Search PubMed⌕ Search

Biomedical subjects

R Haskell

Publications and source records attributed to R Haskell.

At least 19 recordsLinked to original sources
PubMed2000

Primary seminal vesicle carcinoma: an immunohistochemical analysis of four cases.

Primary adenocarcinoma of the seminal vesicles is an extremely rare neoplasm. Because prompt diagnosis and treatment are associated with improved long-term survival, accurate recognition of this neoplasm is important, particularly when evaluating limited biopsy material. Immunohistochemistry can be used to rule out neoplasms that commonly invade the seminal vesicles, such as prostatic adenocarcinoma. Previous reports have shown that seminal vesicle adenocarcinoma (SVCA) is negative for prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PAP); however, little else is known of its immunophenotype. Consequently, we evaluated the utility of cancer antigen 125 (CA-125) and cytokeratin (CK) subsets 7 and 20 for distinguishing SVCA from other neoplasms that enter the differential diagnosis. Four cases of SVCA-three cases of bladder adenocarcinoma and a rare case of adenocarcinoma arising in a mullerian duct cyst-were immunostained for CA-125, CK7, and CK20. Three of four cases of SVCA were CA-125 positive and CK7 positive. All four cases were CK20 negative. All bladder adenocarcinomas and the mullerian duct cyst adenocarcinoma were CK7 positive and negative for CA-125 and CK20. In addition, CA-125 immunostaining was performed in neoplasms that commonly invade the seminal vesicles, including prostatic adenocarcinoma (n = 40), bladder transitional cell carcinoma (n = 32), and rectal adenocarcinoma (n = 10), and all were negative for this antigen. In conclusion, the present study has shown that the CK7-positive, CK20-negative, CA-125-positive, PSA/PAP-negative immunophenotype of papillary SVCA is unique and can be used in conjunction with histomorphology to distinguish it from other tumors that enter the differential diagnosis, including prostatic adenocarcinoma (CA-125 negative, PSA/PAP positive), bladder transitional cell carcinoma (CK20 positive, CA-125 negative), rectal adenocarcinoma (CA-125 negative, CK7 negative, CK20 positive), bladder adenocarcinoma (CA-125 negative), and adenocarcinoma arising in a mullerian duct cyst (CA-125 negative).

Adenocarcinoma↗
PubMed1999

Hypomagnesemia in trauma patients.

The objective of this study was to determine the incidence of hypomagnesemia in injured patients (versus a general hospital cohort) and to compare total and ionized values with each other and with the incidence of injury severity and ethanol level. It was a descriptive study of consecutive injured patients at a level II trauma center. For 3 months subjects underwent admission paired analysis of blood total magnesium (TMg) and ionized magnesium (IMg). IMg was determined by microanalysis of whole blood (Nova Biomedical, NovaSP9). During the same time period, all hospital samples for TMg (m = 1308) underwent simultaneous IMg testing. Pearson correlation coefficients were determined for IMg versus TMg, Injury Severity Score (ISS), Trauma Score (TS), Glasgow Coma Scale (GCS), and blood units transfused. By convention, hypomagnesemia was defined as TMg < or =1.6 mg/dl and IMg < or = 0.5 mg/dl. Altogether 43% of 113 trauma patients had low magnesium levels compared to 30% of noninjured cohorts (p<0.05). The correlation coefficient (r(2)) for TMg and IMg was 0.74 for TMg values >1.6, but for TMg < or =1.6 the r(2) was 0.35. Coefficients for IMg and ISS, TS, GCS, units transfused, and ethanol level were 0.06, 0.08, 0.10, 0.04, and 0.01, respectively. Mean IMg was 0.57+/-0.09 mg/dl with ethanol ingestion and 0.56+/-0.06 mg/dl without ethanol ingestion (mean +/- SD, p>0.05). It was concluded that hypomagnesia is common in injured patients but does not correlate with indices of injury severity or ethanol level. TMg is not a good predictor of IMg at low levels. Trauma patients may benefit from determination of IMg for accurate diagnosis of a low Mg level to facilitate repletion.

