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Biomedical subjects

A D Kaye

Publications and source records attributed to A D Kaye.

65 records · Page 4Linked to original sources
PubMed1992

Inhibitory effects of DuP 753 and EXP3174 on responses to angiotensin II in pulmonary vascular bed of the cat.

The effects of the non-peptide antagonist DuP 753 and its metabolite EXP3174 on responses to angiotensin II were investigated in the pulmonary vascular bed of the intact-chest cat. Under conditions of controlled blood flow and constant left atrial pressure, injections of angiotensin II into the perfused lobar artery caused dose-related increases in lobar arterial pressure. Responses to angiotensin II were reproducible and were not changed by meclofenamate or prazosin, indicating that prostaglandin or norepinephrine release does not mediate or modulate pulmonary vascular responses to the peptide. DuP 753 (1-5 mg/kg iv) decreased responses to angiotensin II in a competitive manner, and the duration of the blockade was related to dose of the antagonist. DuP 753 had no significant effect on responses to U-46619, norepinephrine, serotonin, endothelin-1, vasopressin, or BAY K 8644. EXP3174 also decreased responses to angiotensin II without altering responses to agents that act by a variety of mechanisms. The inhibitory effect of EXP3174 (1 mg/kg iv) was not overcome by angiotensin II in the range of doses studied, and the shift to the right of the dose-response curve was nonparallel, suggesting that the blockade was noncompetitive. The blockade was long in duration, and, when the dose of EXP3174 was decreased to 0.1 mg/kg iv, the blockade was surmounted and the shift to the right of the dose-response relationship was parallel. DuP 753 and EXP3174 had little effect on mean baseline pressures in the cat.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin II↗
PubMed1991

Carcinoembryonic antigen in fine-needle aspirate of liver: a diagnostic adjunct to cytology.

Carcinoembryonic antigen (CEA) was measured in 50 consecutive fine-needle aspirates of liver to determine whether elevated levels could predict the presence of carcinoma in cytologically negative aspirates. There were 44 malignant and 6 benign lesions. The highest mean CEA values (591-672 ng/ml) were obtained in metastatic adenocarcinoma of the colon, stomach, and pancreas; lower levels (13.5-151 ng/ml) were found in metastatic carcinoma from the breast and lung. Carcinoid, hepatoma, Hodgkin's disease, and benign liver aspirates had low (less than 5 ng/ml) CEA levels. Cytologic diagnosis of malignancy was 96% sensitive and 100% specific. Using 5 ng as a cutoff for malignancy, the overall sensitivity of CEA for detection of malignancy was 77%; for detection of adenocarcinoma alone, sensitivity was 85%. Specificity was 100%. The CEA content of fine-needle aspirates generally exceeded serum values by 10-100-fold. Although CEA content did not enhance the sensitivity of cytologic diagnosis, it may suggest metastatic carcinoma of the GI tract in patients presenting with adenocarcinoma of an unknown primary source.

Adenocarcinoma↗
PubMed1989

Rotator cuff tear: clinical experience with sonographic detection.

Between June 1986 and April 1988, 86 sonographic examinations of the shoulder were performed on patients suspected of having rotator cuff tears. Major sonographic diagnostic criteria included (a) a well-defined discontinuity usually visible as a hypoechoic focus within the cuff, (b) nonvisualization of the cuff and (c) an echogenic focus within the cuff. Seventy-five patients underwent both sonography and arthrography. Compared with arthrography alone, ultrasound examinations enabled detection of 92% of rotator cuff tears (24 of 26 tears), with a specificity of 84% and a negative predictive value of 95%. Correlation was obtained in 30 of these patients who underwent surgery for rotator cuff tear or other soft-tissue abnormality. In this group, the sensitivity of sonography for detection of a tear was 93%, with a specificity of 73%, while for arthrography sensitivity was 87% and specificity was 100%. These data indicate that sonography is a useful, noninvasive screening procedure for patients suspected of having rotator cuff injury.

