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Biomedical subjects

J J Quinn

Publications and source records attributed to J J Quinn.

18 recordsLinked to original sources
PubMed1992

Capnocytophaga bacteremia in a patient with Hodgkin's disease following bone marrow transplantation: case report and review.

Capnocytophaga is a gram-negative, capnophilic, facultatively anaerobic bacillus that normally inhabits the oral cavity. We report the case of a patient who developed capnocytophaga bacteremia following autologous bone marrow transplantation for Hodgkin's disease, and we review other reported cases of capnocytophaga bacteremia in immunocompromised patients. In our case infection followed pretransplantation conditioning and was associated with severe oral mucositis and neutropenia. Antibiotic therapy resulted in clinical resolution of infection. Capnocytophaga bacteremia should be included in the differential diagnosis of febrile neutropenia in immunocompromised patients (e.g., those undergoing bone marrow transplantation) especially in the presence of mucositis and gingival bleeding.

Adult↗
PubMed1991

Effective treatment of unresectable or metastatic hepatoblastoma with cisplatin and continuous infusion doxorubicin chemotherapy: a report from the Childrens Cancer Study Group.

The Childrens Cancer Study Group (CCSG) undertook a study (CCG-823F) to test the feasibility of administering continuous infusion doxorubicin (CI DOX) and cisplatin (CDDP) in patients with unresectable or incompletely resected hepatoblastoma (HB) or hepatocellular carcinoma (HCC). Chemotherapy consisted of CI DOX 20 mg/m2/d for days 1 to 4 and CDDP 100 mg/m2 on day 1 followed by a 21-day rest period. Second-look surgery was performed after the administration of four chemotherapy courses. Forty-seven (47) assessable patients were entered on study, 33 with HB and 14 with HCC; of these, 34 (26 HB and eight HCC) completed the initial four courses of chemotherapy. Of the 26 HB patients, 25 were evaluated as responding to chemotherapy before the scheduled second-look procedure and were considered surgically resectable at that time. Surgery was performed on 22 patients; three patients refused the second-look surgery. Nine patients had no evidence of residual malignant disease, seven underwent surgical resection of remaining tumor, four were left with microscopic residual disease, one had a partial resection with gross tumor left behind, and one remained unresectable. Nine HCC patients completed four chemotherapy courses. Eight patients achieved a partial remission and second-look surgery was attempted on seven. Only two had all malignant disease removed at the second procedure. Data from 225 courses of chemotherapy were evaluated for toxicity. Neutropenia (absolute granulocyte count less than 500/mL) was observed in 68 courses, and five of these episodes were associated with sepsis. Severe mucositis was documented in 21 courses, and hypomagnesemia (magnesium less than 1.2 mg) was noted in 30 patients. Two patients developed decreased left ventricular shortening fraction, which resolved when chemotherapy was discontinued. In summary, CI DOX plus CDDP is a well-tolerated and effective regimen in inducing surgical resectability in HB patients who are unresectable at diagnosis and significantly improves survival for this group of patients to 66.6%.

Adolescent↗
PubMed1990

Septicemia in pediatric oncology patients: the significance of viridans streptococcal infections.

One hundred nine consecutive episodes of septicemia were retrospectively evaluated in 61 children with malignancy. In addition, the records of all pediatric oncology patients who received high-dose cytarabine (HDAC) chemotherapy were reviewed. Gram-positive organisms accounted for 82.6% of the septicemic episodes. In the total group, coagulase-negative staphylococci and viridans streptococci accounted for 35.8% and 28.4% of the episodes, respectively. In granulocytopenic patients, viridans streptococci were the most common pathogens (36.8%). In the subset of patients who received HDAC, 62.5% of the septicemic episodes were caused by viridans streptococci. Pulmonary complications developed in nine (29%) of the total cases of viridans streptococcal sepsis, whereas these complications occurred in only eight (10.3%) of the septic episodes caused by other organisms. In patients who had viridans septicemia, prior treatment with HDAC did not increase the incidence of pulmonary complications. In septic children with malignancy, our results demonstrate a high incidence of gram-positive organisms, including viridans streptococci, which were once regarded as culture contaminants.

Adolescent↗
PubMed1989

Schistosoma mansoni: the host immune response to egg antigens. I. Partial characterization of cellular and humoral responses to pI fractions of soluble egg antigens.

