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Biomedical subjects

R L Katz

Publications and source records attributed to R L Katz.

At least 91 records · Page 5Linked to original sources
PubMed1989

Fine-needle aspiration cytology of peripheral T-cell lymphoma. A cytologic, immunologic, and cytometric study.

The diagnosis of peripheral T-cell lymphoma (PTCL) is difficult. This entity can be misdiagnosed as Hodgkin's disease or a reactive process such as nonnecrotizing granulomatous lymphadenitis or it can present a problem in lymphoma classification. Fine-needle aspirates from 13 patients with histologically proven PTCL were evaluated by cytology, immunochemistry, and flow cytometry. Of the 13 patients with PTCL, initial cytologic diagnoses were atypical lymphocytic infiltrate (2), mixed-cell lymphoma (6), mixed-cell lymphoma with associated histiocytes (2), large cell lymphoma (2), and small cell lymphoma (1). Surface marker studies were performed on cytospin preparations. Antibodies against cytotoxic-suppressor (Leu-2a) and helper-inducer (Leu-3a,b) antigens were used in 11 cases. Ten lymphomas demonstrated helper phenotype and one showed phenotypic heterogeneity in two different sites. The most prominent cytologic features of PTCL were a variable combination of small, intermediate, and large lymphoid cells with irregular nuclei, presence of epithelioid histiocytes, and atypical mononuclear cells. Flow cytometry studies showed a diploid stem line with intermediate proliferative activity (mean S-phase of 6.7%) in most cases, despite the clinical aggressiveness of this neoplasm.

Adult↗
PubMed1989

Leukemic lymphadenopathy: diagnosis by fine needle aspiration.

We report cytologic findings in 6 patients (2 with a history of chronic myelogenous leukemia and 2 with a history of acute lymphoblastic leukemia) who presented with generalized or localized lymphadenopathy of undetermined etiology. Fine needle aspiration of enlarged lymph nodes resulted in the initial diagnosis of leukemia (1 case) or blast crisis of leukemia (2 cases), confirmation of involvement by leukemia at presentation (1 case), or confirmation of relapse of leukemia (2 cases). The average number of cells in the aspirates was 20 million, sufficient for performing immunophenotypic studies, flow cytometry, cytogenetic studies, and electron microscopy. The cytological features, combined with the ancillary studies, resulted in the diagnosis and subclassification of the leukemias as follows: chronic myelogenous leukemia, blast crisis (lymphoid); chronic myelogenous leukemia, blast crisis (undifferentiated); common acute lymphoblastic leukemia; acute lymphoblastic leukemia (T-cell), acute lymphoblastic leukemia (T-cell); and malignant lymphoma, small lymphocytic type.

Adolescent↗
PubMed1989

Lymphokine activity in malignant effusions after intracavitary viral oncolysate.

Six patient with malignant effusions (five with ascites and one with malignant pleural effusion) due to refractory ovarian carcinomatosis, received intracavitary injections of ovarian viral oncolysate (VO). Measurements were made of the intracavitary activities of T cell growth factor (TCGF-IL-2) and B cell growth factor 12-kD (BCGF) and these were correlated with the clinical activity and cytologic changes in the malignant effusions. Both BCGF and IL-2 activities were demonstrated in malignant effusions prior to therapy although these were relatively higher for BCGF. Increases in the activities of both lymphokines were observed in the post VO treatment samples ranging from 4.1% to 45.0% for BCGF and 4.8% - 33.9% for IL-2. One patient who exhibited marked clinical improvement accompanied by mononuclear cell infiltrates and diminution of ascitic fluid malignant cells, also had elevation of lymphokine activities after repeated VO injections. These data provide further support for the role of VO as inducers of regional immunity.

Ascitic Fluid↗
PubMed1989

The effect of cimetidine and ranitidine on the duration of action of succinylcholine.

A recent study suggested that cimetidine prolongs the duration of action of succinylcholine (SCh). We examined this reported interaction, and investigated whether it is the result of inhibition of plasma cholinesterase (PChE). We also studied the effect of ranitidine on the duration of action of succinylcholine. Thirty patients were randomly assigned to three groups to receive oral cimetidine 300 mg or ranitidine 150 mg or no H2-antagonist the night before surgery and again 1-2 hours prior to induction of anesthesia. Succinylcholine (1.5 mg/kg i.v.) was given to facilitate tracheal intubation after induction of anesthesia; neuromuscular function was monitored by evoked compound electromyogram. Pretreatment blood samples were analyzed for PChE activity. PChE activity and levels of appropriate H2-antagonists were measured in preinduction blood samples. No significant effect of either cimetidine or ranitidine on the duration of action of SCh or PChE activity was demonstrated. We conclude that H2-antagonists administered preoperatively do not prolong the duration of action of succinylcholine or alter PChE activity.

