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Biomedical subjects

J Currie

Publications and source records attributed to J Currie.

At least 91 records · Page 5Linked to original sources
PubMed1988

Intraperitoneal chromic phosphate therapy after second-look laparotomy for ovarian cancer.

Between 1973 and 1985, 118 patients in clinical remission after initial surgery and postoperative chemotherapy for epithelial ovarian carcinoma underwent second-look laparotomy at the University of North Carolina. No evidence of disease (NED) was found in 57 of these patients; 43 patients received 15 mCi of radioactive chromic phosphate (32P) suspension given intraperitoneally in the immediate postoperative period. In 29 other patients, only microscopic or minimal residual disease (nodules less than 2 cm in size) was found, seven received 32P alone, ten received 32P and further chemotherapy, and 12 received chemotherapy alone. The 4-year postsecond-look survival of the patients with NED at second-look was 89% for those receiving 32P and 67% for those who had not. The respective figures for patients with minimal residual disease at second-look are 59% versus 22%. Irrespective of treatment, a group at high risk for failure after negative second-look laparotomy has been identified; those with an initial International Federation of Gynecology and Obstetrics (FIGO) stage greater than I and histologic grade greater than 1. A comparison of our data with 18 previously published series, indicates that use of postsecond-look intraperitoneal 32P can improve the progression-free interval, and possibly overall survival, of patients with NED or minimal residual disease without adding significant complications.

Carcinoma↗
PubMed1988

Eye movement abnormalities as a predictor of the acquired immunodeficiency syndrome dementia complex.

Using infrared oculography, we recorded the eye movements in a group of patients with acquired immunodeficiency syndrome (AIDS), with or without the AIDS dementia complex (ADC). Our aim was to determine whether the severity of dementia could be correlated with abnormalities of eye movement and whether eye movement abnormalities could be detected prior to the onset of clinical dementia. Abnormalities of eye movement were present in seven of seven patients with mild, moderate, or severe ADC and in six of seven AIDS or asymptomatic human immunodeficiency virus-seropositive patients without clinical dementia, but at risk for ADC. The eye movement abnormalities detected included disturbances of both saccadic and smooth-pursuit function, and their severity correlated strongly with the severity of dementia. The abnormalities were qualitatively similar to those that occur in Alzheimer's disease but quantitatively less severe. Recording of eye movements may be a valuable, noninvasive technique for the early detection of neurologic dysfunction in asymptomatic patients who are seropositive for human immunodeficiency virus or in patients with AIDS, even prior to other clinical evidence of ADC. In particular, it may be of use in selecting high-risk patients requiring antiviral therapy and in monitoring the neurologic response to such treatment.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Massive ovarian cyst: a comprehensive surgical approach.

The massive ovarian cyst (greater than 25 pounds) presents a challenging opportunity for surgical intervention and potential cure of a debilitating problem. Although infrequently seen, such a patient requires awareness of the unique problems removal of these large masses may cause. Successful management requires a comprehensive approach before, during, and after the operative procedure. There are three keys to optimal management: 1) a multisystem, team approach, 2) intact cyst removal, and 3) a special incision and reconstructive technique.

Abdominal Muscles↗
PubMed1987

Primary radiation therapy for medically inoperable patients with endometrial carcinoma--stages I-II.

Surgery with or without adjuvant radiation is the established method of treating patients with Stage I and II adenocarcinoma of the endometrium. However, patients who are poor operative risks must be treated with radiation therapy only. We report on 73 such patients treated at the University of North Carolina between 1969 and 1980. All patients had an adenocarcinoma of the endometrium; 41 were FIGO Stage I, 32 Stage II. The minimum follow-up period was 4 years. Life table analysis shows a disease-free survival of 72% at 3 years and 57% at 5 years for Stage I patients. There was a strong correlation between histologic tumor grade and survival in these patients; the 5-year survival for grade 1 was 72%, for grade 2 59%, and for grade 3 31%. The difference between G1 and G3 is significant at the p = .045 level. Coexisting medical conditions were responsible for 12 deaths; almost as many as the 16 cancer-related deaths. Stage II patients have an actuarial disease-free survival of 36% at 3 years and 26% at 5 years, significantly worse than Stage I patients (p = .029 at 3 years). Failures were seen in 16/41 (39%) Stage I and 19/32 (59%) Stage II patients; 29/35 (83%) of these recurrences had component of local/pelvic failure and 15/35 (43%) of the recurrences were local/pelvic only. Specific suggestions on how to improve local therapy for these patients are presented.

