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Biomedical subjects

J M Baron

Publications and source records attributed to J M Baron.

At least 55 records · Page 3Linked to original sources
PubMed1996

Evaluation of a new general primer pair for rapid detection and differentiation of HSV-1, HSV-2, and VZV by polymerase chain reaction.

The polymerase chain reaction (PCR) enables rapid and sensitive detection of VZV and HSV DNA and its efficiency depends mainly on the choice of the primers. Primers should hybridize to conserved DNA sequences within the viral genomes in order to avoid unreliable amplification due to DNA sequence variation between different strains. The aim of the study was to design and to evaluate a general primer pair which permits fast and reliable detection of HSV and VZV. The genes UL 15 of HSV and UL 42 of VZV share the highest degree of homology within the two genomes. We designed a primer pair (GPHV-RU) which hybridizes to these genes. The genetic variability of amplified sequences from clinical specimens was analyzed by restriction enzyme cleavage analysis and by temperature gradient SSCP analysis (TG-SSCP). PCR with GPHV-RU amplified viral sequences from all analyzed specimens (25 x VZV, 10 x HSV-1, 5 x HSV-2) obtained from patients with clinical evidence of HSV or VZV infection. Restriction enzyme cleavage analysis with Hpa II further permitted reliable distinction between VZV, HSV-1, and HSV-2. Analysis of the heterogeneity of the amplified sequences by restriction enzyme cleavage and by TG-SSCP demonstrated no variability between the analyzed clinical specimens of VZ and of HSV-2 and only one differing TG-SSCP-pattern within the HSV-1 isolates. The results suggest that detection of HSV and VZV using the new primer pair GPHV-RU should give reliable results as the amplified sequences show little genetic variability within clinical isolates of HSV-1/2 and VZV.

DNA Primers↗
PubMed1995

Evaluation of non-radioactive temperature gradient SSCP analysis and of temperature gradient gel electrophoresis for the detection of HPV 6-variants in condylomata acuminata and Buschke-Loewenstein tumours.

A modified non-radioactive single strand conformation polymorphism analysis incorporating a temperature gradient (TG-SSCP) and temperature gradient gel electrophoresis (TGGE) were evaluated for the detection of human papillomavirus type 6 (HPV 6)-variants in 41 condylomata acuminata and 5 Buschke-Loewenstein tumours. TG-SSCP and TGGE analysed part of the transforming ORF E6 of HPV 6 spanning nucleotides 10 to 495. TG-SSCP distinguished between 8 HPV 6-variants whereas TGGE demonstrated 6 different DNA-species. HPV 6-strains found in Buschke-Loewenstein tumours did not vary in the analysed portion of the E6 ORF as compared to ordinary condylomata acuminata. TG-SSCP and TGGE further showed absence of double infection with different HPV 6-strains in the analysed samples. Our results demonstrated that both methods may be successfully used for the detection of different strains of microbiological agents, although TG-SSCP seemed to provide easier execution and to confer a higher degree of flexibility than TGGE.

Condylomata Acuminata↗
PubMed1994

Management of ovarian cyst detected by prenatal ultrasounds.

As a result of refinements in Prenatal Ultrasonography (US), neonatal ovarian cysts are more frequently encountered than in the past. Between January 1981 and December 1990, 21 consecutive fetuses with ovarian cysts were followed up by ultrasonography. 23 ovarian cysts were diagnosed between 28 and 38 weeks gestation. 18 cysts were initially large cysts (more than 50 mm in diameter). In 9 cases, an anechoic cyst was observed and a US-guided needle aspiration of the cyst was performed (2 antenatally and 7 postnatally). Ultrasonographic patterns of complicated cyst were observed in 3 fetuses. After a postnatal ultrasound control, 11 infants were operated on: 8 surgical interventions were required for complicated cysts (torsion: 4, hemorrhage: 4), 3 cases irrespective of their sonographic appearance in our initial experience. In the remaining cases, spontaneous resolution was followed by repeated ultrasonographic examination. Prenatal ultrasonography today allows diagnosis of ovarian cysts and may suggest antenatal complications. To preserve as much ovarian tissue as possible, cysts greater than 50 mm in diameter should be candidates for percutaneous aspiration and complex cystic masses should be operated on.