Soluble egg Ag (SEA) were separated according to charge by agarose-IEF (A-IEF) in order to partially characterize those antigenic determinants that may elicit the granulomatous response in schistosomiasis mansoni. Coomassie blue-stained A-IEF gels of SEA showed that this technique was able to resolve multiple isobands. A-IEF gels were sliced into 18 or 36 fractions from anode to cathode, and the SEA components from the isoelectric point (pI) fractions were eluted from gels in a manner that allowed for their direct utilization in both cellular and in humoral immunoassays. Only Ag in two distinct pI ranges consistently elicited lymphoproliferative responses, with the major stimulatory fractions being in the acid (3.5 to 5.0) range. Lymphocytes from mice infected for 10 wk had higher proliferative responses to both SEA and fractionated Ag in this acid pI range when compared to lymphocytes from mice infected for 25 wk; however, the latter had an enhanced response to Ag with a pI range of 6.2 to 6.4. In contrast to the cellular responses, the corresponding sera from these mice, or from schistosome-infected patients, recognized Ag in all pI fractions as determined by ELISA. However, although protective and nonprotective mAb (which recognize an egg Ag that cross-reacts with a 38-kDa schistosomular Ag) bound to most acidic fractions, only the nonprotective mAb (which also recognize determinants on keyhole limpet hemocyanin), bound, in addition, to fractions in the basic range. Finally, the m.w. of Ag in the various pI fractions were determined by SDS-PAGE analysis.

Animals↗
PubMed1989

Severe hyponatremia after repeated intravenous administration of desmopressin.

Desmopressin (DDAVP) has recently been found to improve hemostasis in patients with congenital or acquired disorders of coagulation and to reduce operative blood loss in patients with normal hemostasis undergoing certain surgical procedures. Despite its potent antidiuretic effect, severe hyponatremia after the intravenous administration of DDAVP is felt to be rare. We report four cases of severe hyponatremia with serious clinical sequelae occurring in patients with underlying coagulopathies who were treated prophylactically with DDAVP to improve hemostasis prior to surgical procedures. Each patient received multiple (3-22) doses of DDAVP and was given intravenous hydration with hypotonic solutions before developing clinical signs and laboratory evidence of hyponatremia. We believe that the risk of significant hyponatremia after treatment with intravenous DDAVP may be higher than is generally appreciated and that patients undergoing surgical procedures, who often receive multiple doses of DDAVP and intravenous hydration, are at particular risk for this complication. Hypotonic intravenous solutions should be avoided and serum sodium levels should be monitored frequently in those patients receiving multiple doses of DDAVP.

Adenoidectomy↗
PubMed1987

Evidence that a protective membrane epitope is involved in early but not late phase immunity in Schistosoma mansoni.

An anti-egg monoclonal antibody E.1, which is partially protective in passive transfer experiments, is shown in this study to recognize a membrane epitope on cercariae, schistosomula, and the ciliary plates of miracidia. E.1 did not bind to the surface membranes of lung or adult worms, or recognize secreted egg antigen in infected liver tissue. The E.1 epitope was present in the glycocalyx of cercariae, as well as on the syncytial membrane as determined by electron microscopy. Immunoprecipitation of iodinated surfaces of cercariae and schistosomula demonstrated E.1 binding to a high m.w. moiety in cercariae, which corresponds to the glycocalyx because it was not immunoprecipitated from schistosomula. In addition, a band at 38,000 daltons was immunoprecipitated from both cercariae and schistosomula. When compared with in vitro cultured parasites, schistosomula that were obtained from mice 1 to 24 hr after tail vein injection showed significant loss of E.1 binding. Consistent with the rapid loss of antigen in vivo, E.1 antibody was unable to passively transfer protection to naive mice when administered 5 days after cercarial challenge.

Animals↗
PubMed1985

Adriamycin and cisplatin for hepatoblastoma.

Four consecutive infants and children with hepatoblastomas were treated with a combination of Adriamycin (doxorubicin) and cisplatin. Three patients had unresectable tumors and in each there was a dramatic decrease in tumor size and serum alpha-fetoprotein (AFP) levels. The tumors of two of these patients, including one with pulmonary metastases which cleared, were rendered resectable. The third patient's tumor remained unresectable but his AFP level returned to normal following radiotherapy. All three patients are disease-free, and both without metastases are off therapy from 9 to 24 months. A fourth child received the combination as adjuvant therapy following resection of an embryonal hepatoblastoma and he remains disease-free 7 months after its discontinuation. Therapy was tolerable in all patients and its principal toxicities were myelosuppression and magnesium wasting. Adriamycin and cisplatin in combination were very effective in these patients and deserve further trials, especially in unresectable and metastatic hepatoblastomas.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Bone marrow transplantation in the management of childhood cancer.

