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Biomedical subjects

A A Keshgegian

Publications and source records attributed to A A Keshgegian.

At least 37 records · Page 2Linked to original sources
PubMed1986

The pathologists' assistant. Distribution, use, and employer perceptions.

Pathologists' assistants have been formally trained since 1969 to assist in technical anatomic pathology procedures. The authors surveyed 165 assistants who are members of their national organization to determine the actual demographic distribution and patterns of use. One hundred respondents were slightly more concentrated in the eastern United States, usually in pathology groups larger than the national average. Assistants generally performed a large percentage of the autopsy and surgical specimen dissections and various ancillary functions: teaching, supervision, administration, or research. Sixty-six of 82 employer pathologists responded to a companion survey. They were satisfied with the assistant's work. Most hired assistants to free themselves from technical functions or to replace residents, believed that assistants' numbers will remain small, and favored a national certification program. Thus, pathologists' assistants are effectively filling a need for ancillary anatomic pathology personnel in selective situations, primarily in larger pathology practices.

Allied Health Personnel↗
PubMed1986

Is duplicate testing for prothrombin time and activated partial thromboplastin time necessary?

To evaluate the necessity of duplicate testing for prothrombin times (PTs) and activated partial thromboplastin times (APTTs), the range of differences between duplicate sample results was analyzed on a widely used automated photo-optical coagulation instrument. Specimens with coagulation test times ranging from normal to threefold above the reference range were included. Of 1,610 PTs and 1,023 APTTs, approximately 95% of duplicates differed by 0.2 s or less and 2.0 s or less, respectively. Approximately 99% of PTs and APTTs differed by 0.4 s or less and 4.0 s or less, respectively; there were three PT and 16 APTT specimens whose duplicates differed by a greater time interval and also by more than 5% of the mean. Thus, PT and APTT testing on automated instrumentation is very precise, but occasional inaccurate single measurements could lead to errors in diagnosis or therapy.

Blood Coagulation Tests↗
PubMed1984

Hypoalbuminemia associated with diffuse hypergammaglobulinemia in chronic diseases: lack of diagnostic specificity.

Although elevated gamma globulin is known to produce hypoalbuminemia both experimentally and in disease, a low albumin concentration in chronic liver disease often is assumed to reflect impaired liver synthetic function. Albumin and gamma globulin measurements in a series of 200 patients with a variety of chronic diseases (including cirrhosis, connective tissue disease, chronic inflammation, and malignancy) associated with diffuse hypergammaglobulinemia were combined with similar measurements from a previous study (Am J Med 1959; 29:596-616). The mean serum albumin concentration correlated inversely with mean gamma globulin, irrespective of disease category. Double reciprocal plot analysis showed that the relationship fits a rectangular hyperbola (r = -0.915, P less than 0.001), with the mean albumin concentration approaching 2.31 g/dL at infinite gamma globulin. This suggests that serum albumin decreases to a similar extent in various chronic diseases and that hypoalbuminemia has no diagnostic implications, except to the extent that it reflects the severity of hypergammaglobulinemia.

Chronic Disease↗
PubMed1984

Immunoperoxidase demonstration of prostatic acid phosphatase in aspiration biopsy cytology (ABC).

The authors investigated the usefulness of immunoperoxidase demonstration of prostate-specific acid phosphatase (PAP) in determining the tissue of origin for carcinoma in aspiration biopsy cytology (ABC) specimens. Antisera from a commercial kit were applied using standard technics directly to Papanicoloau-stained slides. PAP was diffusely positive in numerous tumor cells of 27/28 moderately or poorly differentiated and 17/18 well-differentiated primary prostatic carcinomas. A negative result upon substituting the primary antiserum confirmed the reaction specificity in 18 cases with an additional available slide. PAP was demonstrable in corresponding histologic sections of 16/17 moderately or poorly differentiated and 18/18 well-differentiated carcinomas. Only 2 of 22 nonprostatic carcinomas (both of breast origin) showed very rare positive cells. Four ABC specimens of metastatic prostatic carcinoma were diffusely positive. Thus, diffuse staining of PAP by immunoperoxidase in tumor cells of ABC specimens gives high sensitivity and specificity for prostate as the tissue of origin.