Adult↗
PubMed1988

Ethnic patterns of thyroid cancer incidence in the United States, 1973-1981.

Descriptive epidemiological findings for 7,696 patients with newly diagnosed thyroid cancer reported to the Surveillance, Epidemiology, and End Results (SEER) program for the years 1973 through 1981 are summarized. The preponderance of this tumor in women and of the papillary histologic subtype are well documented. The data suggest that previously reported increases in the incidence of thyroid cancer among Whites levelled off in the late 1970s. Differences in the incidence of this cancer according to ethnic group were particularly striking. Compared with White men and women, Puerto Rico Hispanics and Blacks had significantly lower thyroid cancer rates (weighted rate ratios ranged from 0.48 to 0.65). New Mexico Hispanic men and Chinese, Japanese, Hawaiian and Filipino men and women had significantly higher rates (weighted rate ratios ranged from 1.56 to 3.17). Elevated thyroid cancer rates for residents of Hawaii, regardless of ethnic group, were also a noteworthy finding. Variations in thyroid cancer risk according to ethnic group and geographical residence may reflect socio-economic or local environmental influences, including the possibility of a carcinogenic agent in volcanic lava.

Adolescent↗
PubMed1988

Negative inotropic effects of ATP on the isometric contractions of isolated rat heart muscle.

The effects of ATP on the isometric contractions of isolated rat left ventricular papillary muscle were studied. Exogenously administered ATP had an immediate onset, an abrupt response, progressive recovery and produced dose-related depression in the peak developed tension, maximum rate of tension development and relaxation, which were statistically significant. There were no significant changes in the resting tension, time to peak tension and relaxation time, except for a significantly prolonged relaxation time at the highest concentration of ATP. In the studies of interactions of ATP and either epinephrine or Ca(++), we observed that ATP seemed to interfere with the inotropic effect of epinephrine, while Ca(++) antagonized the negative inotropic action of ATP. We conclude that the site of negative inotropic action of ATP is most likely on the cell membrane, where ATP interferes with Ca(++) flux, and that ATP interferes with the positive inotropic action of epinephrine.

Journal Article↗
PubMed1988

Medullary thyroid carcinoma metastatic to breast diagnosed by fine-needle aspiration biopsy.

We report a patient with a 22-yr history of medullary thyroid carcinoma in whom fine-needle aspiration biopsy of a breast mass, clinically suspected of being a primary mammary carcinoma, established the diagnosis of metastasis. This article demonstrates the importance of the use of immunocytochemical methods on fine-needle aspirates to diagnose metastases to the breast.

Biopsy, Needle↗
PubMed1988

Flow cytometric applications in cytopathology.

Flow cytometric (FCM) methodology represents a powerful analytical tool for screening and detecting abnormal and malignant cells, for subclassifying malignancies beyond conventional morphologic type and grade and for transcending light microscopic features by providing more biologically meaningful information. This paper reviews the historical background leading to the development of the FCM methodology and instrumentation that is presently being used for cytopathologic (and histopathologic) diagnosis, tumor subclassification and identification of aggressive cancers. Emphasis is placed on human carcinomas, with reference to hematologic malignancies when appropriate. Examples of FCM DNA content and cytokinetic techniques are described for the various cytologic sampling methods. The advantages, limitations and future prospects for the application of flow cytometric techniques in cytopathology are discussed.

Biopsy↗
PubMed1987

Acridine-orange flow cytometry of urinary bladder washings for the detection of transitional cell carcinoma of the bladder. The influence of prior local therapy.

