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Biomedical subjects

S Kay

Publications and source records attributed to S Kay.

At least 109 records · Page 6Linked to original sources
PubMed1985

Prognosis of level V malignant melanoma.

Level V melanomas have been reported to have a poor prognosis, but in-depth analyses of prognostic factors and treatment have not been reported. From 1952 through 1982, 41 patients presented with primary Clark's Level V melanomas. There were 23 patients who presented with clinical Stage I disease and 18 with Stage II. Among Stage I patients, 9 were treated by wide excision alone and 13 underwent wide excision plus prophylactic regional lymph node dissection (RLND); 8 of 13 patients had histologically positive nodes. Twelve Stage II patients were treated by wide excision and RLND (including three hemipelvectomies), and four refused surgery. The 5-year survival was 52%. For Stage I patients, survival was 62% and disease-free survival (DFS) 28% at 5 years; 6 of 10 recurrences were local or regional only. Prophylactic RLND reduced the incidence of recurrence but did not appear to influence survival rates. Among 14 evaluable Stage II patients, overall survival was 60% and DFS 42% at 3 years; of 4 patients who subsequently had a recurrence, 3 had distant metastases. All seven patients with distant metastases at the time of first recurrence died of disease within 14 months (median, 4 months) of detection of metastatic disease. Primary melanomas of the foot (11 patients) and trunk (4 patients) appeared to have a worse prognosis than other sites. Ulceration (seen in 21 patients) did not appear to significantly influence outcome. These data suggest that most patients with Level V melanoma present with clinically localized disease. Prophylactic RLND did not significantly affect overall survival. The invasiveness of these deep tumors appears to reduce the influence of other factors, including primary site, sex, race, and ulceration. The prognosis of patients with Level V melanoma, even with clinically or histologically positive lymph nodes, is not hopeless, and these patients should be treated aggressively.

Actuarial Analysis↗
PubMed1985

Syndrome of inappropriate secretion of antidiuretic hormone after severe head injury.

This study is based on 109 patients with severe head injury who had a Glasgow coma score equal to or less than 7 and a Liège coma score equal to or less than 12 in the first 24 hours. The syndrome of inappropriate secretion of antidiuretic hormone seems to us to be a frequent complication of severe craniocerebral trauma. It has been discovered in 33% of our patients. On the other hand, diabetes insipidus was rarely diagnosed (2.8%). We propose, in cranial trauma, to subdivide the syndrome of inappropriate secretion of antidiuretic hormone into two clinical forms: an early syndrome (5%) that becomes apparent towards the second day and is significantly associated with lesions at the base of the skull; and a delayed syndrome that occurs at the end of the first week and is related to different factors inherent in intensive care procedures. Surgical intervention, in the case of acute craniocerebral trauma, does not result in a higher frequency of inappropriate secretion of antidiuretic hormone.

Adolescent↗
PubMed1985

Venous occlusion plethysmography in patients with cold related symptoms after digital salvage procedures.

Fourteen patients who had undergone microsurgical salvage of one or more digits were interviewed and examined. An assessment of sensitivity to cold is defined as cold intolerance and correlated with nerve function and arterial inflow measured by venous occlusion plethysmography. No relationship between arterial inflow and cold intolerance nor nerve function was found. There was, however a tendency for worsening cold intolerance to be associated with poorer nerve function. Half the salvaged digits had arterial inflow greater than the contralateral control digit.

Adolescent↗
PubMed1985

Electrical injuries due to railway high tension cables.

We have noted a large number of young boys being admitted to our Unit with burns due to railway high tension cables. On review of these cases we have noted: most of the burns were due to arcing, there is a high level of ignorance among the population at risk. We propose some ways of preventing these injuries.

Adolescent↗
PubMed1985

Flow cytometric determinations of ploidy and proliferation patterns of adrenal neoplasms: an adjunct to histological classification.

Flow cytometric deoxyribonucleic acid measurements were performed with propidium iodide on 7 adrenal neoplasms and 4 normal adrenal glands to determine how useful this technique would be in defining malignancy. The 4 cases classified histologically as carcinoma all had aneuploid stemlines of 2.7, 3.3, 3.4 and 3.6c respectively, whereas the 4 normal glands and an aldosteronoma had only a small percentage (less than 10 per cent) of hyperdiploid cells (greater than 2c) at the tetraploid level (4c). A pheochromocytoma and benign adenoma had significant tetraploid populations of 30 and 18 per cent, respectively, with no evidence of aneuploid cells. Flow cytometry determination of deoxyribonucleic acid ploidy values is an accurate, objective, quantitative mean to identify adrenal malignancy and should have a role in the pathological evaluation of adrenal neoplasms.

Adenoma↗
PubMed1985

Microglandular adenosis of the female mammary gland: study of a case with ultrastructural observations.

