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Biomedical subjects

K J Cronin

Publications and source records attributed to K J Cronin.

8 recordsLinked to original sources
PubMed2006

Vascularized tissue-engineered chambers promote survival and function of transplanted islets and improve glycemic control.

We have developed a chamber model of islet engraftment that optimizes islet survival by rapidly restoring islet-extracellular matrix relationships and vascularization. Our aim was to assess the ability of syngeneic adult islets seeded into blood vessel-containing chambers to correct streptozotocin-induced diabetes in mice. Approximately 350 syngeneic islets suspended in Matrigel extracellular matrix were inserted into chambers based on either the splenic or groin (epigastric) vascular beds, or, in the standard approach, injected under the renal capsule. Blood glucose was monitored weekly for 7 weeks, and an intraperitoneal glucose tolerance test performed at 6 weeks in the presence of the islet grafts. Relative to untreated diabetic animals, glycemic control significantly improved in all islet transplant groups, strongly correlating with islet counts in the graft (P<0.01), and with best results in the splenic chamber group. Glycemic control deteriorated after chambers were surgically removed at week 8. Immunohistochemistry revealed islets with abundant insulin content in grafts from all groups, but with significantly more islets in splenic chamber grafts than the other treatment groups (P<0.05). It is concluded that hyperglycemia in experimental type 1 diabetes can be effectively treated by islets seeded into a vascularized chamber functioning as a "pancreatic organoid."

Animals↗
PubMed1996

A 1-year prospective study of burns in an Irish paediatric burns unit.

Burns are the fourth leading cause of injury death in children in the USA, accounting for 1300 paediatric deaths annually. The majority of paediatric burns mortality and morbidity result from simple domestic accidents that are preventable. A prospective study of paediatric burns from 1 January 1992 to 1 January 1993 was undertaken at our burns unit to outline the profile of the Irish paediatric burns problem. A total of 336 burns were referred to our unit over the 12 months (80 per cent self-referrals, 15 per cent tertiary referrals from district hospitals and 5 per cent GP referrals). Sixteen per cent (57) of the patients required admission and 33 per cent (112) required prolonged dressings as outpatients. Mortality and morbidity rates were comparable to other centres at 1.8 per cent and 39 per cent respectively. The demographic analysis of the patient population was similar to that seen in other studies from developed countries but there were some notable differences. First, there was an alarmingly high incidence of serious sunburn injuries, especially among young infants. Most parents were unaware of the association between childhood sunburn and the development of skin cancer in later life. Second, 90 per cent of the accidents occurred in the home and almost all were preventable. A parent or guardian was present in 87 per cent of cases but parental knowledge of the appropriate first aid measures was poor. It is suggested that a public health education campaign on this issue would help in reducing the incidence and severity of paediatric burn injuries in Ireland.

Accidents, Home↗
PubMed1994

Stereotactic cytology in a regional breast-screening programme.

Stereotactic localization and fine-needle aspiration are new procedures for the management of non-palpable mammographic abnormalities. In this prospective study, stereotactically guided cytology with immediate reporting was performed before biopsy in a consecutive series of 166 patients with screen-detected non-palpable abnormalities. All specimens were obtained by multiple stereotactically guided passes with a 22-G Franzén needle and graded as: 1, acellular or inadequate; 2, benign; 3, atypical, probably benign; 4, probably malignant; or 5, malignant. After definitive surgery all tumours were staged according to the Union Internacional Contra la Cancrum classification. Of 71 patients with malignancy, 56 were correctly diagnosed by cytology before operation. Twelve patients with malignancy had grade 1 cytology and 50 of the 52 with grade 2 cytology had benign disease. This study confirms that stereotactic cytology is a valuable diagnostic test in a breast-screening programme.

Aged↗
PubMed1994

Proliferating cell nuclear antigen: a new prognostic indicator in renal cell carcinoma.