Adolescent↗
PubMed1983

Mediastinal computed tomography in myasthenia gravis.

Thirty-six of 119 patients with myasthenia gravis examined by computed tomography for possible thymic mass had a thymectomy. The computed tomographic findings were compared to the findings of chest x-ray and linear tomography and then correlated with the surgical histopathologic results. Computed tomography detected all cases of thymoma or thymic enlargement due to hyperplasia. Chest x-ray correctly demonstrated 50% of thymomas present while linear tomography demonstrated 88%. Computed tomography was not able to distinguish between enlargement due to thymoma or hyperplasia unless calcification was present. The role of computed tomography is detailed and discussed in relationship to the other diagnostic modalities.

Adolescent↗
PubMed1983

Radiologic evaluation of the mediastinum in myasthenia gravis.

We reviewed the records of 36 patients with myasthenia gravis who had CT of the anterior mediastinum before thymectomy in an effort to improve preoperative detection of thymoma. At surgery, 10 patients had thymomas, 21 had germinal center follicular hyperplasia, and 5 had histologically normal glands. CT performed on an EMI 5005 was abnormal in 23 of 36 patients; 10 had thymoma, 11 had hyperplasia, 1 had a normal gland, and 1 had a cyst. Tumors were detected by routine chest x-ray in 5 of 10 patients and by linear tomography in 7 of 8. All four patients with calcified masses on CT had thymomas (including the patient with normal linear tomograms). CT alone is too sensitive a screening test; 12 of 25 patients with hyperplasia or normal glands had abnormal scans. However, in combination with chest x-ray and linear tomography, we detected 10 of 10 patients with thymoma with reasonable certainty.

Adolescent↗
PubMedDate not supplied

Diagnosis of cystic lesions of the pancreas: a biochemical and cytologic analysis of material obtained utilizing radiographic or intraoperative technique.

The widespread use of imaging modalities may detect clinically unsuspected "pancreatic cysts" in which the differential diagnoses include pseudocysts, cystic neoplasms, necrotic carcinomas, abscesses, and, uncommonly, islet cell tumors. Accurate preoperative diagnosis requires clinical, radiologic, microbiologic, cytologic, and biochemical studies. Material obtained by fine-needle aspiration from cysts can be triaged for cytology, amylase, and carcinoembryonic antigen (CEA) studies. The four cases described suggest that an elevated fluid CEA is specific for carcinoma, and an elevated amylase and negative CEA suggests pseudocysts, while both amylase and CEA are negative in abscesses. Thus, "cystic lesions of pancreas" can be accurately diagnosed in cases in which radiologic and cytologic studies are inconclusive. The routine inclusion of these tests with cytologic study should be encouraged to obviate unnecessary surgery for diagnostic purposes.

Aged↗
PubMedDate not supplied

Effects of garlic extract (Allium sativum) on neutrophil migration at the cellular level.

Studies of the effects of garlic extract on oxidative and lipoprotein levels have yielded widely different findings. Leukocytes play an important role during many processes, including inflammation. They migrate from intravascular spaces into tissues and attack microorganisms. In a recent study, the inhibitory effects of the nonsteroidal antiinflammatory drug, ibuprofen, on leukocyte transmigration were demonstrated using an in vitro assay. Little is known about the cellular effects of garlic extracts (Allium sativum). The aim of the current study was to investigate the influence of garlic extract on leukocyte migration through endothelial cell monolayers and thereby evaluate a possible role in inflammatory processes. Human umbilical endothelial cells were cultured on microporous membranes to make an endothelial cell monolayer (ECM). Freshly isolated neutrophils were used in a recently described migration assay. The amount of untreated neutrophils migrating through the untreated ECM was used as control and set at 100%. Neutrophils and/or ECM were pretreated with garlic extract using moderate, higher, and lower concentrations. Moderate plasma concentrations of garlic extract inhibited neutrophil migration through ECM significantly (64 +/- 5.8% standard deviation [SD]; P < 0.05) when both cell types were treated, (a situation that may have clinical relevance). Treating either neutrophils or ECM alone showed significant reductions in migratory rate (neutrophils treated alone: 81 +/- 7.7% SD, P < 0.05; ECM alone: 70 +/- 6.7%, P < 0.05). Thus, garlic extract is identified as a potent inhibitor of leukocyte migration through endothelial cell monolayers. Treatment of both cell types has an additive effect. Endothelial cells seem to be more affected than neutrophils. Further investigations are necessary to understand the potential clinical consequences.