A case of microglandular adenosis of the breast in a 75-year-old woman is presented, with emphasis on the ultrastructural features. While the tumor was histologically similar to those reported previously in the literature, certain microscopic aspects suggested malignant change. Ultrastructurally, the characteristic findings were villus interdigitation between epithelial cells, thick basement membranes around individual tubules, and abundant apical lysosomal granules.

Aged↗
PubMed1985

Reactive spindle cell nodule of the endocervix simulating uterine sarcoma.

A case of a reparative spindle cell nodule involving the endocervix is reported. The nodule was present in a curetted specimen of the endocervix 2 weeks following an endometrial curettage that showed adenocarcinoma of the endometrium. The lesion was interpreted at first as a carcinosarcoma until the historical facts were appreciated.

Aged↗
PubMed1985

Angiomatoid malignant fibrous histiocytoma. Report of two cases with ultrastructural observations of one case.

Two cases of so-called angiomatoid malignant fibrous histiocytoma are reported herein. One of the cases was studied ultrastructurally, representing, to my knowledge, the fourth such set of observations reported in the literature. It is concluded that the histiocytelike cells making up the bulk of the tumor are modified endothelial cells with histiocytic function, so that the term histiocytoid hemangioma may be a valid one. The principal point of difference, however, is that these tumors as described herein are aggressive with a potential both for local recurrence and metastasis.

Child↗
PubMed1984

Spontaneous healing and relief of pain in a patient with intractable vasculitic ulceration of the lower limb following an intravenous infusion of prostacyclin: a case report.

A case is reported of a patient with diabetes and rheumatoid arthritis who presented with vasculitic ulceration of the lower leg and foot. The ulceration was associated with severe pain and showed no sign of healing despite conservative treatment and skin grafting. At the time when amputation seemed inevitable an intravenous infusion of prostacyclin was given. There was a rapid and lasting relief of pain and the ulcerated area began to heal spontaneously.

Epoprostenol↗
PubMed1984

Fibrous defect (nonossifying fibroma) of the mandible.

Two cases of fibrous defect (nonossifying fibroma) of the mandible are presented. Each case occurred in the mandibular ramus of an 11-year-old girl. The usual fibrous defect of bone is an intraosseous fibrous, nonneoplastic, reactive lesion which appears as a well-delineated defect in the metaphysis of long bones. This report reviews the literature, histopathology, and classification of the fibrous defect of bone.

Child↗
PubMed1984

Improved survival following complete excision of retroperitoneal sarcomas.

Charts and slides of 47 patients with primary retroperitoneal sarcomas (excluding pediatric rhabdomyosarcoma) were reviewed to determine clinical presentation, histologic features, extent of surgical resection, operative morbidity and mortality, use of radiation and/or chemotherapy, and survival data. Most patients presented with pain and a palpable mass. Leiomyosarcomas and liposarcomas were the most common tumors. Eighteen of the 47 patients (38%) had complete tumor excision; 68% required resection of adjacent organs. Operative morbidity was 33% with no mortality. After complete resection, the disease-free 5-year survival was 50% and the overall survival was 70% at 5 years; 10-year disease-free survival was 25% with an overall 58% survival at 10 years. Eleven patients (61%) developed recurrent disease with a median interval of 5 years following complete excision. Six patients received adjuvant radiation and/or chemotherapy with four remaining disease-free from 46 to 61 months. Eighteen patients underwent partial excision of tumor and 11 patients underwent biopsy only; these groups had similar survival curves with only 4% alive at 5 years. Their operative morbidity was 18% and mortality was 7%; median time to clinical evidence of tumor progression was 12 months. Sixty per cent of these patients received therapeutic radiation and/or chemotherapy, but their survival was the same as those undergoing surgery alone. These data emphasize the importance of an aggressive surgical approach in the treatment of retroperitoneal sarcomas. Complete tumor resection and total excision of recurrences will allow many patients long-term survival.

Adolescent↗
PubMed1984

The circumareolar incision: a useful incision for gynaecomastia.

A simple incision for the treatment of gynaecomastia is presented which combines the advantages of adjustment of areolar size and good cosmetic result with increased access when compared with conventional periareolar incisions. This technique has also been used to provide access in augmentation mammoplasty, and could be used for the removal of benign tumours in the periareolar region.

Breast↗
PubMed1983

Hyaline globules and intracellular lumina in a hepatocellular carcinoma.

The authors report ultrastructural findings on the morphogenesis of hyaline globular inclusions (HG) of a moderately well-differentiated hepatocellular carcinoma, with the features of a fibrolamellar variant. Pale blue cytoplasmic inclusions (pale bodies) of the tumor cells were shown to be intracellular lumina lined with numerous microvilli. Our findings suggest that HG were formed apparently by the successive deposition of fine granular materials in the lumina. Small accumulations were present in the intracellular lumina, which were seen on light microscopy as central hyaline cores of pale inclusions. Larger globular deposits, corresponding to HG and presumably mature ones, were lined closely with membranes devoid of microvilli that were probably shed intraluminally. Our observation was discussed with relation to the previous findings on the inclusions.

Adult↗