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Biomedical subjects

R Munn

Publications and source records attributed to R Munn.

At least 19 recordsLinked to original sources
PubMed1998

Hot flashes in postmenopausal women treated for breast carcinoma: prevalence, severity, correlates, management, and relation to quality of life.

BACKGROUND: Research on hot flashes (HFs) after the diagnosis and treatment of breast carcinoma (BC) is scarce. To our knowledge, this research represents the second study of HF prevalence and severity in women with BC and the first study of 1) correlates of HF prevalence and severity, 2) use of HF management strategies, and 3) the relation between HFs and quality of life (QOL) among women with BC. METHODS: Eligible women (n = 136) participated in structured telephone interviews. RESULTS: Of the 114 postmenopausal women interviewed, 65% reported HFs, with 59% of women with HFs (n = 74) rating the symptom as severe. Multivariate analysis revealed that 1) HFs were most common in women with a high school education or less and those who were younger at diagnosis and 2) HFs were most severe in women with a higher body mass index, those who were younger at diagnosis, and those receiving tamoxifen. Among women with HFs, 37% were not using any HF management strategies and 63% expressed interest in learning more regarding > or = 1 strategy. HFs marginally were related to decreased mental and physical QOL using the SF-12 Health Survey (P < 0.10). CONCLUSIONS: The results of the current study significantly contribute to knowledge regarding HFs in women with BC and support the need for carefully controlled clinical trials evaluating interventions for relieving HFs in this population.

Adult↗
PubMed1997

Prospective, open-label, add-on study of lamotrigine in 56 children with intractable generalized epilepsy.

The role of lamotrigine (LTG) in childhood epilepsy is emerging. We evaluated the efficacy and adverse effects of LTG in an open, prospective study of 56 children with generalized epilepsies. Six (11%) children became seizure-free, and 24 (43%) had greater than 50% reduction in seizure frequency. LTG was effective against a broad range of generalized seizure types. Three of 15 patients with Lennox-Gastaut syndrome achieved complete seizure control and eight demonstrated 50 to 99% improvement in seizure control. Increase in seizures (7) and rash (5) were the most common side effects. After valproate was discontinued, LTG therapy was resumed, with no recurrence of rash in any patient. This study suggests that LTG may be a useful drug in the treatment of generalized epilepsies in children.

Adolescent↗
PubMed1995

Angiomatoid features in fibrohistiocytic sarcomas. Immunohistochemical, ultrastructural, and clinical distinction from vascular neoplasms.

The typical example of malignant fibrous histiocytoma (MFH) or dermatofibrosarcoma protruberans (DFSP) does not require ancillary studies for diagnosis. However, hemorrhage with cystic change consisting of blood-filled spaces may closely mimic a vascular neoplasm. Eight fibrohistiocytic sarcomas exhibiting these angiomatoid features, initially mistaken for vascular neoplasms, were identified from personal consultation files and review of 157 consecutive sarcomas (1985 through 1993) at the University of California-(Davis) Medical Center. They included five MFH giant-cell-type sarcomas, two MFH angiomatoid-type sarcomas, and one DFSP. Immunohistochemical analysis of paraffin-embedded material showed vimentin diffuse positive, CD68 (KP-1) diffuse positive, and factor VIII negative in all eight sarcomas; actin HHF-45 focal positive in six, diffuse positive in one, and negative in one sarcoma; desmin focal positive in two and negative in six sarcomas; and S100 protein, cytokeratin AE1:AE3, cytokeratin 10.11, and EMA negative in all eight sarcomas. Electron microscopy of three tumors exhibited neoplastic cells with fibroblastic, myofibroblastic, and histiocytic features. Weibel-Palade bodies or neolumens diagnostic of vascular differentiation were absent. The clinical characteristics and behavior of these sarcomas reflect entities in the spectrum of fibrohistiocytic lineage (MFH subtypes and DFSP) rather than vascular neoplasms. Patients with deep, large, giant-cell-type MFHs did poorly (two of four patients died from disease at 8 and 25 months). Both patients with angiomatoid MFHs showed local recurrences from large incompletely excised head and neck lesions. One died of disease at 21 months and the other is free of disease 12 months following excision of a local metastasis to the opposite side of the neck. The patient with DFSP had an 18-cm locally recurrent scalp tumor that extended into bone. Immunohistochemical and ultrastructural confirmation of fibroblastic, myofibroblastic, and histiocytic lineage and exclusion of vascular differentiation help to establish the correct diagnosis in these fibrohistiocytic sarcomas with angiomatoid features. The clinicopathologic features of these eight cases reaffirm the practical utility of MFH and DFSP as diagnostic entities in the spectrum of fibrohistiocytic sarcomas.

