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Biomedical subjects

E B Chung

Publications and source records attributed to E B Chung.

At least 19 recordsLinked to original sources

Hyperparathyroidism in black patients: an update.

Cervical exploration with removal of the pathologic gland or glands is effective treatment for parathyroid adenomas and hyperplasia. This article reports the results of a retrospective study of 41 patients who underwent elective cervical exploration for primary hyperparathyroidism at Howard University Hospital between 1974 and 1989. Preoperative localization studies for primary neck exploration consisted of an ultrasound of the neck. Removing the diseased gland/glands resulted in the resolution of the patients' symptoms and the return of calcium levels to normal. Complications included transient hypocalcemia, a wound hematoma, and a postoperative death.

Adenoma

Colorectal cancer in young black patients.

A higher percentage of young black patients are discovered with a more advanced stage of colorectal cancer than is reported for white patients. To evalute this phenomenon, various prognostic factors in young colorectal cancer patients at Howard University Hospital were studied.

Adenocarcinoma, Mucinous

Extraskeletal osteosarcoma.

A retrospective study of 88 cases of extraskeletal osteosarcoma revealed that this tumor affects adults almost exclusively, with a high incidence in patients older than 50 years, and is slightly more common in males (58%) than in female patients. The tumor occurred principally as a soft tissue mass in an extremity, with a predilection for the thighs (lower extremity, 46.6%; upper extremity, 20.5%) and the retroperitoneum (17%). Most were deep-seated and were firmly attached to the fascia, but occasionally they were freely movable and confined to the subcutis or dermis. Nearly all presented as an insidiously growing mass rarely causing pain or tenderness. The preoperative duration of symptoms ranged from 2 weeks to 25 years (median, 6 months). In 17 cases, it exceeded 2 years. A history of prior trauma to the site of the tumor was stated in 11 of the 88 cases (12.5%) and of radiation in five cases (5.7%). Microscopically, the tumors contained varying amounts of neoplastic osteoid and bone, sometimes together with islands of malignant-appearing cartilage. Like osteosarcoma of bone, extraskeletal osteosarcoma showed a striking variation in histologic appearance and focally resembled malignant fibrous histiocytoma, fibrosarcoma, and malignant schwannoma. Follow-up information was available for 65 patients. Eight (12.3%) patients were alive with no evidence of recurrence; 12 (18.5%) patients were alive with one or more recurrences; and five (7.6%) were alive with metastases. Twenty-eight of the tumors (43%) recurred and 39 (63%) metastasized. Forty (61.5%) of the patients with follow-up information had died, 36 from the tumor and four from miscellaneous causes. The prevailing sites of metastases were the lung, the regional lymph nodes, and bone.

Adolescent

Thorotrast-associated anemia and bone marrow hypoplasia.

Two patients with chronic anemia and bone marrow hypoplasia secondary to Thorotrast deposition are described. In one case thorium dioxide was identified by histoautoradiography, scanning electron microscopy, and x-ray spectrometry.

Aged

Ultrasound contribution to diagnosis of Peutz-Jeghers syndrome.

The ultrasonographic finding of small bowel polyps is reported in a 16-year-old girl, referred for evaluation of abdominal pain. The sonographic study was of particular value in also excluding pregnancy and in documenting small bowel obstruction. We have found that distended small bowel and its contents are accessible to sonographic evaluation, in this case, the constellation of clinical and sonographic findings were of considerable value in diagnosing Peutz-Jeghers syndrome.

Adolescent

Malignant melanoma of soft parts. A reassessment of clear cell sarcoma.

