli↗
PubMed2000

Criterion-validity-based assessment of four scale constructs.

BACKGROUND: The aim of this study was to discuss, in general, selected crucial aspects of the appropriate methodology for the development and validation of scales indicating health status, and to illustrate this empirically by within-material comparison of the accuracy of four different scale constructs based on identical raw data. METHODS: The empirical example was based on information from the parents of 99 refugee children, aged 3-15 years, from the Middle East, who participated in a structured interview on their children's mental health. Following this, they were exposed to a blinded semi-structured psychological interview. Four anxiety scales were constructed based on answers to 12 anxiety symptom questions in the structured interview: Scale 1, by cumulation of original item scores, each ranging from 0 to 3; Scale 2, by counting the number of symptoms being present; Scale 3, by counting the number of frequent or intense anxiety symptoms; Scale 4, by estimation of the multivariate probability of the child being anxious, as assessed by the psychological interview. The scales were compared for their accuracy in the identification of children assessed as anxious by psychological interview. RESULTS: The four scales correlated mutually, and each of them was significantly associated with anxiety, as assessed by psychological interview. The weighted scale, however, performed significantly better than the unweighted scales for sensitivity but not for specificity. In the present data set the overall amount of misclassification was, however, significantly less than in the unweighted scales. CONCLUSION: As expected from theory, the weighted scale was found to be superior to the unweighted scales, in identifying the anxious children of the empirical example. In the presence of a blinded criterion measurement, empirical regression-based weighting of scale items thus constitutes an accessible and valid alternative to traditional methods of health and social scaling.

Adolescent↗
PubMed2000

KAI1 protein is down-regulated during the progression of human breast cancer.

The KAI1 gene was identified as a metastasis suppressor gene for human prostate cancer. Recently, we showed that KAI1 mRNA levels were higher in an immortal, normal-like breast epithelial cell line and nonmetastatic breast cancer cell lines but lower substantially in highly metastatic breast cancer cell lines. In this study, we examined KAI1 protein expression in breast cancer cell lines by Western blot and immunohistochemical study. KAI1 protein levels paralleled KAI1 mRNA levels and were inversely correlated with the metastatic potential of breast cancer cells. Furthermore, we examined KAI1 protein expression immunohistochemically in specimens from 81 patients with breast cancer and then correlated the findings with the clinical and histopathological parameters of the patients. High levels of KAI1 protein expression were found in normal breast tissues and noninvasive breast cancer (ductal carcinoma in situ). In contrast, KAI1 expression was reduced in most of the infiltrating breast tumors. We found that, in general, more malignant tumors demonstrated significantly lower KAI1 expression (P = 0.004). Additionally, among 29 specimens demonstrating multiple stages of malignancy within a single specimen, 23 demonstrated significant differences in KAI1 expression between benign breast tissue, ductal carcinoma in situ, and invasive carcinoma. The higher the incidence for malignancy within a given specimen, the lower the KAI1 expression (P < 0.001). These data suggest that in advanced breast cancer, KAI1 expression is down-regulated. Therefore, KAI1 may be a potentially useful indicator of human breast cancer progression.

Antigens, CD↗
PubMed1999

Ribozyme-mediated down-regulation of ErbB-4 in estrogen receptor-positive breast cancer cells inhibits proliferation both in vitro and in vivo.

ErbB-4 is a recently discovered member of the class I receptor tyrosine kinase family (ErbB). Little is known about its expression and its importance in human malignancy. To delineate the biological function of ErbB-4 receptors in breast cancer, we used a hammerhead ribozyme strategy to achieve down-regulation of ErbB-4 receptors in various breast cancer cell lines. We observed that down-regulation of ErbB-4 in estrogen receptor-positive (ER+) human breast cancer cell lines (MCF-7 and T47D), which express relatively high levels of ErbB-4, significantly inhibited colony formation. No effects were observed in estrogen receptor-negative (ER-) MDA-MB-453 cells, which express low levels of endogenous ErbB4 and high levels of ErbB-2 and ErbB-3. This occurred despite the fact that fluorescence-activated cell sorter analysis of these latter cells revealed that the expression of the ErbB-4 receptor was completely abrogated by ribozyme treatment. Furthermore, down-regulation of ErbB-4 in T47D and MCF-7 cells significantly inhibited tumor formation in athymic nude mice (P < 0.03 and P < 0.001, respectively). In addition, NRG-stimulated phosphorylation of ErbB-4- and NRG-induced colony formation was significantly reduced in ribozyme-transfected T47D cells. These data provide the first evidence that elevation of ErbB-4 expression plays a role in the proliferation of some ER+ human breast cancer cell lines (T47D and MCF-7) that express high levels of ErbB-4. We have also investigated the expression of ErbB-4 in human primary breast carcinoma specimens, using immunohistochemical staining with an anti-ErbB-4 monoclonal antibody. ErbB-4 expression was found in 60% of the 50 primary breast tumors examined, and high intense immunoreactivity of ErbB-4 was detected in 18% of these primary breast tumors. ErbB-4 receptor expression appeared to correlate with ER+ primary breast tumors. A similar correlation was also observed in the human breast cancer cell lines. These results provide a better understanding of the biological significance of ErbB-4 receptor in breast cancer. Our data suggest that elevation of the ErbB-4 receptor plays a role in ER+ breast cancer cell proliferation. Moreover, ribozyme technology provides a useful tool to delineate the role of a particular gene product.

