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Biomedical subjects

R Komorowski

Publications and source records attributed to R Komorowski.

At least 37 records · Page 2Linked to original sources

RS3PE syndrome: no evidence for retroviruses.

OBJECTIVE: To determine whether human T cell lymphotrophic virus (HTLV) infection is associated with remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. METHODS: Three patients presenting with RS3PE syndrome and 7 controls were examined for the presence of HTLV crossreactive antigens. RESULTS: Our patients were elderly men who presented with typical symptoms of abrupt onset of synovitis of the wrist, carpal joints, metacarpophalangeal, proximal interphalangeal, distal interphalangeal joints, and flexor tendons, associated with remarkable pitting edema of the hands. Transmission electron microscopy and immunohistochemical analysis for HTLV-1 P19 and P20 related antigens failed to detect retroviral presence in the sample specimens or controls. CONCLUSION: Our investigation suggests there is no evidence for HTLV synovial infection associated with RS3PE.

Aged↗

Cytomegalovirus infection causing pseudomembranous colitis.

A liver transplant patient with previous episodes of diarrhea and pseudomembranous colitis due to Clostridium difficile subsequently developed pseudomembranous colitis due to cytomegalovirus. The patient responded to ganciclovir. Cytomegalovirus infection should be considered in the differential of pseudomembranous colitis in immunocompromised patients, particularly when C. difficile toxin assays or cultures are negative.

Cytomegalovirus Infections↗

Immunosuppressant combinations in primate cardiac xenografts. A review.

ABO matched cynomolgus monkey to baboon heterotopic xenografts were performed using three different immunosuppressant regimens. Group 1 (n = 4) baboons, which did not receive immunosuppression, had a mean graft survival of 9 days. Group 2 (n = 6) received cyclosporine (CsA) and methylprednisolone acetate which prolonged graft survival to an average of 78 days. Group 3 (n = 5) received CsA, Pred, and azathioprine (Aza) as well as steroid pulses and antithymocyte globulin (ATG) for rejection episodes. Survival in this group averaged 94 days. In Group 4 (n = 3), the same regimen as group 3 was used; however, Mycophenolate Mofetil was substituted for Aza. This resulted in a mean survival of 296 days. Histologic examination of the coronary vasculature in baboons treated with Mofetil showed a reduction in vascular pathologic changes when compared to those treated with Aza. Long-term cardiac xenograft survival is possible using currently available immunosuppressive agents.

Animals↗

The lack of effect of hemodilution, myocardial water content, and increased coronary artery blood flow on integrated myocardial ultrasonic backscatter in the beating canine heart.

The effects of coronary blood flow, tissue water content and hematocrit variation on the Integrated Myocardial Backscatter Rayleigh 5 (IBR5) and Fourier coefficient of amplitude modulation (FAM, an index of cardiac cycle-dependent variation in IBR5) were measured in five open chest dogs. Data were obtained at baseline, during adenosine infusion and after two hours of crystalloid hemodilution (Hct 15%). IBR5 of -46.4 +/- .94 dB at baseline did not change significantly during adenosine infusion (-45 +/- .85 dB) and after hemodilution (-46.4 +/- 2.0 dB). FAM at baseline was (4.0 +/- 1.0 dB) (3.8 +/- -1.0 dB) during adenosine infusion and after hemodilution (5.0 +/- 1.8 dB). Myocardial water content increased significantly (p < .05) from 78 +/- .20% at baseline to 80.7 +/- .17% after hemodilution. Coronary blood flow demonstrated a three-fold increase with adenosine and two-fold increase with hemodilution. Electronmicroscopy demonstrated an increase in intracellular and extracellular water content. In conclusion, IBR5 and FAM did not change significantly despite significant increases in coronary blood flow and myocardial water content. Myocardial cellular derangements seen with nonischemic cell swelling, increased blood flow and a fall in hematocrit are insufficient to affect integrated backscatter.

Animals↗

Tulopafant, a PAF receptor antagonist, increases capillary patency and prolongs survival in discordant cardiac xenotransplants.

Hyperacute rejection is a serious complication of xenogeneic organ transplantation. It is believed that platelets play a pivotal role in this phenomenon. In this study, we provide the first known evidence of the efficacy of the PAF receptor antagonist, tulopafant, in improvement in graft function and histology of discordant cardiac xenografts. Transplantation of guinea pig hearts into recipient rats resulted in hyperacute rejection. Pretreatment of recipient animals with tulopafant (but not indomethacin) extended rejection time by 4-5-fold. Histological examination revealed marked diminution of both interstitial hemorrhage and deposition of platelet and granulocytes in capillaries of cardiac xenografts when recipient animals were pretreated with tulopafant.

Animals↗

Immature teratoma of the ovary--an unusual case.

A 30-year-old female was found to have a malignant immature teratoma of the ovary 14 years ago. This was treated with surgery followed by chemotherapy. Two years later, hepatic metastasis was discovered and treated with different multiple-agent chemotherapy, resulting in transformation or evolution into a mature teratoma form of disease. Twelve years later, this disease underwent malignant degeneration and transformed into a metastatic adenocarcinoma. This case report illustrates that malignant ovarian immature teratoma, teratocarcinoma, like its testicular counterpart, can evolve or differentiate into an apparently benign form of disease, but ultimately leads to death due to subsequent malignant transformation into new forms of malignancy arising from any of the three primordial germ cell layers.

