Biomedical subjects
L K Diaz
Publications and source records attributed to L K Diaz.
Soft tissue cyst secondary to bullet retention.
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Are malignant cells displaced by large-gauge needle core biopsy of the breast?
OBJECTIVE: The purpose of this paper is to determine the rate of tumor displacement resulting from large-gauge needle core biopsy in patients with breast carcinoma. MATERIALS AND METHODS: Three hundred fifty-two cancer excisions in patients who had undergone large-gauge needle core biopsy were evaluated for evidence of tumor displacement. Three needle procedures were compared: vacuum-assisted, automated gun, and core biopsy guided by palpation. Needle track visualization, presence and amount of tumor displacement, tumor morphology, and interval between core biopsy and surgical excision were recorded for each case. RESULTS: Seventy-six cases showed tumor displacement of one or two cell clusters, and 38 cases-showed displacement of multiple tumor fragments. Tumor displacement was identified in 37% of automated gun specimens, 38% of specimens obtained with palpable guidance, and 23% of specimens obtained with a vacuum-assisted needle. Tumor displacement was seen in 42% of patients with an interval between biopsy and excision of less than 15 days, in 31% of patients with an interval of 15-28 days, and in 15% of tumors excised more than 28 days after core biopsy (p < .005). CONCLUSION: Tumor cell displacement was observed in 32% of patients who had undergone large-gauge needle core biopsy. The incidence and amount of tumor displacement was inversely related to the interval between core biopsy and excision. This relation suggests that tumor cells do not survive displacement.
Early extubation after cardiac operations in neonates and young infants.
OBJECTIVE: This study was undertaken to determine the feasibility of early extubation of the neonate and young infant after surgical repair of congenital heart lesions. METHODS: The records of all patients less than 90 days of age who had cardiac operations over a 1-year period were reviewed. During this time, all patients were managed as potential candidates for early extubation. Fifty-six patients are included with a mean age of 32 +/- 31 days and a mean weight of 3.7 +/- 0.9 kg. RESULTS: Twenty-eight patients (50%) were extubated in the operating room or within 3 hours after arriving in the intensive care unit. This included 38% of patients less than 7 days of age, 50% of patients 8 to 30 days of age, 44% of patients 31 to 60 days of age, and 69% of patients 61 to 90 days of age. Three patients (11%) extubated early required reintubation. No deaths were related to early extubation. Only one patient was negatively affected by early extubation. Patients extubated early had shorter stays in the intensive care unit (3.3 +/- 3.9 vs 6.7 +/- 2.9 days) and shorter postoperative hospital stays (5.9 +/- 3.3 vs 13.5 +/- 9.7 days), as well as lower intensive care unit ($5,851 +/- $7,225 vs $12,064 +/- $4,419) and total hospital ($21,108 +/- $14,941 vs $31,608 +/- $9,861) costs than patients who were ventilated. CONCLUSIONS: Early extubation can be accomplished safely in many neonates and young infants undergoing cardiac operations for repair of congenital heart defects and can shorten hospital stay and reduce costs.
Expression of epithelial mucins Muc1, Muc2, and Muc3 in ductal carcinoma in situ of the breast.
Epithelial mucins are glycoproteins secreted by epithelial cells and their carcinomas. At least nine mucin genes have been identified, and their products (MUC1-MUC9) are expressed in various epithelia. MUC1 is a mucin expressed in breast epithelial cells, whereas MUC2 and MUC3 are primarily intestinal mucins. Although MUC1 and MUC2 expression has been documented in invasive ductal carcinoma of the breast, mucin expression in pure ductal carcinoma in situ (DCIS) has not been investigated. Sixty-one of 105 cases of DCIS without coexisting infiltrating carcinoma diagnosed during a 30-month period were selected as having sufficient tissue for study. Paraffin-embedded tissue sections were stained using immunohistochemical techniques with mouse monoclonal anti-MUC1, anti-MUC2, and rabbit-specific polyclonal anti-MUC3 antibodies. Immunoreactive epitopes of MUC1, MUC2, and MUC3 were expressed in DCIS in 61, 19, and 16 of 61 cases, respectively. MUC2 and MUC3 staining intensity in DCIS was markedly less than that observed for MUC1. Luminal and/or cytoplasmic patterns of staining were observed for MUC1. MUC2 and MUC3 showed only cytoplasmic staining. Cytoplasmic-only staining of MUC1 was associated with a higher grade of DCIS. Any MUC2 staining was also associated with a higher grade of DCIS. Coexpression of MUC2 and MUC3 was present in only 6 of 61 cases, and MUC3 staining was unrelated to the grade of DCIS. Cytoplasmic expression of MUC1 and MUC2 appears to be associated with a higher grade of DCIS. MUC3 expression appears to be independent of grade and expression of MUC1 and MUC2. The relationship of mucin expression and grade warrants further study.