Animals↗
PubMed1999

Monitoring relapsing remitting MS patients.

The availability of safe and partially effective disease modifying therapies necessitates changes in how neurologists monitor patients with relapsing remitting multiple sclerosis (RRMS). Neurologists need to make the diagnosis of MS as soon as possible to be able to initiate therapy early in the course of disease. In deciding whom to treat, neurologists should consider information on disease activity and burden acquired from the neurologic history and examination and magnetic resonance imaging (MRI). Patients not on a disease modifying therapy should undergo yearly clinical assessments and periodic cerebral MRI to monitor for changes in disease activity. Patients on disease modifying therapy should undergo regular clinical assessments to monitor for side-effects and disease activity. Cerebral MRI scanning may also be useful in assessing patients on therapy, particularly when considering changes in therapy.

Brain↗
PubMed1999

Incidental liposarcomas identified during hernia repair operations.

BACKGROUND AND OBJECTIVES: Since the inguinal region communicates with the retroperitoneum, both retroperitoneal as well as de novo spermatic cord liposarcomas may be detected during hernia repair operations. We assessed the incidence of liposarcomas presenting at hernia repair in our hospital. METHODS: We performed a clerical review of pathology reports on adult tissue accessioned during hernia repair operations and reviewed operating room logs to obtain information concerning the total number of hernia repair operations (since some operations afford no accessioned tissue). RESULTS: Between 1992 and 1997, 1,736 adult hernia repair specimens were accessioned from approximately 2,000 operations. Among these, 22% had an associated cord lipoma; 2 cases were well-differentiated liposarcomas. These were from males aged 56 and 64 years in contrast to the mean age of 35 years for cord lipoma and measured 13 and 10 cm, whereas the mean size for cord lipomas was 5.5 cm. One of the liposarcomas had radiographic evidence of extension from a retroperitoneal lesion; the other appeared confined to the groin. On surgical exploration, the lesion was restricted to the spermatic cord region in both cases despite the suggestion of retroperitoneal extension/involvement in one. CONCLUSIONS: Incidental liposarcomas identified during hernia operations are rare (<0.1% at our institution) but their presence merits histologic evaluation of adipose tissue from these cases. However, if efforts to contain costs are implemented and histologic review of such tissue is deemed generally unrewarding, large (>10 cm) fatty masses from this area should still be sampled.

Adult↗
PubMed1999

Posteroventral medial pallidotomy in Parkinson's disease.

There has been a resurgence in the use of functional neurosurgery for Parkinson's disease. An important factor that has played a role in this development is the recent understanding of the functional anatomy of the basal ganglia including a knowledge of the changes in the activities of neurons in the internal segment of the globus pallidus (Gpi) and the subthalamic nucleus (STN) in Parkinson's disease as well as the knowledge of the presence of segregated functional loops within the basal ganglia which include a sensory-motor loop that involves the posteromedial globus pallidus rather than the anterior GPi where earlier pallidotomy lesions had been made. Laitinen reintroduced the modern posteroventral medial pallidotomy (PVMP) in 1992. Since then it has become clear that this treatment has major effects on levodopa-induced dyskinesias and, unlike Vim thalamotomy, improves bradykinesia and rigidity as well as tremor. In this report, we review a number of topics related to PVMP including the clinical results of pallidotomy available in the literature as well as an update of our own 2 year follow-up data, studies evaluating factors that might predict the subsequent response to pallidotomy, the neuropsychological effects of the procedure, results of imaging studies including the correlation of clinical effects with lesion location, the question of bilateral pallidotomy and pallidotomy combined with deep brain stimulation and finally whether PVMP is effective in other parkinsonian disorders.

Globus Pallidus↗
PubMed1999

Comparison of acetaminophen, ibuprofen, and nabumetone therapy in rats with pulpal pathosis.