Female↗
PubMed1994

Hematuria in sickle cell anemia--not always benign: evidence for excess frequency of sickle cell anemia in African Americans with renal cell carcinoma.

Between 1952 and 1992, we identified 117 African Americans with renal cell carcinoma (RCC) at the University of Chicago. Three of these had sickle cell disease (SS) and 11 had presumed sickle trait (AS). Based on genotype frequencies, these represented a 16.7-fold excess of SS patients (p < 0.0001), but the incidence of AS patients was as expected. In addition, the median age for the SS patients at presentation with RCC (36 years) was significantly less (p = 0.04) than for the AS patients (55 years). We have found no prior reports of SS in RCC patients and suggest that chronic renal injury from sickling and possible immunosuppressive effects of multiple red cell transfusions may be risk factors. We also suggest the need to be aware of the possibility of RCC in SS patients who may have hematuria solely related to sickling.

Adult↗
PubMed1994

Phase I trial of a genetically engineered interleukin-2 fusion toxin (DAB486IL-2) as a 6 hour intravenous infusion in patients with hematologic malignancies.

DAB486IL-2 is a recombinant fusion toxin, created by replacement of the receptor binding domain sequences of the diphtheria toxin gene with the sequences for human interleukin-2 (IL-2). It selectively binds to and intoxicates cells expressing the high-affinity IL-2 receptor. A total of 17 patients with refractory hematologic malignancies were entered in a phase I study of DAB486IL-2, administered as a 6 hour continuous intravenous infusion on days 1, 2, 8, 9, 15, and 16 of each 28 day cycle. Cohorts of 3 to 6 patients were treated with escalating doses. The starting dose was 0.1 mg/kg/day with increments of 0.1 mg/kg/day per dose level up to 0.3 mg/kg/day. Significant adverse effects included transient asymptomatic elevation of liver transaminases, hypersensitivity, anemia, thrombocytopenia, fever, and creatinine elevation. A partial response of approximately nine months duration was observed in a patient with small cell lymphocytic non-Hodgkin's lymphoma, previously refractory to high-dose chemotherapy and autologous bone marrow transplantation. The observance of antitumor activity in a patient highly refractory to chemotherapy suggests that DAB486IL-2 may have efficacy in selected patients whose malignant cells express the IL-2 receptor.

Adult↗
PubMed1993

Combined plateletpheresis and cytotoxic chemotherapy for symptomatic thrombocytosis in myeloproliferative disorders.

BACKGROUND: Patients with myeloproliferative disorders (MPD) may have symptomatic thrombocytosis develop that requires prompt and sustained lowering of platelet counts to avert serious thrombotic or hemorrhagic sequelae. METHODS: The authors retrospectively studied the short- and long-term effects of plateletpheresis combined with three different chemotherapy regimens (busulfan, hydroxyurea, or busulfan/hydroxyurea) in 30 patients with MPD with symptomatic thrombocytosis. RESULTS: Twenty-nine patients entered first remission (FR) with initial treatment. The average number of plateletphereses to FR was three (standard deviation [SD], +/- 3). Average total dose of busulfan (216 mg) and time to FR (1.6 months) were less than for previously reported patients treated without plateletphereses. Addition of hydroxyurea to busulfan decreased the number of plateletpheresis needed (P = 0.02) but did not additionally reduce the amount of busulfan needed or the time to FR. The shortest time to FR was in the hydroxyurea group (mean, 0.6 +/- 0.3 months), but unmaintained remission could be achieved only in the busulfan-treated groups. With median follow-up of 68 months, median survival was 53 months for the busulfan group, 55 months for the hydroxyurea group, and was undefined with no deaths for the busulfan/hydroxyurea group. Neither fatal complications of recurrent symptomatic thrombocytosis nor development of acute leukemia has occurred, except for progression to blast crisis in two patients with chronic myelogenous leukemia. CONCLUSION: Combined plateletpheresis and chemotherapy is a rapidly effective initial treatment for patients with MPD with symptomatic thrombocytosis. With maintenance therapy or prompt treatment at relapse of disease, prolonged good quality survival can be expected.

Adult↗
PubMed1993

Myocardial risk area defined by technetium-99m sestamibi imaging during percutaneous transluminal coronary angioplasty: comparison with coronary angiography.

