Search PubMed⌕ Search

Biomedical subjects

E Russell

Publications and source records attributed to E Russell.

At least 19 recordsLinked to original sources
PubMed1992

Effects of a normal, human-concentration, phytoestrogen diet on rat uterine growth.

The estrogenic action of the prototype natural phytoestrogen coumestrol was examined in rats in in vitro and in vivo tests. To establish the binding specificity of coumestrol and its relation to biological activities, saturation analyses and uterine weight assays were performed. These assays indicated that coumestrol competitively inhibited binding to the estrogen receptor and induced increases in uterine weight in keeping with its estrogen receptor affinity constant. Most importantly, coumestrol was uterotrophic when incorporated in a semipurified diet at natural dietary concentrations. Significant increases occurred in both uterine wet weight and dry weight, indicating that coumestrol produces true uterine growth. Effects appeared to be cumulative, raising questions of time-related interactions with other estrogen-sensitive mechanisms and clearance of isoflavonoids. Coumestrol induced uterine growth over a 90-hour period at dietary concentrations of 0.01 to 0.1%. Lower doses not active over this period were active when provided over a longer period of time: a 0.005% concentration was not active over a 90-hour period, but was active when provided over a 180-hour period. Coumestrol-induced uterine growth was accompanied by the induction of cytosolic progestin receptors and increases in nuclear estrogen binding. Scatchard analyses verified that these changes were due to changes in receptor number. These studies show that the naturally occurring phytoestrogens have dramatic estrogenic effects at natural dietary levels. These actions may be expressed via traditional receptor-mediated actions and therefore may have the same implications for development, health, and disease as do the steroidal estrogens produced by the body. Because rats have no sex hormone-binding globulin, further studies must be conducted in humans. However, these findings suggest that the natural dietary phytoestrogen coumestrol is a potent estrogen that must be considered in calculating the total estrogenic load to which humans are exposed during normal life.

Animals↗
PubMed1992

The efficacy of image-guided stereotactic brain biopsy in neurologically symptomatic acquired immunodeficiency syndrome patients.

A prospective series of 50 neurologically symptomatic human immunodeficiency infected patients with intracranial lesions who underwent image-guided stereotactic brain biopsy is presented. Patients were diagnosed with primary central nervous system lymphoma (14 patients), progressive multifocal leukoencephalopathy (14 patients), toxoplasmosis (13 patients), human immunodeficiency virus encephalitis (3 patients), infarction (2 patients), and 1 patient each with metastatic adenocarcinoma, metastatic melanoma, cryptococcoma, and atypical mycobacterial infection. Two of the patients with toxoplasmosis had a second intracranial abnormality. Two biopsies resulted in either descriptive diagnosis only or were nondiagnostic; the definitive diagnostic efficacy of image-guided stereotactic biopsy was thus 96%. No deaths were incurred as a result of biopsy. Four intraoperative or postoperative hemorrhages occurred; in only 1 patient was there a residual neurological deficit related to the surgery. Image-guided stereotactic biopsy may thus be considered both safe and effective in this patient population.

Acquired Immunodeficiency Syndrome↗
PubMed1992

High frequency of somatically acquired p53 mutations in small-cell lung cancer cell lines and tumors.

We analysed the p53 open reading frame (ORF) in 16 small-cell lung cancer (SCLC) cell lines by direct sequencing of cDNA/PCR products and in 20 SCLC tumors by chemical cleavage and single-strand conformation polymorphism analyses of genomic DNA/PCR products. Abnormalities of p53 were found in 16/16 cell lines (100%) and in 16/20 tumors (80%). In the SCLC cell lines, mutations (59% missense, 18% nonsense and 23% splicing) changing the coding sequence were dispersed between amino acids 68 and 342. In the tumor samples, while the mutations occurred predominantly in exons 5-8, other mutations were located outside these regions. G to T transversions were common, occurring in 32% of the cases. We found no p53 mutations in the corresponding normal tissue from 19 patients whose tumors had p53 lesions, indicating that the mutations were all somatically acquired. In analysing the clinical data of the patients we found no correlation between tumor response to therapy or survival and the location or type of mutations. We conclude from these data that: (1) p53 mutations are found in SCLC with high frequency; (2) p53 mutations in a significant fraction of cases generate cDNAs with nonsense or splicing mutations; and (3) to date, these mutations have all been somatically acquired events.