The purpose of this study was to determine if daily treatment with acetaminophen, ibuprofen, or nabumetone would alter prostaglandin E2 (PGE2)/leukotriene B4 (LTB4) synthesis in exposed, infected dental pulp and periradicular tissue in rats. Dental pulp of the bilateral first and second mandibular molars were exposed for 15 or 24 days. Rats were divided into four groups. A daily pharmacological oral dose of one of the medications or the suspending solution alone was administered to the designated group. Eicosanoids were extracted from pulpal and periradicular tissues and assayed. PGE2 was significantly elevated in pulp-exposed, nontreated rats and was significantly reduced in the ibuprofen- and nabumetone-treated groups. LTB4 was significantly increased in all pulp-exposed groups at 15 days when compared with control nonexposed groups. Results showed that only ibuprofen reduced LTB4 in the exposed dental pulp at 24 days, although it did not do so at 15 days. Repetitive treatment with acetaminophen did not suppress PGE2/LTB4 in pulp-exposed molars.

Acetaminophen↗
PubMed1998

Refugee children from the Middle East.

OBJECTIVE: To map the frequency (prevalence) of torture victims among parents in asylum seeking Middle Eastern refugee families, to map the occurrence (prevalence) of experiences of war and other forms of organised violence among the children in these families, to map the occurrence (prevalence) of emotional symptoms and behavioural problems among the children, and to identify risk indicators and modifying factors for anxiety symptoms among the children. DESIGN: Interview with parents using a structured interview questionnaire developed for this study. Validated through a blinded semi-structured interview conducted with approximately 1/3 of the families. AUSPICES: The study has been carried out by the Rehabilitation and Research Centre for Torture Victims (RCT) in cooperation with the Danish Red Cross. MATERIAL: Structured interviews with parents regarding 311 children aged 3-15 from 149 families, all registered as asylum seekers from the Middle East between February 1, 1992 and April 30, 1993. The response was 90.4%. PRINCIPAL VARIABLES: Background (past-past)--social and demographic data; trauma complex (past)--war-related life circumstances (conditions) and experiences of war and other forms of organized violence such as loss, separation, direct exposure to violence and witnessing acts of violence (specific events and changes of life conditions); present life context (past-present)--family circumstances upon arrival in Denmark; effect (present)--the child's current psychological state. RESULTS: 28% of the parents (44% of the fathers and 13% of the mothers) had been tortured, to the effect that 51% of the children were part of a family including a survivor of torture. The most frequent specific types of violence-related events or circumstances were 'lived in a refugee camp outside the home country' (92%), 'lived under conditions of war' (89%) and 'been on the run with parents' (89%). Twenty percent of the children had lost one parent, and another 60% had been separated from one parent for more than a month. The highest prevalence of emotional symptoms were found within the anxiety dimension, as 67% of the children were assessed as being clinically anxious. The most important risk indicators for anxiety were 'lived in a refugee camp outside the home country', 'part of a torture surviving family', 'lack of opportunities for play with other children', 'beaten/kicked by an official', and 'loss of father'. Current parental behaviour was also an important risk indicator for anxiety, if the mother or father hit or punished the child more than was the case prior to arrival in Denmark. The most important anxiety-modifying factor was arrival in Denmark in the company of both parents. CONCLUSIONS: Asylum seeking refugee children from the Middle East have had many experiences of war and other forms of organised violence. The children frequently reacted with anxiety and with other symptoms of emotional instability. Prevalent anxiety symptoms correlated both with previous living conditions and present family situation. Living under prolonged conditions influenced by war and other forms of organised violence (prevalence) were found to a higher degree to be risk indicators for anxiety than were specific events or changes of life conditions (incidence).

Adolescent↗
PubMed1998

Pallidotomy and deep brain stimulation of the pallidum and subthalamic nucleus in advanced Parkinson's disease.

There has been a resurgence in the use of neurosurgical procedures for the treatment of Parkinson's disease (PD). Pallidotomy has become a widely performed procedure on the basis of reports which describe marked reduction of levodopa-induced dyskinesias and variable improvement in parkinsonism. Preliminary reports of the effects of globus pallidus internus (GPi) and subthalamic nucleus (STN) deep brain stimulation (DBS) have also been promising. At 6-month follow up, a cohort of our first 40 patients undergoing pallidotomy demonstrated the following mean improvements when examined after drug withdrawal (off) and under optimal medication (on): total motor off scores-31%; total off activities of daily living scores-30%; and total on dyskinesias-63% (contralateral and ipsilateral dyskinesias improved 82% and 50%, respectively). Although improvements in contralateral dyskinesias and total off parkinsonism were sustained at 2-year follow up (N = 11), benefit for ipsilateral dyskinesias was lost after 1-year follow up (N = 24). and postural stability and gait improvements lasted only 3-6 months. On-period, levodopa-resistant symptoms did not benefit from pallidotomy. Mean improvements in 8 patients undergoing GPi DBS (4 unilateral and 4 bilateral) at 3 months were as follows: total motor off scores-27%; total off activities of daily living scores-26%; and total on dyskinesias-60%. At most recent follow up, 6 patients with STN DBS (5 bilateral and 1 unilateral) showed the following mean improvements: total motor off scores-41%; total motor on scores-27%; total off activities of daily living scores-40%; and total on dyskinesias 41%. Pallidotomy reduces dyskinesias and off disability. GPi DBS may have effects similar to pallidotomy, but might be safer when bilateral procedures are required. Bilateral STN DBS may improve off parkinsonism more than other procedures and might also improve on-period motor function. A randomized trial will be required to determine which procedure is most effective for patients with different clinical features.