A retrospective study of 141 cases of clear cell sarcoma of tendons and aponeuroses revealed that the tumor occurred predominantly in young patients between 15 and 35 years of age, was slightly more common in female than in male patients, and originated chiefly from tendons, aponeuroses, and fascial structures of the extremities with a predilection for the feet and knees. The tumor presented as an insidiously growing mass causing pain or tenderness in slightly more than half of the patients. The preoperative duration of symptoms varied greatly, and in 29 cases the time interval between discovery of the tumor and operation exceeded 5 years. Microscopically, the tumors varied little in appearance and were composed of short fascicles of fusiform cells with a clear to granular eosinophilic cytoplasm, vesicular nuclei with prominent nucleoli, and occasional multinucleated giant cells. Melanin was demonstrated in 72% of the 92 tumors in which the Fontana or Warthin-Starry preparation for melanin was performed. S-100 protein, a neuroectodermal marker, was positive in 13 of 19 cases. Follow-up information was available in 115 patients. Thirty-four (29.6%) were alive and well with no evidence of recurrence. Twenty-four (20.9%) patients were alive with one or two recurrences, three (2.6%) were alive following pulmonary lobectomy for metastatic sarcoma, and one was alive with metastasis in the thoracic spine. Fifty-three of the 115 patients with follow-up information had died, 50 from metastatic tumor and three from miscellaneous causes. The prevailing sites of metastasis were the lung and the regional lymph nodes. The exact histogenesis remains obscure, but the presence of intracellular melanin in two-thirds of the cases supports origin from migrated neural crest cells with the capacity for producing melanin. For this reason the term, malignant melanoma of soft parts, seems preferable over the purely descriptive term of clear cell sarcoma.

Adolescent

A follow-up study on familial polyposis coli in black patients.

We have updated our experience concerning eight families (24 patients) with FPC, 11 of whom had FPC with carcinoma and 13, FPC only. The importance of biopsy to prove the presence of an adenoma (tubular, villous or tubulovillous) was emphasized. Although we prefer total colectomy with ileorectal anastomosis as definitive treatment, total proctocolectomy also has been recommended. The value of careful follow-up examination to detect carcinoma in the retained rectal segment and the periampullary region has been stressed. No racial differences were noted.

Adenocarcinoma

Granular cell tumor in black patients.

A 12-year review of granular cell tumors at Howard University Hospital is reported. Sixty-one cases were studied (56 patients). A female preponderance was clearly established and multicentricity of lesions constituted a higher percentage than previously reported in other series. Malignant transformation was not found. Electron microscopic studies tended to support the Schwann cell origin theory for the tumor but no conclusion could be drawn as to whether or not the lesion is neoplastic, degenerative, or metabolic in nature.

Adolescent

Colorectal carcinoma in young persons: experience at Howard University Hospital, 1955--1977.

Case records of all patients 30 years of age and under with a proven pathological diagnosis of colorectal cancer at Howard University Hospital between January 1955 and December 1977 were reviewed. Over this 23-year period, 14 cases were documented. All patients were black. This study reaffirms the poor prognosis which accompanies colorectal carcinoma in the young, particularly in those patients with mucinous carcinoma.

Adenocarcinoma

Chondroma of soft parts.

The clinical and pathological features of 104 cases of chondroma of soft parts are presented. The tumor occurred predominately in the third and fourth decades, was slightly more common in male (61%) than in female patients, and affected chiefly the soft tissues of the hand (64%) and feet (20%). The presenting symptom was usually a slowly and insidiously growing mass, occasionally causing tenderness or pain. Nearly always the tumor was well demarcated and lobulated and measured between 1 and 2 cm in greatest diameter. Microscopically, most of the tumors were composed of adult-type hyaline cartilage, undergoing calcification in a large percentage of cases. In addition, histologic variants with giant cell proliferation and chondroblastic activity could be distinguished. Despite the slight cellular pleomorphism and the plump appearance of many cartilage cells in the chondroblastic variants, there was no evidence that these tumors behaved differently from the tumors composed predominately of adult-type hyaline cartilage. Of the 56 patients with follow-up information (median follow-up period, 5.7 years) 44 were alive and well with no evidence of recurrence in the follow-up period. In 10 patients the tumor had recurred once. Multiple recurrences or metastatic lesions were no observed. Two patients died of unrelated cause. Complete local excision appears to be the treatment of choice.

