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Biomedical subjects

C Angel

Publications and source records attributed to C Angel.

At least 37 records · Page 2Linked to original sources
PubMed1992

Autonomic changes during cancer chemotherapy induced nausea and emesis.

Certain autonomic variables have been shown to be responsive to motion induced nausea and vomiting. Here we report preliminary data on changes in heart rate, blood volume pulse, pallor and skin temperature assessed during a one hour period at baseline, a one hour period of peak nausea, and a one hour period of emesis in five female patients receiving identical cancer chemotherapy and antiemetic drugs according to a common protocol. Examination of coefficients of variation showed that heart rate and face temperature were more stable measures across each of the three time periods than blood volume pulse and pallor. Furthermore, the four measures were found to be more variable during times of emesis than times of nausea. The four measures were shown to be responsive to patient reported nausea and vomiting. Temperature and pallor showed a linear change from baseline to nausea to vomiting. Heart rate and blood volume pulse significantly decreased from baseline time during nausea and then significantly increased from a time of nausea to during emesis. Variations in the time course of each variable change during nausea supported a view that nausea may be more related to a rebound of parasympathetic activity than a slow decrease of sympathetic activity. Replication with larger samples is needed. Examination of the nausea and vomiting of pregnancy, general anaesthesia or different chemotherapeutic agents could help explore whether results reported here are singular or representative of a more generalisable autonomic response associated with patient reported nausea.

Antineoplastic Agents↗
PubMed1992

Meigs syndrome with elevated serum CA 125.

Elevation of serum CA 125 levels is associated with malignant serous ovarian carcinomas and has been described in one patient with Meigs syndrome. We present two additional cases of Meigs syndrome with significant elevations in serum CA 125 and report the results of immunohistochemical staining for CA 125. CA 125 expression was localized to the omentum and peritoneal surfaces rather than the fibroma. We suggest that expression of CA 125 and accumulation of ascites in these two patients may have resulted from some common peritoneal process.

Aged↗
PubMed1991

Management of anorectal/perineal infections caused by Pseudomonas aeruginosa in children with malignant diseases.

The role of operation for anorectal infections associated with perineal gangrene and cellulitis in children with myelo-suppression from cancer chemotherapy is unclear. We evaluated anorectal/perineal infections caused by Pseudomonas aeruginosa in 16 children with malignant diseases seen over 27 years. In 12 of 16 patients, leukemia was the underlying malignancy (ALL 10, AML 2), and in 13 of 16, severe neutropenia (absolute neutrophil count less than 500/mm3) was present at diagnosis. Cultures of the lesions showed multiple organisms in 14 of 16 patients with Escherichia coli, Klebsiella species, and Enterococcus being the most frequent coexisting organisms. All positive blood cultures grew P aeruginosa exclusively. Of three patients with necrotizing infections, two had complete resolution with medical treatment alone; the other patient who developed this problem while on terminal care died. In none of the 16 patients was a major operation (debridement or diversion) performed. Five patients died, three of whom were considered terminally ill when the anorectal infections occurred. Four of the five deaths occurred before 1974. Since then, only 1 of 7 patients died. Excluding the three terminally ill patients, the success rate of medical therapy alone is 85% (11/13). The antibiotic regimen should include an aminoglycoside in synergistic combination with anti-Pseudomonas penicillin. These results suggest that operative management may have no role in the management of anorectal infections caused by P aeruginosa in children with cancer.

Administration, Topical↗
PubMed1991

Endometrial carcinoma: the relevance of cervical cytology.

In patients with endometrial carcinoma, preoperative identification of poor prognostic factors is helpful in planning therapy. Extended surgical staging, including pelvic and periaortic node dissection, is indicated in patients with deep myometrial invasion or high-grade tumor, or when other risk factors for extrauterine spread are present. In this study, cervical cytology was reviewed in 86 patients with endometrial carcinoma, all of whom underwent surgical staging, to correlate the cytologic results with surgical and pathologic findings. Cervical cytology was normal in 20 patients (23%), whereas suspicious or malignant endometrial cells were present in 23 and 43 cases (27 and 50%), respectively. Suspicious or malignant cervical cytology was associated with deeper myometrial invasion (P = .011), higher postoperative tumor grade (P = .006), positive peritoneal washings (P = .012), and more advanced stage by International Federation of Gynecology and Obstetrics criteria (P = .024). When compared with patients with normal cervical cytology, those who had malignant endometrial cells had over twice the risk of deep myometrial invasion (67 versus 30%), twice the risk of grade 2 or 3 tumor (60 versus 30%), and three times the risk of positive peritoneal washings (33 versus 10%). Seventy-four percent of patients with malignant cervical cytology were stage IC or more. In contrast, 70% of patients with normal cervical cytology were stage IA or IB. Patients with endometrial carcinoma who have malignant endometrial cells detected by cervical cytology are at increased risk of having a deeply invasive, high-grade, advanced-stage tumor, and therefore are more likely to require extended surgical staging.