Base Sequence↗
PubMed1992

Coronal computerized tomography and cerebrospinal fluid rhinorrhea.

Accurate diagnosis of cerebrospinal fluid rhinorrhea (CSFR) is a challenge for physicians caring for patients with traumatic brain injury. Failure to recognize this condition may result in significant medical complications and prolong hospitalization. Two male patients who developed CSFR within 2 months of severe head injury are described. A clear nasal discharge was noted on examination approximately 30 and 35 days after head injury in both patients and a CSF fistula was suspected. High-resolution computerized tomography (CT) with coronal sections confirmed the diagnosis. Both patients underwent neurosurgical intervention to repair the fistulous tracts without recurrence. Sequelae of CSFR in one case included meningitis and pneumocephalus. Literature review shows water-soluble contrast CT cisternography (CTC) to be the gold standard for the diagnosis of CSFR. However, other diagnostic studies may include immunoelectrophoresis of rhinorrhea, use of isotope tracers, plain x-rays, tomography, and noncontrast high-resolution CT. More invasive studies like CTC are often recommended in the diagnosis of this condition, but are more costly, painful, and carry a small risk of infection. Our two case reports emphasize that high-resolution CT may be performed as a primary noninvasive diagnostic procedure before more invasive studies, and the results obtained may be sufficient for therapeutic planning.

Adult↗
PubMed1991

myc family DNA amplification in 107 tumors and tumor cell lines from patients with small cell lung cancer treated with different combination chemotherapy regimens.

We studied 107 specimens (38 tumors and 69 tumor cell lines) from 90 patients with small cell lung cancer to determine the characteristics and clinical situations of patients from whom tumor cell lines could be established and the myc family DNA copy number. The proportion of extensive stage small cell lung cancer patients from whom a tumor cell line could be established prior to the initiation of therapy increased during the 10 years of the study (P less than 0.001). Amplification of one of the myc family genes occurred in 3 of 40 (8%) of the untreated patient specimens compared to 19 of 67 (28%) of the treated patient specimens (P = 0.01). The myc family DNA amplification occurred in 17 of 54 (31%) of the specimens from patients treated with cyclophosphamide-based combinations and 2 of 13 (15%) of the specimens from patients treated with etoposide/cisplatin (P = 0.25). Both tumors and tumor cell lines were obtained from 17 patients with small cell lung cancer and the myc family DNA copy number was similar in 16 of the 17 patients. We conclude that: (a) myc family DNA amplification occurs more commonly in specimens from treated than untreated patients (b) there are no prominent differences in the frequency of amplification following treatment with different chemotherapy regimens; and (c) myc family DNA amplification is similar in tumors and tumor cell lines from the same patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Percutaneous drainage and serial magnetic resonance imaging in the diagnosis of symptomatic posttraumatic syringomyelia: case report and review of the literature.

A patient with high cervical tetraplegia with new-onset headaches and posttraumatic syringomyelia is presented. Percutaneous drainage of the syrinx resulted in a resolution of the headaches and collapse of the syrinx on follow-up magnetic resonance imaging (MRI). The return of the symptoms correlated with the re-expansion of the syrinx on MRI. The patient underwent syringopleural shunting with persistent resolution of the symptoms and collapse of the syrinx on MRI. The value of percutaneous drainage and serial MRI to determine the clinical significance of posttraumatic syringomyelia is discussed.

Adult↗
PubMed1991

Ruptured petrous carotid aneurysm presenting with otorrhagia and epistaxis.

