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Biomedical subjects

M Osborne

Publications and source records attributed to M Osborne.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Do immunologic markers facilitate differentiation between histologic types of stomach cancer?].

Seventeen gastric carcinomas (intestinal n = 12; diffuse n = 1; mixed type n = 4) and one Barrett's carcinoma were prospectively studied by immunohistochemistry for the expression of different keratin polypeptides and of the brush border markers villin, sucrase isomaltase and aminopeptidase N. All carcinomas expressed the keratin polypeptides 8, 18, and 19 and were stained by the broad specific keratin antibody KL1, irrespective of histologic type. Keratin 7, however, was expressed in only one carcinoma in most tumor cells and in two further carcinomas in some tumor cells. Thus, specific differentiation of the various histologic types of gastric carcinoma does not seem to be aided by the use of keratin antibodies. Villin was positive in 80% of the tumors and sucrase isomaltase and aminopeptidase N were positive in 67% respectively with no obvious histologic difference. The frequent positivity of the brush border markers, usually typical for intestinal epithelium, reflects the high degree of intestinal differentiation of gastric carcinomas, but again does not seem to be associated with a particular histologic type.

Adenocarcinoma↗
PubMed1990

Nursing ethics: a turning point.

The authors contend that the methods used to prepare current practitioners for competent and confident participation in the resolution of complex ethical dilemmas are inadequate. They identify some of the forces affecting nursing ethics, and discuss a need for renewed evaluation of how nurses can be helped to fulfill their mandate of ethical practitioner. They also suggest strategies for nurses to contribute effectively to ethical decisions that affect their patients as well as the healthcare system within society.

Decision Making↗
PubMed1989

Imaging techniques in breast cancer.

In the diagnosis of clinically inapparent breast cancer, mammography remains the most effective imaging modality, which is due in large part to its ability to detect microcalcifications. Of the ancillary modalities, sonography is the most useful because it readily differentiates cysts from other breast lesions. Internal mammary and axillary node imaging have been tried with varying levels of success, but false-positive and false-negative rates remain high with available techniques. Pulmonary metastases are best evaluated by chest X-ray with specificity increased by other imaging techniques. Liver and bone metastases may be screened for with isotope scans with computerized tomography, sonography, and magnetic resonance imaging, increasing the specificity of abnormal scans. CT and MRI are the most effective tools for evaluating CNS disease.

Adult↗
PubMed1988

The long march of the cerebrospinal fluid profile indicative of clinical definite multiple sclerosis; and still marching.

Much progress has been made, especially in the last two decades, in laboratory aids to diagnosis and to follow the course of patients with multiple sclerosis (MS). The cerebrospinal fluid (CSF) profile indicative of MS, though not pathognomonic of MS, is present in almost every case of clinical definite MS in a chronic progressive phase (probably also true for early MS). The cardinal aspect of the profile is intra-blood-brain barrier (BBB) IgG synthesis which can be qualitatively detected by determining unique CSF oligoclonal IgG bands and quantitated by rate formula, mg/day. We believe that intra-BBB IgG synthesis is caused by a persistent antigen, most likely a virus, possibly measles. A number of issues about the profile are proposed and opportunities are presented to resolve them.

Antibodies↗
PubMed1988

CT prior to second-look operation in ovarian cancer.

Second-look surgery is used in restaging patients with ovarian cancer to define sites of recurrence, plan therapy, and perform tumor debulking. We evaluated the role of CT in detecting residual or recurrent tumor in 55 patients in whom 64 abdominopelvic CT scans were obtained. Forty-eight patients underwent a second-look operation, and eight of these patients had an additional third-look operation. CT correctly identified 17 (85%) of 20 cases with residual or recurrent pelvic disease and three (75%) of four cases with bulky abdominal disease. CT failed to detect tumor in any of the five cases with minimal abdominopelvic disease and was able to detect carcinomatosis in only two (8%) of 24 cases. In four cases, CT detected pelvic disease not identified on clinical pelvic examination. On the 56 scans in 48 patients with surgical proof (280 surgical findings), CT had a sensitivity of 40% (22/55) and a specificity of 99% (224/225). In seven additional patients, second-look laparotomy was canceled because of CT findings of extensive, unresectable tumor. We conclude that CT provided valuable information regarding residual or recurrent tumor prior to second- and third-look surgery. In selective cases, CT findings obviated unnecessary surgery. However, the CT's lack of sensitivity in identifying minimal abdominopelvic disease and carcinomatosis precludes its use as a substitute for second-look surgery.

Female↗
PubMed1988

Copolymer 1 as therapy for multiple sclerosis: the cons.