Acid Phosphatase↗
PubMed1983

Influence of surgical technique on estrogen and progesterone receptor determinations in breast cancer.

The effect of surgical technique on hormone receptor values in breast cancer tissue was examined. One hundred and thirty-one women with breast cancer were divided into three groups: Group I, definitive diagnosis at frozen section and tissue taken for receptor determination; Groups II and III, diagnosis made by aspiration biopsy cytology, with tissue obtained from modified radical mastectomy in Group II and tissue obtained from mastectomy performed separately, prior to axillary lymph node dissection, in Group III. The rates of estrogen and progesterone receptor positivity, and the mean levels of receptor, did not differ significantly among the three groups. Thus tumor tissue from a mastectomy specimen can be reliably used for hormone receptor determinations, if the tumor tissue is kept cold and rapidly frozen for storage. Women whose cancer has been diagnosed by aspiration biopsy cytology need not undergo an additional open biopsy solely to obtain tissue for receptor determinations.

Axilla↗
PubMed1983

Suppression of one monoclonal immunoglobulin in the presence of another in multiple myeloma. Evidence for benign B-cell neoplasia.

The case of a 77-year-old man with two monoclonal proteins, IgG lambda and IgG kappa, is presented. The IgG kappa protein increased in concentration, and, after two years, overt multiple myeloma developed with anemia and suppression of polyclonal immunoglobulins. The IgG lambda protein at first remained constant, but disappeared when overt myeloma developed. The disappearance of the IgG lambda protein suggests suppression of one neoplastic immunoglobulin clone by another, more aggressive, clone. This indicates that idiopathic monoclonal gammopathy can result from a benign neoplasm of B-cells that is responsive to regulatory factors and is not an early stage of myeloma.

Aged↗
PubMed1983

Cathodal bands in electrophoretograms of creatine kinase isoenzymes in serum collected after cardiac surgery: a poor prognostic sign.

Of 708 patients who had undergone cardiac surgery, the serum of 23 showed one or two enzyme bands cathodal to CK-MM in creatine kinase (CK) isoenzyme electrophoretograms. Postoperative mortality rate during hospitalization was: no bands, 8.8%; one band, 13%, two bands, 63% (p less than 0.001). Patients whose sera showed cathodal bands were slightly older than those without, and their postoperative serum lactate dehydrogenase (LD) activity was greater, with very high proportions of LD 5. The two cathodal bands in patients who died differed in cathodal electrophoretic mobility from the two bands in survivors, implying that different enzyme forms were involved. All cathodal bands were inhibited by reagent containing diadenosine pentaphosphate, as was adenylate kinase from erythrocytes and liver cytoplasm. Mitochondrial CK from liver and presumed mitochondrial CK in serum from a patient with malignancy were not inhibited. We conclude that the appearance of two enzyme bands cathodal to CK-MM, probably representing adenylate kinase and possibly originating from various tissues, is associated with a poor prognosis in patients after cardiac surgery.

Adenylate Kinase↗
PubMed1982

Demonstration of cerebrospinal fluid oligoclonal banding in neurologic diseases by agarose gel electrophoresis and immunofixation.

Demonstration of an oligoclonal immunoglobulin pattern in cerebrospinal fluid by a commercial agarose gel electrophoresis system and immunofixation were evaluated in the service clinical laboratory of a university hospital. In 303 patients, 45 with clinically definite multiple sclerosis and 209 with other neurologic diseases, the sensitivity of oligoclonal banding for multiple sclerosis was 71%, and the specificity, 83%. Oligoclonal banding was frequent in inflammatory disease, tumor/pseudotumor or vascular diseases of the central nervous system (35%, 36% and 26%, respectively) and less frequent in degenerative central nervous system disease and peripheral neuropathy (5.2% and 15%). No patient with non-neurologic disease had oligoclonal banding. The addition of an immunochemical step (immunofixation) did not increase sensitivity and only minimally increased specificity. It did permit distinction in selected cases between immunoglobulin and other molecules with identical electrophoretic mobility.

Brain Neoplasms↗
PubMed1982

Prevalence of small monoclonal proteins in the serum of hospitalized patients.

