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Biomedical subjects

K Bottles

Publications and source records attributed to K Bottles.

82 records · Page 5Linked to original sources
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The doctor/patient relationship for the 21st century. Clash of 'cultural creatives' and 'traditionals' helps focus the future of patient care.

The doctor/patient relationship is at a crossroads. Some patients--traditionals--want the doctor calling all the shots, deciding the best treatment path to follow. But cultural creatives--heavily influenced by bioethics--desire more of a give and take when it comes to their health care. They see the physician as an advisor, and they want to decide the best treatment on their own terms. Take a close-up look at factors influencing the doctor/patient relationship in the 21st Century.

Cultural Characteristics↗
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Tales of two medical startup companies.

Convincing investors to fund your medical startup company is never easy. Check out two rapidly growing startups and gain some insights on how it can be done successfully.

Biotechnology↗
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Spontaneous infarction of a parotid gland pleomorphic adenoma. Report of a case with cytologic and radiographic overlap with a primary salivary gland malignancy.

Pleomorphic adenoma is the most common neoplasm of the parotid gland, generally presenting as a slowly enlarging, firm, well-circumscribed, painless nodule. Occasional cases have presented after a short period of rapid growth or have been associated with pain. The vast majority of these tumors are solid, but rare examples have been associated with cystic degeneration or hemorrhage. Spontaneous and tumor-associated infarction of the parotid has been reported, but these examples have been limited to infarctions of Warthin's tumors and postoperative infarctions of salivary glands. We present the case of a 48-year-old male with a one-year history of a painful, enlarging, left parotid mass associated with paresthesia of the tongue. Computed tomographic examination of the parotid demonstrated a left superficial lobe mass with a rim of enhancement and low attenuation center. Fine needle aspiration yielded necrotic debris and atypical squamous elements that were thought to be compatible with carcinoma. A superficial parotidectomy with intraoperative frozen section revealed a pleomorphic adenoma with extensive central necrosis. To our knowledge, this represents the first reported case of an infarcted pleomorphic adenoma and illustrates the potential for misinterpretation of these cytologic and radiologic findings as indicative of malignancy.

Adenoma, Pleomorphic↗
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Fine needle aspiration biopsy diagnosis of mucoepidermoid carcinoma. Statistical analysis.

Fine needle aspiration (FNA) biopsy is an increasingly popular method for the evaluation of salivary gland tumors. Of the common salivary gland tumors, mucoepidermoid carcinoma is probably the most difficult to diagnose accurately by this means. A series of 96 FNA biopsy specimens of salivary gland masses, including 34 mucoepidermoid carcinomas, 51 other benign and malignant neoplasms, 7 nonneoplastic lesions and 4 normal salivary glands, were analyzed in order to identify the most useful criteria for diagnosing mucoepidermoid carcinoma. Thirteen cytologic criteria were evaluated in the FNA specimens, and a stepwise logistic regression analysis was performed. The three cytologic features selected as most predictive of mucoepidermoid carcinoma were intermediate cells, squamous cells and overlapping epithelial groups. Using these three features together, the sensitivity and specificity of accurately diagnosing mucoepidermoid carcinoma were 97% and 100%, respectively.

Biopsy, Needle↗
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Mast cells in the aspiration cytology differential diagnosis of adenolymphoma.

Review was undertaken of 20 cases of adenolymphoma (Warthin's tumor) of the salivary glands diagnosed by fine needle aspiration (FNA). Smears of the aspirates from 16 of the 20 cases (80%) contained mast cells associated with monolayered sheets of oncocytes. Aspiration smears from control cases showed cells in significantly fewer instances: 10% of the cases of mucoepidermoid carcinoma, 5% of the cases of pleomorphic adenoma and none of the cases of acinic-cell tumor, squamous-cell carcinoma and branchial cysts. Mast cells in association with oncocytes thus should be considered supportive evidence of an FNA diagnosis of adenolymphoma.

Adenolymphoma↗
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A step-wise logistic regression analysis of papillary carcinoma of the thyroid.

Fourteen cytologic features seen in fine needle aspirates of papillary carcinoma of the thyroid were subjected to a step-wise logistic regression analysis to determine which are predictive of papillary carcinoma. The study cases included 38 histologically proven papillary carcinomas and 54 other palpable thyroid nodules. The three most important variables in making the prediction of papillary carcinoma were intranuclear inclusions, papillary structures without vessels and cells with metaplastic cytoplasm.

Biopsy↗
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Neuroblastoma diagnosed by fine needle aspiration biopsy.

Small-cell malignancies of childhood are a source of diagnostic difficulty, both in cytology and histology. Four cases of neuroblastoma are presented that were diagnosed by fine needle aspiration cytology. The importance of a complete history, physical examination and laboratory evaluation is stressed. In addition to the usual description of cytologic detail obtained by routine methods, a new method of study is introduced: the potential use of plastic embedding and histochemical studies in small-cell tumors is discussed.

Adolescent↗