Screening for hyperthyroidism.
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Carrier Proteins↗
Biomedical subjects
D K Oxley
Publications and source records attributed to D K Oxley.
Models for clinical pathology training.
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Humans↗
Cerebellar astrocytomas in elderly patients with very long preoperative histories: report of three cases.
Three patients, ages 69, 67, and 74 years, respectively, underwent surgical removal of cystic cerebellar astrocytomas. All three had past histories pointing to the existence of a cerebellar lesion for many decades prior to surgery: Patient 1 had had nystagmus on lateral gaze on the side of the tumor since early childhood; Patient 2 had had sensorineural hearing loss on the side of her neoplasm for 38 years preceding the operation; and Patient 3 was diagnosed as having a brain tumor 51 years before the operation. (He has been blind because of pressure hydrocephalus for half a century, but otherwise managed to live a productive farming and family life until he sustained a head injury in a car accident, which forced him to undergo removal of his cerebellar tumor.) The neoplasms in all three instances were found by histological examination to be low-grade astrocytomas. These cases indicate that low-grade cerebellar astrocytomas, which are well known for their characteristically long postoperative courses, may at times manifest a slow growth potential with an exceptionally long preoperative course.
Aged↗
Cholesterol measurements. Quality assurance and medical usefulness interrelationships.
This is a status report on cholesterol testing, using data from the College of American Pathologists Surveys program and Quality Assurance Service and the Lipid Research Clinics program. The clinical context for cholesterol testing is reviewed in order to develop a conceptual framework for analytic goals. Our analysis leads us to the following conclusions: First, the accuracy of cholesterol assays will be improved by using newly available reference material labeled by definitive methodology; this aspect of cholesterol testing is well monitored by proficiency testing. Tight goals for accuracy must await a consensus on the true value of test specimens. Second, long-term intralaboratory analytic variability, which is crucial in cholesterol testing, is well monitored by programs like the Quality Assurance Service, but not by proficiency testing. It is proposed that pathologists use realistic performance goals that incorporate a total error model and biologic variability.
Cholesterol↗
Myoglobin in myocardial infarction. Results in a coronary-care-unit population.
The purpose of this study was to define the performance characteristics of serum myoglobin determinations in the diagnosis of acute myocardial infarction (MI). Subjects of the study were 118 patients admitted consecutively to the coronary care unit. Daily measurements of serum myoglobin (by radioimmunoassay) were performed. For patients admitted within 24 hours of the onset of symptoms, a serum myoglobin level of 75 ng/ml had a diagnostic sensitivity of 91% and a specificity of 85%. In the same group of patients, the presence of the myocardial isoenzyme of creatine phosphokinase (CK-MB) showed a sensitivity of 94% and a specificity of 89%. Among the 32 patients with MI, the elevation of myoglobin preceded the appearance of CK-MB in 12 (38%), was concomitant with CK-MB appearance in 15 (47%), and followed CK-MB in none. Given the spectrum of patients in this coronary care unit, the addition of the myoglobin assay to the heart profile has increased its sensitivity for the diagnosis of MI. The assay materials are available in kit form, and the test can be performed in the routine radioimmunoassay laboratory. The results are available for reporting four to five hours after venipuncture.
Adult↗
Intracoronary myocardial perfusion imaging: patterns in patients with coronary artery disease.
Myocardial imaging following the intracoronary injection of radiolabeled particles is used to identify transmural scars in patients being evaluated for coronary atherosclerosis. Selective imaging of the microcirculation derived from each major coronary vessel is accomplished using a dual radionuclide technique. This report illustrates the various normal and abnormal imaging patterns encountered in patients with coronary artery disease. The regional myocardial nomenclature proposed by the American Heart Association Council on Cardiovascular Surgery is used. Correlation of the nuclear study with the contrast arteriogram and ventriculogram is essential for identifying both transmural scars and regions of collateral circulation. The procedure is safe and can be performed during routine coronary angiography.
Aged↗
Therapeutic drug monitoring.
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Computers↗
LDH isoenzymes and acute MI.
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Acute Disease↗
Nuclear diagnosis of disseminated cancer of the breast. Results of liver-, brain-, and tumor-directed imaging studies.
Radionuclide imaging technics to identify metastases in liver and brain have preductive values that show the expected variation depending upon the prevalence of metastatic disease in the population studied. Liver scanning combined with peritoneoscopy may prove more accurate than either study alone for routine use in staging. Brain scanning is most useful when reserved for patients selected because of suspicious neurologic findings or in following the response to therapy of established metastatic disease. "Tumor-directed" scanning agents are useful in certain cases where soft-tissue metastases are suspected but cannot be identified with more conventional procedures.
Bleomycin↗