Actuarial Analysis↗
PubMed1987

Continuous extradural analgesia in labour. Comparison between "on demand" and regular "top-up" injections.

In a prospective comparative study 240 patients received extradural bupivacaine, either by regular timed injections or "on demand", for pain relief during the first stage of labour. Three concentrations of bupivacaine were used (0.5%, 0.375% and 0.25%). Quality and continuity of analgesia, motor blockade, spread of sensory blockade, cardiovascular changes, fetal outcome and maternal sequelae were recorded. Overall, the analgesia provided by regular top-up injections was superior to the on demand technique, especially when 0.375% bupivacaine was used. This improved analgesia was achieved without causing an increased incidence of operative deliveries or deleterious sequelae, with respect to the mother or the neonate.

Adult↗
PubMed1987

Ophthalmic midline dysgenesis in Kallmann syndrome.

Partial coloboma, observed only with transillumination techniques, occur in 16% of male patients diagnosed with Kallmann syndrome. This sign represents an additional midline defect in this multisystem disorder noted for midline dysgenesis. Its high incidence may be helpful in the diagnosis of this disorder although it does not appear to be the harbinger of any other ocular abnormality.

Abnormalities, Multiple↗
PubMed1986

Wernicke's encephalopathy in a metropolitan hospital. A prospective study of incidence, characteristics and outcome.

Thirty-two cases of Wernicke's encephalopathy were admitted to hospital for treatment in a period of 33 months; this represented a relatively low incidence in total hospital admissions. Thiamin status was deficient, borderline and normal in 21 (66%), five (16%) and six (19%) patients, respectively, and responded immediately to treatment in those who had abnormal thiamin status. Ophthalmoplegia responded rapidly to treatment. Nystagmus, ataxia, disturbance of mental function and peripheral neuropathy responded incompletely to treatment in both the short-and the long-term. The overall setting for the development of Wernicke's encephalopathy appears to be chronic alcohol abuse, accompanied by cerebral "atrophy" and liver disease, but often without gross evidence of malnutrition.

Alcoholism↗
PubMed1985

Screening for cervical intraepithelial neoplasia in Dundee and Angus 1962-81 and its relation with invasive cervical cancer.

Cervical cytology screening started in Dundee and Angus in 1962 and apart from the five-year recall is largely opportunistic, the screening policy being in line with the recommendations of the Scottish Health Service Planning Council (1978) report. In the 1977-81 period the screening rate was 47% (maximum 70-80% in the 20-40 age-group). The incidence rate of cervical intraepithelial neoplasia 3 varied from 3.2/1000 in women under age 35 to 0.5/1000 in those over age 55. The average yearly incidence and death rates per 100 000 women over the age of 20 were calculated from gynaecological cancer registry records. In women between the ages of 35 and 54, there was a progressive reduction in incidence from 40.89 during the five-year period before screening to 17.11 between 1977-81, with deaths falling from 20.71 to 7.33. Incidence figures recorded by the East of Scotland Cancer Registration Office were practically identical with those of the gynaecological cancer registry, but the many inaccuracies in death certificate records led to an over-recording of deaths in women over 55 between 1972 and 1981.

Adolescent↗
PubMed1985

Branch retinal artery occlusion in the Churg-Strauss syndrome.

Amaurosis fugax followed by retinal infarction occurred as an early manifestation of exacerbation in a 46-year-old woman with allergic angiitis and granulomatosis (Churg-Strauss syndrome). There was evidence of widespread intraluminal branch retinal artery occlusions without accompanying retinal vasculitis. Low molecular weight dextran and heparin, in addition to systemic steroid therapy, appeared to be beneficial. A review of the ophthalmic manifestations of the Churg-Strauss syndrome and of other hypereosinophilic conditions suggests that thromboembolism resulting from a hypercoagulable state may be as important as vasculitis in causing visual symptoms. Specific therapy attempting to alter blood coagulation and rheology may have an important role in these conditions.

