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J McGinty

Publications and source records attributed to J McGinty.

10 recordsLinked to original sources
PubMed2001

Preoperative chemoradiotherapy and radical surgery for locally advanced distal rectal adenocarcinoma: pathologic findings and clinical implications.

PURPOSE: Preoperative chemoradiotherapy followed by radical surgical resection has been the preferred treatment for patients presenting with locally advanced distal rectal carcinoma at our institutions. We postulated that chemoradiotherapy-induced pathologic response of the primary tumor would identify which patients would be candidates for local excision as definitive surgical therapy. METHODS: A retrospective analysis of 60 patients with palpable, locally advanced, distal rectal adenocarcinomas treated from 1995 to 2000 was performed. All patients received preoperative chemoradiotherapy consisting of 5-fluorouracil (325 mg/m(2)) and leucovorin (20 mg/m(2)) by bolus infusion on Days 1 through 5 and 29 through 33 delivered concurrently with at least 45.0 to 50.4 Gy of pelvic radiation, followed six to eight weeks later by radical surgery and then adjuvant chemotherapy. RESULTS: Among 60 patients (20 females) there was a mean age of 58.7 (28-84) years. Clinical staging was as follows: Stage II, 14 patients (23 percent); Stage III, 35 patients (58 percent); and Stage IV, 11 patients (18 percent). Pathologic examination revealed that negative margins were obtained in 58 patients (97 percent). Downstaging to T0-2N0 was achieved in 17 patients (28 percent), with five (8 percent) achieving a pathologically complete response. Lymph nodes were positive in 24 patients (40 percent) despite chemoradiotherapy. Pathologic node positivity was found in 0 of 5 pT0 patients, 9 (41 percent) of 22 pT1 or pT2, and 15 (45 percent) of 33 pT3. Clinical stage, tumor size, pathologic stage, and adverse histologic features could not reliably predict pN0 status, except pT0 (5 patients only). CONCLUSIONS: Preoperative chemoradiotherapy often downsizes and downstages locally advanced rectal carcinoma. Neither pretreatment clinical characteristics, response to preoperative chemoradiotherapy, or pathologic features reliably predict pN0 status. Therefore, local excision is not recommended as an alternative to radical surgery for locally advanced adenocarcinoma of the distal rectum regardless of the response of the primary tumor to preoperative chemoradiotherapy.

Adenocarcinoma↗
PubMed1999

Small but mighty. In the face of an impending natural disaster, you need a great plan, an electronic patient record and community cooperation.

UNLABELLED: Englewood Community Hospital, a small, acute-care facility in the Gulf Coast area of South Florida PROBLEM: Hurricane Georges forced the staff and administrators of Englewood Community Hospital to evacuate patients and provide emergency care for the community. SOLUTION: A comprehensive disaster plan. RESULTS: Englewood staff discovered they were well-prepared for patient evacuation in times of threatening natural disasters. The MEDITECH clinical data repository allowed no disruption in access to the patients' history or current clinical profile. KEY TO SUCCESS: "Englewood Community Hospital's comprehensive, well thought-out disaster plan covered critical issues such as staffing, reimbursement, documentation, and most importantly, continuity of care during the move to another hospital."

Community-Institutional Relations↗
PubMed1996

Prescriptions by modem.

Explore the source record for details and available documents.

Clinical Pharmacy Information Systems↗
PubMed1988

Dentate granule cells are essential for kainic acid-induced wet dog shakes but not for seizures.

The purpose of this study was to determine the role that dentate granule cells play in wet dog shakes (WDS), behavioral seizures, and hippocampal cell loss caused by systemic administration of kainic acid (KA). Rats were given bilateral injections of colchicine (COL) into the hippocampal formation to selectively lesion dentate granule cells. Two weeks later, they were injected subcutaneously with KA and were observed for WDS and seizures. Seizures were terminated with pentobarbital 2.5 hr after KA injection, and the rats were killed 48 hr later. The integrity of hippocampal cell populations and projections to the hippocampal formation from entorhinal cortex was assessed with radioimmunoassay and immunostaining for methionine-enkephalin (ME) and dynorphin (DYN) A, as well as with Timm and Nissl staining. Results indicate that COL injections eliminated KA-induced WDS, did not affect the latency to onset of seizures, and potentiated KA-induced cell loss in the CA3 region of hippocampus. COL lesions eliminated ME and DYN immunostaining of granule cells, but not ME immunostaining of entorhinal afferents to the dentate gyrus or Ammon's horn. These findings indicate that granule cells are an essential neuronal link in the expression of KA-induced WDS, but that seizures propagate along other pathways in the limbic system.

Animals↗
PubMed1986

Enkephalin contained in dentate granule cells is important for kainic acid-induced wet dog shakes.

Kainic acid (KA) caused an initial decrease and a subsequent rebound in hippocampal enkephalin (ENK) in rats exhibiting wet dog shakes (WDS) without behavioral convulsions. Antibody to methionine-enkephalin but not dynorphin A(1-8) injected into lateral ventricles attenuated KA-induced WDS, as did naloxone. Granule-cell destroying injections of colchicine into ventral but not dorsal hippocampus caused a 60% reduction of hippocampal ENK and a complete elimination of KA-induced WDS. These studies suggest that release of granule cell ENK, which is 3 times more concentrated in ventral than dorsal hippocampus, plays an important role in KA-induced WDS.

Animals↗