Adult↗
PubMed1997

Posteroventral medial pallidotomy in advanced Parkinson's disease.

BACKGROUND: Posteroventral medial pallidotomy sometimes produces striking improvement in patients with advanced Parkinson's disease, but the studies to date have involved small numbers of patients and short-term follow-up. METHODS: Forty patients with Parkinson's disease underwent serial, detailed assessments both after drug withdrawal ("off" period) and while taking their optimal medical regimens ("on" period). All patients were examined preoperatively and 39 were examined at six months; 27 of the patients were also examined at one year, and 11 at two years. RESULTS: The percent improvements at six months were as follows: off-period score for overall motor function, 28 percent (95 percent confidence interval, 19 to 38 percent), with most of the improvement in the contralateral limbs; off-period score for activities of daily living, 29 percent (95 percent confidence interval, 19 to 39 percent); on-period score for contralateral dyskinesias, 82 percent (95 percent confidence interval, 72 to 91 percent); and on-period score for ipsilateral dyskinesias, 44 percent (95 percent confidence interval, 29 to 59 percent). The improvements in dyskinesias and the total scores for off-period parkinsonism, contralateral bradykinesia, and rigidity were sustained in the 11 patients examined at two years. The improvement in ipsilateral dyskinesias was lost after one year, and the improvements in postural stability and gait lasted only three to six months. Approximately half the patients who had been dependent on assistance in activities of daily living in the off period before surgery became independent after surgery. The complications of surgery were generally well tolerated, and there were no significant changes in the use of medication. CONCLUSIONS: In late-stage Parkinson's disease, pallidotomy significantly reduces levodopa-induced dyskinesias and off-period disability. Much of the benefit is sustained at two years, although some improvements, such as those on the ipsilateral side and in axial symptoms, wane within the first year. The on-period symptoms that are resistant to dopaminergic therapy do not respond to pallidotomy.

Activities of Daily Living↗
PubMed1996

Iron deficiency anemia. When is parenteral therapy warranted?

Iron deficiency anemia is a common problem encountered in primary care practice. Once the diagnosis is confirmed and the possible causes are identified, replacement of iron stores is indicated. Most patients respond favorably to oral iron preparations. However, therapy with intravenous iron dextran (InFeD) may be warranted in some cases. Side effects, which are usually mild, occur in 25% of patients. Test doses of undiluted iron dextran occasionally elicit anaphylactic reactions. However, affected patients still may be successfully treated intravenously with the use of prophylactic antihistamines, corticosteroids, and histamine2 blockers. Treatment of iron deficiency anemia almost always brings symptomatic improvement.

Adult↗
PubMed1994

Assessing postnatal uterine involution: a review and a challenge.

OBJECTIVE: to examine the literature relating to the assessment of postnatal uterine involution. LITERATURE REVIEW: the following databases were searched--Cumulated Index to Nursing & Allied Health Literature (CINAHL), Medline, Excerpta Medica (Obstetrics & Gynaecology), MIDIRS. KEY CONCLUSIONS: no evidence was found that any form of anthropometric assessment of uterine involution in the early postnatal period has either preventative or predictive value. Research on this topic is long overdue.

Anthropometry↗
PubMed1994

Criterion-related validity of screening for exposure to torture.

Using an in-depth psychological assessment as reference, the aim of the study was to validate adult Middle Eastern refugees' own testimonies of their possible previous exposure to torture. The study group comprised 31 male and 43 female refugees, who accepted participation in a structured interview with closed questions and a following blinded in-depth psychological interview. According to the psychological interview, 30% (55% of males, 12% of females) had been exposed to torture. The sensitivity and the specificity of the structured interview in identifying previous torture was 82% and 92%, respectively, without significant differences concerning the refugee's gender. It is concluded that refugees' own testimonies of torture appear fairly valid. This enables anamnestic torture prevalence estimation in refugee groups, based on pre-structured interview techniques. Rehabilitation and Research Centre for Torture Victims (RCT), Copenhagen, and Department of Epidemiology and Social Medicine, Aarhus University.

Adolescent↗