Adenocarcinoma↗

Silicone gel infiltration of a peripheral nerve and constrictive neuropathy following rupture of a breast prosthesis.

Following rupture of a subpectoral breast prosthesis, massive amounts of silicone gel migrated into the arm of a patient. The patient developed painful paresthesias and decreased sensation in the cutaneous distribution of the superficial radial nerve. Nerve conduction studies showed both an increase in distal latency and decreased amplitude in this nerve compared with the normal opposite side. Subsequent neurolysis confirmed dense fibrosis surrounding the nerve. Silicone droplets also were observed within the thickened epineurium of the median nerve, but no electrophysiologic evidence of neuropathy occurred. Multiple debridements of the subcutaneous tissue of the arm were necessary. In one of these specimens, histologic sections demonstrated silicone gel infiltration of a subcutaneous nerve. This is the first reported case of silicone gel infiltration of a nerve and constrictive neuropathy associated with a prosthesis rupture.

Female↗

Bronchiolitis obliterans organizing pneumonia in common variable immunodeficiency syndrome.

A 26-year-old woman with common variable immunodeficiency syndrome (CVID) associated with frequent episodes of pneumonia underwent an open lung biopsy showing bronchiolitis obliterans organizing pneumonia (BOOP). Following corticosteroid therapy, there were no further episodes of pneumonia. In addition, there was roentgenographic and gas exchange improvement. This is the first case of BOOP in association with CVID. An immunologic basis of BOOP is postulated.

Adult↗

Bronchiolitis obliterans. A new clinical-pathologic complication of irradiation pneumonitis.

A patient underwent chest irradiation for small-cell carcinoma of the left lung. Several weeks following cessation of irradiation, the patient developed hypoxemia and reticulonodular densities within the radiation port. Open lung biopsy yielded a pathologic diagnosis consistent with irradiation pneumonitis along with a previously unreported association, bronchiolitis obliterans. Bronchiolitis obliterans should be included in the pathologic description of irradiation pneumonitis.

Biopsy↗

Radiation-associated thyroid tumors: extent of operation and pathology technique influence the apparent incidence of carcinoma.

A prospective study and follow-up program of 2,118 patients with prior low-dose head and neck irradiation, entered into a thyroid screening project, allowed us to examine how the extent of operation and pathology technique influenced the incidence of thyroid carcinoma. Patients with palpable nodular thyroid disease were referred to their physicians with a recommendation for surgery: 107 patients had thyroid surgery in community hospitals (CHs) where enucleation of the nodule or lobectomy was the usual operation, and 29 patients had surgery at Milwaukee County Medical Complex (MCMC) where near-total thyroidectomy was routine. Lymph nodes were sampled in 69% of MCMC operations but in only 16% of CH operations. The pathologist's usual method at MCMC was to submit the total surgical specimen and to do serial sections. Less than total specimen examination and random sections typically were done in community hospitals. The mean age and sex ratio of the patients and size of thyroid lesions in the two groups were not different. Cancer was found in 59% (17/29) of patients who underwent operation at MCMC, while only 21% (22/107) of patients who underwent operation in CHs were found to have carcinoma (P less than 0.001). Surprisingly, there was nearly uniform agreement (99%) in the diagnoses made by MCMC and CH pathologists, and the incidence of microscopic foci of carcinoma was similar in both groups. We conclude that the incidence of thyroid carcinoma found in patients with prior head and neck irradiation who have had operation for thyroid nodules is related to the extent of thyroidectomy, routine lymph node sampling, the amount of resected thyroid tissue processed for histologic examination, and the absolute number of sections examined by the pathologist.

Adult↗

Gonococcal endocarditis associated with immune complex glomerulonephritis.

A case is described in which chronic gonococcemia probably resulted in endocarditis, nephrotic syndrome and diffuse immune-complex glomerulonephritis. This is the 11th case of gonococcal endocarditis reported since 1948 and the first report with accompanying immunofluorescence and electron microscopy of the kidney. These studies revealed immune-complex nephritis to be the likely cause of the patient's deteriorating renal function.

Adult↗

Koilocytotic atypia of the cervix.

Koilocytotic atypia was found in 217 of 858 cervical biopsies obtained during a 26-month period. Koilocytotic change was more common in younger women. Nuclear atypia in the koilocytotic cells was associated with cervical dysplasia in a high proportion of cases. There was a significant difference in the incidence of dysplasia in koilocytosis with marked nuclear atypia when compared to koilocytosis without nuclear atypia. In some cases koilocytosis was associated with vesicular changes in the cervical epithelium. The significance of this change and its association with other abnormalities of the cervix is discussed.

Adolescent↗

Light chain disease: report of an atypical case.

A 50-year-old black man had the signs and symptoms of severe anemia. His bone marrow contained sheets of primitive cells that could only be conclusively identified as being of plasmacytic origin by electron microscopy. These cells produced only a small quantity of kappa light chain but did fluoresce when stained with immunofluorescent antikappa stain. His initial response to chemotherapy was dramatic, but after eight months his condition was refractory to all further attempts at treatment. This case supports the observation of Hobbs that patients with Bence-Jones myeloma may have a poorer prognosis than those with otherwise typical IgG or IgA myeloma.

Autopsy↗