Biomedical subjects

M A Tempero

Publications and source records attributed to M A Tempero.

46 records · Page 3Linked to original sources

PubMed1986

The importance of luminal factors in neomucosal growth.

Growing neomucosa on patched intestinal defects has been investigated as a method of expanding the intestinal absorptive area. The purpose of this study was to determine the effect of luminal factors on the rate of growth and function of neomucosa in rabbit ileum. A 2 X 5-cm distal ileal defect was patched with adjacent colon serosa in 10 New Zealand white male rabbits. A similar defect was patched in a bypassed ileal segment in an additional 10 rabbits. Five animals in each group were sacrificed at 4 and 8 weeks for determination of the gross and microscopic growth of neomucosa, glucose uptake, and disaccharidase activity. In addition, tritiated thymidine uptake was measured in neomucosa and incontinuity ileum at the 4-week sacrifice. Grossly, the patched defects were covered in nearly all animals by 4 weeks and coverage was complete at 8 weeks. Microscopically, the mucosa was less well developed in the bypassed group with a mean villous height significantly less than the incontinuity group (139.9 +/- 13.9 microns vs 212.33 +/- 30.3 microns, P less than 0.0005). In vitro uptake of [3H]thymidine was significantly higher in neomucosa in bypassed segments when compared with neomucosa in incontinuity segments (692.5 +/- 347.8 vs 278.0 +/- 134.8, P less than .05, expressed as percentage of normal incontinuity ileum). Glucose uptake was similar in both groups but disaccharidase activity was significantly less in the bypassed group. The increased uptake of [3H]thymidine in neomucosa in the bypassed segment may reflect the histologic immaturity of this tissue with a greater proportion of DNA synthesizing cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1986

The value of hepatic ultrasound and biochemical liver tests in screening for liver metastases.

The records of 92 patients with a known diagnosis of extrahepatic cancer who had undergone hepatic ultrasound, biochemical liver tests (alkaline phosphatase, SGOT, lactic dehydrogenase, and bilirubin levels), and subsequent liver biopsy or autopsy within a 6-week period were reviewed. The sensitivity, specificity, and accuracy of the ultrasound and biochemical tests in the detection of metastatic liver disease were calculated. Although there was no significant difference in the sensitivity of either examination, the ultrasound demonstrated higher specificity and accuracy than the biochemical liver tests. The high sensitivity of hepatic ultrasound prevailed even in patients with normal biochemical liver tests. The sensitivity of hepatic ultrasound was significantly lower in patients with lymphoma compared with patients with colorectal cancer (50% v 100%, P less than .05). Notable incidental extrahepatic findings were reported in 25% of the ultrasound examinations. In institutions skilled in sonography, hepatic ultrasound may be a superior tool in the detection of liver metastases in most solid tumors, excluding lymphoma, and offers the additional advantage of simultaneous biliary tract and perihepatic visualization.

Alkaline Phosphatase↗

PubMed1986

Monoclonal antibody CO17-1A and leukapheresis in immunotherapy of pancreatic cancer.

Eighteen patients with measurable or evaluable advanced (metastatic or unresectable) adenocarcinoma of the pancreas were treated with a single infusion of monoclonal antibody CO17-1A in autologous leukocytes. No toxicity was experienced with treatment. Three of seventeen patients evaluable for response demonstrated unusually stable disease and a decrease in serum CA 19-9 antigen in two patients who expressed this biomarker. Human anti-mouse antibody developed in 81% of these patients. Monoclonal antibody CO17-1A may have a cytostatic effect in a small fraction of patients. Future clinical trials will focus on enhancing this effect with other immune modulators.

Adenocarcinoma↗

PubMed1985

The undifferentiated malignant neoplasm. Identification of lymphoma arising in skeletal muscle by immunohistochemical analysis.

The undifferentiated malignant neoplasm presents a significant problem in the intelligent selection of therapy. Because of advances in chemotherapy, there are cancers that are effectively palliated, and sometimes cured if appropriately treated. Characterization of tumors by immunohistochemical stains drastically reduces the incidence of "undifferentiated" diagnoses and will optimize patient management, as illustrated by two cases of large-cell lymphoma arising in skeletal muscle.

Biopsy↗

PubMed1985

Thrombocytopenia and laboratory evidence of disseminated intravascular coagulation after shunts for ascites in malignant disease.

Twenty-eight peritoneovenous shunts were placed to relieve ascites in 26 patients with a variety of underlying malignancies. Nine of the patients had documented liver metastases and hyperbilirubinemia. Severe thrombocytopenia with laboratory evidence of disseminated intravascular coagulation (DIC) occurred in four of these nine patients following shunt placement. Relative or absolute thrombocytopenia was also commonly observed in this series. Other complications included pulmonary edema, ventricular tachycardia, culture-negative fever, pneumonia, and late shunt occlusion. Good palliation, with relief of abdominal pain or respiratory compromise, was achieved in 57% of these patients. Our experience suggests that DIC following peritoneovenous shunts in patients with malignancy may be more common than previously reported, although not as frequent as the incidence of DIC associated with shunt placement for cirrhotic ascites. Platelet aggregation or Factor X activation by ascitic fluid and failure of the liver to inactivate activated clotting factors may play a role in this coagulopathy. Because of the risk of potentially fatal DIC, palliative peritoneovenous shunts should be considered with caution in patients with liver metastases and hyperbilirubinemia.

Adult↗

PubMed1982

Detection of metastatic liver disease. Use of liver scans and biochemical liver tests.