Cell Adhesion↗
PubMedDate not supplied

Perioperative considerations for the patient taking herbal medicines.

There has been a significant increase in the proliferation and use of dietary supplements known as neutraceuticals. Since 1994, herbal products have been regulated by the Dietary Supplement Health and Education Act (DSHEA), which does not require burden of proof to demonstrate premarketing safety and efficacy studies. Scientific literature and government policies have not adequately addressed this fast-emerging group of more than 20,000 health supplements. Lack of purity and standardization of these agents, combined with minimal education in traditional homeopathic medical education, has led to serious health-related problems including arrhythmias, cardiovascular compromise, strokes, and deaths. Even though 30% of our traditional medicines are derived from botanicals, most physicians are either unfamiliar or unwilling to develop any level of expertise with neutraceuticals. A review emphasizing perioperative considerations is provided of the history of herbal medicines, governmental policies, and specific herbal agent-drug interactions.

Adult↗
PubMedDate not supplied

Fine needle aspiration of cystic liver lesions. Cytologic examination and carcinoembryonic antigen assay of cyst contents.

Since fine needle aspiration (FNA) cytology has been rarely successful in preoperatively separating neoplastic from nonneoplastic (inflammatory and congenital) liver cysts, the adjunctive use of measurements of cyst fluid carcinoembryonic antigen (CEA) levels for enhancing the accuracy of the cytologic diagnosis was examined. FNA was performed on 17 consecutive cystic lesions from 15 patients. Cytologic examination performed on Papanicolaou-stained smears or Cytospins of the sediment gave a sensitivity of 66% and a specificity of 100%. CEA measurements on the supernatant by enzyme immunoassay showed negative levels (less than 5 ng/mL) in fluids from benign (nonmucinous) cysts and abscesses and elevated levels (greater than 600 ng/mL) in fluids from biliary cystadenoma/cystadenocarcinoma and pseudocystic metastatic carcinoma. CEA assay gave a sensitivity of 100% and a specificity of 94%, thus enhancing the sensitivity of FNA for the detection of malignancy in cystic liver lesions.

Adenocarcinoma↗
PubMedDate not supplied

Fine needle aspiration for diagnosing a thymoma producing CA-125. A case report.

This case report describes the cytologic appearance of a solid and cystic thymoma with high CA-125 content (35,532 microns/mL, measured by enzyme immunoassay) in the cyst fluid obtained by fine needle aspiration (FNA). The initial FNA yielded straw-colored fluid that contained scanty foam cells, lymphocytes and benign epithelial cells and was interpreted as a bronchial inflammatory cyst. The cyst fluid CA-125 was 35,532 microns/mL and serum CA-125, 5.2 microns/mL (normal < 15). In view of the discordance between the cytologic diagnosis, suspicious radiologic appearance and high fluid CA-125 level, FNA of the solid portion of the mass was performed. Smears/cell block examination showed large, cohesive clusters of benign, spindle-shaped epithelial cells (keratin positive) admixed with mature lymphocytes diagnostic of thymoma. This report illustrates the importance of (1) sampling solid areas of solid/cystic tumors, (2) rapid assessment of FNA material, and (3) appropriate clinical and radiologic correlation. It also describes the cytologic features of a solid/cystic thymoma with elevated CA-125 content in the cyst fluid.

Aged↗