PubMed Health⌕ Search

Biomedical subjects

M J Ness

Publications and source records attributed to M J Ness.

10 recordsLinked to original sources
PubMed1990

Anomalous origin of the right coronary artery from the left sinus of Valsalva.

A 1-month-old boy without precedent clinical signs of heart disease died unexpectedly. At autopsy, the child was found to have origin of the right coronary artery from the left sinus of Valsalva immediately leftward to the thickening of the aortic wall at the cuspal commissure and adjacent to the ostium of the left main coronary artery. The association of this coronary anomaly with otherwise unexplained prenatal or early postnatal death has only recently been appreciated as a potential cause of sudden infant death and mimic of sepsis, dysrhythmias, congestive heart failure, or metabolic storage diseases.

Coronary Vessel Anomalies↗
PubMed1990

Recurrent neurologic symptoms during peripheral stem cell apheresis in two patients with intracranial metastases.

Leukapheresis recently has been used to harvest circulating hematopoietic stem cells for autologous transplantation. This technique is especially useful when involvement of the bone marrow by tumor precludes its use as a source for stem cells. Thirty-five patients have had peripheral blood stem cells harvested for transplantation by this technique at our institution. Two patients with adenocarcinoma of the breast developed severe headaches during apheresis, and both were found to have extensive intracranial metastases. For one patient, the pain was excruciating and associated with hypotension at the end of each collection phase of the apheresis procedure and resolved approximately 5 minutes after reinfusion of the patient's red cells and plasma. Subsequently this patient had a documented subdural hydroma. Following an apheresis procedure, while receiving local low dose thrombolytic therapy for thrombosis of the brachiocephalic vein, she suffered a fatal intracerebral hemorrhage. The second patient had a severe exacerbation of a headache of recent onset. Leukapheresis was abandoned when extensive intracranial disease was documented. We conclude that recurrent neurologic symptoms, especially cranial pain, during the withdrawal phase of intermittent flow apheresis may predict intracranial pathology in patients. Peripheral stem cell apheresis and lymphocytapheresis are bringing patients with metastatic malignancies to the apheresis department with increasing frequency, and the apheresis staff must be alert to previously undescribed complications of apheresis.

Adenocarcinoma↗
PubMed1989

Disseminated Trichosporon beigelii infection after orthotopic liver transplantation.

A 25-year-old male, who received an orthotopic liver transplant for fulminant hepatic failure resulting from hepatitis B, had disseminated Trichosporon beigelii infection develop. Of the 55 cases of disseminated T. beigelii that have been reported in the English-language medical literature, most have occurred in patients who were both neutropenic and had compromised cell-mediated immunity. Mortality has ranged from 60 to 78%. Outcome appears to depend significantly on leukocyte recovery. Histologically, Trichosporon can be confused with Candida; however, recognition of the arthroconidia and pleomorphic hyphae and pseudohyphae of Trichosporon should allow their differentiation.

Adult↗
PubMed1989

Candida antigen latex test for detection of invasive candidiasis in immunocompromised patients.

Candida antigen latex agglutination testing was performed twice weekly during 217 admissions of 200 patients undergoing intensive chemotherapy alone or supported by autologous or allogeneic bone marrow transplantation. Eleven patients developed invasive candidiasis, three of whom survived; 6 (54.5%) of the 11 had positive Candida antigens. In 206 admissions, invasive candidiasis could not be documented. Of the 60 patients who died, 41 underwent autopsy examination, and 29 (71%) had positive Candida antigens. The latex test was also positive in 30 (20.5%) of the survivors and 10 (53%) of the unautopsied patients. Serum creatinine levels were greater than 2 mg/dL in 61% and 13% of patients with positive and negative Candida antigens, respectively (P less than .0001). For patients in whom the presence or absence of invasive candidiasis could be unequivocally demonstrated, the sensitivity, specificity, and positive and negative predictive values of the latex test at a titer of 1:4 were 54.5%, 29%, 17%, and 70.5%, respectively, suggesting that the latex test should not be used to diagnose invasive candidiasis in immunocompromised patients.

Amphotericin B↗
PubMed1988

Comparative studies on the expression of tumor-associated glycoprotein (TAG-72), CA 19-9 and DU-PAN-2 in normal, benign and malignant pancreatic tissue.

Expression of tumor-associated glycoprotein (TAG-72) was examined by immunohistochemistry in pancreatic specimens from normal donors, and from patients with chronic pancreatitis and pancreatic cancer, and was compared with expression of CA 19-9 and DU-PAN-2. In the normal pancreas, TAG-72 was expressed in fewer ductal and ductular cells than were CA 19-9 (p less than 0.05) and DU-PAN-2 (p less than 0.01 and 0.001 respectively), whereas in chronic pancreatitis all 3 antigens were expressed in ductal cells but only CA 19-9 and DU-PAN-2 in ductular cells (p less than 0.001). In the specimens from normal pancreas and chronic pancreatitis cases, TAG-72 was localized in the Golgi region, whereas CA 19-9 and DU-PAN-2 showed diffuse cytoplasmic and glycocalyx patterns. In pancreatic cancer, although the rate of expression of all 3 antigens was similar, their cellular localization differed significantly: only TAG-72 was expressed in the Golgi region (p less than 0.001), whereas CA 19-9 showed mainly glycocalyx (p less than 0.05) and/or intra-luminal patterns (p less than 0.01) compared with that of the other 2 antigens. We conclude that, due to differences in expression of TAG-72 in benign versus malignant cells, the monoclonal antibody against TAG-72 (B72.3) may be suitable for radio-immunodetection or radio-immunotherapy of pancreatic cancer.

