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Biomedical subjects

J Brody

Publications and source records attributed to J Brody.

At least 37 records · Page 2Linked to original sources

Risk factors for dementia associated with multiple cerebral infarcts. A case-control analysis in predominantly African-American hospital-based patients.

OBJECTIVE: To clarify risk factors for dementia associated with cerebral infarction. DESIGN: Case-control study. SETTING: The study was conducted in a hospital setting. PATIENTS: The subjects were consecutive patients with acute stroke with multiple cerebral infarctions who were admitted to the hospital between November 1, 1987, and December 1, 1990. They were predominantly elderly African Americans. Index cases met criteria of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, for multi-infarct dementia, whereas control subjects were patients with multiple infarcts who did not have dementia. There were 61 multi-infarct disease index cases and 86 controls without cognitive impairment. MAIN OUTCOME MEASURES: Demographic and cardiovascular disease risk factor variables. RESULTS: Index cases were older (mean [+/- SD] age, 75.5 +/- 9.7 vs 69.6 +/- 9.1 years), were less well educated (odds ratio, 4.37; confidence interval, 2.12 to 9.04), had lower annual incomes (odds ratio, 8.82; confidence interval, 2.38 to 32.70), more frequently had a family history of dementia (odds ratio, 3.61; confidence interval, 1.09 to 11.96) and laboratory evidence of proteinuria (odds ratio, 3.66; confidence interval, 1.54 to 8.71), had lower scores on neuropsychological tests, had more neurologic signs and symptoms, and were more functionally impaired in activities of daily living. Multiple logistic regression analysis showed that advanced age, lower educational attainment, history of myocardial infarction, and recent cigarette smoking were positively associated with case status and systolic blood pressure level was negatively associated with case status. CONCLUSIONS: Cardiovascular disease risk factors may be modifiable predictors of dementia associated with cerebral infarction. Additional well-designed epidemiologic studies are needed to clarify these associations.

Black or African American↗

Aggressive natural killer cell lymphoma/leukemia. A recently recognized clinicopathologic entity.

We report a comprehensive study of a case of aggressive natural killer cell lymphoma/leukemia, which is characterized by young male predominance, rapidly progressive clinical course, and presence of lymphadenopathy, hepatosplenomegaly, and bone marrow involvement. The leukemic phase is frequently preceded by pancytopenia. The diagnostic clues are the detection of cytoplasmic granules in tumor cells on Wright-Giemsa-stained tissue imprints or smears and a selective loss of T-cell antigens. Immunophenotyping is decisive in making the final diagnosis by showing positive natural killer cell markers (CD16, CD56, and/or CD57), CD2, CD11c, and Ia, but negative CD3, T-cell receptor heterodimers, terminal deoxynucleotidyl transferase, and B-cell markers. Genotyping always shows germline configuration in both immunoglobulin and T-cell receptor genes. The unique feature in this case is its presentation as a testicular lymphoma, which has not been previously reported. Polymerase chain reaction was performed in this case but failed to detect human T-cell leukemia virus type I/II provirus. It is important to recognize this new entity as it is a highly aggressive disease with a rapidly progressive clinical course and fails to respond to any chemotherapeutic regimen available.

Adult↗

Hodgkin's disease and non-Hodgkin's lymphoma in an HIV positive patient.

The occurrence of HIV associated non-Hodgkin's lymphoma (NHL) is a well recognized event. HIV associated Hodgkin's disease (HD) has also been observed. A unique patient with both entities is described. The patient was a 29 year old homosexual male who developed clinical IIA nodular sclerosis HD in 1985. He was HIV + with CD4/CD8 = 0.2 and his sister had HD 20 years earlier. He received MOPP and had a complete response. In October 1988 he developed weight loss with an abdominal mass and biopsy revealed diffuse small non-cleaved NHL, with bone marrow involvement. This was his first AIDS associated illness. Probes identified clonally rearranged DNA fragments in the J region of IgH chains and clonal rearrangements in the c-myc gene were also observed but EBV sequences could not be demonstrated. He was treated with m-BACOD but died in March 1989. His course was not complicated by opportunistic infection. Possible etiologies for the HD include his HIV status or shared sibling environment. The development of the NHL may have resulted from HIV infection and/or secondary to his treatment for HD. The relationship between the two lymphomas is uncertain and factors other than HIV exposure and its immune dysfunction may have been causal.