Adolescent

Carcinogenicity of some folk medicinal herbs in rats.

Twelve medicinal herbs were bioassayed to correlate a high incidence of esophageal carcinoma in natives of different places with their habitual consumption of these products. Outbred NIH Black rats were given 72 weekly sc injections of the total aqueous extracts of the plant materials. The tanninrich plant extracts from Areca catechu and Rhus copallina produced local tumors in 100 and 33%, respectively, of the experimental animals. Other materials included Diospyros virginiana and extracts from plants not rich in tannins. Diospyros and extracts of Sassafras albidum and Chenopodium ambrosiodes were tumorigenic in over 50% of the treated animals.

Animals

Thyroid carcinoma in black patients.

From 680 surgical specimens of thyroid disease, 31 cases of thyroid carcinoma found at Howard University Hospital, from January 1950 to December 1975, are reviewed. Eighteen (58 percent) were females and 13 (42 percent) were males. Of the 31 patients, there were 11 patients with follicular carcinoma, 11 with papillary carcinoma, seven with mixed papillary and follicular carcinoma, one with Hurthle cell carcinoma, and one with medullary carcinoma. Thyroid carcinoma accounts for only .001 percent of all admissions during the period of study, and is indeed a rare cause of disease among blacks at this institution. Recommendations for surgery and follow-up data are presented.

Adolescent

Crohn's disease in black patients.

The diagnosis of Crohn's disease in 13 patients (ten females and three males) at the Howard University Hospital during the ten-year period, 1965-1975, is examined. The most common presenting symptoms were right lower quadrant (RLQ) pain, diarrhea, anorexia, weight loss, and vomiting, while the most common physical finding was RLQ tenderness. Ileocolic involvement occurred most frequently. Eight patients had surgical resection. The most frequent operation was ileocolic resection with ileo-ascending colostomy. The chief indications for surgery were: (1) presumed appendicitis, (2) intestinal obstruction, and (3) internal fistulae.Crohn's disease seems to occur in blacks much less frequently than in whites. When compared to series of white patients reported by others, the series studied here has more females and more ileocolic involvement. In most other series, the greatest involvement is in the "ileum only" group.

Adolescent

Familial polyposis coli in black patients.

We have presented our experience with 19 black patients who had familial polyposis coli, seven of whom had associated cancer. Four of the seven had multiple cancers. Seventeen of the 19 patients were female but most of the patients at risk in our series were female. Sixteen of the 19 had extracolonic manifestations which have been described as part of Gardner's syndrome. Although our series was quite small, larger series do not report as high an incidence of extracolonic manifestations. Follow-up was too short to make any statements concerning the development of cancer in the retained rectal stump.

Adolescent

Thyroglossal cyst in black patients.

During the 16-year period, July 1, 1959 to June 30, 1975, inclusively, there were only 20 patients with thyroglossal cyst found at the Howard University Hospital (0.03 percent of routine surgicals). There were 12 males and eight females, all of whom were black. Anatomic and histopathologic variations of thyroglossal cysts will be emphasized, and the pitfalls in diagnosis discussed. A brief review of the literature will be presented.

Adolescent

Thyroid diseases in black patients.

During the 26-year period, January 1, 1950 to December 31, 1975, inclusively, there were 680 thyroidectomies for clinical evidence of primary thyroid disease performed at the Howard University Hospital (0.6 percent of routine surgicals). There were 595 female and 85 male patients (ratio 7:1). All of the patients were black. In the 680 cases, the incidence of carcinoma was 4.6 percent, adenoma 11.3 percent, nodular goiter 51.9 percent, diffuse hyperplasia 21.3 percent, various thyroiditis 7.1 percent, and miscellaneous conditions 3.8 percent. A statistical analysis, together with a brief review of the literature on each entity, will be presented.

Adolescent