Adult↗
PubMed1990

[Value of superior angiocardiography in the evaluation of the surgical excision of bronchial cancer. Respective role compared to thoracic x-ray computed tomography].

The place of angiography-superior vena cavography in the assessment of the resectability of a lung cancer must be defined in comparison with the data provided by thoracic computed tomography. Sixty-six patients with proximal lung cancers of doubtful resectability were studied by means of angiography and computed tomography and the results of these preoperative investigations were correlated with the operative findings. The sensitivity of these two examinations for the diagnosis of vascular invasion preventing pulmonary resection is poor (53% and 47% respectively). The specificity and positive predictive value of angiography appear to be slightly superior to those of computed tomography (Sp: 96% and 82%, PPV: 78% and 47%, respectively). The diagnostic performance of these two examinations remains poor. Magnetic resonance imaging may replace these two examinations in the future.

Carcinoma, Bronchogenic↗
PubMed1989

Gangrenous acalculous cholecystitis in a premature infant.

Acute acalculous cholecystitis is uncommon, although children are more likely to have this condition than adults. A 1,100-g premature baby girl with a gangrenous acalculous cholecystitis is reported. She presented with clinical and radiographic findings that were initially interpreted as necrotizing enterocolitis. An exploratory laparotomy demonstrated the presence of an acute gangrenous acalculous cholecystitis, and a cholecystectomy was performed. To our knowledge, this one of the smallest patients reported with this entity, and the first whose condition was initially diagnosed as necrotizing enterocolitis. It is important to recognize this entity and consider it in the differential diagnosis of premature infants, because in patients with necrotizing enterocolitis nonoperative management should be attempted initially, and patients with acute gangrenous cholecystitis most likely will require a laparotomy and cholecystectomy.

Acute Disease↗
PubMed1988

Hemispheric activation increases positive manifold for lateralized cognitive tasks: an extension of Stankov's hypothesis.

Stankov (1983a, Journal of Educational Psychology, 75, 471-490) suggests that the dual task paradigm, requiring the division of attention, increases positive manifold (i.e., positive intercorrelations) for cognitive tasks relative to the single task paradigm. Two dual task studies are reported. Unimanual finger-tapping served as the primary task and the short-term retention (20 sec) of digit or spatial-location sequences served as the secondary tasks. When both tasks were lateralized to the same hemisphere (digits and right-hand tapping or spatial locations and left-hand tapping), highest memory task intercorrelations (Experiment 1) and better retention of sequences (Experiments 1 and 2) resulted. Left-hand tapping produced more leftward looking and right-hand tapping more rightward looking (Experiment 2). Overflow from lateralized finger-tapping may shift the gradient of attentional activation toward the contralateral hemisphere, producing the homolateral gaze direction, the increase in positive manifold, and the better retention of sequences lateralized to that hemisphere.

Adult↗
PubMed1988

Survival time, causes of death, and tumor/treatment-related morbidity in 100 women with ovarian cancer.

One hundred cases of ovarian cancer were studied at autopsy to determine the effect of morphologic and clinical factors on survival time, the primary cause of death, and tumor/treatment-related morbidity. The mean survival time was 19 months (0 to 174 months). Increasing neoplastic histologic grade and increasing clinical stage at diagnosis were each associated with decreased survival time. In grade I tumors, the mean survival time was 84 months; in grade II tumors, it was 18 months; and in grade III tumors, it was 12 months (P = .0008). Patients who presented in stage I or II had a better survival time (28 months) than those who presented in stage III or IV (15 months) (P = .02). The most common causes of death were disseminated carcinomatosis (48%), infection (17%), pulmonary embolus (8%), and combinations of infection and carcinomatosis (11%). In patients dying of infection, 43% had sepsis, 21% had pneumonia, and 25% had a combination of sepsis and pneumonia. Escherichia coli and Klebsiella were the most common pathogens identified postmortem. Intestinal obstruction (51%) and ureteral obstruction (28%) were the most common forms of tumor-induced morbidity. Bone marrow depression and resultant pancytopenia was the most common form of treatment-induced morbidity.

Adolescent↗
PubMed1988

Distribution of disease at autopsy in 100 women with ovarian cancer.

Clinical and morphologic factors that affected the distribution of disease are described in 100 cases of ovarian cancer at autopsy. In addition to the expected pattern of pelvic and abdominal peritoneal spread, extensive visceral parenchymal metastases were seen: liver parenchyma (45%), lung parenchyma (39%), small and large intestinal wall (52% and 55%), lymph nodes (70%), pancreas (21%), ureter (24%), bone (11%), and brain (6%). Liver parenchymal metastases replaced more than one third of the liver in 25% of cases, whereas lung metastases always involved less than one third of the lungs. When intestinal wall invasion was seen, bowel obstruction was present more often (71%) than when only intestinal serosa was involved (30%). Lymphatic invasion was predictive of lymph node, small intestinal wall, pancreatic, and liver as well as lung parenchymal metastases. Blood vessel invasion was predictive of pancreatic and ureteral metastases. Clinical stage I at diagnosis was associated with high incidences of liver parenchymal (56%), lymph node (56%), lung parenchymal (44%), large intestinal wall (33%), and bone (33%) metastases. Thus, ovarian cancer has parenchymal metastases similar to other carcinomas in addition to its peritoneal spread. Lymphatic and blood vessel invasion is predictive of such involvement. Intestinal wall invasion predicts bowel obstruction.