Adult↗
PubMed1998

UK National Third Molar project: the initial report.

The National Third Molar (NTM) project was set up to assess current clinical practice in the UK concerning the management of third molar teeth. Patients were recruited from both hospital and general dental practice. During the one month study period 9248 patients with 26,577 third molars were recruited. In this report we present the findings in the 8298 patients with 25,001 third molars who were referred to hospital for assessment. Over half of all patients referred for assessment had either no extractions or a single third molar extracted. Less than a quarter of all patients referred underwent removal of all four third molars. Twenty per cent of all third molars assessed were not extracted. Of all lower third molars listed for extraction, 9574 (78%) were associated with symptoms or disease. Pericoronitis was the commonest indication for extraction and was cited in 39.5% of all extractions. Almost 70% of third molar extractions were done under general anaesthesia while less than a quarter were performed under local anaesthesia alone.

Adult↗
PubMed1998

Recidivism in equestrian trauma.

A 3-year chart survey and questionnaire was conducted of equestrian-injured patients at a regional trauma center to determine patterns and consequences of injury and rate of recidivism. Ninety-two patients (95 encounters) were treated; most were young (mean age, 27 +/- 11 years) women (84%) riders sustaining falls (80%). Most injuries were orthopedic (47%); 19 per cent of patients required hospital admission. There was one death. Helmet use was documented in only 34 per cent. Eighty-one per cent of patients responded to a follow-up telephone survey; 36 per cent recounted additional accidents (mean, 1.4 +/- 0.5). Mean time lost from work was 3 weeks, with 19 per cent reporting chronic disability. Mean annual hospital charges for the cohort were $88,925.00. Recidivism is common in equestrian trauma. Hospital charges are significant. Lost time from work is considerable, with one in five patients reporting long-term disability. Given the cost and disability incurred with equestrian trauma, efforts at injury prevention appear warranted.

Accidental Falls↗
PubMed1997

Giant cell arteritis of the uterus: case report and review.

We here report a rare case of giant cell arteritis (GCA) of the myometrium found incidentally in a 68-year-old Caucasian woman presenting with uterovaginal prolapse and a known past history of temporal arteritis/polymyalgia rheumatica. Histology revealed a segmental arteritis of small, medium and some quite large myometrial arteries with extensive destruction of both internal and external elastic laminae. Multinucleate giant cells, lymphocytes and histiocytes were most prominent in the inflammatory infiltrate. The findings in this case are compared with previous reports. In a review of the literature it was found that almost one third of cases presented with generalised symptoms such as fever, anemia, fatigue and weight loss. The symptoms were not immediately recognised as temporal arteritis or polymyalgia rheumatica. On routine physical examination or radiological investigation, benign gynecological pathology such as a simple ovarian cyst or uterine leiomyoma were found. The subsequent unexpected discovery of GCA on histological examination was the critical event in alerting clinicians to the diagnosis of temporal arteritis/polymyalgia rheumatica. Without exception steroid therapy was successful in achieving relief of generalised symptoms.

Female↗
PubMed1996

Bilateral primary seminal vesicle carcinoma.

We report a rare case of bilateral primary seminal vesicle carcinoma in a 73 yr old Australian man. To our knowledge this case report is the 48th histologically confirmed case of primary seminal vesicle neoplasia and only the fourth reported case of primary bilateral seminal vesicle carcinoma. Macroscopically the tumor was localized to both seminal vesicles and the adjacent right lobe of the prostate. Histologically the tumor and metastases displayed a PSA, PAP and CEA negative, well differentiated papillary adenocarcinoma resembling the pattern of normal seminal vesicle epithelium. No other primary carcinoma in the body was demonstrated. The patient survived for 3 yrs and 4 mths without recurrence of tumor. The pathological criteria for acceptance of primary seminal vesicle carcinoma, difficulties in clinical/radiological detection of seminal vesicle tumors and CA-125 immunoreactivity are discussed.