Adult↗
PubMed1992

Acute encephalomyelitis: extending the neurological manifestations of acute rheumatic fever?

The clinical course of a five-year-old boy who developed meningeal irritation, encephalomyelitis, and optic neuritis four weeks after Streptococcus pyogenes pharyngitis is detailed. The patient responded to therapy with corticosteroids and recovered fully. Review of the literature reveals that a wide range of neurological disorders have been described in association with rheumatic fever. We suggest that disseminated encephalomyelitis in this child most probably was related to the streptococcal infection and that the spectrum of post-infectious neurological disorders associated with Streptococcus pyogenes may be broader than is currently appreciated.

Acute Disease↗
PubMed1991

Development of IL-2-independent feline lymphoid cell lines chronically infected with feline immunodeficiency virus: importance for diagnostic reagents and vaccines.

Two interleukin 2 (IL-2)-independent feline immunodeficiency virus (FIV) producer cell lines (FL-4 and FL-6) were produced by selecting cells from an IL-2-dependent culture of mixed peripheral blood lymphocytes infected with FIV. The new cell lines have been stable for over 1 year and spontaneously produce FIV with an average reverse transcriptase titer of 300,000 cpm/ml and an average sucrose gradient purified viral protein concentration of 1 mg/l. FIV produced from these cultures is highly infectious in vitro and in vivo. The FL-6 cell line was phenotyped as expressing the feline CD8 and Pan-T antigens, while the FL-4 cell line expressed the CD4, CD8, and Pan-T antigens. Both cell lines, however, express high levels of viral core and envelope proteins. Paraformaldehyde-inactivated whole virus and similarly inactivated whole-cell virus preparations induced a strong antibody response to core and envelope antigens in immunized cats. The establishment of FIV-producing feline IL-2-independent peripheral blood lymphocyte lines should be valuable for the development of FIV-diagnostic reagents and vaccines and also as a model for human acquired immunodeficiency syndrome vaccine development.

Animals↗
PubMed1990

Angiotrophic lymphoma. Presentation in uterine vessels with cytogenetic studies.

An unusual case of angiotrophic lymphoma diagnosed initially in the uterus is described. Immunohistochemical studies documented the intravascular tumor cells in the myometrium to be of B lymphocytic origin. The patient's bone marrow was hypercellular, and cytogenetic studies of the aspirate revealed a subpopulation of cells with multiple clonal chromosomal abnormalities. To our knowledge, this is the first case to document abnormal cytogenetic findings in this uncommon malignancy.

B-Lymphocytes↗
PubMed1989

Subcutaneous abscesses and arthritis caused by a probable bacterial L-form in cats.

Three cats in one household developed pyogenic subcutaneous abscesses and arthritis over a period of 9.5 months. Despite vigorous surgical and antibiotic treatment, the infections in each of these cats continued to spread locally and hematogenously to involve other joints and subcutaneous sites. Although the infections did not respond to modern broad-spectrum antibiotics, they were susceptible to tetracycline. In spite of a favorable response to tetracycline, all 3 cats were euthanatized. A causative agent could not be identified by microbiologic culture of tissues obtained prior to death and at necropsy, or with special tissue stains. The infection was transmitted experimentally by sc inoculation with cell-free material from one of the naturally infected cats to a specific-pathogen-free cat. A tissue extract from the experimentally infected cat was, in turn, infectious for another specific-pathogen-free cat. The experimentally induced lesion was a rapidly enlarging necrotizing and pyogenic cellulitis and panniculitis, with no demonstrable causative agent by special tissue stains or microbiologic culture. A probable bacterial L-form was visualized in affected tissues of the experimentally infected cats and propagated in special L-form broth. Like the natural disease, infection in experimentally inoculated cats was progressive in nature, but could be treated successfully with tetracycline.