Adenocarcinoma↗
PubMed1988

Immunohistochemistry with monoclonal antibody B72.3 as an adjunct in the cytologic diagnosis of pancreatic carcinoma.

Due to the morbidity of open tissue biopsy, the cytologic diagnosis of pancreatic carcinoma by fine needle aspiration or examination of biliary tree fluid is highly desirable. Immunohistochemistry with monoclonal antibody B72.3 has been advocated as an adjunct in the identification of tumor cells in body fluids. To assess its usefulness as an adjunct in the diagnosis of pancreatic carcinoma, we examined cytologic specimens of the pancreas from 35 patients [24 pancreatic carcinoma, 6 metastases (4 adenocarcinoma and 1 each of Hodgkin's disease and melanoma), 5 with benign conditions] with an immunohistochemical procedure using B72.3 directly over the Papanicolaou-stained slides. Of the pancreatic carcinomas, 21 of 24 (87%) were cytologically positive and 21 of 24 (87%) marked with B72.3. With both techniques, 23 of 24 cases (96%) could be identified. Three of four metastatic adenocarcinomas were positive by both cytology and B72.3. No staining occurred in the metastatic melanoma, Hodgkin's disease, or 3 of 5 benign conditions. In two benign duodenal aspirates, an unusual reticular B72.3 staining occurred in the mucin of acinar and goblet cells which could be misinterpreted as positive staining. In our experience, B72.3 enhances the sensitivity of the cytologic diagnosis of pancreatic cancer. Unrecognized single tumor cells, cytologically uninterpretable cells, and tumor cell clusters that could be misinterpreted as reactive epithelium mark with B72.3. Care should be taken to avoid misinterpretation of nonspecific mucin staining with this antibody.

Adenocarcinoma↗
PubMed1988

Anomalous right coronary artery origin in otherwise unexplained infant death.

Anomalous origin of the right coronary artery from the left sinus of Valsalva has only recently become recognized as a cause of sudden death in neonates, infants, and young children. The mechanism of death in these cases may be decreased myocardial perfusion by the anomalous vessel due to a combination of factors. Tangential takeoff of the vessel with resultant slitlike ostium and its initial investment in the aortic adventitia with diastolic entrapment and compression are both thought to be at play. Since 1983, three infants with this anomaly and associated sudden death have been described. We describe a fourth case and offer an assessment of the overall frequency of this potentially fatal abnormality.

Coronary Vessel Anomalies↗
PubMedDate not supplied

Bronchoalveolar lavage in the assessment of pulmonary Hodgkin's disease.

Abnormal chest radiographs in patients with Hodgkin's disease are occasionally due to pulmonary Hodgkin's disease. The fluids recovered from bronchoalveolar lavages (BALs) from 50 patients prior to autologous bone marrow transplantation for advanced Hodgkin's disease were examined. Abnormal chest roentgenograms were present in 24 patients (48%); 4 (17%) of these had Reed-Sternberg cells or their mononucleated variants in the lavage fluid and an alveolar lymphocytosis averaging 31.4% (normal: 11.5%). The lymphocytes were small and monotonous. Of the 20 patients with abnormal chest roentgenograms but no Reed-Sternberg cells in the lavage fluid, the lymphocyte count was 10.88%, with only 3 patients exceeding 17%. Two patients with normal chest roentgenograms had Reed-Sternberg-like cells in their lavage fluids and averaged 23% lymphocytes in their lavage differential count. Eosinophils averaged 1% or less of the lavage differential and were not predictive of pulmonary Hodgkin's disease. This experience suggests that pulmonary Hodgkin's disease can be diagnosed by BAL. Reed-Sternberg cells and their mononucleated variants can be recognized by their characteristic cytomorphologic features, although care must be taken not to misinterpret reactive binucleated macrophages as neoplastic cells. In patients with Hodgkin's disease, Reed-Sternberg cells should be sought when an alveolar lymphocytosis is present.

Bone Marrow Transplantation↗
PubMedDate not supplied

Detection of Candida antigen in bronchoalveolar lavage fluid.

While bronchoalveolar lavage is frequently performed to evaluate immunocompromised hosts for infection, the significance of rare yeasts found on the cytologic examination of lavage fluid is unclear. This study used the latex agglutination method to test lavage fluids for Candida antigen to assess its usefulness in distinguishing Candida pneumonia from Candida colonization of the respiratory tract or oral contamination of the lavage specimen. Ninety-seven specimens from 87 patients were categorized on the basis of historical, microbiologic, cytologic and serologic data. Bronchoalveolar lavage fluids were positive for Candida antigen in 0 of 20 specimens from normal controls, 0 of 14 specimens from patient controls, 5 (36%) of 14 specimens from patients with Pneumocystis carinii pneumonia, 0 of 5 specimens from patients with gastrointestinal candidiasis, 0 of 9 specimens contaminated by oral-derived yeasts, 2 (10%) of 19 specimens from patients with probable Candida colonization and 15 (94%) of 16 specimens from patients with clinical and laboratory evidence of Candida pneumonia. We conclude that this test assists in the differentiation of Candida pneumonia from other situations in which yeasts are recovered by bronchoalveolar lavage.

Antigens, Fungal↗