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Biomedical subjects

K Bottles

Publications and source records attributed to K Bottles.

At least 73 records · Page 4Linked to original sources
PubMed1984

Malignant eccrine poroma. Case report and review of the literature.

A case of malignant eccrine poroma with lymph node metastases is described. The patient had a nodular growth of the right thigh 2 years before its first excision. Local recurrence in the scar occurred in 6 months, and by 8 months a right groin lymph node was involved. Subsequent skin nodules of the right thigh occurred over the next 12 months, associated with recurrent lymphedema of the leg. During several follow-up visits, associated malignancies were found including villous adenoma of the ascending colon and renal cell carcinoma of the right kidney, both typical histologically and unrelated to the cutaneous tumor. Subsequently, left inguinal lymph node disease histologically identical to the skin tumor was found. Clinical and histologic findings were similar to the 31 previous cases reviewed. Electron microscopic examination confirmed the presence of a ductal structure consistent with eccrine duct and a crystalline membrane-bound granule which may represent a specific marker for this rare tumor. The histologic features of this tumor are important to separate from other differential diagnostic possibilities which may have a quite different prognosis.

Adenoma, Sweat Gland↗
PubMed1984

Atypical melanocytic hyperplasia of the vagina.

A case of extensive pigmentation of the vagina is reported. Microscopic sections showed a resemblance to atypical melanocytic hyperplasia, which has been described as a possible precursor of malignant melanoma of the skin including the acral lentiginous form.

Female↗
PubMed1984

Enzyme histochemical characterization of chordomas.

The differential diagnosis of chordoma includes chondrosarcoma and ependymoma. We describe four cases of chordoma characterized by enzyme histochemistry in plastic-embedded sections. All the chordomas exhibited strong 5'-nucleotidase positivity localized on the plasma membrane. None of the fetal notochord remnants, chondrosarcomas, ependymomas, or chondroid chordomas tested showed such a reaction. The lack of similarity in enzyme staining between fetal notochord and chordomas is unexpected since notochord has been traditionally regarded as the source of chordomas. This staining pattern provides a marker that can be useful in differentiating chordoma from other neoplasms which have a similar appearance by light microscopy.

5'-Nucleotidase↗
PubMed1984

Merkel cell carcinoma of the vulva.

The authors describe the clinical and histologic findings in a case of Merkel cell carcinoma of the vulva, which was associated with squamous cell carcinoma in situ and lichen sclerosus. Electron microscopy of the tumor revealed membrane-bound granules. At postmortem examination, metastases from this primary skin tumor were found in the pelvic lymph nodes, in paraortic lymph nodes, in the liver, and in vertebral bodies. The case is unusual because Merkel cell tumors are usually found on the face or the extremities and seldom metastasize widely.

Aged↗
PubMed1983

CT diagnosis of tracheobronchopathia osteochondroplastica.

Computed tomography (CT) demonstrated nodular thickening with calcification in the anterior and lateral tracheal walls of a patient with tracheobronchopathia osteochondroplastica. The CT findings in this rare disease are pathognomonic.

Aged↗
PubMedDate not supplied

Clinician perception of fine needle aspiration cytology.

Private practitioners in San Francisco were surveyed about their perceptions of fine needle aspiration cytology. The overall response rate was 60% (369/614). The responding group was uncertain about the utility of fine needle aspiration cytology in several specific clinical settings, but 83% (307/369) believed fine needle aspiration cytology will be used more extensively in the future.

Attitude of Health Personnel↗
PubMedDate not supplied

Fine-needle aspiration cytology of lymphadenopathy in homosexual males.

We report five patients who illustrate the usefulness of fine-needle aspiration cytology (FNAC) in the differential diagnosis of lymphadenopathy in homosexual males. This differential includes hyperplasia, disseminated Kaposi's sarcoma, mycobacterial infections, and non-Hodgkin's lymphoma.

Adult↗
PubMedDate not supplied

Does addition of anti-inflammatory agents to antimicrobial therapy reduce infertility after murine chlamydial salpingitis?

BACKGROUND AND OBJECTIVES: Infertility after murine chlamydial salpingitis can be prevented by tetracycline treatment given before or at the time of infection. This study evaluates the efficacy and timing of tetracycline treatment and anti-inflammatory agents in the prevention of inflammation and subsequent infertility. STUDY DESIGN: The left ovarian bursae and uterine horns were inoculated with the mouse pneumonitis strain of Chlamydia trachomatis. Mice were mated 54 days after inoculation. RESULTS: Infected mice treated with tetracycline beginning 2 days after infection showed mild inflammation and no significant reduction in fertility. However, when tetracycline treatment was delayed until 5 days after infection, a moderate degree of inflammation and a significant reduction in fertility (P < 0.01) was noted. Treatment with ibuprofen, prostaglandin E1 (PGE-1), or hydrocortisone beginning day 2 post-inoculation did not significantly alter the degree of inflammation or subsequent fertility. Mean anti-chlamydial IgG titers were significantly lower in mice treated with either PGE1 or hydrocortisone compared with infected, untreated mice. CONCLUSION: These results indicate that while early treatment of chlamydial salpingitis may prevent infertility, delay in treatment may result in significant inflammatory damage and infertility. There was no apparent benefit from the addition of anti-inflammatory agents.