Abscess↗
PubMed1989

Cytopathic effects of Moraxella bovis on cultured bovine neutrophils and corneal epithelial cells.

The effects of Moraxella bovis on the morphologic features of purified bovine neutrophils and bovine corneal epithelial cells were examined, using transmission and scanning electron microscopy and light microscopy. Within 2 minutes after incubation of bovine neutrophils with living M bovis, electron microscopic cellular changes included vacuolation, swelling, and loss of microplicae. Most of the neutrophils were lysed by 10 minutes of incubation. Human neutrophils phagocytosed the M bovis and remained intact, even after 30 minutes of incubation with the bacteria. Living M bovis killed bovine corneal epithelial cells in vitro. Sterile filtrates prepared from 6-hour shaker cultures of M bovis also killed bovine corneal epithelial cells, but the cytotoxic activity was less than that produced by the living bacteria. Cellular changes were first observed in specimens collected 1 hour after corneal cell monolayers were inoculated with sterile culture filtrates. The changes in these cells included pit-like lesions on the cellular surface, cellular separation, and vacuolation.

Animals↗
PubMed1988

Pathogenesis of experimentally induced feline immunodeficiency virus infection in cats.

Feline immunodeficiency virus (FIV; formerly, feline T-lymphotropic lentivirus) is a typical lentivirus resembling human and simian immunodeficiency viruses in morphologic features, protein structure, and reverse transcriptase enzyme. It is antigenically dissimilar, however. The virus is tropic for primary and permanent feline T-lymphoblastoid cells and Crandell feline kidney cells. The virus did not grow in other permanent feline non-lymphoblastoid cells that were tested, or in lymphoid and non-lymphoid cells from man, dogs, mice, and sheep. During short-term inoculation studies in cats, the feline immunodeficiency-like syndrome found in nature was not experimentally induced, but a distinct primary phase of infection was observed. Fever and neutropenia were observed 4 to 5 weeks after inoculation; fever lasted several days, and neutropenia persisted from 1 to 9 weeks. Generalized lymphadenopathy that persisted for 2 to 9 months appeared at the same time. Antibodies to FIV appeared 2 weeks after inoculation and then plateaued. Virus was reisolated from the blood of all infected cats within 4 to 5 weeks after inoculation and persisted indefinitely in the face of humoral antibody response. Virus was recovered from blood, plasma, CSF and saliva, but not from colostrum or milk. Contact transmission was achieved slowly in one colony of naturally infected cats, but not between experimentally infected and susceptible specific-pathogen-free cats kept together for periods as long as 4 to 14 months. The infection was transmitted readily, however, by parenteral inoculation with blood, plasma, or infective cell culture fluids. In utero and lactogenic transmission were not observed in kittens born to naturally or experimentally infected queens. Lymphadenopathy observed during the initial stage of FIV infection was ascribed to lymphoid hyperplasia and follicular dysplasia. A myeloproliferative disorder was observed in 1 cat with experimentally induced infection.

Animals↗
PubMed1988

Light and electron microscopic changes in corneas of healthy and immunomodulated calves infected with Moraxella bovis.