OBJECTIVES: The purpose of this study was to compare the assessment of myocardial area at risk in patients with coronary artery stenosis by coronary angiography and quantitative myocardial perfusion imaging with technetium-99m sestamibi. BACKGROUND: Decisions concerning patient management frequently rely on semiquantitative angiographic estimation of the myocardial area at risk, although this approach has not been well validated. Technetium-99m sestamibi is a perfusion imaging agent with little redistribution after initial myocardial uptake. This characteristic allows for injection during angioplasty and later imaging for visualization and quantitation of the nonperfused area at risk. METHODS: Thirty-nine patients referred for coronary angioplasty were studied. Technetium-99m sestamibi was injected intravenously during angioplasty balloon inflation. Planar (33 patients) or tomographic (6 patients) imaging was performed after completion of angioplasty. Imaging was repeated 24 to 48 h later. Myocardial risk area (perfusion defect on angioplasty image) was quantified as an integral using circumferential count distribution profiles and normal reference. Angiographic risk area was assessed using five scoring methods. RESULTS: The scintigraphic risk area was 14 +/- 15 on planar images and 39 +/- 16 on tomography. Scintigraphic risk area of patients with infarction was larger than in patients without (22 +/- 17 versus 7 +/- 8, p = 0.003). The left anterior descending coronary artery had a larger mean risk area than other vessels (22 +/- 15 versus 7 +/- 11, p = 0.002). The presence of angiographic collateral channels was associated with smaller risk areas. Angiographic risk scores correlated only moderately with the technetium-99m sestamibi risk area (r = 0.54 to 0.65), with considerable spread of data. CONCLUSIONS: Area at risk estimated from coronary angiography does not correlate well with that from quantitative myocardial perfusion imaging with technetium-99m sestamibi. These findings emphasize that the functional significance of coronary artery disease is not predicted by coronary anatomy alone.

Adult↗
PubMed1993

Glomerular disease and urinary Sézary cells in cutaneous T-cell lymphomas.

We report three cases of biopsy-documented renal glomerular disease occurring in patients with cutaneous T-cell lymphomas. One patient had immunoglobulin A (IgA) nephropathy and another had membranous nephropathy. The remaining patient had an immune complex glomerulonephritis without immunofluorescent evidence of IgA, but with mesangial deposits and a clinical course notable for stable renal function, minimal proteinuria, and episodic gross hematuria of renal origin. These three cases, along with IgA nephropathy in two of the four previously reported cases, suggest a possible association between cutaneous T-cell lymphoma and this glomerular lesion. In addition, Sézary cells were observed in the urine of two patients, one without evidence of glomerular disease. The prognostic value of this new observation is unknown.

Adult↗
PubMed1993

The role of the radionuclide renal study in the management of renal colic.

If renal colic is suspected in the patient presenting with acute flank or lower abdominal pain it must be established whether or not the affected kidney is obstructed and whether there is functional impairment that may require urological intervention. The radionuclide renal study developed in this hospital and used routinely for over 10 years can reveal obstruction when the results of commonly used tests are negative. It also provides information on renal function, morphology and blood flow. It is a cost-effective, safe and reliable procedure for the initial investigation of patients presenting with suspected renal colic.

Adult↗
PubMed1993

Lichen myxedematosus treated with chlorambucil.

BACKGROUND: Chemotherapy with various alkylating agents has been reported to be successful in the treatment of lichen myxedematosus. However, serious toxicities have accompanied such use. OBJECTIVE: To report a case of treatment of lichen myxedematosus with chlorambucil. RESULT: There was a favorable response using chlorambucil as an alternative therapeutic agent.

Adult↗
PubMed1991

Acute cutaneous vasculitis associated with prolonged intravenous ritodrine hydrochloride therapy.

A patient with twin gestation was hospitalized because of preterm labor and treated with intravenous ritodrine hydrochloride (Yutopar, Astra Pharmaceutical Products, Westborough, Mass.). After greater than 4 weeks of therapy, the patient had a petechial rash and prolonged bleeding time, which were diagnosed and confirmed by skin biopsy at cesarean section as vasculitis. This is the first documented case of vasculitis associated with ritodrine use.

Adult↗
PubMed1988

White blood cell aplasia associated with thymoma.

