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Biomedical subjects

Robert A Lee

Publications and source records attributed to Robert A Lee.

7 recordsLinked to original sources
PubMed2006

Update in dermatopathology.

Inflammatory skin disease is a diagnostic challenge for both dermatologists and pathologists. Unlike the diagnosis of cutaneous neoplasms, biopsies of inflammatory disorders generally present a differential diagnosis for the pathologist. Similarly, the dermatologist is also presented with a clinical differential diagnosis prompting the biopsy. Assimilating all of the information is challenging yet rewarding when an accurate diagnosis is made. In this review we present several "newer" inflammatory diseases of the skin and discuss the differential diagnosis. Many of these entities are associated with underlying systemic disease, making early recognition and diagnosis critical. Pathologists should be familiar with these histopathologic findings to assist with the optimal clinical-pathological diagnosis.

Dermatology↗
PubMed2005

Intraoperative sonogram in mesenteric revascularization: spectrum of findings.

OBJECTIVE: The role of intraoperative sonography is to detect and prompt revision of technical defects that may adversely affect results. Our objective is to describe the technique and illustrate normal and abnormal findings in intraoperative sonography of mesenteric revascularization. CONCLUSION: An abnormality on a gray-scale image associated with hemodynamic changes is a significant finding. Awareness and recognition of major abnormalities should prompt immediate surgical revision and improved outcome.

Humans↗
PubMed2003

BMP4 acts upstream of FGF in modulating thymic stroma and regulating thymopoiesis.

Thymocyte development is a non-cell-autonomous process that requires signals provided by the thymic stroma. Bone morphogenetic proteins (BMPs) and fibroblast growth factors (FGFs) derived from thymic stroma have been implicated as possible regulators of T-cell development. Using thymic organ culture, this study demonstrates that both BMP4 and FGF7/FGF10 arrest early T-cell development at the CD4-CD8-CD44+CD25- (double-negative 1 [DN1]) population and at the CD4-CD8- double-negative (DN) to CD4+CD8+ double-positive (DP) transition in a stromal compartment-dependent manner. Furthermore, BMP4 functions upstream of FGF7/FGF10, as the effects of BMP can be suppressed by cotreatment with an FGF receptor antagonist. BMP4 also acts directly on the thymic stroma to up-regulate the stroma-specific transcription factor Foxn1 and stroma-expressed chemokines. Taken together, the data in this report demonstrate that BMP acts upstream of FGF in the regulation of early T-cell development and that BMP4 acts primarily through the thymic stroma, thereby altering the thymic microenvironment and affecting thymopoiesis.

Animals↗
PubMed2003

Intraoperative duplex ultrasound of visceral revascularizations: optimizing technical success and outcome.

PURPOSE: The purpose of this study was to evaluate the use of intraoperative duplex ultrasound scanning (IOUS) during visceral revascularizations and correlate its results with clinical outcome. METHODS: We studied 68 patients (15 men and 53 women, mean age 66.5 years, range 27-86 years) who underwent visceral revascularization with concomitant IOUS examination of 120 visceral arteries (52 celiac, 60 superior mesenteric, and 8 inferior mesenteric arteries) from 1992 to 2002. Patients were divided into two groups on the basis of ultrasound findings: normal and abnormal IOUS. The incidence of early and late graft-related complications (thrombosis, restenosis, recurrent symptoms, reintervention) and graft-related death was compared in both groups. RESULTS: One-hundred and two (85%) arteries had normal IOUS. Eight (6.6%) arteries had minor defects, including small kinks (4), mild residual stenoses (3), and small intimal flap (1). Ten (8.4%) arteries had major defects, consisting of hemodynamically significant residual stenoses (4), thrombus (2), kinks (2), bidirectional flow (1), and intimal flap (1). Major defects were successfully revised in all except three cases: two persistent mild stenoses and one bidirectional flow. Patients with abnormal IOUS at the end of the operation had increased incidence of graft-related complications and/or death (55.5% vs 7.8%; P =.004), early graft thrombosis (14.2% vs 1.0; P =.04), reintervention (21.4% vs 3.2%; P =.03), and graft-related death (33.3% vs 1.9%; P =.02), compared with patients with normal IOUS. CONCLUSION: This study supports the routine use of IOUS during visceral revascularizations to optimize technical success and outcome. Persistent ultrasound scanning abnormalities are associated with risk of early graft failure, reintervention, and death. Patients with normal ultrasound scans can expect excellent results.

Adult↗
PubMed2002

Painful metastases involving bone: feasibility of percutaneous CT- and US-guided radio-frequency ablation.

PURPOSE: To determine the safety and efficacy of radio-frequency (RF) ablation for pain reduction, quality of life improvement, and analgesics use reduction in patients with skeletal metastases. MATERIALS AND METHODS: Over 10 months, 12 adult patients with a single painful osteolytic metastasis in whom radiation therapy or chemotherapy had failed and who reported severe pain (pain score > or = 4 [scale of 0-10]) over a 24-hour period were treated with percutaneous imaging-guided RF ablation with a multi-tined electrode while under general anesthesia. Patient pain was measured with a Brief Pain Inventory 1 day after the procedure, every week for 1 month, and thereafter every other week (total follow-up, 6 months). Patient analgesics use was also recorded at these follow-up intervals. Follow-up contrast material-enhanced computed tomography was performed 1 week after the procedure. Complications were monitored. Analysis of the primary end point was undertaken with paired comparison procedures. RESULTS: Lesion size was 1-11 cm. Before RF ablation, mean worst pain score in a 24-hour period in 12 patients was 8.0 (range, 6-10). At 4 weeks after treatment, mean worst pain decreased to 3.1 (P =.001). Mean pain before treatment was 6.5 and decreased to 1.8 (P <.001) 4 weeks after treatment. Mean pain interference in general activity decreased from 6.6 to 2.7 (P =.002) 4 weeks after treatment. Eight of 10 patients using analgesics reported reduced use at some time after RF ablation. No serious complications were observed. CONCLUSION: RF ablation of painful osteolytic metastases is safe, and the relief of pain is substantial.

Adolescent↗