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Biomedical subjects

S Y Cho

Publications and source records attributed to S Y Cho.

At least 199 records · Page 11Linked to original sources

Causes of death and metastatic patterns in patients with mammary cancer. Ten-year autopsy study.

As periodic evaluation of the causes of death in cancer patients may provide guidelines for further research on supportive care in cancer, the authors studied autopsy records of 144 mammary-cancer patients from the past ten years. The causes of death were analyzed and compared for the first and second five-year periods. During the first five-year period (65 cases), death was caused by the malignant process itself in 70.8% of the patients, by infection in 10.8% and by hemorrhage in 7.7%. During the second five-year period (79 cases), the malignant process itself was still the most frequent cause of death but in only 47.4% of the patients, and deaths due to infections (23.7%) and hemorrhages (9.2%) were relatively more frequent, without noticeable changes in the patients' survival times. These findings may be related to the more aggressive methods of treatment applied in recent years. The metastases to the organs tended to be massive, and except for the lymph nodes, the lung was the organ most frequently involved by tumors (60%), followed by bone (54%), liver (54%), adrenal gland (36%), pleura (36%) and brain (26%). As the chance of life-threatening infections is great in mammary cancer, the early detection and treatment of infections in mammary-cancer patients could become an important factor in prolonging the survival of these patients.

Autopsy↗

Malignant mixed tumor of the gallbladder.

Multimorphic malignant tumors containing elements of two or more germ layers presenting as mixed tumors are rarely encountered in the gallbladder. A review of the literature revealed a report of a single case in which the histologic appearance was similar to that of the case reported herein. The malignant mixed tumor of the gallbladder appears to be a highly anaplastic and rapidly fatal neoplasm. It may be suspected by the presence of chondroid or myxoid tissue, or both, on gross examination.

Aged↗

Multiple myeloma associated with acquired cutis laxa.

Acquired cutis laxa is a rare disorder characterized by diffuse laxity of the skin and loss of connective tissue support with involvement of the lungs, gastrointestinal tract, pelvic organs, and aorta. The case report presented herein describes a forty-six year old woman with multiple myeloma and cutis laxa. Her history included several severe allergic reactions and the gradual development of lax skin, loss of connective tissue support throughout the body, and emphysema. At autopsy, multiple myeloma, diffuse laxity of the skin, and panacinar emphysema were found. The amount of elastic fiber in the skin, lungs, and aorta was decreased and showed abnormal fragmentation. Results of direct immunofluorescence study demonstrated IgG bound to dermal elastic fibers. Speculation regarding an immunologic etiology of the elastic tissue abnormality is presented herein.

Adult↗

The anthelmintic effects of flubendazole on Brugia pahangi.

The anthelmintic effects of flubendazole (methyl [5-(4-fluorobenzoyl)-1-H-benzimidazol-2-yl] carbamate) (Janssen Pharmaceutica) were evaluated in jirds (Meriones unguiculatus) and cats (Felis cattus) infected with Brugia pahangi. Flubendazole was macrofilaricidal at 5 x 2.5 mg/kg and 1 x 25 mg/kg in jirds and 1 x 100 mg/kg in cats when administered by subcutaneous injection. It also killed developing larvae in jirds. It was not microfilaricidal.

Animals↗

Opportunistic fungal infection among cancer patients. A ten-year autopsy study.

A high incidence of opportunistic fungal infections among cancer patients has been a pressing problem confronting clinicians. The fungal infections in 3,278 consecutive autopsies at Thomas Jefferson University Hospital during a ten-year period (1966-1975) were studied. There were 1,204 (36.7%) cancer patients; 85 (7.1%) of these patients had concomitant fungal infections. The incidence was 9.3% during the last five-year period; 5.1% during the first five-year period. Candidiasis was the most frequent fungal infection (52.2%) among these patients, followed by aspergillosis (31.1%), mucormycosis, cryptococcosis, histoplasmosis and nocardiosis. The leukemias and lymphomas were the most frequent malignancies associated with fungal infections. However, in this study, unlike others, the incidences of fungal infection in patients with some solid tumors were also high, especially those in patients with cancers of the colon and pancreas.

Adolescent↗

Accelerated atherosclerosis in chronic-dialysis patients--another look.

Actuarial statistics of 53 dialysis patients treated between 1965 and 1976 are reviewed. It is suggested that dialysis did not accelerate atherosclerosis over the observed time period. It appears as though a fundamental change in the dialysis population has occurred and there are too few long-term dialysis patients available to establish whether dialysis does accelerate atherosclerosis.

Adult↗

Coexistence of Hodgkin's disease and Gaucher's disease.

A case of Hodgkin's disease associated with long-standing Gaucher's disease is presented and compared with the only previously reported case. The two diseases coexisted in lymph nodes both above and below the diaphragm, liver, bone marrow, and pancreas. The question of a possible relationship of the two diseases is discussed.

Adult↗

Pulmonary yellow hyaline membrane disease. New variant in premature infants with intrahepatic cholestasis.

Two premature female infants with a new variant of pulmonary hyaline membrane disease had both received assisted ventilation with high oxygen concentrations. Postmortem examination showed straw-yellow hyaline membranes lining the terminal bronchioles and alveoli. Pneumonocytes and macrophages also contained straw-yellow pigments in the cytoplasm. These yellow membranes and pigments in pneumonocytes and in macrophages stained positively for bile and negatively for iron. Both infants had severe intrahepatic cholestasis. Cholestasis and pulmonary changes due to oxygen toxicity are believed to be the main features leading to this curious entity.

Cholestasis↗

Glucocorticoid protection of the myocardial cell membrane and the reduction of edema in experimental acute myocardial ischemia.