Analysis of cellular DNA and RNA contents of 249 bladder irrigation specimens from 129 patients with a history of transitional cell carcinoma (TCC) of the bladder was performed using acridine-orange flow cytometry (FCM). Washings from patients with prior intravesical chemotherapy or radiation therapy were compared to those from patients with no history of treatment other than tumor resection to evaluate the reliability of FCM for the detection of tumor and the influence of prior local therapy on that reliability. Five FCM patterns were defined on the basis of DNA and RNA indexes in relationship to peripheral blood lymphocytes. FCM results were compared to cytologic findings in 237 cases, cystoscopic findings in 230 cases, and histologic data in 99 cases. Presence of a single diploid stem line was associated with absence of bladder tumor in 71% of cases from patients treated with surgery alone or with radiation therapy, but there was residual tumor in 53% of patients exposed to prior local chemotherapy. An elevated RNA content in a diploid cell population did not provide additional diagnostic information. Presence of an aneuploid stem line was associated with tumor in 85% of cases, regardless of prior therapy. Aneuploidy predicted the appearance of tumor in four of six patients with a negative cystoscopy. Tetraploidy (greater than 10% of total cell population) was associated with tumor in 79% of patients treated with surgery alone, whereas no tumor was found in more than 50% of patients who had undergone prior chemotherapy or radiation therapy. This study stresses the importance of prior treatment history in evaluating the results of DNA-FCM for bladder cancer. It demonstrates the unreliability of FCM diploid and tetraploid cell populations in patients previously treated by local chemotherapy or radiation. However, it also supports prior observations that DNA-aneuploidy and DNA-tetraploidy are useful for detecting and predicting bladder cancer in patients submitted to surgery alone.

Acridine Orange↗
PubMed1987

A morphologic, immunologic, and cytometric approach to the classification of non-Hodgkin's lymphoma in effusions.

The biologic and clinical heterogeneity of the various subtypes of non-Hodgkin's lymphoma is related to differences in morphologic, immunologic, and kinetic properties. Comprehensive studies characterizing these features in lymphomatous effusion have yet to be reported. We recently studied 27 effusion specimens from 26 patients with clinically suspected or confirmed lymphoma. Wright-Giemsa- and Papanicolaou-stained cytologic preparations, acridine orange nucleic acid flow cytometry, and immunoperoxidase staining of cell suspensions using antibodies to a battery of T and B cell markers were evaluated and compared with prior histologic accessions. Specimens were classified by cytologic characteristics according to the International Working Formulation Scheme and by acridine orange nucleic acid flow cytometry using the parameters of DNA, RNA, and proliferative activity. Correlation of the cytometric and morphologic data demonstrated that with increasing cytologic grade of lymphoma, the proliferative activity increased progressively and distinguished between grades (P less than 0.01). Immunologic studies identified B cell phenotype in 16 specimens, T cell in three, and true histiocytic lymphoma in one; one lymphoma had no cell markers (null cell). Six effusions proved to be inflammatory and reactive according to surface marker studies. Classification by cytologic characteristics showed good correlation with histologic classification performed previously. Immunologic study of cytologic specimens gave results identical to those achieved by frozen-section immunohistologic examination. Thus, immunologic and cytometric parameters can be readily performed on effusion specimens and aid in the diagnosis and classification of lymphomas.

Adult↗
PubMed1987

Malignant carcinoid of the pancreas: a cytologic, ultrastructural, and immunocytochemical study of a case diagnosed by fine-needle aspiration of a supraclavicular node metastasis.

Carcinoid tumor of the pancreas is extremely rare. This article describes the case of a 22-year-old woman who manifested a typical carcinoid syndrome; a definitive diagnosis of a metastatic carcinoid tumor was made from needle aspiration of a supraclavicular lymph node using morphologic, immunocytochemical, and ultrastructural criteria. The carcinoid tumor was subsequently shown to be of pancreatic origin.

Adult↗
PubMed1987

Zinc deficiency in anorexia nervosa.

Adolescents with anorexia nervosa were evaluated for clinical and biochemical evidence of zinc deficiency. To assess whether these patients would benefit from zinc supplementation, a double-blind, randomized, controlled trial was conducted. The mean zinc intake of the anorexic group calculated on the basis of three-day dietary records was 7.7 +/- 5.2 mg/day, which is significantly below the recommended daily allowance of 15 mg for adolescents (p less than 0.001). The mean urinary zinc excretion in the anorexic group was 257.1 +/- 212.7 micrograms/24 hours compared to 749.9 +/- 897.8 micrograms/24 hours in the control group (p less than 0.005). This result suggests that the zinc status of anorexia nervosa patients may be compromised due to an inadequate zinc intake. Zinc supplementation (50 mg elemental zinc/day) was followed by a decrease in the level of depression and anxiety as assessed by the Zung Depression Scale (p less than 0.05) and the State-Trait Anxiety Inventory (p less than 0.05), respectively. Our data suggest that individuals with anorexia nervosa may be at risk for zinc deficiency and may respond favorably after zinc supplementation.