Thirty-nine Holstein calves (50 to 100 kg and 2 to 3 months old) were randomly assigned to 4 groups. Calves in group I (n = 12) were inoculated with Moraxella bovis and were euthanatized 24 hours (6 calves) or 8 days after inoculation (6 calves). Group-II calves (n = 12) were treated with hydroxyurea for 6 days, and then 6 of these calves were inoculated with M bovis. The daily hydroxyurea treatments continued for 14 days, and then all calves in group II were euthanatized. Group-III calves (n = 9) were administered dexamethasone parenterally, beginning 24 hours before inoculation with M bovis, and then daily thereafter, until they were euthanatized at either 24 hours (n = 5) or 8 days (n = 4). Group-IV calves (n = 6) were inoculated with M bovis, and euthanatized 12 hours later. Tears were collected from all calves that had been inoculated more than 24 hours earlier. The concentration of myeloperoxidase and collagenase was determined for each sample. After the calves were euthanatized, the corneas were dissected free, fixed, and examined by use of scanning or transmission electron microscopy, or light microscopy. Microscopic corneal erosions were detected 12 hours after inoculation. These lesions were not accompanied by inflammatory cell infiltration and were detected by use of scanning electron microscopy. Inflammatory cells were first observed in the corneal lesions in specimens collected 24 hours after inoculation. Bacteria that resembled M bovis morphologically were seen in several locations in these lesions. By 8 days, corneas of the group-I calves had the least number of intracorneal bacteria, compared with the corneas from other groups. The number of calves that developed corneal ulcers by 8 days was similar in all groups. The corneal ulcers of the hydroxyurea-treated calves were shallower, but appeared larger in surface area than those of the controls. By 8 days after inoculation, the corneal ulcers of the dexamethasone-treated calves had less corneal neovascularization and opacification than did the controls. Corneal perforations developed in 2 eyes of the dexamethasone-treated calves, but did not develop in any eyes of the controls. Microscopically, a larger number of M bovis were observed in corneas of dexamethasone-treated calves than in corneas of calves from other groups. Collagenase was not detected in any tear samples. The concentration of myeloperoxidase in tear samples were significantly (P less than 0.05) higher in the prehydroxyurea-treatment samples than in the posttreatment samples from corresponding calves.

Animals↗
PubMed1988

Clobazam for refractory childhood seizure disorders--a valuable supplementary drug.

Clobazam is a new benzodiazepine recently introduced in Canada on an experimental basis. We report our experience with 27 children (average age 9.1 years) with severe intractable seizure disorders. All had mixed seizures (41% focal plus generalized, 59% mixed generalized) and 93% were mentally retarded. Eighty-five percent had multiple daily seizures and all had been on an average of 6 other anticonvulsants in the past. Forty-one percent of our patients responded to clobazam with a reduction of greater than 75% in seizure frequency and 15% had no further seizures. Tolerance to clobazam which could not be overcome by dose increases developed in 26% of patients. Forty-four percent of non-responders had exacerbations of their seizures shortly after starting clobazam, however 43% of these patients had reductions in comedications simultaneously. Side effects of clobazam in responders were minimal. We conclude that clobazam shows sufficient promise to warrant further trials in more benign seizure disorders in children.

Adolescent↗
PubMed1985

Goat papillomatosis.

The present study indicates that the development of caprine mammary gland warts seems to depend on several factors--namely, nonpigmented skin, adult age, excessive exposure to sunlight, and contact with a yet undefined infective agent. Three types of goat papillomas are described: mammary, cutaneous, other than mammary, and genital. Warts on animals lacking pigmented skin are more frequent in adult animals that live in areas where there is abundant sunlight. Mammary gland papillomas are the most numerous and occur in different stages: ie, goats with mammary gland papillomas that regress, never to recur, goats with papillomas that regress in the winter and reoccur in summer, goats with persistent papillomas of which some are from the group that had previous winter time regression, and goats that have progression of persistent papilloma to carcinoma. Saanen, Saanen crossbreeds, and goats of other breeds that lack pigmented skin and live in sunbelt areas are at high risk for papillomatosis. An infective agent was not defined even after electron microscopic, immunocytochemical, and DNA-DNA hybridization studies. Yet, there is high probability that an infective agent is involved, because mammary gland papillomas usually occur in the susceptible herd 4 to 6 months after an affected goat is introduced.

Animals↗