PubMed Health⌕ Search

Biomedical subjects

C W Sewell

Publications and source records attributed to C W Sewell.

31 records · Page 2Linked to original sources

Multiple NMR T2 relaxation values in human liver tissue.

Twenty-one human hepatic liver biopsy samples were evaluated by nuclear magnetic resonance spectroscopy. This spectroscopy was performed by obtaining multiple and not single T2 values (T2-long and T2-short). Neoplastic tissue had greater T2-long and T2-short values than diffuse liver disease. The T2-short correlated, r = 0.947 (p less than 0.01), with the percentage of cancer cellularity within the tissue specimens. There was no correlation between the multiple T2 values and the degree of fibrosis and inflammation. Minimal correlation was noted between the T2-long and percentage of fat within the diffuse disease (cirrhotic) specimens, r = 0.636 (p less than 0.05). The possible reasons for the above findings are discussed.

Biopsy↗

CT directed hepatic biopsies: increased diagnostic accuracy with low patient risk.

A technique for computed tomography directed percutaneous liver biopsy using small gauge (18-20) needles is described. In 51 procedures performed on 50 patients tissue specimens adequate for diagnosis were obtained 49 times (96%). There was one false negative diagnosis. The correct diagnosis was made in 48 of 51 (94%) procedures on 48 of 50 (96%) patients. There were no significant complications.

Adult↗

Immunologic abnormalities in two patients with pulmonary hyalinizing granuloma.

Pulmonary hyalinizing granuloma (PHG) is a disease of slowly enlarging pulmonary nodules made up of dense bundles of collagen accompanied by an infiltrate of chronic inflammatory cells. The etiology is unknown. Although it has been suggested that the lesions represent an exaggerated immune response to unidentified agents, results of a detailed immunologic work-up of these patients have not been published. This report presents the laboratory findings of two patients with biopsy-proven PHG who have been followed four and eighteen years. Autoantibodies were detected (antinuclear antibody, rheumatoid factor, and positive antiglobulin tests), although clinically there was no evidence of a specific collagen-vascular disorder. Both patients had elevated levels of circulating immune complexes. These data suggest that immune complex mechanisms may be important in the pathogenesis of PHG.

Adult↗

Intramammary calcifications without an associated mass in benign and malignant diseases.

During a 16-year period, 42,888 clinical and radiographic breast studies were performed on 8,000 women. Of this number, 1,161 malignant and 5,270 benign lesions were histologically confirmed. Biopsy of 468 of the 721 breasts that had clustered calcifications not associated with a mass and that were subject to a five- to 16-year follow-up demonstrated 353 benign and 115 malignant lesions. Radiography of the biopsy specimen assured removal and proper study of the area of concern. Radiographic characteristics of the calcifications provide clues to estimate the risk of carcinoma. However, these signs are so nonspecific that all radiographically demonstrable clusters of stippled calcification require histopathologic study. Treatment prior to the formation of a mass provides an excellent prognosis.

Adult↗

Relationship between survival and histologic type in small cell anaplastic carcinoma of the lung.

Survival and histologic subtype were compared in 61 patients with small cell anaplastic lung cancer. Patients with lymphocyte-like (oat cell) and fusiform histologies treated with chemotherapy had longer median survivals than the polygonal and other varieties on the same treatment. Likewise, when detectable disease was confined to the chest and supraclavicular nodes, the patients with lymphocyte-like and fusiform types lived longer. The improved survival in the lymphocyte-like and fusiform categories accounted for most of our improved overall median survival rates with the COPP regimen in small cell lung cancer. Survival in the polygonal and other types was not appreciably different from that seen in non-small cell lung cancer (squamous and adenocarcinoma). It may be possible to refine treatment plans on the basis of cell type so as to further increase survival in small cell anaplastic lung carcinoma.

Antineoplastic Agents↗

Distribution of branched-chain alpha-keto acid dehydrogenases in primate tissues.