Adult↗

A case of acute megakaryocytic leukemia with hematogones.

A case of an infant male with Down's syndrome, pancytopenia, and a relative lymphocytosis is presented. A bone marrow aspirate and crushed marrow biopsy were evaluated by microscopy and flow cytometry. A population of immature lymphoid cells positive for CD10 (CALLA) and CD19 (Leu 12) was initially interpreted as suggestive of an acute lymphoblastic leukemia (ALL). However, a second bone marrow biopsy revealed morphologic features consistent with acute megakaryocytic leukemia (AMKL) with fibrosis. This diagnosis was supported by the flow cytometric study showing increased myeloid and megakaryocytic antigen-positive cells in the bone marrow and peripheral blood obtained after chemotherapy for ALL. This report presents evidence that the original lymphoid population represented hematogones, which were preferentially aspirated due to marrow fibrosis. There are no previous reports of hematogones identified at the presentation of an acute leukemia. It also emphasizes that the presence of hematogones with the resultant marker findings can be misleading. The diagnosis of ALL in pediatric patients should not be based solely on the presence of increased CD10-positive cells.

Biopsy↗

A study of lymphoma of large granular lymphocytes with modern modalities: report of two cases and review of the literature.

Two cases of lymphoma of large granular lymphocytes are reported. The first case expressed natural killer (NK) cell, some T-cell (CD 2, CD 5, CD 8), and HLA-DR antigens, but was negative for other T-cell (CD 3, CD 4, CD 7), T-cell receptor (TCR), B-cell, and myeloid antigens. Germline configuration was demonstrated for TCR, and immunoglobulin heavy and light chain genes. The second case expressed NK cell, some T-cell (CD 3, CD 7, CD 8), and TCR antigens, but was negative for other T-cell (CD 4, CD 5), B-cell, myeloid, and HLA-DR antigens. Rearrangement of TCR alpha and beta chains were detected. Thus, the findings of case 1 were consistent with true NK cell lineage and case 2 with NK-like T-cell lineage. Our report underscores the heterogeneity of this newly recognized lymphoma, which nevertheless carries a consistently poor prognosis and is probably more prevalent in the Asian population. This study also provides information concerning immunophenotypes of cellular infiltrates in internal organs and cytogenetic abnormalities in this lymphoma; neither has been reported frequently in the literature. The importance of detecting cytoplasmic granules in tissue imprints or electron micrographs for differentiating other T-cell lymphomas is emphasized, and the classification of large granular lymphoproliferative disorders is discussed.

Adolescent↗

Study of the major phenotype of large granular T-cell lymphoproliferative disorder.

Six cases of large granular T-cell lymphoproliferative disorder with a selected immunophenotype (CD3+, CD4-, CD8+, CD16+) were studied to characterize a homogeneous group of patients. It was found that most of these patients did not exhibit the clinical features frequently described in large granular T-cell lymphoproliferative disorder--recurrent infection, rheumatoid arthritis, and splenomegaly. The laboratory tests usually positive in large granular T-cell lymphoproliferative disorder, including rheumatoid factor and anti-nuclear antibodies, also were frequently negative. The pathognomonic features were found to be neutropenia and large granular lymphocytosis with positive killer cell markers. All six cases showed T-cell receptor gene rearrangement that indicated a monoclonal proliferation of lymphoid cells, which were natural killer-like T cells by immunophenotyping. B cells were essentially absent in all cases. It should be emphasized that bone marrow aspirates are as informative as peripheral blood samples for the diagnosis of large granular T-cell lymphoproliferative disorder; indeed, phenotypes of blood and marrow in one case were identical in terms of percentages of markers. In this selected group of patients, the clinical courses were indolent with uncomplicated outcomes. In three patients, chemotherapy did not induce an obvious clinical response, but all patients' conditions remained stable with only supportive care.