Biopsy↗
PubMed1984

Tonic pupil with giant cell arteritis.

A patient with giant cell arteritis and ischaemic optic neuropathy developed bilateral tonic pupils. This pupillary abnormality may result from ischaemia of the ciliary ganglia. Despite the propensity for patients with giant cell arteritis to develop vascular occlusions in the eye and orbit, tonic pupils have rarely been described, and several reasons for this are proposed. The arteries supplying the ciliary ganglia are frequently involved in giant cell arteritis, but their anastomotic pattern may confer protection from ischaemia. Tonic pupils may also be overlooked amidst the more dramatic manifestations of giant cell arteritis.

Adie Syndrome↗
PubMed1984

Multicenter clinical evaluation of ketoconazole in the treatment of cutaneous fungal infections.

An open, multicenter study was conducted to evaluate the efficacy and adverse effects of ketoconazole in patients with cutaneous fungal infections seen in typical dermatology practices. One hundred twelve American investigators entered 954 patients into this trial. Responses based on clinical and mycologic assessments were available on 672 patients. Mycologic evaluations were conducted using pre- and post-therapy wet mounts in potassium hydroxide. Eighty percent of these patients were mycologically clear and clinically rated as either excellent (cured) or marked improvement. Adverse effects were mild to moderate in severity and only rarely caused therapy to be interrupted. Gastrointestinal effects were the most frequently reported complaints.

Adolescent↗
PubMed1984

Cervical ripening and labor induction with intracervical triacetin base prostaglandin E2 gel: a placebo-controlled study.

A double-blind, randomized, placebo-controlled study was undertaken to evaluate the efficacy of a single-dose, shelf-stable preparation of prostaglandin E2 gel (PGE2) when used intracervically in patients with low Bishop scores. Two different preparations (0.5 and 0.25 mg) of PGE2 were used and a total of 45 patients were studied. Both preparations of PGE2 demonstrated a statistically significant increase in the spontaneous labor rate as compared with the placebo gel. Bishop scores were altered in all patients not proceeding to labor spontaneously, but the changes were most significant in the low- and high-dose groups. No significant deleterious affects were noted. The efficacy and safety of this new, sterile, and stable preparation makes it suitable for clinical use.

Apgar Score↗
PubMed1983

Chronic isolated abducens paresis from tumors at the base of the brain.

A chronic sixth-nerve paresis, even if isolated, may be neither benign nor idiopathic. We describe five patients with tumors in the basisphenoid region manifested clinically by isolated, unilateral abducens paresis for five to 20 years. There were three meningiomas (one confirmed by biopsy, two presumed), a neurilemmoma, and a chondrosarcoma. Isolated abducens paresis may persist for years in both children and adults with tumors or aneurysms. All patients with chronic sixth-nerve paresis should undergo vigorous neuroradiologic investigations to rule out a petrous apex-cavernous sinus mass lesion.

Abducens Nerve↗
PubMedDate not supplied

Cytoskeletal protein pathology and the formation of beta-amyloid fibers in Alzheimer's disease.

Discovery of the abnormally phosphorylated tau in paired helical filaments, its accumulation preceding the formation of the tangles and the in vitro microtubule assembly defect suggest that an abnormality in the protein phosphorylation/dephosphorylation system is involved in the pathogenesis of Alzheimer cytoskeletal pathology. The levels of mRNA for the beta-amyloid precursor protein (beta APP) in the brain suggest that only a small deficiency in the processing of the precursor would be sufficient to account for the accumulation of beta-amyloid in Alzheimer brain. Identification of reticuloendothelial system cells responsible for the production/processing of beta-amyloid will help to elucidate the pathogenesis of the brain amyloidosis. The disproportionate accumulation of paired helical filaments and amyloid within the same affected brain and from disease to disease raises the possibility of different etiologies for each of these lesions coexisting in Alzheimer's disease.

Alzheimer Disease↗