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A Kennedy

Publications and source records attributed to A Kennedy.

At least 19 recordsLinked to original sources
PubMed1992

Detection of mRNA by in situ hybridisation and in northern blot analysis using oligodeoxynucleotide probes labelled with alkaline phosphatase.

AIMS: To assess whether a reduction in intensity of signal observed using an alkaline phosphatase labelled oligodeoxynucleotide probe could be explained on the basis of procedural steps rather than reduced sensitivity. METHOD: Signal intensity was assessed on in situ hybridisation for pro-opiomelanocortin (POMC) mRNA in rat pituitary and for somatostatin mRNA in human pancreas and in northern blot analysis for POMC mRNA in the presence and absence of formamide. The direct effects of formamide on the alkaline phosphatase detection step were assessed using histochemical enzyme detection in rat kidney. RESULTS: All signals were reduced in systems containing formamide. CONCLUSIONS: In the absence of formamide clear, strong signals for specific mRNAs can be obtained by in situ hybridisation and northern blot analysis using oligodeoxynucleotide probes directly labelled with alkaline phosphatase. Formamide seems to inhibit the activity of alkaline phosphatase.

Alkaline Phosphatase↗
PubMed1992

Factors which influence necropsy requests: a psychological approach.

AIMS: To determine which factors influence a clinician's decision to request a necropsy. METHODS: Patient age, confidence in premortem diagnosis, relatives' attitudes, and conditions of necropsy practice were combined factorially (two levels each) in separate medical and surgical questionnaires based on clinical case histories. The interactions between the factors were measured by a repeated measures factorial analysis of variance for each of the two clinical groups. The influence of the clinician's interest in necropsies on these interactions was also examined by a similar method. RESULTS: Necropsies were more likely to be requested on young patients, when diagnostic confidence was low, and when relatives' attitudes were favourable. Conditions of necropsy practice did not affect the likelihood of a request and there was no apparent overall difference in necropsy requests between the two groups of clinicians. The "patient age" and "relatives" factors had less influence on the decision of the surgical group to request necropsy. This was attributed to the opportunity to "see for themselves" at operation and was supported by the finding that surgeons were very likely to request necropsies in the absence of surgical intervention. Clinicians from both groups with a high pre-existing interest in the necropsy were consistently more likely to request necropsies. CONCLUSIONS: The "case history" based questionnaires successfully measured the relative influence of multiple factors in relation to the decision of clinicians to request a necropsy. These findings suggest that any attempt to reverse the decline in necropsy rates should focus on changing the clinician's perception of the value of the modern necropsy.

Age Factors↗
PubMed1992

Nd:YAG laser endometrial ablation: histological aspects of uterine healing.

Laser ablation of the endometrium performed under hysteroscopic control is a novel procedure for the conservative management of menorrhagia in cases of dysfunctional uterine bleeding. The effect this has on the uterine cavity and the mechanism of reepithelialisation and endometrial regeneration have been examined by means of histological examination of endometrial biopsies and four hysterectomy specimens obtained for various indications at varying time intervals after laser endometrial ablation. During the first 3 months, fragments of necrotic and granulation tissue are found surrounded by a limited polymorph response. By 3 months, the uterine cavity appears to be completely reepithelialised. After 6 months, areas of normal-appearing endometrium may persist, but in other areas there is an attenuated cuboidal surface epithelium closely applied, to the underlying myometrium. Stromal fibrosis reminiscent of Asherman syndrome is also apparent.

Adult↗
PubMed1992

General practitioners, skin lesions and the new contract.

We reviewed all skin lesions received in our laboratory from general practitioners (GPs) during a three-month period before the introduction of the new contract for GPs and during the same period a year later. For comparison we also reviewed skin lesions received from the general and plastic surgeons. Particular attention was paid to the completeness of excision. There was a significant increase in the number of skin lesions removed in general practice after the introduction of the new contract. Both benign and malignant lesions were more likely to be incompletely excised by GPs compared with surgeons. The GPs first noted to carry out minor surgery after the new contract came into force were less likely to have completely excised lesions than their more experienced colleagues. We suggest the future monitoring of lesions removed in general practice, possibly by the formation of a joint audit group.

Biopsy↗
PubMed1991

Case report: cisplatin-induced hemolytic uremic syndrome.