Adult↗

Effect of human recombinant mullerian inhibiting substance on isolated epithelial and mesenchymal cells during mullerian duct regression in the rat.

The effect of human recombinant Mullerian Inhibiting Substance (MIS) on the regression of the Mullerian duct (MD) of female rat fetuses was examined in vitro to determine whether MIS acts on MD epithelium and/or mesenchyme at the critical periods of sexual differentiation. Urogenital ridges (URs) of female rat fetuses at 14.5- to 18.5-days of gestation (plug day = 0) were cultured for 3 days with or without recombinant human MIS in CMRL 1066 medium with 10% female fetal calf serum. In URs from 14.5- and 15.5-day-old fetuses, the cranial portion of the MD regressed almost completely during the 3-day culture period in the presence of MIS, whereas the caudal half to third of the MD remained intact but tapered to a fine point cranially. MDs survived in URs from 16.5-day-old fetuses cultured in the presence of MIS except that the cranial portion of the MDs was deformed. MIS did not elicit regression of MDs in URs obtained from 17.5- and 18.5-day-old fetuses, but instead caused the MD epithelium to form bulges projecting into the mesenchyme. MD epithelium at 15.5-days of gestation was separated from the surrounding UR mesenchyme, and both components (MD epithelium and mesenchyme) were cultured separately for 3 days in the presence or absence of MIS. Both epithelial and mesenchymal cells survived in the presence or absence of MIS. MD epithelium formed typical epithelial colonies, whereas UR mesenchyme spread as fibroblastic cells. Analysis of labeling index after incorporation of [3H] thymidine demonstrated that MD epithelial DNA synthesis was not influenced by MIS. In contrast, mesenchymal labeling index was reduced significantly by MIS. This effect of MIS on UR mesenchyme in conjunction with earlier histological observations of mesenchymal condensation during MD regression and an absence of direct effects of MIS on the epithelium suggests that MIS elicits its effect on the MD epithelium via the surrounding mesenchyme.

Animals↗

Role of epithelial-mesenchymal interactions in the differentiation and spatial organization of visceral smooth muscle.

Uterine mesenchyme from newborn (0-day) rats was grown in association with epithelia from the adult cornea, urinary bladder, oesophagus, mammary gland, 1-day skin, and 1-day uterus. Following 1 month of growth, the differentiation of uterine mesenchyme into actin-positive smooth muscle cells was assessed immunocytochemically with antibodies to smooth muscle actin. Whereas grafts of uterine mesenchyme produced only small amounts of myometrium, all types of epithelia induced extensive myometrial differentiation in the uterine mesenchyme, which indicates that this effect is non-specific. The role of cell-cell interactions in the morphological patterning of smooth muscle layers was assessed by analysing tissue recombinants composed of adult prostatic epithelium (PRE) plus mesenchyme of the urogenital sinus (UGM), or seminal vesicle (SVM), or adult bladder epithelium (BLE) plus UGM or SVM. Prostatic ducts developed in all of these tissue recombinants (UGM + BLE, SVM + BLE, UGM + PRE and SVM + PRE). When UGM was used (UGM + PRE and UGM + BLE recombinants), actin-positive smooth muscle cells became organized into thin sheaths resembling the prostatic pattern. Conversely, when SVM was grown in association with PRE or BLE, the induced prostatic ducts were surrounded by thick layers of smooth muscle cells exhibiting the seminal vesicle pattern of organization. Smooth muscle cells were unorganized in grafts of SVM or UGM alone. These observations suggest that in male urogenital glands the mesenchyme dictates the spatial organization of the smooth muscle layers.(ABSTRACT TRUNCATED AT 250 WORDS)

Actins↗

Extramedullary blast crisis in chronic myelogenous leukemia. Demonstration of T-cell lineage and Philadelphia chromosome in a paraspinal tumor.

