Biomedical subjects

B Randall

Publications and source records attributed to B Randall.

32 records · Page 2Linked to original sources

PubMed1993

Psychosocial effects of unrelated bone marrow donation: experiences of the National Marrow Donor Program.

In this study, we investigated the psychosocial effects of unrelated marrow donation. Survey questionnaires were administered pre-donation, shortly post-donation, and 1 year post-donation to all donors through the National Marrow Donor Program over a 3-year period. Univariate, bivariate, and multivariate analyses were then performed. Donors were generally quite positive about the donation 1 year post-donation: 87% felt it was "very worthwhile" and 91% would be willing to donate again in the future. Marrow donors were more likely than kidney donors to feel better about themselves as a result of the donation (P < .001). Donors with longer collection times, in general, had less positive psychosocial outcomes from the donation. Donors who experienced lower back pain or difficulty walking as a result of the donation were more likely to experience the donation as more stressful and painful than expected, but no more likely to experience it as less positive emotionally than donors who did not experience these side effects.

Anesthesia↗

PubMed1993

Epidemiology of chronic fatigue syndrome: the Centers for Disease Control Study.

The US Centers for Disease Control initiated physician-based chronic fatigue syndrome (CFS) surveillance systems in four cities in September 1989 to determine the prevalence, incidence, course and impact of the illness. The participating physicians have referred to our surveillance system 590 patients who were ill during the first two years of surveillance with severe, debilitating, unexplained fatigue for at least the preceding six months. Referred patients were screened for psychiatric disorders preceding, concurrent with, and subsequent to the onset of their fatigue by specially trained nurses using a modified Diagnostic Interview Schedule. Complete health histories were obtained by interview and review of medical records and a basic panel of standard laboratory diagnostic tests were conducted. Four physicians have independently reviewed the health information of 337 of the patients for classification. Approximately 26% of patients referred to the surveillance system met the CFS case definition in all regards, 14% lacked one or more of the required eight symptom criteria, 15% were judged to have another possible or known medical illness which could account for the severe fatigue, and the remaining 45% did not meet the case definition because of histories of psychiatric disorders preceding the onset of fatigue. Minimum prevalence rates for the period 1 September 1989 to 1 September 1991 ranged from 2.0 to 7.3 per 100,000 of the general population across the four study sites and rates based on prorated data ranged from 4.6 to 11.3 per 100,000. More than 80% of the CFS cases were female, most were white, and their average age at onset was approximately 30 years.

Adult↗

PubMed1992

Retinoblastoma and p53 gene expression related to relapse and survival in human breast cancer: an immunohistochemical study.

Inactivation of tumour suppressor genes may be an important aetiological factor in many human cancers including breast. In a study of 197 breast cancer patients, tumour tissue was snap-frozen at the time of surgery and immunohistochemical labelling for p53 protein and retinoblastoma (Rb) gene product carried out using an indirect immunohistochemical technique. Tumours were scored by two independent observers for the intensity of nuclear staining for each antibody. Expression of p53 protein showed a significant association with a shorter time to relapse (P = 0.03) and death (P = 0.02) (log rank test). p53 expression did not correlate with nodal status but showed a significant association with high tumour grade (P = 0.001). Rb gene expression showed no relationship to relapse or survival but loss of expression showed a significant correlation with positive lymph node status. The manner by which these proteins might act to determine tumour behaviour remains to be established.

Breast Neoplasms↗

PubMed1991

Gunshot entrance wound abrasion ring width as a function of projectile diameter and velocity.

The relationships between gunshot entrance wound abrasion ring widths versus projectile diameter and velocity, using foam-backed deer hides as targets, were investigated. At a fixed velocity, abrasion ring width increased with increasing projectile diameter but decreased in proportion to the central defect diameter. For fixed-diameter projectiles, very slow and high velocities produced minimal abrasion width. Maximal abrasion width occurred at intermediate velocities. The authors postulate that abrasion width is a function of the ratio of projectile velocity and the maximum deformation velocity of the target skin. The largest abrasion width occurs when the ratio is one. Using a projectile velocity known to produce maximum abrasion width at an initial warm temperature, then decreasing the target deformation velocity by cooling, produced the expected results of decreasing abrasion width.

Animals↗

PubMed1989

Comparison of gunshot wounds and field-tipped arrow wounds using morphological criteria and chemical spot tests.

