Biomedical subjects
Publications and source records attributed to M Casey.
Twenty-eight carcinoid tumours were stained with monoclonal antibodies to epithelial and neural related intermediate filaments. All were found to express epithelial markers, and none expressed neural markers. These results support the theory that carcinoids are of epithelial, rather than neural crest origin.
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A Minnesota Department of Health study on the financial condition of Minnesota's small, rural hospitals found that at least 12 hospitals were in precarious financial condition at the start of 1989, and many other hospitals were financially vulnerable. One-third or more of Minnesota's hospitals with fewer than 50 beds had negative net income in each year from 1984 to 1987. Using a standard of 30 minutes' maximum travel time for adequate access, the study revealed that about 19,000 Minnesotans in 14 counties currently have inadequate access to hospital services. Closing rural hospitals could leave additional Minnesotans without adequate access to hospital services. Given the financial condition of Minnesota's small, rural hospitals and the importance of maintaining access to hospital services in rural communities, the state may need to provide limited hospital subsidies to ensure access in geographically isolated areas.
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We studied 11 glomus tumours immunohistochemically, with a panel of connective tissue and epithelial markers. Most tumours contained small nerve fibres located in connective tissue septae between groups of glomus cells, thus accounting for the frequent occurrence of pain associated with glomus tumours. All tumours stained positively for muscle-specific actin and vimentin. Immunostaining for high and low molecular weight cytokeratins, desmin, myoglobin, S-100 protein, neurofilaments and Factor VIII related antigen was negative. Our findings confirm and amplify the proposed smooth muscle histogenesis of glomus tumours. This immunohistochemical profile may be of diagnostic value in the differential diagnosis of atypical glomus tumours.
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Gallium-67 (67Ga) lung scanning has been applied for some years in pulmonary sarcoidosis to assess the activity of the alveolitis. Interpreting the scans, however, is difficult due to the low uptake of 67Ga in the disease process relative to background activity. In this study we have measured the mean parenchymal lung activity of 67Ga and have compared the lung activity to that at three remote sites, the liver, the abdomen and the thigh. The results obtained were compared with the percentage of lymphocytes in broncho-alveolar lavage fluid. There was a very good correlation with the lung-to-thigh uptake measurements and a much poorer correlation with the lung-to-liver and the lung-to-abdomen measurements. It was observed that steroid therapy reduced dramatically the correlation between the broncho-alveolar lavage findings and the 67Ga scan measurements. The results suggest that in patients not on steroid therapy, the 67Ga lung-to-thigh measurements may be used, similarly to the broncho-alveolar lavage lymphocyte counts, to identify those with high-intensity alveolitis from those with low-intensity alveolitis.
Contrast examinations of the subarachnoid space are associated with side effects including convulsions. Attention has been given to the prophylactic use of anticonvulsants. We describe a simple oral regimen using the established anticonvulsant phenytoin that can be administered to short-stay patients and that achieves effective serum and CSF concentrations. A preliminary account of this work was presented to the British Pharmacological Society in January 1984 in London.
Numerous centers perform glomerular filtration rate (GFR) measurements on patients undergoing renal imaging with Tc-99m DTPA. GFR measurement, however, does involve multiple blood samples taken over a 4-hour period, and this has led to attempts to simplify the technique by reducing the number of blood samples required and hence diminish the time taken to perform the test and the inconvenience to the patient. Four different simplified techniques for measuring GFR that have been reported in the literature are compared with a reference 2 blood sample method. Three of the methods do not require any blood samples but have standard errors of greater than 20 ml/min in adults and greater than 14 ml/min in children. The other method requires one blood sample, and if this is taken at 2 hours postinjection, the standard error is 9 ml/min in adults and 5 ml/min in children. The latter method is suitable for routine use in renography when accuracy is not of paramount importance.
Conventional nuclear medicine methods for measuring glomerular filtration rate, GFR, are invalidated if the initial injection of radiopharmaceutical is tissued. An analytical method proposed by Veall and Gibbs in 1982 overcomes this difficulty but does require multiple blood samples. This paper investigates whether it is feasible to use the analytical method on data acquired with a CdTe detector system and thereby reducing to one the number of blood samples required. Synthetic data were used to investigate the effect of (a) duration of sampling (b) statistical noise and (c) non-stationarity on the GFR values derived by the Veall and Gibbs method. A sampling duration of 100 min is shown to be adequate and statistical noise is not a limiting factor. However, data fluctuations, mainly due to detector motion, do reduce the accuracy of the method. When the analytical technique is applied to data obtained using a CdTe detector on 40 patients the GFR values are similar to those derived by the conventional method (r = 0.957, Syx = 9.1 ml min-1). The technique is sufficiently attractive to warrant further studies to establish its absolute accuracy.
This study reports the effects of an inverted position on pulse rate, blood pressure, and deep tendon reflexes of the biceps muscle, triceps muscle, and Achilles tendon. Twenty healthy adults were used as subjects. We collected data both before and after the subjects were in the inverted position for eight minutes on a specially designed tonic labyrinthine inverted table. A significant decrease in systolic blood pressure and all tendon reflexes was observed along with a significant increase in diastolic blood pressure (p less than .05). Pulse rate showed no change. The findings indicate that the inverted position is likely to be effective for decreasing muscle tone and systolic blood pressure. Although this study used healthy subjects, the inverted position may be used as a therapeutic technique, provided the clinician monitors closely the physiological effects on patients.
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The authors describe the development of a double antibody radioimmunoassay specific for human secretory IgA (sIgA), and they report the results of measurements of serum sIgA concentrations in patients with chronic, nonalcoholic liver disease or carcinoma. Above-normal sIgA concentrations (greater than 25 micrograms/mL) were found in 22 of 38 sera from patients with chronic active liver disease and in 37 of 40 sera from patients with primary biliary cirrhosis. Markedly increased concentrations (greater than 118 micrograms/mL) were specific for primary biliary cirrhosis. Above-normal sIgA concentrations were found frequently in patients with colorectal (29/86, 34%), pancreatic (38/70, 54%), gastric (11/30, 37%), or mammary (6/46, 13%) carcinoma. An above-normal concentration of sIgA was more specific for hepatic metastases than an above-normal alkaline phosphatase activity in each type of carcinoma. The authors conclude that measurement of sIgA in serum is a useful diagnostic test in patients with chronic liver disease suspected of having primary biliary cirrhosis or in patients with carcinoma suspected of having hepatic metastases.
Decreased cognitive performance was significantly correlated with increased quantity of alcohol per occasion and with total lifetime consumption in both women and men college students tested while sober. In men, however, increased performance on some tasks was also significantly correlated with increased frequency of drinking.
The response of a gamma camera and a rectilinear scanner to small sources containing 131I was assessed from the point of view of thier suitability for measuring the activity of a source, as opposed to their capacity to produce well-resolved images. The influence of the size of the area over which counts were integrated, and of the size and depth of hte source, were investigated for both instruments. The results indicate that both instruments are dependent on these variables, though with the particular instruments investigated the dependence of the gamma camera is much more complex and difficult to define. The conclusions indicate that with these systems quantitative activity measurements are more readily achievable with the scanner than with the camera.
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