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Biomedical subjects

C Farrell

Publications and source records attributed to C Farrell.

At least 19 recordsLinked to original sources
PubMed1990

Thalidomide, pregnancy and renal failure.

A 26-year-old woman with upper limb phocomelia as a result of thalidemide embryopathy developed renal failure that required dialysis during pregnancy. The pregnancy was complicated by dialysis difficulties, uncontrollable hypertension and deteriorating renal function resulting in fetal loss at 26-weeks' gestation. The patient was left with end-stage renal failure and recently has undergone cadaveric renal transplantation. This case highlights the widespread effects, including urinary-tract abnormalities, that thalidomide may have and illustrates the peculiar difficulties in managing such a patient during and after pregnancy.

Adult↗
PubMed1988

The Na+-Ca2+ exchange system in vascular smooth muscle cell membrane vesicles isolated from cultured cells and from tissue is similar.

The existence of a Na+-Ca2+ exchange system was investigated in sarcolemmal vesicles isolated from cultured cells of dog mesenteric artery. When Na+-loaded membrane vesicles were suspended in a Na+-free KCl medium to create an outwardly directed Na+ concentration gradient across the membrane, a time-dependent uptake of Ca2+ was observed. This uptake of Ca2+ was drastically reduced when the vesicles were suspended in NaCl medium to eliminate the Na+ concentration gradient across the membrane. Monensin also decreased Ca2+ uptake in Na+-loaded vesicles. The apparent Km for Ca2+ was 2.97 microM and the apparent maximum velocity was 4.27 nmol/min per mg protein. The data indicate that a Na+-Ca2+ exchange system exists in sarcolemmal membranes isolated from cultured cells and that it is similar to the system in membranes isolated from the tissue.

Animals↗
PubMed1988

Surveillance for stage I non-seminomatous germ cell tumours of the testis: the optimal protocol has not yet been defined.

Forty-six patients with clinical stage I testicular non-seminomatous germ cell tumours were followed up according to a protocol of active surveillance between 1979 and 1987. The median follow-up time was 40+ months. Thirteen patients (28%) relapsed, predominantly in retroperitoneum and/or lung. Ten of these relapses (76%) occurred within 8 months of orchiectomy. Relapses occurred in 7/35 T1 tumours and 5/10 T2 to T4 tumours. No correlation was detected between the histological type and relapse rate. Three late relapses were diagnosed at 23, 29 and 36 months. Eleven of the relapsed patients remain in prolonged complete remission after PVB chemotherapy +/- surgery; one patient, who initially refused treatment at the time of relapse, has died. Another relapsed with predominant elements of rhabdomyosarcoma intermingled with malignant teratoma in a bone metastasis. He had a partial response to PVB chemotherapy but subsequently died. Thirty-four patients (74%) did not undergo lymphography (LG) and had a higher relapse rate (11/34) than those who had LG (2/12); this was not a statistically significant difference in this small series. The policy of active surveillance is not yet the "state of the art" and should be under constant scrutiny with respect to safety and practice.

Adult↗
PubMed1987

Simplified technique for placement of implantable vascular devices.

A simplified technique for insertion of an implantable vascular device is described. Use of a percutaneous technique with adherence to the steps described with reference to the site of the venipuncture, use of sterile lubricant while introducing the sheathed tapered dilator and Silastic catheter, creation of the subcutaneous pocket after adequate catheter placement and routine use of fluoroscopy helped to avoid technical intraoperative complications, as well as reduce postoperative morbidity.

Catheters, Indwelling↗
PubMed1986

Female marrow donors increase the risk of acute graft-versus-host disease: effect of donor age and parity and analysis of cell subpopulations in the donor marrow inoculum.

We evaluated 27 factors for their influence on acute graft-versus-host disease (GVHD) in 40 recipients of HLA-identical sibling marrow transplants. These factors included the doses of mononuclear cell subpopulations present in the donor marrow inoculum quantitated using a panel of monoclonal antibodies. Female donors were associated with increased severity of acute GVHD, and the older the female donor the greater this effect. Increasing donor parity was also associated with an increased risk of acute GVHD. The number of T cells, T cells subsets, natural killer cells and monocytes infused did not influence the incidence or severity of acute GVHD in this study, and we could not explain the influence of female donors and of female donor age on acute GVHD by the cellular content of their marrow inocula. We postulate that non-HLA histocompatibility antigen disparity is a more important determinant for acute GVHD than the number of infused donor T cells, especially when female donors are used. The association between acute GVHD and increasing parity suggests that some female marrow donors have been pre-sensitized to their respective recipients by preceding pregnancies.

