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Biomedical subjects

J Finley

Publications and source records attributed to J Finley.

At least 37 records · Page 2Linked to original sources

Stretch syncope in adolescence.

We describe 6 adolescents with syncope induced by stretching with the neck hyperextended. Studies of the cardiovascular responses to stretching and Valsalva in these patients were the same as controls, indicating that the mechanism is not simply Valsalva but may also involve vertebral artery compression coupled with a familial tendency to faint.

Adolescent↗

Screening of subsequent siblings of children who die of sudden infant death syndrome.

Since the value of home apnea monitoring for subsequent siblings (subsibs) of an infant who died of sudden infant death syndrome is uncertain, we describe an evaluation and monitoring program for subsibs. Eighty subsibs were screened in hospital at an average age of 4.6 weeks. The most valuable investigations included history, physical examination, blood gas tests, and four days on an apnea monitor in hospital. Sleep recordings added no decision-making data. Only 23 infants met one of the following criteria for home apnea monitoring: (1) sleep apnea for more than 15 s (either on sleep recording or recognized by apnea alarm), (2) more than 4.5 episodes of apnea per hour of sleep, (3) periodic breathing greater than 24% of sleep time, or (4) severe parental anxiety. Twenty-two infants were monitored until they were aged 6 months and had spent two months apnea free. Twelve had apnea at home. All of the infants survived. Excessive periodic breathing alone did not seem to be a valid reason for home monitoring. Our screening program is simple, acceptable to families, and useful to select a smaller number of subsibs for home apnea monitoring.

Diseases in Twins↗

Clinical correlations of antibodies that bind, block, or modulate human acetylcholine receptors in myasthenia gravis.

Acetylcholine receptor (AChR) binding and AChR modulating antibodies were found with approximately the same frequency (86%) in 349 patients with myasthenia gravis (MG). However, the total yield of positive serological results was significantly improved (90%) by assaying AChR modulating antibodies when AChR binding antibodies were not detected, because in 27 patients (8%) only one of the two tests was positive. The immunoprecipitation test for AChR blocking antibodies yielded fewer positive results (52%), but there was a significant correlation between the degree of AChR blockade and generalization of muscle weakness. In no patient was this the only positive test, because the test for AChR modulating antibodies in this study detected both AChR blocking and modulating antibodies. Human muscle AChR was used as antigen in all tests. False positive results were rare and were attributed to unexplained antibodies to 125I-alpha-Bgt (AChR binding antibody assay) and recent general anesthesia using muscle relaxants (AChR blocking and AChR modulating antibody assays). Unexplained positive results, documented previously in 5% of patients with the Lambert-Eaton myasthenic syndrome and amyotrophic lateral sclerosis (ALS), were found in this study in two of 22 patients with ALS, but in none of 427 patients with miscellaneous neurological diseases. Patients with severe generalized MG and/or thymoma tended to have higher titers of AChR binding antibodies and greater AChR modulating antibody activity. However, some patients with severe muscle weakness had low titers of antibodies, and some patients in remission or with only ocular manifestations had high titers. These seemingly paradoxical results reflect heterogeneity in the specificities, affinities, and isotypes of anti-AChR antibodies. To effect pathogenicity, antibodies must have access in vivo to extracellular antigenic sites on the AChR. One would anticipate that antibodies with greatest pathophysiological potential would be of an IgG with greatest pathophysiological potential would be of an IgG subclass that activates complement, or of a specificity that competes for acetylcholine's binding site on the receptor or readily cross-links two AChR molecules to trigger receptor modulation (e.g., by binding to sites on the duplicated alpha-subunit). In patients with suspected MG who lack serological evidence of anti-AChR antibodies, motor endplate biopsy is required for microelectrophysiological, immunochemical, and ultrastructural studies to establish with certainty whether or not the condition is acquired MG.

Autoantibodies↗

Immunological probes for oestradiol receptors in human breast tumours.

Monoclonal antibodies have been prepared against a soluble oestradiol receptor (REC) preparation partially purified from human myometrium by oestradiol affinity chromatography. The antibodies were detected by their ability to immunoprecipitate receptor bound [125I] oestradiol. One of the antibodies (D5) has been studied in detail. It will only precipitate REC after activation by salt, heat, low pH or KCNS and will not react with nuclear RE. It will not react with androgen, progesterone or glucocorticoid receptors nor with sex hormone binding globulin; it will only combine with REC from human sources. D5 recognizes a cytoplasmic 29 kdalton protein (p29) that can be separated from both type I and II soluble oestradiol binding proteins. p29 can react with activated REC and is qualitatively and quantitatively related to REC. IRMA and histochemical methods have been developed for quantitating p29 and relating its amount to receptors in human breast tumours. With both methods, highly significant (P less than 0.001) correlations with REC but not RP have been obtained. Both methods indicate that many REC-RP+ tumours contain p29. The histochemical method detects marked cellular heterogeneity in some tumours. The function of p29 is not known. It is an REC-related antigen that may be a previously undetected component of the oestradiol receptor machinery.

Antibodies, Monoclonal↗

Cardiovascular consequences of beta-agonist tocolysis: an echocardiographic study.

M-mode echocardiography was performed before and during intravenous beta-adrenergic agonist tocolysis in 13 patients with preterm labor. There was a significant increase in heart rate, fractional shortening, and calculated cardiac output. There was also a significant decrease in both end-systolic and end-diastolic left ventricular dimensions, which resolved in 24 to 36 hours. There were, however, no changes in left atrial dimensions. The data derived from this study suggest that the pulmonary edema occasionally complicating beta-adrenergic agonist tocolysis is not the result of systolic cardiac dysfunction.