Adolescent↗
PubMed1988

Stage IB cervical carcinoma: comparison of clinical, MR, and pathologic staging.

In patients with stage IB cervical carcinoma (carcinoma confined to the cervix), accurate staging is essential in order to determine the best treatment strategy--that is, whether to use surgery alone or surgery in combination with pre- or postsurgical radiation therapy. Currently, decisions regarding the management of patients are made on the basis of clinical staging that has an error rate of 34-39% (when surgical staging is used as the standard). To investigate the value of MR in staging patients with IB cervical cancer, we performed prospective MR examinations in 27 patients who had cervical carcinoma. Of these, 10 were clinically staged as having IB cervical carcinoma and underwent radical hysterectomy, providing specimens for pathologic correlation. In six of these 10 patients, the extent of disease had been underestimated during clinical examination under anesthesia. These six patients would have received radiation therapy before surgery had the MR information been used at the treatment-planning stage. MR imaging correlated better with surgical pathology than did clinical examination under anesthesia in determining the location and extent of tumor. MR imaging should be used in conjunction with clinical staging to determine appropriate therapy in patients with stage IB cervical carcinoma.

Adult↗
PubMed1987

Magnetic resonance imaging and pathologic correlation in stage IB cervix cancers.

Ten patients with Stage IB cervical carcinoma underwent primary radical surgery within 2 weeks following magnetic resonance imaging (MRI) examination. Underestimation of stromal disease was common on examination under anesthesia (EUA), while MRI correctly estimated tumor volume and degree of stromal invasion in 9 of 10 cases. In six patients, EUA severely underestimated the tumor: stroma ratio, and five of these six underwent postoperative pelvic radiation therapy. Had the true extent of tumor involvement been recognized preoperatively, we probably would have selected either primary radiation or radiation plus extrafascial hysterectomy for these patients. Pathologic correlation revealed that MRI more accurately predicted tumor size and extent of stromal involvement than clinical examination. We believe that magnetic resonance imaging may have a role in treatment planning of patients with Stage IB cervical carcinoma.

Adult↗
PubMed1985

[Quantification of left ventricular function by subtraction intravenous angiography].

Digitised intravenous angiography (Diva), initially applied to the study of the aorta and great vessels, has benefited from technical advances, especially the possibility of recording 25 frames per second, which now allows studies of the heart itself. 22 subjects underwent angiography with digitised subtraction after injection of 50 ml of sodium diatrizoate and meglumine in the right atrium and selective left ventriculography in the same catheter session. The end diastolic and systolic indices and global ejection fractions were measured independently for each technique by Chapman's method by two observers. The model of digitised angiography used was a CGR Divas prototype functioning in the pulsed graphic mode at 25 images per second. The results showed that the Diva method gave reproducible values of the end diastolic index (101 +/- 29.8 and 104.5 +/- 30.7: r = 0.98), of the end systolic index (43.2 +/- 32.9 and 44.6 +/- 32.5; r = 0.98), and of the ejection fraction (62.5 +/- 17.16 p. 100 and 62.17 +/- 15.7 p. 100; r = 0.96). There was a close correlation between the results of Diva and selective ventriculography (end diastolic index: 97.8 +/- 21.1 and 101.6 +/- 10.3; r = 0.87; end systolic index: 38.82 +/- 24.8 and 43.9 +/- 21.17; r = 0.95; ejection fraction: 62.12 +/- 16.27 and 57.29 +/- 15.53; r = 0.95). There was a significant underestimation of the end systolic index using Diva (0.01 less than p less than 0.02). The originality of the pulsed graphic method is the totally digitised character of the data.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Percutaneous endoluminal angioplasty of the supra-aortic arterial trunks. Immediate and remote results].

Twelve tight stenoses (9 of the subclavian artery, 1 of the axillary artery and 2 of the brachio-cephalic artery) were dilated with immediate satisfactory results in all cases. Only one complication (regressive lesion of the median nerve) was recorded. Eight patients were followed-up for a mean period of 13 months: all were symptom-free, and digital angiography by the intravenous route showed a stable image of patency. From a review of published dilatations of the subclavian artery it appeared that the method is 95% effective, that its mortality is nil and that no complication, notably embolism, has been reported. In view of the risks involved in surgical procedures and of the advantages of percutaneous transluminal angioplasty, at least in theory, this technique seems to be a suitable alternative to surgery in stenoses of the subclavian arteries.

Adult↗