A case of chronic myelogenous leukemia (CML) with penetrance of the Ph1 molecular alteration into the T-cell lineage of a paraspinal tumor is reported. The T-cell nature of the paraspinal tumor was documented by immunochemical study and genotyping. The Philadelphia chromosome was also detected by genotyping in the same tumor cell population. To the authors' knowledge, this is the first case of extramedullary T-cell blast crisis in CML demonstrated in an extranodal tumor. The clinical significance of detecting extramedullary blast crisis, and the theories for the scarcity of T-cell transformation in CML are discussed.

Blast Crisis↗

Extranodal T-cell lymphoma mimicking malignant histiocytosis.

We report a case of extranodal T-cell lymphoma with fever, hepatosplenomegaly, pancytopenia, and diffuse sinusoidal infiltration of the spleen, liver, and bone marrow by the tumor cells, mimicking malignant histiocytosis. This is the second case of T-gamma (T-cell suppressor) lymphoma resembling the case reported by Kadin et al. [N Engl J Med 304:648, 1981]. The lack of lymph node involvement in this case supports the theory that this type of lymphoma arises in the spleen. This paper draws attention to the extranodal T-cell lymphoma groups that mimic malignant histiocytosis and the need of immunophenotyping for a correct diagnosis. The causes for the absence of T-cell receptor gene rearrangement in T-cell tumors are discussed.

Adult↗

Characterization of extended primary and secondary cultures of hamster tracheal epithelial cells.

Studies on the regulation of differentiation in airway epithelial cells have been hampered by the lack of cell culture systems that differentiate in vitro. One such system that does exhibit differentiation is hamster tracheal epithelial cells (HTE). A major problem with this system, however, is that at the time cells differentiate, they lyze the collagen gel upon which they grow, resulting in termination of the culture. Here we report that by growing the HTE cells at 32 degrees instead of 37 degrees C we can totally prevent lysis of the collagen gel. Cells grown at this lower temperature maintain their differentiated phenotype as evidenced by abundant mucus granules and the secretion of authentic mucus glycoproteins into the culture media. We have also developed a method for subculturing the primary cells which allows growth and differentiation in secondary culture. The HTE cells were capable of being passaged at least three times and did not become transformed as judged by their inability to grow in soft agar and to produce tumors in syngeneic animals. This improved HTE cell culture system will allow detailed studies on the mechanisms which regulate growth, differentiation, and mucus secretion in surface airway epithelial cells.

Animals↗

Biological and social predictors of health in an aging cohort.

A cohort of over 5000 men of Japanese ancestry, aged 46-69 and free of chronic disease at entry examination were studied for factors associated with remaining free of major chronic diseases during a 12 yr followup period. Over 1600 disease-free men were compared with 3400 individuals who developed coronary heart disease (CHD), stroke, cancer or a variety of other conditions. From more than 30 variables examined in multivariate analyses, blood pressure, obesity, cigarette smoking, alcohol consumption, serum glucose, uric acid and triglyceride, were inversely associated with staying healthy while forced vital capacity and years spent in Japan were directly associated with health. Of these nine variables, blood pressure was the strongest discriminator between healthy status and all categories of disease, while cigarette smoking and alcohol consumption were the next most important factors. This study suggests that the use of individuals who remain free of disease as a "standard" for health can facilitate the evaluation of risk factors for both total illness and a broad range of specific chronic diseases in a single population.

Aged↗

Pneumoconiosis associated with exposure to glass and abrasive particles.

A patient with a history of decorating glass fixtures by means of abrasive etching presented with a disease characterized by diffuse infiltrates on chest roentgenogram and restriction and diffusion impairment on pulmonary function testing. Mineralogic analysis of biopsied pulmonary lesions showed particles consistent in composition to the glasses etched and abrasives used. The former particles were noncrystalline. Silicate mineral phases were identified as well, these displaying crystalline properties. Previous studies of workers exposed to abrasives, ie, silicon carbide and emery (as a form of corundum) suggest slight pneumoconiotic risk exists; this is also the case for workers exposed to forms of industrially made glass. The question is raised as to whether there exists, in this present case, an etiological association between exposure to respirable glassy particles and the development of pulmonary scarring.

Aluminum↗