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Biomedical subjects

A Renshaw

Publications and source records attributed to A Renshaw.

18 recordsLinked to original sources
PubMed2003

Massive plexiform neurofibroma with associated meningo-encephalocoele and occipital bone defect presenting as a cervical mass.

The commonest skull manifestations in neurofibromatosis involve the orbit, with very few reports about occipital defects. We report a rare case of a 54-year-old lady with a massive plexiform neurofibroma extending from the auricular region down her left neck and into her shoulder, with an associated large left occipital and left petrous bone defect and extensive cerebellar meningo-encephalocoele, which presented with a relatively asymptomatic cervical mass and was treated with resection of the neurofibroma and advancement and rotational skin flaps.

Encephalocele↗
PubMed2001

The acute febrile response to burn injury in children may be modified by the type of intravenous fluid used during resuscitation--observations using fresh frozen plasma (FFP) or Hartmann's solution.

Fever is a common clinical problem in burned children. The purpose of this study was to compare rectal temperature (T(r)) in two groups of children with burns, > or =10% of the total body surface area (tbsa) who received fresh frozen plasma (FFP) or a crystalloid solution (Hartmann's) for restoration of blood volume. Twelve to 16 h after the burn T(r) reached a peak. The children who had received FFP for restoration of blood volume had significantly higher fever than those children who received crystalloid solutions only.

Acute Disease↗
PubMed2000

The significance of peripheral skin temperature measurement during the acute phase of burn injury: an illustrative case report.

An increase in the gradient between core and peripheral skin temperature is a common finding during the early post burn period which is often interpreted as an indication of inadequate circulating blood volume. In this case study we monitored the pattern of rectal and skin surface (toe) temperature and skin blood flow (by laser Doppler imaging) during the first 16 h after a 34% bath scald in a child (female) of 36 months. In the absence of invasive monitoring of cardiac output, clinical assessment of the adequacy of fluid resuscitation was made from changes in hourly urine volumes and regular (4-h) monitoring of haematocrit. Peripheral vasoconstriction, leading to an increase in the temperature gradient between the inside and outside of the body, was not related to either a fall in urine volume or to haemoconcentration. We suggest that during the first 16 h after burn injury, widening of the core-to-peripheral temperature gradient cannot be used reliably as a clinical indicator of inadequate circulating blood volume.

Accidents, Home↗
PubMed1997

Calculated prostate cancer volume: the optimal predictor of actual cancer volume and pathologic stage.

OBJECTIVES: A new clinical pretreatment quantity called the calculated prostate cancer volume has been defined. The correlation between the calculated parameter and the actual prostate cancer volume, and its ability to predict for pathologic Stage T3 disease in patients with clinically localized disease, is tested. METHODS: Prostate cancer volume measurements were obtained using a 3-dimensional computerized morphometric reconstruction technique on 104 whole-mounted radical prostatectomy specimens. The calculated prostate cancer volume was determined based on pretreatment clinical parameters (prostate-specific antigen [PSA], biopsy Gleason score, and prostate ultrasound volume). Linear regression was used to determine the Pearson correlation coefficients (r) between the PSA, the calculated prostate cancer volume, and the measured prostate cancer volume. Logistic regression multivariable analysis evaluating the predictive value of the pretreatment PSA, biopsy Gleason score, clinical stage, and calculated prostate cancer volume in predicting pathologic Stage T3 disease in patients with clinically organ-confined disease was performed. RESULTS: The calculated prostate cancer volume (r 0.71 to 0.96) was superior to PSA (r 0.12 to 0.67) in predicting the measured prostate cancer volume over a wide range (0.02 to 9.5 cm3) of cancer volumes. The calculated prostate cancer volume was the only significant predictor (P = 0.02) of pathologic Stage T3 disease in patients with clinical Stage T1 to T2 disease on multivariable analysis. CONCLUSIONS: The calculated volume of prostate cancer is superior to PSA in predicting both the pathologic prostate cancer volume and pathologic Stage T3 disease in patients with clinical Stage T1 and T2 disease. Therefore, it may be useful in determining the optimal candidates for radical prostatectomy.

Humans↗
PubMed1997

Transitional cell carcinoma of the fossa navicularis.

We report a case of transitional cell carcinoma of the fossa navicularis in an elderly white male. The patient presented in urinary retention, with a large exophytic mass at the external urethral meatus. Both the pathogenesis and natural history of this highly unusual tumor are unclear. Treatment depends on grade and stage of disease. Transurethral resection and fulguration have been successfully used to treat superficial lesions. Segmental resection and partial penectomy, with or without inguinal lymph node dissection, form the mainstay of treatment for invasive disease. The role of chemotherapy for advanced disease is unknown.

Aged↗
PubMed1996

An analysis of the time course of postoperative prostate-specific antigen failure in patients with positive surgical margins: implications on the use of adjuvant therapy.