A possible protective effect of glucocorticoids on the ischemic myocardium was investigated in in situ dog hearts subjected to regional ischemia and in isolated rat hearts subjected to global ischemia. In the whole-animal preparation, the left anterior descending coronary artery (LAD) was occluded for 3 hours, or for 2 1/2 hours followed by 30 minutes of reperfusion. Dexamethasone phosphate was randomly administered (20 mg. per kilogram intravenously) after 15 minutes of ischemia. Its effects were studied on the following: (1) myocardial cell membrane integrity, using electron microscopic examination of tissue biopsies treated with colloidal lanthanum; (2) myocardial water content, measuring the wet/dry weight of myocardial tissue; (3) ischemic injury, by a count of fuchsinophilic cells at light microscopy. In isolated rat hearts, ischemia was produced by a 60 per cent reduction of coronary flow. Randomized hearts were perfused for 2 hours with dexamethasone, 15 mg. per milliliter in buffered salt solution. Study included determination of tissue water content and coronary vascular resistance. Lanthanum was confined to the extracellular spaces in normal dog myocardium, but it was found all intracellularly after 3 hours of ischemia or after reperfusion. This was associated with morphologic changes characteristic of irreversible cell injury. In the hearts treated with dexamethasone, lanthanum remained excluded from the cells, water content was less (p less than 0.005), and fuchsinophilia less severe (p less than 0.005). Likewise, water content was less (p less than 0.005) and the increase in coronary vascular resistance resulting from ischemia less severe (p less than 0.005) in the dexamethasone-treated isolated rat hearts. Thus dexamethasone administered in pharmacologic doses, early, appeared to stabilize the cell membrane, limit myocardial edema, and reduce the severity of injury, both during ischemia and upon reperfusion.

Acute Disease↗

The use of high-resolution computed tomography in the evaluation of pulmonary hemodynamics in patients with congenital heart disease: in pulmonary vessels larger than 1 mm in diameter.

High-resolution computed tomography (HRCT) was carried out in 36 patients with congenital left-to-right shunt disease and 10 normal control subjects to assess the feasibility of CT in the evaluation of pulmonary hemodynamics. The patients had a left-to-right or a bidirectional shunt and the hemodynamic data obtained by cardiac catheterization in these patients were compared to the information obtained by CT imaging. The pulmonary/systemic blood flow (Q(p)/Q(s)) ratio and pulmonic/systemic resistance (R(p)/R(s)) ratio had a significant correlation with the pulmonary artery/bronchus (PA/Br) ratio (r = 0.54 and r = -0.37, respectively) and pulmonary vein/bronchus (PV/Br) ratio (r = 0.66 and r = -0.66, respectively), and the R(p)/R(s) and mean PA pressure also showed a significant correlation with the PA/PV ratio (r = 0.53 and r = -0.61, respectively) in the mid-lung field when accompanying bronchi were 4. 0-5.9 mm in diameter. There was no correlation between the hemodynamic data and the size of the central and hilar PA or with the rate of PA tapering. With HRCT, it is possible to evaluate pulmonary hemodynamics in patients with congenital heart disease with a left-to-right or bidirectional shunt, particularly R(p)/R(s) and mean PA pressure, which have been very difficult to obtain noninvasively. The small-sized pulmonary vessel/Br ratio or the small-sized PA/PV ratio could offer very useful information, but the dimension of the central PA provided the least useful information.

Adolescent↗

123I-MIBG myocardial scintigraphy as a noninvasive screen for the diagnosis of coronary artery spasm.

BACKGROUND: It has been suggested that the sympathetic nervous system might play an important role in the development of coronary artery spasm. However, no cardiac imaging modality has been able to demonstrate abnormal sympathetic innervation in patients with coronary artery spasm. The purpose of this study was to assess the presence and location of abnormal sympathetic innervation using iodine 123-metaiodobenzylguanidine (123I-MIBG) single photon emission computed tomography (SPECT) and to evaluate the clinical efficacy of 123I-MIBG SPECT as a noninvasive screening test in patients with coronary artery spasm. METHODS AND RESULTS: Coronary arteriography and a provocative test with intravenous administration of ergonovine maleate were performed in 26 patients (20 men, 6 women, mean age 48.2+/-12.0 years, range 20 to 67 years) who were suspected of having a coronary artery spasm. The subjects were divided into 2 groups: group 1 (n = 18) comprised subjects with a positive provocative test result, and group 2 (n = 8) comprised subjects with negative provocative test results. Ten healthy subjects served as controls. No abnormal MIBG uptake was observed in the control subjects. Abnormal sympathetic nervous innervation using 123I-MIBG SPECT was observed either as a reduced uptake or a defective pattern in the perfused areas in 13 of the 18 regions supplied by vessels of ergonovine-induced vasospasm. Normal sympathetic innervation, as evidenced by normal 123I-MIBG uptake, was noted in all of the 60 segments of normal vessel territories. Reduced uptake of 123I-MIBG was not detected in the perfused areas of 5 vasospasm-induced vessels (perfusion territory of left anterior descending coronary artery [LAD] and the right coronary artery [RCA] in 2 and 3 patients, respectively). The sensitivity and specificity of 123I-MIBG for detection of coronary artery spasm were 72.2% (95% confidence interval [CI] 55% to 89%) and 100%, respectively. The positive predictive and negative predictive values were 100% and 92.3% (95% CI 91% to 93%), respectively. CONCLUSION: 123I-MIBG SPECT is a feasible method to evaluate noninvasively and localize the territories of coronary arteries with spasm. Invasive diagnostic coronary arteriography with ergonovine provocation test may be unnecessary for diagnosis of coronary artery spasm in patients with typical resting pain, negative exercise test or normal thallium perfusion scan results, but showing abnormalities in 123I-MIBG SPECT.

3-Iodobenzylguanidine↗