Arrow wounds represent an unusual class of wounds rarely seen by most death investigators. Although the edged, broadhead-tipped arrow produces a wound usually characteristic of archery/crossbow weapons, the plain, field-tipped arrow wound can be confused with gunshot injuries in those cases in which powder residue or firearm projectiles or fragments or both are not recovered. We present a case of a deer carcass with a wound of uncertain firearm or archery origin which initiated a comparison of firearm wounds and archery wounds on fresh road-killed deer. We found the following features to be valuable in the differentiation of gunshot wounds and field-tipped archery wounds: First, the majority of the gunshot wounds (but none of the arrow wounds) had identifiable, macroscopic, wipe-off material and chemically identifiable wipe-off residue by spot test. Second, the archery wound defects had very inconspicuous abrasion rings as compared to the often prominent abrasion rings of gunshot wounds. Third, the actual central defect in the archery wounds was more likely to be oblong or slit-like compared to the gunshot wound defects, which were more likely to be round.

Animals↗

PubMed1988

Glycogenated squamous epithelial cells as a marker of foreign body penetration in sexual assault.

Nonconsensual insertion of a foreign object into the vagina, anus, or mouth in some judicial jurisdictions is synonymous with rape, and elsewhere may constitute some degree of sexual assault or battery. Few techniques, however, are available to assist the criminalist in determining whether an object has been criminally inserted. Glycogenated epithelial cells have been used as a marker for vaginal epithelium, and as such, may indicate vaginal insertion if recovered from an object. This hypothesis was tested by studying orally and vaginally inserted objects from 42 volunteers and 20 rectally inserted objects recovered from cadavers. Glycogen positivity was assayed from smears of object swabbings stained with the periodic acid-Schiff (PAS) technique. More than 75 glycogen positive cells were recovered from 39 of 42 vaginally inserted objects. Glycogenated cells were recovered from 8 of 20 rectally inserted objects (5 with more than 100 positive cells). Of 42 orally inserted objects, 32 also contained glycogen positive cells, but none with more than 28 positive cells. No glycogen positive cells were seen in skin exposed but not inserted objects. Large numbers of glycogen cells were seen in dried saliva drops. Amylase activity was not seen on 5 of 20 orally inserted shields, and thus the possibility of noninsertional saliva contamination could not be ruled out with shields yielding only small numbers of positive cells. Recovery of large numbers of glycogenated cells from foreign objects is strongly suggestive of either vaginal or anal insertion assuming amylase negativity. Glycogen positive cells are not seen secondary to glabrous skin exposure.

Adult↗

PubMed1987

Persistence of vaginal spermatozoa as assessed by routine cervicovaginal (Pap) smears.

Retrospective review of cervicovaginal (Pap) smears of women with known sexual histories affords an opportunity to assess the potential for postcoital sperm recovery for large numbers of individuals. This study reviewed 542 individuals' Pap smears with accompanying sexual histories. Three hundred forty-nine respondents reported at least one act of sexual intercourse during the five days preceding the Pap smear. Unlike a previous report, the current study showed very poor sperm recovery (maximum of 25% during the first postcoital day). The observed results roughly correlate with the incidence of sperm noted on screening of large numbers of routine clinical Pap smears in a private reference laboratory. Routine Pap smears can detect sperm but do not appear to be an ideal method to substantiate recent sexual intercourse.

Adult↗

PubMed1986

Fatal intravenous drug abuse secondary to streptomycin overdose.

A fatal case of chronic intravenous drug abuse involving the injection of a nonpsychoactive veterinary combination of penicillin G and streptomycin is reported. The circumstances surrounding the death indicate that the decedent died as a result of streptomycin induced paralytic neuromuscular blockade.

Adult↗

PubMed1986

Dicyclomine in the sudden infant death syndrome (SIDS)--a cause of death or an incidental finding?

We report a case of a small infant apparently dying of the Sudden Infant Death Syndrome (SIDS) with a postmortem blood dicyclomine level of 200 ng/mL. Review of the literature and the comparison with blood dicyclomine values from four rabbits given equivalent doses suggests that a blood dicyclomine value of 200 ng/mL probably is in the therapeutic range for infants. Although safely used for years for infantile colic, recently, the administration of dicyclomine has been related to acute episodes of apnea, seizures, and coma. In the absence of those acute reactions, we feel that a 200-ng/mL blood dicyclomine level in a child dying of apparent SIDS should not prevent categorization of the death as SIDS.

Animals↗

PubMed1985

Comparison of the distribution and binding of monoclonal antibodies labeled with 131-iodine or 111-indium.

