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Biomedical subjects

C E Keller

Publications and source records attributed to C E Keller.

16 recordsLinked to original sources
PubMed2006

The spectrum of myelodysplastic syndromes post-solid organ transplantation: a single institutional experience.

An increased incidence of acute myeloid leukemia (AML) has recently been documented in patients post-solid organ transplantation but the incidence and types of myelodysplastic syndromes (MDS) occurring in this patient population are not known. We identified 5 patients (3M, 2F, age 48-64 years) who developed MDS ranging from 1.8 to 25 years (median 4.2 years) post-solid organ transplantation, only 2 patients had received azathioprine. The cumulative incidence of MDS in heart and lung transplant recipients at 15 years was 0.5% and 1.8%, respectively, which is markedly higher compared to the general population. Low-risk types of MDS predominated, 3 of 5 patients are alive (median 3.9 years) since diagnosis. Deletions of chromosome 20q, which have not been previously reported in post-transplant MDS/AML, were identified in 3 cases. Our findings expand the morphologic and cytogenetic spectrum of MDS occurring post-solid organ transplantation and suggest that mechanisms beside azathioprine toxicity might be important in disease pathogenesis.

Biopsy↗
PubMed2000

I.Q.H., information and quality healthcare: improving the care of patients with acute myocardial infarction and congestive heart failure.

Acute myocardial infarction and congestive heart failure are prevalent conditions in Mississippi associated with significant mortality and morbidity. It is critically important that physicians and hospital staffs work together to implement system and process changes that will facilitate the appropriate, timely evaluation and use of indicated therapies in both AMI and CHF patients. Change, while never easy, can be beneficial when properly motivated, designed and implemented. Physicians can and do make a difference not only in the quality of care given but also in the quality of life lived by their patients. I.Q.H. is encouraging all Mississippi physicians and healthcare facilities to examine their treatment processes for AMI and CHF.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1998

Type of affirmative action policy: a determinant of reactions to sex-based preferential selection?

In 3 studies, 150 undergraduates and 75 MBA students, men and women, were exposed to selection policies differing in the degree to which merit and group membership were weighted in selection decisions involving women. Results indicated that in self-views and self-assessments of beneficiaries (Study 1), competence perceptions on the part of others (Study 2), and work-related reactions of nonbeneficiaries (Study 3), many, but not all, negative reactions to sex-based preferential selection were alleviated when the policy made clear that merit considerations were central to the decision-making process. In the absence of information about policy type, participants acted as if merit had not been a factor in preferential selection decisions.

Adolescent↗
PubMed1995

Relationship of anatomic disease to appropriateness ratings of coronary angiography.

BACKGROUND: At Harvard Community Health Plan (HCHP), Brookline, Mass, a mixed-model health maintenance organization (HMO), coronary angiography is performed at numerous community and tertiary-level teaching hospitals. OBJECTIVE: To determine the appropriateness of coronary angiography within HCHP according to RAND (1992) criteria and to examine the relationship between the appropriateness rating and (1) the clinical indication for catheterization and (2) the extent of anatomic disease. METHOD: A retrospective, randomized hospital medical record review of 292 patients enrolled in HCHP who underwent coronary angiography in 1992, stratified by four distinct HCHP subgroups. RESULTS: Of the coronary angiographies reviewed, 78% were rated appropriate, 16% uncertain, and only 6% inappropriate across the entire sample. Ratings were comparable in all subdivisions of HCHP despite an incidence rate of catheterization in one of the three HMO divisions that was 60% and 40% higher than in the other two divisions. The lowest appropriateness ratings were for Asymptomatic patients (43%) and those with Chest Pain of Uncertain Origin (35%) (capital letters refer to the RAND clinical indication criteria mentioned above). A rating of necessity was not a better discriminator of anatomic disease than a rating of appropriateness alone: 82% and 84%, respectively, were found to have disease by angiography. CONCLUSION: The low HCHP rate of inappropriateness for coronary angiography is comparable with the RAND 1992 New York State data. This finding, coupled with marked differences in the incidence rate of this procedure among the HCHP divisions, is consistent with either major differences in the sickness of the HMO's sub-populations or, more likely, a lack of specificity of the RAND criteria for coronary angiography.