One of the hallmarks of multiple sclerosis (MS) is intra-blood-brain-barrier (BBB) IgG synthesis, a byproduct of plasma cells located in and around active inflammatory demyelinating plaques. The rate of IgG synthesis can be measured by plugging CSF and blood IgG and albumin concentrations into our equation. When done in conjunction with CSF and serum analyses for IgG oligoclonal bands, 99% of definite MS patients demonstrate intra-BBB IgG synthesis. At autopsy the pathologic criterion of an inactive plaque of demyelination is absence of inflammatory cells. Hence, we propose that modulation downward or eradication of intra-BBB IgG synthesis (ie, a manifestation of reduced white matter inflammation) in a living patient is a reasonable therapeutic criterion and goal of MS therapy. In a preliminary trial of five severely disabled MS patients, we evaluated the effects of copolymer 1 (COP-1) in daily intramuscular doses of 20 mg (2 patients) and twice daily subcutaneous doses of 15 mg (3 patients) on clinical parameters and on intra-BBB IgG synthesis over a 2-month study period. The results of this trial showed no beneficial effect on neurologic function or on inflammatory demyelination, as assessed by monitoring of intra-BBB IgG synthesis.

Adult↗
PubMed1987

Limited resection for breast cancer: a study of inked specimen margins before radiotherapy.

This is an analysis of tumor margins of 108 patients who underwent a limited resection for infiltrating breast cancer, prior to starting radiation therapy. This represented the initial resection (IR) in 75 patients, and a re-excision (RE) after biopsy elsewhere in 33 patients. All specimens were processed by the India ink method prior to frozen and paraffin section analysis. Overall, the incidence of involved margins was 28% for the IR group, and 15% for the RE group. No correlation was found with the axillary node status, or with the type of prior surgery in the RE group. The data suggest a correlation between increasing tumor size and margin involvement. Further surgery in the IR group with involved margins yielded negative margins in all cases; the finding of residual carcinoma was correlated with the type of secondary surgery, that is, further re-excision or mastectomy.

Biopsy↗
PubMed1986

Electrofluorescence study of polycyclic hydrocarbon diol-epoxide binding to DNA.

By the use of a novel electrofluorescence method, estimates have been made of the geometry of binding to DNA of racemic mixtures of the anti-diol-epoxide derivatives of three polycyclic hydrocarbon carcinogens. These anti-configurations bind in a manner consistent with the planar diol-epoxide ring's being inclined at approximately 50 degrees to the DNA axis. This is true for the derivatives of benzo(a)pyrene, benz(a)anthracene and 3-methylcholanthrene. This binding is thus different from the regular intercalative interaction associated with the native hydrocarbons. As the (+ anti)-diol-epoxides are thought to be the initiatory compounds for carcinogenesis, the common binding characteristics for the three hydrocarbons may be significant in understanding the molecular interactions precursive to cancer.

7,8-Dihydro-7,8-dihydroxybenzo(a)pyrene 9,10-oxide↗
PubMed1986

Changing patterns and outcome of acute renal failure requiring hemodialysis.

To identify factors that may explain the persistently high mortality of acute renal failure (ARF), we compared the cause, clinical course, and outcome of 55 consecutive patients with ARF who underwent hemodialysis (HD) from 1962 to 1969 with 46 similar patients from 1979 to 1981 at the same medical center. We noted an overall increase in mortality from 54.5% to 71.7%. There was an increase in the number of elderly patients developing ARF, but age per se did not influence survival. There was a significant increase in mortality in younger patients resulting from the severity of their underlying illness. We saw an increase in the number of complicating factors occurring at the onset of ARF that correlated with the increase in mortality. In survivors ARF was more prolonged in our most recent experience. The development of prolonged, complicated ARF and the poor survival seen in younger patients led to the increase in mortality in our patients.

Acute Kidney Injury↗
PubMed1982

Greater omentum used for carotid cover after pharyngolaryngoesophagectomy and gastric 'pull-up' or colonic 'swing'.

An excellent method of rehabilitation for swallowing after total pharyngolaryngoesophagectomy is the reconstruction of the pharyngoesophagus with an autogenous visceral transplant. The most popular and reliable methods are the gastric "pull-up" and colonic "swing." A complication of this procedure--which can result in morbidity as well as mortality--is carotid artery rupture, especially when a neck dissection is performed. This is usually the result of wound breakdown secondary to adjunctive use of radiotherapy. When we have performed a radical neck dissection in conjunction with a visceral transplantation, we have used pedicled omentum as a live, durable cover for the carotid artery. ?

Carotid Artery Diseases↗
PubMed1977

Effects of innervation on acetylcholine sensitivity of developing muscle in vitro.

1. Chick embryo skeletal muscle fibres were grown in culture. The acetylcholine (AACh) sensitivity of non-innervated fibres was compared with that of fibres innervated in vitro by chick embryo ciliary ganglion neurones. 2. The general pattern of ACh sensitivity was unchanged by innervation: ACh hot spots were superimposed on a background of uniform ACh sensitivity. 3. Quantitative comparisons revealed two differences between non-innervated and innervated fibres. First, hot spots were encountered about one third more often on innervated fibres. Secondly, about one-third of the hot spots on innervated fibres had significantly higher ACh sensitivities than the remainder, which were similar to those on control fibres. 4. Apossible explanation of these results is that nerves which form synapses induce the appearanceof end-plates which have higher ACh sensitivities than the pre-existing ACh hot spots.

Acetylcholine↗