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S Chan

Publications and source records attributed to S Chan.

240 records · Page 14Linked to original sources

Racial differences in prostate-specific antigen levels in patients with local-regional prostate cancer.

Prostate cancer is a significant health problem for blacks. The incidence and mortality rates are higher in blacks than in whites; blacks often present with a higher stage. Prostate-specific antigen (PSA) is a very useful serum marker in prostate cancer. We analyzed data from a cohort of 161 patients to determine whether there were any racial differences in PSA levels prior to treatment in local-regional prostate cancer. The immunoradiometric method was used to determine the PSA values. The mean PSA levels were significantly higher in blacks than in whites (P = 0.022), and the difference remained significant in multivariate analysis after adjusting for stage and grade (P = 0.020). However, when analyzed further, the difference was statistically significant in one hospital (P = 0.001) and not in another (P = 0.493). Thus, our results are not unequivocal, but our data do suggest that racial differences in PSA levels not accounted for by tumor stage or grade may exist. Assuming that the data truly reflect a racial difference, the cause(s) of this difference remains to be determined. It may exist because, within each clinical stage, blacks are presenting with a higher tumor cell burden, or it may be indicative of more aggressive biological behavior. The possibility that racial differences are due to socioeconomic factors was considered by estimating median income level from zip code of residence; although a correlation between socioeconomic status and PSA level was found, racial differences remained borderline significant (P = 0.055) after adjusting for income level (in addition to stage and grade).

Black or African American↗

Retroperitoneal endodermal sinus tumor. Report of a case with an abnormal cervicovaginal smear.

An unusual case of an endodermal sinus tumor arising in the retroperitoneum and invading the fallopian tube is reported. The patient presented with malignant cells mimicking adenocarcinoma in the cervicovaginal smear. The differential diagnoses of such cells in cervicovaginal cytology are discussed. The cytohistologic, immunohistochemical and ultrastructural findings of the tumor are correlated.

Adult↗

Multifocal hypointense cerebral lesions on gradient-echo MR are associated with chronic hypertension.

PURPOSE: To investigate the basis for multifocal hypointense lesions within the brain as identified on T2*-weighted gradient-echo MR imaging in patients with no known or presumed cause of these lesions. METHODS: In the first of a two-part study design, we retrospectively reviewed a case series of 38 patients whose gradient-echo MR images showed multiple hypointense lesions within the brain parenchyma. Thirty-one cases in which the cause was known or presumed (eg, head trauma or cavernous angioma) were excluded from further review. The MR studies and clinical findings of the remaining seven cases were reexamined. In the second part, using a cohort study design with respect to hypertension, we prospectively reviewed the gradient-echo images from MR studies of 65 patients and control subjects enrolled in two ongoing clinical studies, one on "possible vascular dementia" (n = 33) and the other on "possible motor neuron disorder" (n = 32). RESULTS: In the first part of the study, we found seven cases with a pattern of multiple hypointense lesions involving the deep gray matter nuclei, especially the basal ganglia (n = 6) and thalamus (n = 5). In addition, involvement of the corona radiata (n = 5), brain stem (n = 4), and cerebellum (n = 3) was seen. Clinical review revealed a history of chronic hypertension in all seven patients. In the cohort study, we found three of 65 persons who had two or more focal hypointense lesions that involved the basal ganglia or thalami. Review of the clinical data showed that all three patients were being treated for hypertension; also, all three were patients from the "possible vascular dementia" group. CONCLUSIONS: The MR imaging pattern of multifocal hypointense lesions within the basal ganglia, thalamus, and other deep cerebral structures is more commonly found among patients with a history of chronic hypertension than in patients without chronic hypertension.

Adult↗