Adolescent↗
PubMed1987

Electrical and mechanical responses after neuromuscular blockade with vecuronium, and subsequent antagonism with neostigmine or edrophonium.

Six unpremedicated patients who had given their informed consent were given vecuronium 0.08 mg kg-1 before elective surgery. Recovery from neuromuscular blockade was measured electrically and mechanically. Neuromuscular blockade was antagonized 1 h after the administration of vecuronium with two doses of neostigmine 2.5 mg (three patients) or edrophonium 0.5 mg kg-1 (three patients). Although the onset of initial recovery was similar, subsequent recovery was faster when measured electrically (EMG) than when measured mechanically. Recovery appeared to be faster in younger patients. Reintroduction of neuromuscular blockade occurred after the second dose of neostigmine 2.5 mg, given to antagonize the block. This did not occur after either dose of edrophonium 0.5 mg kg-1.

Adult↗
PubMed1987

DNA hybridization for human papillomavirus (HPV) in cervical lesions. Relationship of the presence of various viral subtypes to expression of HPV structural proteins, involucrin, and carcinoembryonic antigen.

We studied cervical tissue from 20 patients with a variety of condylomatous, preneoplastic, and neoplastic lesions to detect various subtypes of human papillomavirus (HPV) at the molecular level by DNA hybridization. In addition, mirror image biopsy specimens were studied by an immunoperoxidase technique for the presence of HPV structural antigens, carcinoembryonic antigen (CEA), and involucrin, as markers of disturbed maturation and/or neoplasia. Of the 20 patients studied, we were able to demonstrate the presence of either HPV 16 or 18, or both, in three of seven squamous carcinomas tested, and three of five dysplasias. Interestingly, two cases of squamous carcinoma and one moderate dysplasia demonstrated HPV types 6 and 11 concurrently with HPV 16 and/or 18. Four of six condylomas showed HPV subtypes 6/11, and only one condyloma showed weak hybridization with HPV 18. Human papillomavirus structural antigen was seen in three of eight condylomas, and three of five dysplasias, but not in any carcinoma. All condylomas showed intense staining for involucrin in full-thickness of the epithelium, but the high-grade dysplasias and carcinomas showed only focal or absence of staining for involucrin. Carcinoembryonic antigen was expressed in 50% of the carcinomas with a pattern similar to that seen with involucrin, but did not correlate with any particular subtype of HPV. The molecular hybridization method seems to be superior for the detection of HPV lesions, and possibly for the prediction of their biologic behavior.

Antigens, Viral↗
PubMed1987

The gene located at chromosome 18 band q21 is rearranged in uncultured diffuse lymphomas as well as follicular lymphomas.

The karyotypic abnormality t(14;18)(q32;q21) is reported to occur in 75% of follicular lymphomas. This translocation results in the rearrangement of a putative oncogene bcl-2, which resides at chromosome 18 band q21 (the 18q21 gene). Using two human genomic DNA fragments cloned from the chromosome 18 band q21 as probes, we analyzed 65 uncultured human lymphoma samples by the Southern blot technique. The 18q21 gene was rearranged in 18 of 26 (69%) follicular lymphomas, 3 of 5 (60%) follicular lymphomas transformed to large cell lymphomas, 8 of 20 (40%) diffuse large cell lymphomas (DLCLs), and 2 of 7 (29%) small noncleaved cell lymphomas (SNCs). Our analysis detected rearrangement of the 18q21 gene in 10 of 13 (77%) cases in which the t(14;18)(q32;q21) translocation was found by cytogenetic techniques. Our analysis also proved helpful in difficult karyotyping situations: (a) identifying the donor chromosome fragment as chromosome 18 band q21 in 4 of 9 (44%) cases that cytogenetically displayed a 14q+ chromosome of unknown origin, and (b) identifying a rearrangement of chromosome 18 band q21 in 12 of 18 (67%) cases that cytogenetically yielded no cells in metaphase. We also demonstrated three cases of submicroscopic rearrangement of the 18q21 gene. In our studies, patients with DLCLs and rearrangement of the 18q21 gene had a significantly higher incidence of extranodal involvement when compared with patients with DLCLs and no 18q21 gene rearrangement (P = 0.03).

Bone Marrow Cells↗