A limited number of cases of acquired hypoplastic neutropenia or pure white blood cell aplasia (PWCA) associated with thymoma have been reported, in contrast to the well-documented association of pure red blood cell aplasia and thymoma. The mechanism of the aplasia in these disorders is unclear. The authors report a case of PWCA (with total absence of all granulopoietic elements in the bone marrow) in a patient with metastatic spindle cell thymoma, in which suppression of autologous granulocyte-macrophage colony-forming units by the patient's serum could be demonstrated. This finding suggests a humoral autoimmune mechanism for the pathogenesis of PWCA in this patient and lends support to the possibility that all hematologic phenomena associated with thymoma may have an autoimmune basis.

Aged↗
PubMed1988

Combined modality therapy for tumor stage mycosis fungoides: results of a 10-year follow-up.

Twenty-one patients with tumor stage mycosis fungoides (MF) with or without lymph node (LN) involvement, were treated with total skin electron beam irradiation (TSEB) followed by six monthly cycles of systemic chemotherapy (CT) of either mechlorethamine (HN2) or cyclophosphamide (CTX) with vincristine (VCR), procarbazine, and prednisone (PRD) (COPP or MOPP). All patients had complete clearing of the skin after TSEB. However, while receiving chemotherapy, two patients developed visceral involvement and eight patients relapsed with limited cutaneous plaques (LCP). The median duration of remission was 12 months from the completion of TSEB, and all patients relapsed with cutaneous plaques within 25 months. Complete remission was again achieved using additional electron irradiation and maintenance therapy in all but one patient. Multiple cutaneous recurrences occurred in all patients. Median survival from the initiation of TSEB is 6 years. Five patients are living beyond 8 years (four off treatment without disease for 1 to 7 years). LN involvement did not influence initial response or survival. Combined modality therapy for tumor stage MF using TSEB followed by systemic CT and subsequent maintenance therapy may lead eventually to prolonged disease-free survival (DFS) in selected patients.

Adult↗
PubMed1987

Gastric adenocarcinoma after gastric lymphoma.

Three men and one woman developed intestinal-type moderately or poorly differentiated gastric adenocarcinoma 4 to 15 years after the diagnosis of gastric lymphoma. Treatment of the lymphomas had included partial gastrectomy and follow-up radiotherapy and/or chemotherapy. Review of the literature reveals an additional 12 patients who developed adenocarcinoma 3.5 to 34 years (median, 14.5 years) after diagnosis of gastric lymphoma. In the total series of 16 patients, only four were women, who tended to be younger (median age, 36.5 years) than the men (median, 48.5 years) when lymphoma was diagnosed. Patients with gastric lymphoma seem to have an increased incidence of gastric adenocarcinoma. Carcinoma after gastric lymphoma often arises in the distal stomach and appears to occur irrespective of the type of therapy for the lymphoma.

Adenocarcinoma↗
PubMed1981

Karyotypic patterns and their clinical significance in polycythemia vera.

We studied a series of 34 polycythemia vera (PV) patients to determine the incidence of chromosome abnormalities and their relationship to leukemic transformation. Metaphase chromosomes from bone marrow or unstimulated peripheral blood were examined with conventional stain and, in 20 patients, also with banding techniques. The overall incidence of clonal abnormalities in first samples was 44% (15 of 34 patients), with a higher incidence in patients who had received prior therapy. The most frequent abnormalities were long-arm deletion of No. 5 (5q-; four patients), gain of all or most of a No. 8 (five patients), gain of all or most of a No. 9 (four patients), and long-arm deletion of No. 20 (three patients); these sometimes occurred in combination. Some of the PV patients who had cytogenetic abnormalities early in the disease have had long survivals without developing leukemia. For example, one patient has been 48,XX,+8,+9 in sequential samples obtained over the last 15 years. Five patients developed acute myeloblastic leukemia (AML); each had a complex chromosomal pattern. Two of these five patients were cytogenetically normal during the polycythemic phase; the change in karyotype occurred with the leukemic transformation. Three AML patients were studied only in the leukemic phase. Three AML patients had a 5q-, and a fourth showed loss of a B-group chromosome. Evolutionary changes in the karyotype during the disease course and the occurrence of a 5q- appear to be associated with a terminal phase of PV.

Adult↗