Small, often multiple, homogeneous bands were observed in the gamma globulin region upon agarose gel electrophoresis of serum from only one of 140 healthy blood donors, but in 10-65% of hospitalized patients. The bands were more frequent if the gamma globulin concentration was high or an acute phase reaction was present. The frequency of bands was unrelated to the age, race, or sex of the patient or to the medical diagnosis. One third of the bands could be characterized at least partially as monoclonal immunoglobulin; a small percentage represented C-reactive protein. Small homogeneous bands, often definable as monoclonal immunoglobulins, are common in the serum of hospitalized patients, and need not imply the presence of a lymphoproliferative disorder. They may reflect a form of human immune response with restricted heterogeneity.

Adult↗
PubMed1981

Immunofixation as an adjunct to immunoelectrophoresis in characterization of serum monoclonal immunoglobulins.

We evaluated quantitatively the usefulness of immunofixation (IF) as an adjunct to immunoelectrophoresis (IEP) in characterizing serum monoclonal proteins. In 33 out of 97 consecutive patients with one or more homogeneous bands on cellulose acetate serum protein electrophoresis, a monoclonal immunoglobulin could not be characterized with certainty by IEP. Of these 33 cases, in 76% a monoclonal immunoglobulin was subsequently characterized by IF on agarose gel. In 18% IF provided additional suggestive information, and in 6% it provided no additional or less information than IEP. The mean concentration of monoclonal proteins (other than free light chains) that could be characterized by IEP was 25 g/l. The monoclonal proteins that required IF for characterization were all less than 10 g/l. Of all monoclonal proteins below 10 g/l, 53% required IF for complete characterization. IF is a useful adjunct to IEP, primarily in cases where the concentration of monoclonal immunoglobulin is less than 10 g/l.

Humans↗
PubMed1981

Orcein-positive hepatitis B surface antigen and liver carcinoma: their association in an Eastern US population.

We retrospectively examined the association of hepatitis B infection and hepatocellular carcinoma (HCC) in a US East Coast population using orcein staining of fixed liver tissue. Hepatitis B surface antigen (HBsAg) was present in non-neoplastic hepatocytes in eight of 53 cases of HCC, but in no cases of cholangiocarcinoma or metastatic tumor. In five of the eight positive cases, macronodular cirrhosis was present; in three positive cases, cirrhosis was absent. The rate of positivity in livers with both HCC and macronodular cirrhosis was 28%, compared with 4.7% in livers with macronodular cirrhosis but no carcinoma. The low, but significant association of HBsAg and HCC, both in the presence and absence of cirrhosis, suggests that HCC may develop in a subset of patients in the United States as a result of infection with hepatitis B virus.

Adenoma, Bile Duct↗
PubMed1980

No relationship between lactate dehydrogenase and estrogen receptor levels in clinical human breast cancer.

The level of lactate dehydrogenase has been reported to increase in a human breast cancer cell line as a result of estrogen action [4]. This finding suggests that lactate dehydrogenase may be useful in clinical human breast cancer as a marker for intactness of the estrogen receptor pathway and for probability of response to hormonal therapy. In 97 hunan breast cancer specimens submitted for estrogen receptor analysis, the level of lactate dehydrogenase varied from 0.19 to 3.3 I.U. per mg of extractable protein and bore no relation with either the presence of estrogen receptor or its level. It thus appears that lactate dehydrogenase is not a useful marker for endocrine responsiveness in clinical breast tumors.

Breast Neoplasms↗
PubMed1980

Estrogen receptor protein in malignant carcinoid tumor: a report of 2 cases.

Two cases of metastatic malignant carcinoid tumor in elderly women contained significant amounts of estrogen receptor (19 and 32 femtomoles/mg protein) as shown by Scatchard-plot analysis of a dextran-coated charcoal assay, inhibition of binding by an estrogen analog (67 and 63%) and high-affinity binding (Kd = 6.8 and 2.6 x 10(-10) M). The demonstration of estrogen receptor in malignant carcinoid tumor expands the spectrum of non-breast or non-gynecologic neoplasms that contain the receptor. The significane of estrogen receptor in such tumors is uncertain; it may represent aberrant derepression of the gene for estrogen receptor protein in a malignant tumor.

Aged↗