OBJECTIVES: The role of adjuvant therapy in the postprostatectomy setting for positive margin patients is an unresolved issue. The purpose of this study is to provide the rationale for patient selection in Phase III trials that test the impact of adjuvant therapy on survival in positive margin prostate cancer patients. METHODS: Early (12 months or less) and delayed (more than 12 months) postoperative prostate-specific antigen (PSA) failure have been correlated with distant and local failure, respectively, as the site of first failure. In this study, a Cox regression multivariate analysis was used to determine the significant independent clinical and pathologic predictors of early and delayed postoperative PSA failure in 143 margin-positive prostate cancer patients. RESULTS: Margin-positive patients with positive pelvic lymph nodes, seminal vesicle invasion, or prostatectomy Gleason sum 8 or higher were excluded. For the remaining patients, a prostatectomy Gleason sum of 7, preoperative PSA more than 20 ng/mL, and an endorectal coil magnetic resonance imaging (erMRI) scan showing extensive disease were significant independent predictors of early postoperative PSA failure. Conversely, a prostatectomy Gleason sum of 6 or less, preoperative PSA 20 ng/mL or less, and an erMRI showing limited disease predicted delayed PSA failure. CONCLUSIONS: Preliminary data suggest that the pattern of first failure can be predicted by the time course of rise in the postoperative PSA. The preliminary results of this study suggest that patient selection for clinical trials examining the efficacy of postoperative adjuvant therapy in the positive margin patient may be determined on the basis of the clinical and pathologic characteristics that predict early versus delayed postoperative PSA failure.

Clinical Trials, Phase III as Topic↗
PubMed1995

Novel fluorescence in situ hybridization approaches in solid tumors. Characterization of frozen specimens, touch preparations, and cytological preparations.

Fluorescence in situ hybridization has emerged as an extremely important tool for detection and characterization of nonrandom chromosome aberrations in cancer. Fluorescence in situ hybridization assays have been very reliable in cytogenetic tumor preparations, but have been more unpredictable in archival, paraffin-embedded specimens. We describe novel approaches for detection of chromosome aberrations in frozen tumor specimens, touch preparations, and cytological preparations. These approaches are both simple and reproducible, with minimal case-to-case variation in hybridization efficiency or hybridization signal quality. We demonstrate potential applications of these novel approaches by evaluating: 1) significance of normal karyotypes in malignant peripheral nerve sheath tumors; 2) p15/p16 copy number in prostate cancer; and 3) clonal chromosome 3p deletion in cytological preparations of pleural fluid from patients with mesothelioma.

Centromere↗
PubMed1975

The use of microfilters as an alternative to centrifugation in radioimmunoassay.

A microfilter was designed, together with a mechanical filtration apparatus for the separation of "antibody-bound" and "free" antigen in radioimmunoassay. A comparison of the results obtained using both filtration and centrifugation was carried out and the optimum incubation times, reaction conditions and washing volume for use with the microfilter were studied. The use of microfilters in radioimmunoassay gave reproducible results and offered a convenient means of automating the separation procedure.

Centrifugation↗
PubMedDate not supplied

Angioplasty with stenting is effective in treating blue toe syndrome.

Blue toe syndrome is a manifestation of distal embolization associated with significant pain and risk of tissue loss. The recommended treatment options for this problem include endarterectomy or bypass with exclusion of the source of emboli. Although focal arterial stenosis can be effectively treated with angioplasty,it is unclear whether performing angioplasty in a lesion suspected of causing distal embolization might actually worsen the condition or what long-term effects this would have in preventing future embolization. The purpose of this study was to evaluate the treatment and outcome of a series of patients with unilateral blue toe syndrome treated with percutaneous angioplasty and stenting. During a 5-year period, a total of 8 patients were identified with unilateral blue toe syndrome. Ankle/brachial indices (ABIs) were obtained, followed by arteriography. The study group included 4 men and 4 women with an age range of 35 to 83 years. Their atherosclerotic risk factors included smoking (8), hypertension (5), diabetes mellitus (3), and hypercholesterolemia (1). One patient had a history of illicit drug use. The patients were followed up by repeat clinical examinations and vascular laboratory studies. Arteriography typically demonstrated a focal preocclusive lesion with thrombus at the distal end of the lesion. Angioplasty and stent placement was technically successful in all cases. The ABIs increased following angioplasty (before 0.81 +/- 0.05; after 1.02 +/-.05). The symptoms resolved in all 8 patients over the ensuing month, and there were no recurrences with a mean follow-up of 18.5 months (range 4 to 36 months). There was 1 death at 4 months associated with preexisting colon carcinoma. Unilateral arterial to arterial emboli were found in association with focal preocclusive lesions. Despite the presence of thrombus in some of the lesions, these patients were not acutely worse following angioplasty. There was good initial angiographic success in all cases. There was also hemodynamic improvement as shown by the increased ankle/brachial indices. Although long-term follow-up is not available, these intermediate results suggest that angioplasty and stenting should be considered a reasonable alternative to standard operative approaches for patients with blue to syndrome associated with embolization from a focal stenosis.

Adult↗