Aged↗
PubMed1994

Derivatives of 3-alkyl-N-hydroxysuccinimide: probing the effect of structure on bioactivity toward human leukocyte elastase.

A structure-activity relationship study was conducted in order to probe the nature of the interaction between some 3-alkyl-N-hydroxysuccinimide derivatives and human leukocyte elastase. The structural features in substituent X (structure I) that lead to the manifestation and optimization of inhibitory activity have been examined. The data suggest that the presence of an alkyl or aryl(sulfonyloxy) group in the active compounds may serve a triple purpose, namely, it functions as a good leaving group as dictated by the established mechanism of action of this class of compounds, secondly, it may enhance binding by assuming a favorable spatial orientation and, thirdly, it may increase the chemical reactivity of the carbonyl carbon in the bioactive compounds.

Chemical Phenomena↗
PubMed1993

Women in medicine.

Explore the source record for details and available documents.

Anesthesiology↗
PubMed1987

Portal hypertension workup by DSA.

To provide information for preoperative planning, combined, selective intravenous (IV) and intraarterial (IA) digital subtraction angiography (DSA) studies were performed on 42 portal hypertension patients scheduled for portal systemic shunt procedures. Selective IV-DSA was performed to demonstrate the hepatic venous system, left renal vein, and inferior vena cava. Portal venous anatomy, direction of flow, and portal systemic collaterals were evaluated by selective IA-DSA. In addition, selective IA-DSA was performed postoperatively on 8 patients to assess shunt patency. Technically adequate DSA studies, suitable for surgical planning or postoperative assessment, were obtained in all of the 50 patients examined. Patient or internal organ motion was not a limiting factor in any study. Such use of DSA represents an efficacious, safe, and cost-effective alternative to conventional film-screen angiography for the evaluation of patients with portal hypertension.

Angiography↗
PubMed1986

Superior vena cava obstruction: evaluation with digital subtraction angiography.

Superior vena cava (SVC) obstruction is an uncommon but dramatic clinical presentation that often requires immediate treatment. We present a technique for evaluation of SVC syndrome using small-gauge butterfly needles and intravenous digital subtraction angiography, and we report our results in ten patients. We find this technique superior to conventional venography since it is rapid, easy, safe, and more cost-effective to perform.

Adult↗
PubMed1985

Hemodynamic and vascular activity of LY127210, a new vasodilator, in anesthetized spontaneously hypertensive rats: comparison with hydralazine.

We used microsphere techniques to determine cardiac output and tissue blood flows in chloralose-anesthetized spontaneously hypertensive rats treated with LY127210 (10 mg/kg, i.p.), hydralazine (2 mg/kg, i.p.), or saline. LY127210 decreased blood pressure, systemic vascular resistance, heart rate and left ventricular end-diastolic pressure. Regional vascular resistance fell in kidney, cerebral cortex, ileum and skin, and blood flow decreased in skin, and cerebral cortex. After hydralazine, blood pressure, systemic resistance and left ventricular end-diastolic pressure also decreased, but heart rate increased. Regional vascular resistance decreased in the kidney, cerebral cortex, ileum, myocardium and skeletal muscle, and blood flow was either maintained or increased in these tissues. Unlike LY127210, hydralazine decreased blood flow and increased vascular resistance in the skin. Thus, LY127210 reduces blood pressure in hypertensive rats by reducing vascular resistance, although about 1/3 of the fall in pressure was attributed to a decrease in cardiac output. Since heart rate, stroke volume and skin resistance did not increase, LY127210 might also interfere with baroreflex mechanisms.

Animals↗
PubMed1984

Radiologic recognition of colonic diverticula simulating polyps.

The differentiation of colonic polyps and diverticula on the double-contrast barium enema is generally straightforward, using current diagnostic criteria. However, diverticula may be misinterpreted on the double-contrast barium enema as polyps when they appear uncommonly as filling defects within the barium pool. As a result of such erroneous interpretation, the patient may subsequently undergo costly and inconvenient repeat barium enema or colonoscopy. Carefully studied scout films, oblique views, compression spot images, and postevacuation films generally can differentiate these diverticula from polyps. The usual reason that a diverticulum assumes the appearance of a polyp is that it contains impacted stool.

Aged↗