Aneurysm formation and rupture within the petrous internal carotid artery (ICA) is an extremely rare occurrence with approximately 10 such cases in the literature. Etiologies of petrous ICA aneurysms include atherosclerosis, closed head trauma, iatrogenic injury during mastoid surgery, chronic middle ear infections, and congenital causes. Therapeutic options include carotid artery ligation, aneurysm resection with or without reconstruction, and radiographically controlled vessel occlusion. The case of a patient who presented with otorrhagia, epistaxis, and transient focal neurologic signs due to a ruptured petrous ICA aneurysm is presented. The incidence, etiology, and anatomy of these aneurysms is reviewed, and the various tests for determining adequacy of collateral cerebral blood flow are described. Factors that affect the selection of surgical versus radiologic control of these lesions are also discussed.

Adult↗
PubMed1991

MRI-guided stereotaxic brain biopsy in neurologically symptomatic AIDS patients.

Two patients with AIDS-related neurologic dysfunction were evaluated with both computed tomographic (CT) brain scans and magnetic resonance imaging (MRI). CT scans were essentially normal in both patients while MRI revealed focal lesions amenable to brain biopsy. Using newly developed instrumentation, MRI-guided stereotaxic brain biopsy was performed without complication. The benefits and impact of this new technology for the care of neurologically symptomatic AIDS patients is discussed.

AIDS Dementia Complex↗
PubMed1990

Left hepatic duct anatomy: implications.

A review of the findings of a 10-year experience with biliary interventional procedures in 838 patients led to consideration of the anatomy of the left hepatic duct. To better illustrate the findings, 15 normal human livers obtained at autopsy were fixed and dissected. Fifty-five percent of the patients had a single left hepatic duct that was formed by the intrahepatic union of ducts draining segments II and III (segmental nomenclature follows Couinaud) lateral to the falciform ligament. Central to this ligament, the left duct became extrahepatic and was joined by ducts from segments I and IV. The real and theoretical implications of the unpredictable variability of biliary anatomy, the frequency of right lateral duct drainage into the left hepatic duct, and the extrahepatic contiguous relationship between the left hepatic duct and the left portal vein are discussed.

Bile Ducts, Intrahepatic↗
PubMed1990

Computed tomography: how accurate a predictor for cochlear implantation?

Cochlear implantation is an accepted medical treatment for profound bilateral postlinguistically acquired hearing loss. Because cochlear implants are still in the process of development, a detailed evaluation of the results of implantation is essential. However, the capability of predetermining the auditory benefit of a cochlear implant is limited and depends upon a number of factors. This report focuses upon the ability of computed tomography (CT) to predict surgical success and audiological results of multichannel cochlear implantation. It also addresses how the disease state might affect the functional benefit of the implant. After undergoing routine clinical and audiological evaluations, 28 cochlear implant candidates underwent CT scans in order to evaluate cochlear patency prior to surgery. Subsequently, 24 patients were implanted with either a single-or 22-channel device. Surgical findings were noted and postoperative audiological assessments of sound detection and speech discrimination were made. The CT risk factors that diminish the likelihood of a successful cochlear implant result are discussed based upon a retrospective comparison of preoperative CT results, surgical findings, and postsurgical audiological evaluations of the 14 patients who received a 22-channel implant. Analysis of the predictive capability of CT will allow clinicians to use that procedure more effectively in the presurgical assessment of cochlear implant candidates.

Adult↗
PubMed1990

General practitioner referral rates to district psychiatry and psychology services.

The number of referrals made to a district psychiatry service by each of the local general practitioners over a five year period was counted and a large variation in general practitioner referral rate was found. Ten referral letters from each of the general practitioners were independently assessed for the amount of detail included and a mean score for each general practitioner obtained. A significant negative correlation was found between referral rate and amount of detail in referral letters, that is low referrers wrote very detailed letters. The procedure was repeated over an 18 month period including referrals to the district psychology service. Referral rate to the psychologists was positively correlated with detailed referral letters, that is those who referred many patients to the psychologists wrote detailed letters. This study has indicated a wide variation in the use of the psychiatry and psychology services by general practitioners which cannot be explained solely on the basis of a general referral tendency. It is likely that constructive liaison between psychiatrists and general practitioners, especially those who refer a large number of patients, could enhance the care of patients with psychiatric disorder in general practice.