Two patients developed noncardiogenic pulmonary edema (NCPE), following red blood cell transfusion in a setting of acute cisplatin nephropathy. One manifested the full picture of hemolytic uremic syndrome, the other had transient features following blood transfusion. We further reviewed the clinical records on blood transfusion for all patients with cisplatin nephropathy. A third case of (NCPE) was identified in a patient with acute renal dysfunction. However, none of the 16 patients with cisplatin-induced, mild stable chronic renal impairment had pulmonary dysfunction or other laboratory evidence for microangiopathy following transfusion. Hemolytic uremic syndrome may be a rare manifestation of cisplatin toxicity. Caution is indicated in transfusing patients with acute platinum nephropathy even in the absence of overt microangiopathy. The pathogenesis of this syndrome and the cause for NCPE is unclear. The literature is reviewed and discussed.

Adenocarcinoma↗
PubMed1991

A comparative study of ethamsylate and mefenamic acid in dysfunctional uterine bleeding.

The effects of ethamsylate and mefenamic acid on menstrual blood loss were compared in a double-blind trial in 34 women with menorrhagia. Both drugs produced statistically significant reductions in blood loss during the 3 months of treatment; the overall reduction was 20% in the ethamsylate group and 24% in the mefenamic acid group. Compared with pretreatment values, blood loss was significantly less in each of the 3 treatment months in the mefenamic acid group, but only in the second and third months of treatment in the ethamsylate group. However, more women had a clinically useful reduction in blood loss (greater than 40%) in the ethamsylate group. The onset of effect of mefenamic acid was rapid but ethamsylate showed a comparatively greater effect as the trial progressed. Cessation of treatment was followed by an increase in blood loss, more pronounced in mefenamic acid group who reverted to pre-treatment levels. A greater number of side-effects were reported with mefenamic acid.

Adolescent↗
PubMed1991

Should eye protection be worn when performing necropsies?

One hundred necropsies were performed by four junior pathologists wearing safety spectacles. The number of blood splashes on the spectacle surfaces were counted after each necropsy. Splashes were found after 22 necropsies (range 10-34%), with higher numbers being seen among the more junior grades of pathologist. This suggests that the use of safety spectacles should be considered by all pathologists performing necropsies.

Autopsy↗
PubMed1979

The diagnosis of pulmonary carcinoid tumours.

Carcinoid tumours of the lung are commonly misdiagnosed as carcinoma and even if they are recognized their behaviour may be unexpected. In a series of ten cases which had caused diagnostic difficulty there had been an incorrect interpretation of broncial biopsy material in four, of the resected tumours in another four, of a needle biopsy core in one and of autopsy material in another. In some cases these errors led to needless radiotherapy and to an unnecessarily poor prognosis being given. In all cases the diagnosis of carcinoid tumour was made retrospectively by the demonstration of argyrophil granules in the tumour cells or by electron microscopy. Electron-dense bodies could be found in material that had been fixed in formol saline or even embedded in paraffin so that this method may be used retrospectively. Two of these ten tumours behaved in a malignant fashion but progressed much more slowly than most samples of bronchial carcinoma. The possibility of carcinoid tumour should be considered in any patient with a tumour of the lung who is unusually young, or who is a non-smoker or where bone or calcification are present in the tumour. It is also suggested that unrecognized cases of carcinoid tumour may be found amongst long-term survivors with lung tumours which havebeen treated by radiotherapy or chemotherapy without surgery.

Adult↗
PubMed1978

Adriamycin in combination for the treatment of breast cancer: a Southwest Oncology Group study.

Patients with advanced breast cancer who had not previously received chemotherapy were treated on a three-arm prospective study: adriamycin day 1 plus 5-FU on day 1 and 8 (AF), adriamycin day 1, plus 5-FU day 1 and 8, and cyclophosphamide day 1 (AFC), and adriamycin day 1 plus 5-FU day 1 and 8, cyclophosphamide day 1 and methotrexate day 1 (AFCM). These courses were repeated every 21 days. The response rate was 44/105 (42%) AF, 44/103 (43%) AFC and 52/105 (49%) AFCM. The length of response was 22, 33 and 35 weeks, respectively, for AF, AFC and AFCM (P = 0.21). The median survival, 64 weeks, was equal in all three limbs. The major toxicity was leukopenia. Twenty-eight percent developed a WBC of less than 2,000/microliter, which resulted in seven deaths (2.2%).

Adult↗
PubMed1978

Acute abdominal complications of systemic lupus erythematosus.

Four patients with acute abdominal complications of systemic lupus erythematosus requiring laparotomy are presented. The complications consisted of intestinal ischaemia, without perforation, in 3 patients and omental infarction in the fourth. In 2 patients the abdominal emergency was the first manifestation of the collagen disease. Tissue removed from 3 patients showed a marked vasculitis on histological examination. The pathogenesis and management of acute abdominal complications of systemic lupus erythematosus are discussed and the literature reviewed.

Abdomen, Acute↗