Bone marrow transplantation has become a curative therapy for selected children with leukemia and offers promise as a treatment for certain childhood solid tumors. Complications such as graft-versus-host disease, interstitial pneumonia, and recurrent malignancy continue to affect many patients. As these are overcome, and as methods for T-cell depletion and marrow purging are developed that extend the scope of bone marrow transplantation, it will become an even more significant therapy for childhood malignancy.

Actuarial Analysis↗
PubMed1984

The effect of chemotherapy on hepatoblastoma.

A 15-month-old girl had a case of mixed hepatoblastoma. The unresectable tumor became surgically resectable after treatment with doxorubicin hydrochloride and cisplatin, which was also continued postoperatively. This regimen had a remarkable necrotizing effect on the fetal epithelial component of the hepatoblastoma. The patient's high alpha-fetoprotein level and extreme thrombocytosis, which resolved with treatment, were used as indicators of the disease's activity. An unaffected mesenchymal component and a few microscopic foci of undisturbed embryonal hepatoblastoma were found. The finding of a mature intestinal epithelial island in this case is unique.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Hatching, chemokinesis, and transformation of miracidia of Schistosoma mansoni.

Hatching, chemokinesis, and transformation of miracidia of Schistosoma mansoni were examined with a light microscope equipped with a video recording system. Saline, linearly and reversibly, inhibited miracidial hatching and swimming. Both hatching and swimming were inhibited at 4 C and 12 C and accelerated at 34 C relative to rates at 22 C. Hatching was an explosive event that began with ciliary beating when the egg was placed in artificial pond water (APW) and culminated in the parasite's escape from the shell in 100 to 300 msec. Broken egg shells had sharp, complementary edges. Neither miracidia nor eggs swelled prior to hatching. Accumulation of miracidia in a spot of snail conditioned water (SCW) occurred rapidly due to a 60-75% decrease in the exit rate from the spot, rather than by an increase in the entry rate. The turning rate in SCW increased tenfold and the time spent in the spot was 6 times that of controls. Eserine sulfate inhibited miracidial turning and accumulation in SCW. Parasites accumulated in a spot of serotonin by increasing their rate of turning. Miracidia transformed to sporocysts in either complex media containing serum, RPMI-1640, Hanks' salts or phosphate buffered saline, but not in amino acids or vitamins. Transformation was inhibited when miracidia were incubated with serotonin or when miracidia had not been exposed previously to APW.

Animals↗
PubMed1979

Childhood leukemia and lymphoma: correlation of clinical features with immunological and morphological studies.

Malignant cells from 49 children with lymphoid neoplasms other than Hodgkin disease were evaluated by surface marker and morphologic studies. We classified the patients into three groups: 36 patients (74%) with acute lymphocytic leukemia; 7 (14%) classified as convoluted lymphocytic lymphoma/leukemia; and 6 (12%) with small noncleaved follicular center cell lymphoma/leukemia. Diffuse marrow involvement was present at diagnosis in some patients in the latter two groups, but their clinical course was not characteristic of the patients with acute lymphocytic leukemia. Male predominance, poor prognosis, and high incidence of central nervous system disease characterized patients in the convoluted lymphocytic and follicular center cell lymphoma/leukemia groups. Clinical presentation in these two groups differed. Proliferations of convoluted lymphocytes were associated with mediastinal masses and proliferations of follicular center cells with intraabdominal tumors. The high incidence of CNS disease in children with neoplasms of convoluted lymphocytes and follicular center cells suggests that these processes have a predilection for the CNS and that patients with them may benefit from CNS prophylaxis.

Adolescent↗
PubMed1979

The multiple hematologic manifestations of neuroblastoma.

The hematologic manifestations of neuroblastoma are numerous and varied. Bone marrow invasion by tumor cells may cause leukoerythroblastic changes or depression of one or more of the cell lines in the peripheral blood; occasionally bone marrow involvement may be so extensive that tumor cells may be released into the peripheral blood and lead to an erroneous diagnosis of leukemia. Anemia in neuroblastoma patients may result not only from bone marrow involvement, but also from bleeding into a tumor mass or from the hemolysis accompanying a consumption coagulopathy. A specific morphologic abnormality, the cogwheel erythrocyte, has been reported in patients with neuroblastoma. Neuroblastoma may also be associated with elevation of the platelet count or a hypercoagulable state. Recognition of these protean hematologic manifestations may facilitate diagnosis in children with atypical presentations of this highly malignant tumor.

Anemia↗
PubMed1971

Disaster aid.

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Dentistry↗