The specific activity of the branched-chain alpha-keto acid (BCKA) dehydrogenases was measured in normal tissues of the rat, monkey, and man, and in cirrhotic human liver. In the rat, specific activity of the dehydrogenases in liver, kidney, and muscle averaged 33, 26, and 0.4 U/g wet tissue, respectively; proportion of the body's content of the enzyme located in these three organs was 70, 12, and 10%. In the monkey, specific activities in liver and kidney were only one-half to one-third as great as in the rat, whereas activity in muscle was the same; the monkey's body content of dehydrogenase was distributed 50% in liver, 13% in kidney, and 20% in muscle. In man, specific activities in liver and kidney were only 1/15th to 1/25th as great as in the rat, but activity in skeletal muscle was the same. Distribution of the dehydrogenases in man was 30% in liver, 2% in kidneys, and 60% in muscle. In six patients with alcoholic cirrhosis, specific activity of the dehydrogenase in liver was reduced to 20-50% of normal (average, 32%). This reduction may alter the efficiency of BCKA as substitutes for branched-chain amino acids when BCKA are administered orally, but will have little influence on efficiency when they are given intravenously.

Animals↗

Deficiency of carnitine in cachectic cirrhotic patients.

Carnitine is synthesized from lysine and methionine. In the rat, inadequate intake of either of these essential amino acids causes carnitine depletion. Inasmuch as protein deficiency is common in the hospital population, we have investigated the possible occurrence of nosocomial carnitine deficiency. Fasting serum carnitine concentration was measured in 16 normal and 247 patients in 16 disease groups. Normal range of carnitine was 55-103 muM. Only the cirrhotic group showed significant (P < 0.05) hypocarnitinemia. 14 of 36 hospitalized cirrhotics had subnormal values for serum carnitine. The creatinine/height index, midarm muscle circumference, and triceps skin-fold thickness indicated protein-calorie starvation in the 14 hypocarnitinemic liver patients. In six of the hypocarnitinemic cirrhotics (average serum level 50% of normal), spontaneous dietary intakes of carnitine, lysine, and methionine were measured and found to be only 5-15% as great as in six normocarnitinemic, healthy controls. When these six cirrhotic and six normal subjects were given the same lysine-rich, methionine-rich, and carnitine-free nutritional intake, the normals maintained normal serum carnitine levels and excreted 100 mumol/day, whereas the cirrhotics' serum level fell to 25% of normal, and urinary excretion declined to 15 mumol/day. Seven hypocarnitinemic cirrhotics died. Postmortem concentrations of carnitine in liver, muscle, heart, kidney, and brain averaged only one-fourth to one-third those in corresponding tissues of eight normally nourished nonhepatic patients who died after an acute illness of a 1-3-day duration. THESE DATA SHOW THAT CARNITINE DEPLETION IS COMMON IN PATIENTS HOSPITALIZED FOR ADVANCED CIRRHOSIS, AND THAT IT RESULTS FROM THREE FACTORS: substandard intake of dietary carnitine; substandard intake of lysine and methionine, the precursors for endogenous carnitine synthesis; and loss of capacity to synthesize carnitine from lysine and methionine.

Adult↗

Inflammatory carcinoma of the breast: A correlation of clinical, radiologic and pathogic findings.

In a study of 75 patients with inflammatory carcinoma of the breast seen at Emory University Clinic over a 38 year period, the average longevity from the time of diagnosis was 22 months and the 5-year survival 5.6%. The results of treatment were poor with all methods used, although supervoltage therapy improved local control, and when followed by mastectomy, gave the longest average local control and survival. The designation of inflammatory carcinoma as primary and secondary is often not applicable and should be dropped. Instead, the terms inflammatory carcinoma and recurrent inflammatory carcinoma seem more appropriate. It is suggested that in a number of patients fulfilling certain criteria, surgery should be contemplated and all others treated by non-surgical means. The diagnosis of inflammatory cancer is still primarily clinical. However, radiologic and pathology examination are invaluable to confirming the clinical impression and occasionally suggest the diagnosis before inflammatory signs appear.

Adult↗