Alprostadil↗
PubMedDate not supplied

Reinventing my medical career.

The author found himself in a surprising situation in the Fall of 1998. For the first time in his life, he was looking for a job. Kent Bottles, MD, shares his experience of reinventing himself from academic chairman in an integrated delivery system to health care consultant. He stresses that physician executives need to package their experiences in terms of transferable skills that are easily understood by potential employers. He also emphasizes that acquaintances are more important than friends in obtaining employment; one needs to network with acquaintances and rely on the sympathy of relative strangers. A lot of hard work, networking, and "selling" his reinvented self resulted in a CEO hiring him. With all the changes brought on by the global economy and the uncertainties of the health care marketplace, other physician executives may be faced with the need to reinvent themselves.

Career Mobility↗
PubMedDate not supplied

The information revolution: opportunities and pitfalls for patients and providers.

The Information Revolution is changing everything in our world. Although this era is developing and evolving, some have described networks, globalization, diffusion of power away from professionals, and information overload as direct results of the Information Revolution. These megatrends are affecting every person and every organization in the world, and this article examines them to see how they might affect medicine and the delivery of health care in the millennium. What is truly significant about the changes brought about by the creation of cyberspace is that through computers, digitized information can be inexpensively and quickly transmitted anywhere in the world. Many of the traditional ethical and professional standards of medicine are feeling the strain of being applied to the strange, unfamiliar world-cyberconsultations and other virtual medical applications are explored. Physicians who understand this revolution will have a far better chance of controlling their destinies--and more importantly, aiding their patients in the quest for good health.

Attitude to Computers↗
PubMedDate not supplied

Leading in a chaotic health care environment.

How can physician executives be effective leaders during a time of such upheaval in health care? How does anyone lead in a confusing environment where planning seems impossible? Is effective leadership even possible when no one seems to understand what is going on? These important questions are addressed in this article. Health care is a confusing field. But it still needs effective leadership. Even though nobody really knows what is going on, physician leaders can play a beneficial role by encouraging everyone they work with to experiment and innovate with ways to make health care work better for patients. Physician executives can insist on accountability and on implementing what really works in their given context, rather than what the latest theory states should work.

Guidelines as Topic↗
PubMedDate not supplied

The ideal physician entrepreneur.

How does the sometimes elusive and high-stakes world of venture capital really work? How can physician executives with innovative ideas or new technologies approach venture capitalists to help them raise capital to form a start-up company? These important questions are explored in this new column on the physician as entrepreneur. The ideal physician executive is described as: (1) an expert in an area that Wall Street perceives as hot; (2) a public speaker who can enthusiastically communicate scientific and business plans to a variety of audiences; (3) a team leader who is willing to share equity in the company with other employees; (4) a recruiter and a motivator; (5) an implementer who can achieve milestones quickly that allow the company to go public as soon as possible; and (6) a realist who does not resent the terms of the typical deal. The lucrative world of the venture capitalists is foreign territory for physician executives and requires a great idea, charisma, risk-taking, connections, patience, and perseverance to navigate it successfully.

Capital Financing↗
PubMedDate not supplied

A revolution in genetics: changing medicine, changing lives.

The sequencing of the human genome is only the tip of the iceberg. It is the beginning of a revolution that many predict will transform medicine. How will genetics research affect physicians and patients and the practice of medicine? When investigators identify the function and association of human genes with common chronic diseases, diagnosis, treatment, and classification of human diseases will be changed forever. Genetic susceptibility testing allows patients to know their predisposition to disease long before symptoms appear. Physicians can intervene with customized advice so that the patient can prevent, modify, or avoid the predisposed condition by better understanding both his or her genetic and environmental risk for disease. The promise of a genetic approach to drug therapy involves moving from one size fits all to personalized medicine tailored to the individual patient. Physicians will become mentors and counselors, advising patients on the best treatment path given their unique genetic predisposition--even in this sophisticated, high tech field, the physician-patient relationship is likely to improve, highlighted by individualized therapies and personal attention.

Clinical Medicine↗
PubMedDate not supplied

The good leader.

What are the traits of successful leaders and can they be applied to those of us in health care? Leaders must deal with conflict to get a group of people to move in the same direction. Successful leaders learn to have difficult conversations that increase understanding and morale and creatively deal with the inevitable interpersonal conflicts present in every organization made up of people. Another useful trait for a leader during uncertain and chaotic times is the ability to see things as they really are, rather than as we wish or believe them to be. Successful leaders are also usually optimists who level with their co-workers.

Conflict, Psychological↗
PubMedDate not supplied

Chance encounters.

How can physician executives change their thinking and expand their understanding? Chance encounters offer a way to draw on others' unique experiences and patterns of thought unknown to us and have our usual way of thinking challenged and sometimes shattered--one of life's most powerful experiences. After reflecting on three optimal personal learning experiences from a recent conference, the author determines that the only common thread is the interdisciplinary thoughts expressed by a passionately involved individual whose approach to the problem is completely different from his own. These conferences offer the inquisitive physician entrepreneur the opportunity to hear how venture capitalists, population geneticists, business development experts, biotech CEOs, and big pharma scientists view the potential of the sequencing of the human genome to change medicine. Being able to see the world in a new way, the author concludes, is tied to the essence of entrepreneurship and the essence of joyful living.

Decision Making↗