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Biomedical subjects

C H McKenna

Publications and source records attributed to C H McKenna.

17 recordsLinked to original sources
PubMed1996

Ovarian cancer and gangrene of the digits: case report and review of the literature.

Digital ischemia has been reported with various types of cancer, especially gastrointestinal. It is more common in elderly women than in any other group, and the most common symptom is a gangrenous finger (or fingers). More than half of the patients have metastatic involvement. Once the primary disease has been treated, when feasible, the digital symptoms usually regress or disappear. The presence of digital ischemia without other rheumatologic stigmata or vascular predisposition in an elderly patient should raise clinical suspicion of a paraneoplastic phenomenon. Herein we describe a 65-year old woman with digital ischemia associated with ovarian cancer. The diagnosis was established by biopsy after extremely high levels of cancer antigen 125 were detected.

Aged↗
PubMed1988

Epidemiology of Reiter's syndrome in Rochester, Minnesota: 1950-1980.

The incidence of Reiter's syndrome in a predominantly white, community-based population is reported. The age-adjusted annual incidence rate for males younger than age 50 was 3.5 per 100,000. No female cases were identified. Over time, a greater proportion of cases have been identified among younger males. In 63% of the patients, either a prolonged or relapsing disease course occurred.

Adolescent↗
PubMed1986

Echovirus polymyositis in patients with hypogammaglobulinemia. Failure of high-dose intravenous gammaglobulin therapy and review of the literature.

A 29-year-old man with X-linked hypogammaglobulinemia was treated with prednisone and methotrexate for polymyositis. Subsequently, it was established that disseminated echovirus 11 infection was causing the polymyositis. Treatment with large doses of intravenous gammaglobulin did not result in improvement. Viral cultures of blood, urine, and cerebrospinal fluid gave positive results throughout treatment and at postmortem examination. Multiple cultures of other tissues, including muscle, also gave positive results at postmortem examination. Severity of infection and treatment with prednisone and methotrexate prior to referral, diagnosis, and gammaglobulin treatment may explain the lack of response. A review of 23 cases of echovirus infection in patients with hypogammaglobulinemia revealed that the infection in these patients may cause meningoencephalitis or a polymyositis-like syndrome or both. Treatment with immunosuppressive agents, the standard therapy for polymyositis, is contraindicated, and intravenous or intraventricular gammaglobulin or both may be helpful.

Adolescent↗
PubMed1986

Relapsing polychondritis. Survival and predictive role of early disease manifestations.

To define the natural history of relapsing polychondritis, the probability of survival and causes of death were determined in 112 patients seen at one institution. By using covariate analysis, early clinical manifestations were identified that predicted mortality. The 5- and 10-year probabilities of survival after diagnosis were 74% and 55%, respectively. The most frequent causes of death were infection, systemic vasculitis, and malignancy. Only 10% of the deaths could be attributed to airway involvement by chondritis. Anemia at diagnosis was a marker for decreased survival in the entire group. There was an interaction between other disease variables and age in determining their impact on outcome. For patients less than 51 years old, saddle-nose deformity and systemic vasculitis were the worst prognostic signs. For older patients, only anemia predicted outcome. The need for corticosteroid therapy did not influence survival.

Adolescent↗
PubMed1985

Epidemiology of systemic lupus erythematosus and other connective tissue diseases in Rochester, Minnesota, 1950 through 1979.

The incidence and prevalence rates of connective tissue disease syndromes in Rochester, Minnesota, from 1950 through 1979 are reported. The incidence of definite systemic lupus erythematosus (SLE) has not increased since 1960. The incidence of SLE in the elderly population was higher than that in previous reports. Rates of SLE and discoid lupus erythematosus were approximately equal. Other diagnoses (in decreasing order of frequency) were suspected lupus erythematosus, scleroderma, drug-induced lupus, and overlapping connective tissue disease syndromes. The 10-year survival of patients with definite SLE was decreased, and the survival of patients with suspected SLE was the same as that of the general population.

Adolescent↗
PubMed1985

Splenectomy does not cure the thrombocytopenia of systemic lupus erythematosus.

Fourteen patients with systemic lupus erythematosus had splenectomies done between 1960 and 1982 for treatment of severe thrombocytopenia. Thrombocytopenia persisted or recurred within 1 month postoperatively in five patients and within 6 months in three others. Three patients had late recurrence (18, 30, and 54 months after splenectomy); in two it was probably related to withdrawal of immunosuppressive agents or corticosteroids. Median lowest platelet count before splenectomy and median platelet count at relapse or failure of splenectomy were both 8000/microL. Only two patients maintained normal platelet counts without need for corticosteroids or other treatment. These results differ from those in patients with idiopathic thrombocytopenic purpura. Other treatments should be tried before splenectomy is done for thrombocytopenia in patients with systemic lupus erythematosus.

Adult↗
PubMed1980

Associations of antibodies to native DNA with HLA-DRw3. A possible major histocompatibility complex-linked human immune response gene.

We examined the incidence of B lymphocyte (HLA-DRw) alloantigens in patients who exhibited elevated antibody titers to native DNA irrespective of their diagnosis. We found a statistically significant (P less than or equal to 0.0001) association between HLA-DRw3 and the presence of antibodies to native DNA not only in patients with a diagnosis of systemic lupus erythematosus but in other patients who did not share that diagnosis. This association supports the existence of a human immune response gene linked to the HLA complex. These data suggest that the hypothesis of an association between HLA and disease operating through disease susceptibility antigens or genes might be invalid and supports an alternative hypothesis, that HLA and disease associations are a manifestation of an immune response gene that controls the production of specific antibodies in any of several disease states.

Antibody Formation↗
PubMed1979

Epidemiology of Ankylosing spondylitis in Rochester, Minnesota, 1935-1973.

The Mayo Clinic records linkage facility for residents of Rochester, Minnesota, Yielded 102 cases of ankylosing spondylitis (AS) diagnosed from 1935 through 1973. The incidence did not change significantly over the 39 years. Three times as many males as females were affected. In contrast to another recent report, survivorship of males with AS was not different from that of the general population, whereas survivorship of females with AS was reduced. The overall prevalence was 129/100,000.

Adolescent↗
PubMed1976

Problems with beaded fluorescence pattern in FTA-ABS test.

The significance of false-positive FTA-ABS fluorescence in connective tissue diseases and other clinical conditions was evaluated by studying the serum from several groups of patients. In 12% of 67 patients without syphilis, serum with an antinuclear antibody (ANA) titer of 1:32 or greater gave low intensity FTA-ABS test fluorescence. In 20% of 150, patients (2.7% with a history of syphilis), serum with rheumatoid factor (RF) titers of 1:640 or greater demonstrated some reactivity. Only 1.3% of 75 donors of normal blood showed low-grade FTA-ABS fluorescence. In 385 patients with diagnostic problems, 2.1% of the serum demonstrated the beaded pattern. Patterns varied, depending on the treponemal antigen preparation and the duration of serum storage. Also, multiple specimens from the same patient produced different patterns. Furthermore, the beaded pattern could be demonstrated in patients with a history of syphilis, with other medical disorders, and in apparently normal persons.

Antibodies, Antinuclear↗
PubMed1976

Hypocomplementemic ear effusion in relapsing polychondritis.

In a case of relapsing polychondritis it was possible to aspirate a collection of subcutaneous fluid from the patient's involved ear. A determination of total hemolytic complement activity of this fluid was low, suggesting that activation of the complement system may have occurred in the course of the patient's disease and might be related to the pathogenesis of this disorder.

Complement System Proteins↗