Renal cell carcinoma is a tumor, the prognosis and behavior of which remain poorly understood. Proliferating cell nuclear antigen levels have been shown to act as an independent prognostic variable in a variety of malignancies. Proliferating cell nuclear antigen was evaluated in 59 cases of renal cell carcinoma, and the results were correlated with existing clinicopathological variables and survival. Proliferating cell nuclear antigen index (percentage of tumor cells positive for proliferating cell nuclear antigen) did not correlate with stage, grade or ploidy. To assess survival, tumors with proliferating cell nuclear antigen indexes of greater than and less than 60% were compared. The 24 patients with a high index (greater than 60%) had a significantly worse survival than did 35 with a low index (less than 60%, p < 0.001). Therefore, the prognostic potential of proliferating cell nuclear antigen in renal cell carcinoma is promising and may be of clinical value in the management of patients with renal cell carcinoma.

Adult↗
PubMed1992

Argyrophylic nucleolar organiser regions (AgNOR's) as a prognostic indicator in breast carcinoma.

Silver staining nucleolar organiser regions (AgNOR's) were determined in archival histological specimens of breast carcinoma. Representative samples from forty-eight female patients were counted manually for AgNOR's--median 3.85 (range 1.1-10.2 AgNOR's per cell). Taking the median value of 3.85 as a cutoff, the patients were divided into two groups: A = Those with AgNOR counts > 3.85; B = Patients with AgNOR counts < or = 3.85. The 5 year survival was 21% in group A and 85% in group B (p < 0.001). There was no significant correlation between AgNOR's and tumour size, lymph node status, tumour grade, menopausal status and oestrogen receptors. We conclude that nucleolar organiser regions may be useful as a prognostic indicator in breast carcinoma especially in patients in whom other prognostic information is unavailable.

Adult↗
PubMed1992

Laparoscopic common bile duct exploration.

Laparoscopic cholecystectomy is now the standard approach to gallbladder disease. While laparoscopic cholecystectomy offers many advantages over the conventional laparotomy procedure one of its drawbacks is that a synchronous common bile duct exploration, for so long a cornerstone of management of choledocholithiasis, is not yet widely practised laparoscopically. Endoscopic sphincterotomy or open surgery, with their attendant hazards and morbidity, remain the most common approaches. A flexible choledochoscope with an operating channel may in future facilitate laparoscopic management of choledocholithiasis but as yet this is not widely available. We report the removal of a common duct stone by dormia basket extraction through the cystic duct at laparoscopic cholecystectomy.

Aged↗
PubMed1991

Endoscopic management of common duct stones with laparoscopic cholecystectomy.

In the first year from October 1990 since starting the procedure 65 laparoscopic cholecystectomies were carried out on one surgical service. There were 4 planned open cholecystectomies and 8 laparoscopic procedures converted during the same period: 7 of these were in the first 3 months with only 1 of the last 53 being opened. Surgery was carried out during the same admission in 22 patients presenting as emergencies: acute cholecystitis (9), colic (6), pancreatitis (3), jaundice (4). Two patients had later laparotomies for complications; one patient bled from the umbilical stab and with ongoing peritonism had a pelvic haematoma drained on day 5 and a second was opened following a bile leak caused by a displaced cystic duct clip--both recovered uneventfully. Peroperative cholangiography was performed in 13 patients; 2 were positive (15%) and had ERCP papillotomy 3 days post op without complication. One patient who presented with pancreatitis had ERCP performed post-op without incident. Seven patients had laparoscopic cholecystectomy following papillotomy for common duct stones. The gallbladder was extracted per umbilicus in 45 (3 wound infections) and per right subcostal stab in 20 (no infections). Mean hospital stay was 48 hours (1-4 days) in uncomplicated cases. In conclusion, the learning curve is associated with higher conversion rates. Extraction through pliable hypochondrial muscles is easier and may be safer and less traumatic. Perioperative endoscopic papillotomy is safe and effective for choledochal stones.

Adult↗