Adrenergic beta-Agonists↗

Cutaneous silica granuloma.

Cutaneous silica granuloma is a rare and fascinating cause of delayed scarring. Symptoms may arise many years after minor wounding if glass, sand, or other silica-containing particles have been embedded. Such granulomatous lesions are often nodular, indurated, and erythematous. They may respond to surgical excision or medical treatment, and in rare cases, they may spontaneously regress. We present one case in which three separate areas of cutaneous silica granulomas developed after a latent period of about 20 years and then involuted without intervention. The etiology and therapeutic options are discussed.

Adult↗

Postrhinoplasty "red nose": differential diagnosis and treatment by laser.

Prior to anticipated nasal surgery, the nasal and facial skin should be examined for any vascular lesions. The skin type should be ascertained. A history of any prior nasal surgery, particularly on the nasal dorsum, should be noted. If rosacea is a clinical possibility, a trial of 1.5 to 2.0 gm q.d. of tetracycline for 6 to 8 weeks is warranted. If, after rhinoplasty, a diffuse "redness" on the nasal dorsum results and one can exclude other diagnoses, then argon laser therapy should be considered. A 3-mm punch biopsy should be obtained to see whether superficial ectatic vessels are present, a finding that would be indicative of a good result from laser therapy.

Diagnosis, Differential↗

Electronic cell volume analysis of growth and rejection of EL-4 ascites tumor cells.

The in vivo growth of EL-4 ascites tumor cells in peritoneal cavities of syngeneic (C57BL/6) and allogeneic (DBA/2) mice was monitored by electronic volume analysis. In the growth of EL-4 cells in the C57BL/6 mice, daily decrease in electronic modal cell volume and labeling indices was observed. After day 7, the rejection of EL-4 cells in DBA/2 mice was indicated by increase in the percentage of small cytotoxic lymphocytes and decrease in the labeling indices of tumor cells.

Animals↗

The effectiveness of post-detoxication referrals: effects on later detoxication admissions, drunkenness and criminality.

This study concerned the effectiveness of post-detoxication referrals to a variety of treatment facilities. The purpose was to discover (i) the proportion of men accepting referrals who actually arrived, (ii) the differences in outcome for patients attending an out-patient clinic, a halfway house, and a long-stay farm, (iii) the differences in outcomes for patients treated in one of the above facilities compared with those for similar patients not receiving treatment. In all, 114 male detoxication admissions were included. However, only 60% arrived, even when firm referrals were made. Those arriving and not arriving did not differ in social or demographic characteristics, nor did those who were referred to the various treatment facilities. However, the referral group had more detoxication admissions in the post-detoxication period. There were no post-treatment overall differences between all treated and untreated patients in detoxication admissions, arrests for drunkenness or criminal convictions. Refusals were more often successes than the treated or untreated groups but this was due to their better prognosis at intake. In general, the data provide little cause for optimism about the value of post-detoxication referrals.

Adult↗

A comparison of recidivism rates for alcoholic detox residents referred to hospitals, halway houses, and outpatient facilities.

Recidivism rates were studied for alcoholics referred to treatment facilities from a detoxication center. The aims were to examine (1) the proportions of clients who arrived, (2) whether similar clients were referred to different facilities, and (3) whether different facilities had different recovery rates. Only a minority improved in terms of recidivism. There were no differences for those referred to halfway houses, hospitals, and nonresidential programs. Those who arrived for treatment or completed it did not have higher improvement rates than those who did not.

Adult↗

Fine needle aspiration cytology of mammary duct ectasia: report of a case with novel cytologic and immunocytochemical findings.

BACKGROUND: Mammary duct ectasia (MDE), or periductal mastitis, is a well-defined clinical entity with a characteristic histopathologic appearance on breast biopsy specimens. However, the cytologic features of MDE have been described only recently in the cytopathology literature, and fine needle aspiration (FNA) cytologic findings are based mainly on a small number of case reports in the English-language literature. Therefore, awareness of this entity and recognition of its cytomorphologic features could aid in a more accurate diagnosis. We report the novel cytologic and immunocytochemical findings on a case of MDE that was confirmed by histologic examination on a subsequent biopsy. CASE: We report the findings of breast FNA cytology in a 50-year-old female with a mammographically and clinically suspicious lesion. Cytology displayed a paucicellular aspirate, typified by a few scattered, cohesive clusters of ductal epithelial cells with mild nuclear atypia and distinct, peripherally located myoepithelial cells. Intermingled within the ductal elements were numerous polygonal cells with abundant, finely vacuolated cytoplasm that were immunoreactive for macrophage-specific antibody, CD68. The background consisted of a variable number of foam cells and negligible amount of blood. CONCLUSION: The current case of MDE demonstrates cytomorphologic features that may pose diagnostic problems, particularly as a consequence of variable cytologic atypia this entity may present on FNA cytology. This diagnostic difficulty is compounded because of the abnormal mammographic and suspicious clinical findings that may be associated with MDE. CD68 immunoreactivity is a useful ancillary tool to verify the histiocytic, rather than epithelial and potentially neoplastic, nature of multivacuolated cells. To the best of our knowledge, there has been no prior reported case of MDE in the English-language literature studied utilizing CD68 antibody. This case report emphasizes that MDE is a heterogeneous entity with diverse cytomorphologic features. FNA cytology in conjunction with immunocytochemistry might permit accurate classification in the proper clinical setting.

Antigens, CD↗