Aged↗
PubMed1995

Oral presentation of minocycline-induced black bone disease.

Minocycline hydrochloride is a semisynthetic tetracycline derivative used widely for the treatment of acne vulgaris. Among its side effects is the ability to pigment many tissues particularly thyroid, skin, tooth, and bone. A case is presented in which long-term minocycline therapy (500 g taken orally over 11 years) resulted in dark bone pigmentation (black bone disease) severe enough to be visible through the alveolar and palatal mucosa. No skin or tooth pigmentation was present.

Acne Vulgaris↗
PubMed1995

An unusual intraosseous melanoma in the maxillary alveolus.

A case is reported of a 31-year-old white man who presented with a solitary melanoma in the maxillary alveolus. The lesion was located between and had displaced the roots of the lateral incisor and canine and was relatively well circumscribed on radiography. No mucosal origin or potential primary lesion was found, and a marginal excision resulted in the patient remaining free from disease after 7 years of follow-up. Metastasis of melanoma to the jaws is rare even in disseminated disease, and this solitary lesion is unusual. Although metastasis from a regressed primary tumor cannot be excluded, some of the features raise the possibility that this melanoma may have arisen as a primary tumor within bone.

Adult↗
PubMed1991

Transfacial access for neurosurgical procedures: an extended role for the maxillofacial surgeon. I. The upper cervical spine and clivus.

A variety of osteoplastic flaps have been devised for transoral or extraoral access to the base of skull and the upper anterior cervical spine. Part I of this two-part review will describe access to the clivus and upper anterior cervical spine. Part II will describe access to the middle cranial fossa, the infratemporal fossa and the pterygoid (retromaxillary) "space".

Bone Diseases↗
PubMed1991

Transfacial access for neurosurgical procedures: an extended role for the maxillofacial surgeon. II. Middle cranial fossa, infratemporal fossa and pterygoid space.

A variety of osteoplastic flaps have been devised for transoral or extraoral access to the base of skull and the upper anterior cervical spine. Part I of this two-part review describes access to the clivus and upper anterior cervical spine. Part II will describe access to the middle cranial fossa, the infratemporal fossa and the pterygoid (retromaxillary) "space".

Bone Diseases↗
PubMed1989

Effect of altering heart rate on oxygen uptake at exercise onset.

At the onset of exercise, both cardiac output and ventilation increase abruptly. We investigated the hypothesis that a rapid change in cardiac output, as effected by an immediate increase in heart rate at the start of exercise and a decrease in heart rate at the termination of exercise, affects the responses of oxygen uptake. Five patients in whom programmable pacemakers had been previously inserted for complete heart block were studied. Responses in ventilation and gas exchange were recorded breath by breath during studies in which each subject performed 16 transitions between rest and moderate exercise on a cycle ergometer. In a randomized fashion, in half of the transitions, heart rate was accelerated from a low rate to a high rate as exercise began; in the other half, heart rate was held constant at the low rate as exercise began. Oxygen uptake increased by 30 percent in the first 20 seconds of exercise, when heart rate was constrained, while it increased by 70 percent when heart rate was abruptly accelerated. Similarly, smaller changes were observed at the cessation of exercise when the heart rate was constrained, as compared to an abrupt decrease in heart rate. Despite this difference in the responses of oxygen uptake, at the transitions in exercise, the ventilatory responses were indistinguishable. We have demonstrated that ventilation-independent changes in oxygen uptake can be induced at the onset and cessation of exercise. These alterations in oxygen uptake are predictable from differences in blood flow which occur as a consequence of the differences in time course of the heart rate.

Adult↗
PubMed1988

Zygomaticotemporal approach to the basis cranii and basilar artery.

When using the zygomaticotemporal approach, one removes the whole of the zygomatic bone with its attachment to the masseter muscle, allowing a lower and more anterior approach to the interpeduncular cistern along the inferomedial surface of the temporal lobe. Minimal brain retraction is required to give an excellent view of the bifurcation of the basilar artery and of the suprasellar region.

Basilar Artery↗