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Biomedical subjects

R Walker

Publications and source records attributed to R Walker.

513 records · Page 29Linked to original sources
PubMedDate not supplied

Sturge-Weber syndrome: cranial MR imaging with Gd-DTPA.

PURPOSE: To study the role of Gd-DTPA in cranial MR of patients with Sturge-Weber syndrome. METHODS AND MATERIALS: Seven patients with Sturge-Weber syndrome, ages 3 months to 36 years, were evaluated with unenhanced and contrast-enhanced (Gd-DTPA) MR imaging. Correlation was made to cranial CT in five patients. RESULTS: MR findings included (in decreasing frequency): pial angiomatosis, cerebral atrophy, decrease in cortical veins, enlargement of deep veins, enlargement of choroid plexus, and parenchymal calcification. Contrast MR imaging was essential in diagnosis in four cases in which cranial CT, unenhanced MR, or angiography was normal or demonstrated nonspecific abnormalities. Pial angiomatosis with adjacent cerebral atrophy were the only consistent radiographic abnormalities. CONCLUSION: In all patients, contrast MR demonstrated the radiographic spectrum of central nervous system abnormalities in Sturge-Weber syndrome to a greater degree than unenhanced MR or CT and may represent the method of diagnosis in these patients. Demonstration of the pial angioma on contrast MR should be considered the most important criterion for the radiographic diagnosis of Sturge-Weber syndrome.

Adolescent↗
PubMedDate not supplied

Chronobiologic aspects of urinary gonadotropin peptide (UGP).

When using urinary gonadotropin peptide (UGP) as a marker for ovarian cancer, a circadian rhythm of large amplitude is best assessed for improving preanalytic quality control, for specifying how often and when to sample and for resolving chronobiologic endpoints. In a patient (EH, 73 y) with an ovarian (Müllerian) adenocarcinoma, overall high UGP values occurred consistently around 07:00 (standard deviation, SD = 2 h), similar to the timing observed in a presumably healthy woman. The circadian rhythm of EH averages in amplitude about 45% of the daily mean value (SD = 15%). The results indicate the desirability of deriving time-specified reference limits in health for an improved diagnostic value of UGP. The circadian UGP pattern awaits tests of applications for a chronodiagnosis of ovarian cancer, for optimizing treatment efficacy by timing according to rhythms, and conceivably for detecting earliest precancer risk.

Aged↗
PubMedDate not supplied

UGP in urogenital disorders: Egyptian experience.

UGP (Urinary gonadotropin peptide) also know as urinary gonadotropin fragment (UGF) or the beta-core of hCG (c beta hCG), was identified as a peptide with a molecular weight of 10.5 kD, having the same amino acid sequence as the core section of the beta-subunit of human chorionic gonadotropin. UGP has been found in normal pregnancy urine as well as in the urine of patients with gestational trophoblastic and non-trophoblastic malignancies. The aim of the present work was to investigate the clinical value of UGP in Egyptian patients with urogenital disorders. The study included 793 cases (462 males and 331 females) classified into 5 groups: 277 with bladder cancer, 121 with benign urinary tract disorders, 27 with different gynecological malignancies, 53 with benign gynecological disease and 315 apparently healthy individuals as a control group. The normal females included 88 premenopausal and 71 postmenopausal women. UGP was determined in 24- hour urine samples from all cases, and in morning urine samples from 151 subjects by ELISA technique using the reagents supplied by Ciba Corning Diagnostics, CA, USA (Triton UGP - EIA). The results of this study revealed significant elevation of UGP in cancer patients when compared to either normal controls or patients with benign diseases. Females in the control and benign diseases groups expressed higher UGP values than males and UGP in postmenopausal women was significantly elevated when compared to premenopausal control females. A a tumor marker, UGP was more sensitive and more specific in bladder than in gynecological cancer. A significant correlation (r = 0.934) was obtained between UGP levels in 24-hr and morning urine samples.

Adult↗
PubMedDate not supplied

Comparative study between sonography, pathology and UGP in women with perimenopausal bleeding.

Adenocarcinoma is the commonest primary malignancy encountered in the endometrium. Adenomatous hyperplasia represents an important precancerous endometrial lesion. In this study, different techniques have been applied in a trial to early detect endometrial carcinoma and to distinguish between hyperplasia with minimal and high risk of progression to endometrial adenocarcinoma. Eighty women were included in this study and classified into 4 groups: 10 with adenocarcinoma, 28 with simple hyperplasia, 12 with hyperplasia with atypia and 30 normal healthy women. All individuals were subjected to Doppler endovaginal ultrasonography (EVS) for endometrial thickness and uterine artery resistance index (RI). Endometrial biopsy was taken for histopathological examination and DNA analysis. 24-hr urine was collected for the estimation of UGP by ELISA using reagents supplied by Ciba Corning Diagnostica, Alameda, CA, USA (Triton UGP-EIA). On referring to histopathological findings, no single parameter was seen to be specific and sensitive enough to differentiate between benign and malignant endometrial lesions. Doppler endovaginal ultrasonography could detect 76% of endometrial abnormalities. DNA ploidy and UGP showed equal sensitivity rate (60%) in endometrial carcinoma but DNA ploidy was more specific than UGP (0% and 10% false positivity in benign endometrial diseases respectively.

Adenocarcinoma↗
PubMedDate not supplied

Effects of simvastatin and enalapril on serum lipoprotein concentrations and left ventricular mass in patients on dialysis. The Perfect Study Collaborative Group.

A randomised trial of simvastatin and enalapril in patients with chronic renal failure on dialysis: effects on serum lipoprotein concentrations and left ventricular mass. Left ventricular hypertrophy and abnormalities of lipoprotein metabolism are both possible contributors to the high risk of cardiovascular death in patients with chronic renal failure on dialysis. We investigated the effects of simvastatin on lipid and lipoprotein concentrations and the effects of enalapril on left ventricular mass in 107 patients receiving haemodialysis or continuous ambulatory peritoneal dialysis. Patients were randomised in a factorial design to receive simvastatin (10 mg daily) or placebo and enalapril (2.5-5 mg daily) or placebo. During follow-up, there was a significant excess of patients withdrawn from enalapril because of hypotension (2p = 0.002), and after 6 months only 55% of those assigned enalapril were still on treatment. From baseline to 6 months, there were no statistically significant differences in left ventricular mass or left ventricular dimensions between patients assigned enalapril and those assigned placebo. Among the patients assigned simvastatin, total cholesterol was reduced by 13% (2p = 0.001), LDL cholesterol was reduced by 17% (2p = 0.003) and apolipoprotein B was reduced by 12% (2p = 0.005) compared to patients assigned placebo. There were borderline significant (2p = 0.05 to 0.08) reductions in VLDL cholesterol, total triglyceride and VLDL triglycerides of 26%, 12% and 17% respectively. Large-scale trials are now required to determine whether reductions in lipid and lipoprotein concentrations confer a reduction in coronary heart disease morbidity and mortality in patients on dialysis.

Adolescent↗