Acute Disease↗
PubMed1985

Neoplasms arising in Paget's disease of bone: a study of 82 cases.

Eighty-two cases of neoplasms arising in Paget's disease of bone from the Mid-America Bone Tumor Registry, accessioned between 1958 and 1983, were reviewed. There were 77 osteosarcomas, 3 fibrosarcomas, 1 chondrosarcoma, and 1 giant cell tumor. The male/female ratio was 2:1. The age distribution was 18%, 29%, 36%, and 17% for the groups less than 51 years, 51-60 years, 61-70 years, and greater than 70 years, respectively. The femur was involved by tumor in 22%; the humerus in 21%; the pelvis in 21%; the calvarium in 12%; the tibia in 10%; and other bones in 15% of the cases. There were 48% survivors after 1 year; 17% after two; and 5% after three and five years; two additional patients with tumor lived for more than seven and 11 years. Radiographs available for simultaneous study in 43 cases revealed predominant tumor patterns that were mixed in 69%, osteoblastic in 21%, and osteolytic in 10%. Other radiographic data and the clinical and histopathologic data are in agreement with five earlier major studies. While the prognosis of neoplasms arising in Paget's disease generally is not good, a small fraction of long-term survivors after aggressive therapy makes this complication a challenge for timely radiographic diagnosis and histopathologic confirmation.

Adult↗
PubMed1979

Cancer of the breast. Mammography and thermography.

Quality mammography with knowledgeable interpretation is now a widely utilized and reliable procedure. It permits clinically occult lesions to be detected and clinically obvious or indeterminate lesions to be managed more intelligently. Abnormal mammographic signs are well defined, as are their differential diagnoses. Thermography of the breast is a younger science than mammography and must mature before its full potential can be realized. It is clear that thermography today cannot be considered an adequate prescreening technique to obviate further examination, as was once anticipated. Used in conjunction with physical examination and mammography it can serve to reinforce suspicions, and the high acceptability of the examination is an impetus to further clarify its role in detection.

Adult↗
PubMed1979

Cancer of the breast. Screening.

Screening is a more complicated issue than has been indicated in this chapter. Long-term followup is essential to exclude misleading initial impressions, and survival predictions must stand this test. The problem of interval cancers must be acknowledged, and methods of developing more cost-effective systems that might provide even broader coverage of the population at risk have to be considered. Suffice it to say that mass screening for breast cancer can be accomplished. Large numbers of American women are sufficiently concerned about this disease to participate, as evidenced by the success of the National Cancer Institute/American Cancer Society Breast Cancer Detection Demonstration Projects. It has been demonstrated that breast cancers so small that they would previously be considered a pathological curiosity are detected with surprising frequency. The ultimate effect on survival time by this screening can of course only be determined after passage of time, but there is every reason to believe that it represents one of the really great advances in detection-diagnosis in recent history. The chief detection modality is mammography, and it is to be expected that technological advances in this area will permit images of even greater reliability and resolution at a level of radiation exposure that will be acceptable to everyone. The definitive role of thermography in detection of breast disease has yet to be fully determined. The maximal scientific benefit and the true impact of the screening demonstration projects will be realized only after long-term followup of the 280,000 participants.

Adult↗
PubMed1977

A survey for circulating immune complexes in patients with acute myocardial infarction. Use of a C1q-binding assay with soluble protein A as indicator.

A new assay for the detection of circulating C1q-binding immune complexes (IC) is described. The assay makes use of solid-phase C1q and iodinated soluble protein A, extracted from the cell wall of Staphylococcus aureus. In a model system the assay could detect heat-aggregated IgG down to a concentration of about 50 ng/ml. This method and three other assays, previously described, were used to survey the appearance of IC activity in sera from hospitalized patients with acute myocardial infarction. Depending on the assay system used, from 56% to 66% of the patients investigated were found to develop circulating IC. The earliest appearance of circulating IC was noted 5 days after infarction. The highest incidence of positive reactions and the strongest reactions occurred 2 to 3 weeks after hospitalization; thereafter the IC positiveness tapered off, and all patients were negative 6 weeks after infarction.

Acute Disease↗