Clinical Competence↗
PubMed1990

Dissemination of research findings: who wants what?

There is growing concern to ensure that the results of health services research reach, and are understood by, those who plan and provide health services. Because of the complexity and variability of services, it is often difficult to translate findings from one setting to another. This paper discusses an attempt to disseminate the findings of one study, Patterns and Pathways of Care of Old People, by visiting local health services on request. The main conclusion is that, for a qualitative study such as this, considerable effort is needed to predetermine which relevant research aspects and local people to bring together to make the exercise useful to either party. If dissemination of National Health Service (NHS) funded research is to be promoted, a central issue to be addressed is who is responsible for initiating and funding this stage. The paper raises a number of options.

Aged↗
PubMed1990

[Hepaticojejunostomy with a subcutaneous blind jejunum segment. An alternative in the treatment of stenosing bile duct diseases].

The choledochojejunostomy and hepaticojejunostomy with a blind subcutaneous segment of the jejunum offer a safe, simple and nearly linear access for repeated retrograde balloon dilatations of the biliary tract. 81 patients, both with malignant as well as benign stenoses of the biliary system have been treated with this method during the last 8 years. Operative technique and preliminary results of this new procedure, which we believe to be the method of choice in recurrent or multiple iatrogenic or posttraumatic biliary strictures, are presented in this paper.

Aged↗
PubMed1989

Retention of chromosome 3 in extrapulmonary small cell cancer shown by molecular and cytogenetic studies.

In small cell lung carcinoma, one of the short arms of chromosome 3 is typically lost. To investigate chromosome 3 in extrapulmonary small cell carcinoma, we used DNA probes that detect restriction-fragment-length polymorphisms at loci on 3p. These probes were used to study DNA extracted from tumors and normal tissues and/or tumor cell lines from five patients with extrapulmonary small cell cancer. Tumor DNA from four of the five patients with extrapulmonary small cell cancer retained heterozygosity at loci on 3p. Cytogenetic studies of the tumor cell lines established from these four patients showed retention of both short arms of chromosome 3. We conclude that the loss of genetic material from 3p observed in small cell lung cancer is not typical in extrapulmonary small cell cancer.

Adult↗
PubMed1979

Current trends on diagnostic work up of pulmonary thromboembolism.

This report describes a six month prospective double blind study of 30 consecutive patients who were evaluated at Jackson Memorial Medical Center for pulmonary emboli. In this series, 77 per cent of the patients with lung scans interpreted as high probability for pulmonary emboli had angiographic confirmation of emboli. In 90 per cent of the patients with lung scans interpreted as low probability for pulmonary emboli, angiography confirmed the absence of pulmonary emboli. Five patients had radionuclide scans that were interpreted as nondiagnostic. Although pulmonary arteriography remains the gold standard for the diagnosis of pulmonary emboli we feel it should not be used in the low probability category because of the accuracy of the ventilation perfusion scans. It should be used in the indeterminant group and in the high probability category when anticoagulation therapy is contraindicated; prior to embolectomy or Mobin-Uddin umbrella insertion.

Adolescent↗
PubMed1978

Portosystemic communications studied by transhepatic portography;.

The experience of collecting 120 transhepatic portograms, performed in patients with different degrees of portal hypertension, affords the opportunity for discussing the anatomical and hemodynamic features of portosystemic communications. Multiple pathways of decompression were found. The coronary-gastroesophageal collateral formed pathways in 108 cases, other major collaterals in 41, and minor collaterals in 2. This multiplicity of communications suggests that no one vessel is indispensable as a collateral pathway.

Collateral Circulation↗