The distribution of two monoclonal antibodies with reactivity against human leukemia/lymphoma associated antigens (BA-1 antibody) and carcinoembryonic antigen (202 antibody) when labeled with 131I or 111In was studied in normal Balb/c mice. The BA-1 antibody of the IgM subclass was labeled with 131I by the micro iodine monochloride method at a 12:1 molar ratio and with 111In by the cyclic DTPA anhydride method at a 10:1 molar ratio. In vitro, the 131I-labeled BA-1 antibody bound 35.5% to 10(7) KM-3 leukemic cells while the 111In-labeled BA-1 antibody bound 29.9% to the same number of KM-3 cells. In vivo, the 111In-labeled BA-1 antibody showed a higher accumulation in liver, spleen, and kidney than the 131I-labeled BA-1 antibody. The 202 antibody of the IgG1 subclass was labeled with 131I at a 5:1 molar ratio and with 111In at a 7:1 molar ratio. In vitro, the 131I-labeled 202 antibody bound 30.9%, 27.4%, and 30.0% to 10(7) CO-112, WIDR, and LS-174T colon cancer cells, respectively. The 111In-labeled 202 antibody bound 20.5%, 30.2%, and 33.6%, respectively to the same number of colon cancer cells. In vivo, the 131I-labeled 202 antibody showed a higher tissue to blood ratio in liver, spleen, and kidney than the 111In-labeled 202 antibody. The data indicate that the relative distribution of 131I-labeled versus 111In-labeled monoclonal antibody may depend on the immunoglobulin subclass of the antibody and the molar ratio used in labeling.

Animals↗

PubMed1985

Penile glycogenated epithelial cells as an indicator of recent vaginal intercourse.

Occasionally, suspected male rape assailants are examined, in part to recover evidence of recent sexual intercourse. Glycogenated squamous epithelial cells are felt to be specific for the vagina, and if recovered from the penis, they are indicative of penile vaginal penetration. From the 45 periodic acid-Schiff (PAS) stained postcoital penile smears examined, 36 (81%) contained PAS-positive cells. Precoital penile smears were all negative. Both precoital and postcoital urethral meatus smears contained many PAS-positive cells. The authors conclude that recovery of PAS-positive cells from the penile shaft is strong presumptive, but not definitive, evidence of recent vaginal intercourse.

Adult↗

PubMed1982

Fatal halothane poisoning during anesthesia with other agents.

A patient was inadvertently overdosed with halothane during the nitrous oxide phase of anesthesia induction. During the subsequent 2 1/2-h resuscitation attempt, the oxygen via the anesthesia machine continued to be contaminated with 5% halothane. Brain death was pronounced when the patient may have been only very deeply anesthetized. The vaporizer had accidentally been left on the full ON position prior to the procedure. Poor design of vaporizer controls and operator neglect combined to allow protracted patient exposure to the toxic concentration of halothane. The medical examiner has a critical role in the adequate management of anesthesia/surgery related deaths.

Anesthesia↗

PubMed1980

Sudden death and hepatic fatty metamorphosis. A North Carolina survey.

There is a generally unrecognized epidemic of sudden, nonviolent deaths among alcohol abusers, largely due to fatty liver--related sudden deaths (FLDs). Using data from the North Carolina Office of the Chief Medical Examiner, 411 cases of FLD were identified from 1972 through 1976. The 411 FLD deaths, in view of a low autopsy rate among nonviolent alcohol abuser deaths and the lack of awareness of FLD, suggest a FLD death rate of epidemic proportions. The FLD population characteristics mirror those of the underlying alcohol-abusing population. The increased incidence of low-level (1 to 50 mg/dL) blood ethanol levels among FLD as compared with "control" groups is consistent with several theories linking FLD to some form of acute or hyperacute ethanol withdrawal phenomenon.

Adult↗

PubMed1980

Fatty liver and sudden death. A review.

Alcoholism is associated with increased mortality from violent and nonviolent causes. The increase in nonviolent deaths is usually ascribed, at least in part, to "cirrhosis." In the majority of these deaths this implies fatty liver rather than true Laennec's cirrhosis. Studies of sudden nonviolent deaths illustrate the largely unrecognized and frequent occurrence of sudden death with autopsy findings limited solely to fatty liver. The mechanism(s) of these sudden fatty liver deaths is unknown. Several attractive theories attribute such deaths to ethanol withdrawal induced hypoglycemia or hypomagnesemia, pulmonary fat embolization from fatty liver, or other facets of the alcohol withdrawal syndrome, including ethanol dependent maladaptive derangements of neurotransmitters. All the theories of fatty liver death remain essentially untested, however, owing to uncontrolled postmortem conditions and the lack of awareness of fatty liver deaths within the scientific community.

Adult↗