The records of 94 patients with a known diagnosis of extrahepatic cancer having liver scan, biochemical liver tests (alkaline phosphatase, SGOT, lactic dehydrogenase, and bilirubin levels, and subsequent liver biopsy within a six-week period were reviewed. The sensitivity, specificity, and accuracy of the scan and biochemical tests in the detection of metastatic liver disease were calculated. The most sensitive single examination was the group of biochemical liver tests. Liver scans performed in the presence of normal biochemical test results were insensitive when compared with the liver scan alone or the liver scan in the presence of abnormal biochemical test results. The specificity and accuracy of all tests and test combinations were statistically equivalent. Screening for hepatic metastases in patients with cancer is best accomplished with the more sensitive and less expensive group of biochemical liver tests, reserving the liver scan for those patients with abnormal biochemical test results.

Alkaline Phosphatase↗

PubMed1982

Hexamethylmelamine and melphalan as salvage therapy in advanced ovarian carcinoma.

Ten patients with advanced ovarian carcinoma were treated with hexamethylmelamine and melphalan after failing first-line combination chemotherapy. In eight patients residual disease was evident only at second-look laparotomy. Surgical debulking was accomplished in four patients but only two patients had residual disease of less than 2 cm. Two of these four patients are alive without evidence of disease to 20 and 24 months. The remaining patients have expired (median survival 6 months). The combination of hexamethylmelamine and melphalan after surgical debulking at second-look operation may improve the salvage of patients with advanced ovarian carcinoma.

Adenocarcinoma, Papillary↗

PubMed1981

Disseminated Mycobacterium kansasii presenting with skin lesions in a patient with chronic lymphocytic leukemia.

A patient with chronic lymphocytic leukemia developed skin lesions from which Mycobacterium kansasii was cultured. The organism was also recovered from sputum cultures. Twenty-three additional cases of disseminated M kansasii infection are reviewed. This disease tends to occur in patients with altered immune response, and atypical histology of tissue specimens may delay diagnosis and treatment.

Aged↗

PubMedDate not supplied

Comparative studies on expression of CA 19-9 and DU-PAN-2 in pancreatic cancer tissue.

Thirty-eight human pancreatic cancer cases were examined by immunohistochemistry for expression of CA 19-9 and DU-PAN-2 antigens by the respective monoclonal antibodies. CA 19-9 was expressed in 82% and DU-PAN-2 in 87% of cases. A combination of two antibodies increased the reactivity to 97%. Six CA 19-9-negative cases were DU-PAN-2 positive and 4 DU-PAN-2-negative cases expressed CA 19-9. In only 1 case (an anaplastic carcinoma), neither of the antibodies was reactive with cancer cells. The reactivity of tumor cells with each of the antibodies varied from case to case, and, within the same tumor, from one area to another. Histologically, all but one tumor were adenocarcinomas. Thirty-five cases showed areas of either a moderate degree of differentiation (16 cases), poor differentiation (11 cases) or anaplastic areas (8 cases). Although both antigens were expressed in a greater number of cancer cells in well differentiated areas, and less frequently in poorly differentiated and anaplastic regions, the difference in antigen expression in relation to the degree of tumor differentiation was not statistically significant. The cellular localization of the antigens varied. DU-PAN-2 was primarily localized within the cytoplasm, whereas CA 19-9 was found mostly on the luminal cell surface and in luminal content of the glandular structure. In tumor-free pancreatic tissue, adjacent to the tumor, CA 19-9 was detected almost exclusively in the cells of large and medium sized ducts, whereas DU-PAN-2 was primarily expressed in terminal ductular and centrocinar cells. The results indicate that a cocktail of CA 19-9 and DU-PAN-2 antibodies could increase the likelihood of identifying a biomarker in most patients with pancreatic cancer.

Adenocarcinoma↗

PubMedDate not supplied

Complications and technical limitations of hepatic arterial infusion catheter placement for chemotherapy.

PURPOSE: To determine the rate of complications associated with hepatic arterial infusion (HAI) catheter placement, as well as technical success related to liver perfusion. MATERIALS AND METHODS: The authors reviewed 44 patients who underwent 106 HAI catheter placements, including 15 men and 29 women with an average age of 55 years (range, 32-82 years). One to nine placements were performed per patient with 61 (58%) via the left brachial artery, 40 (38%) via the right femoral artery, and five (4%) via the left femoral artery. Chemoinfusion lasted 4 days, with initial catheter placement assessed on technetium-99m macroaggregated albumin (MAA) perfusion scans, as well as daily abdominal radiographs. RESULTS: One hundred attempted hepatic arterial catheter placements were completed. Liver perfusion was global in 66 (66%) cases, in the right lobe only in 28 (28%) cases, and in the left lobe only in six (6%) cases. Eight (8%) had gastrointestinal (GI) tract perfusion; this was eliminated in seven cases (7%) after catheter repositioning. Forty-six (43%) placement attempts required embolization of 62 GI vessels to preclude GI chemoinfusion. Complications included one cerebrovascular accident (related to removal of a left brachial catheter), eight brachial artery thromboses (four that required emergent thrombectomy), six hepatic arterial dissections, four hepatic arterial thromboses, and four catheter malfunctions. CONCLUSIONS: HAI catheter placement via the left brachial artery has increased complications. Nearly one-half of placements required embolization of GI vessels to preclude GI perfusion. Global perfusion is possible in two-thirds of cases.

Adult↗