Biomedical subjects
Publications and source records attributed to T A Hosty.
The design and implementation of a profile titled Consultative Laboratory Assessment System, or CLAS Profile, is described. The profile is a pathologist-directed laboratory study to assist the ordering physician with recently hospitalized patients. The goals are to provide summarized information, decrease the evaluation intervals, and assist in diagnosis and coding.
Hairy cell leukemia is a chronic lymphoproliferative disorder characterized clinically by splenomegaly and cytopenias. Spontaneous remissions are rare and splenectomy is often performed when the blood counts worsen and cause symptoms. Three of our patients with hairy cell leukemia developed recurrent pancytopenia and transfusion-dependent anemia after splenectomy. Each subsequently acquired transfusion hepatitis and in two patients marked hematologic improvement was noted within 2 months. Complete peripheral blood remission occurred within 17 months in all patients although bone marrow infiltration with hairy cells persisted. One patient remains in remission for 12 years; the other two succumbed to infectious illnesses but with normal blood counts. The mechanism by which hepatitis virus induces hematologic recovery in patients with hairy cell leukemia is unknown but may involve augmentation of the interferon system.
Institutional performance in application of the French-American-British (FAB) classification of acute leukemia in The Southwest Oncology Group is presented, demonstrating a disparity between institutional and expert performance. A significant improvement is shown with an educational effort coupled with experience in use of the classification, and the importance of cytochemistry in the use of the classification is illustrated. A simplification of the classification, merging M1, M2, and M4 as M7, is proposed. This simplification improves institutional performance in use of the classification, while preserving distinctions that appear clinically important.
After initial French-American-British (FAB) diagnosis by a multiinstitutional Southwest Oncology Group panel, slides of acute leukemia cases were recirculated to panel members for second review. The reproducibility of the FAB classification is analyzed. The classification is reproducible in the 70% range in panel reviewer hands and allows remarkable reproducibility in the morphologic and cytochemical distinction of acute lymphoid leukemia (ALL) from acute myeloid leukemia (AML). The limitations of a morphologic and cytochemical classification of acute leukemia are discussed. A simplification of the FAB system, merging M1, M2, and M4 as M7, is proposed; this simplification improves the system's reproducibility.
A patient with thrombotic thrombocytopenic purpura had a seizure as the result of a contrast media injection given during computed tomographic examination. To our knowledge, ours is the first such case reported.
Several years ago we began to inject mineral oil through a ureteral catheter to facilitate stone extraction. Some success was achieved, particularly with impacted calculi. However, we report 2 cases of mineral oil granuloma of the ureter. We now urge that only water soluble lubricants be used in the ureter to avoid this problem.
This article is the fourth in a five part series on laboratory data processing and computers. Preceding the article are enabling and performance objectives, defined by the Laboratory Computer Applications and Data Processing Committee, for the systems analysis and planning competency area. Following the article are questions with which readers can test their understanding of the material.
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The authors of this article review briefly their original classification for clinical laboratory data (February 1979), which they proposed as an aid in analyzing and solving data processing problems, and recommend some extensions based on recent experience.
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This article is the second in a five-part educational series on laboratory data processing and computers. The authors describe the major components of peripheral storage and the limitations of input/output devices, and analyze in terms of laboratory workflow the type and placement of input/output devices. Preceding the article are competency areas and performance objectives, defined by the Laboratory Computer Applications and Data Processing Committee. Following the article are questions with which readers can test their understanding of the material. Next month the authors will focus on software.
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The CAP Laboratory Computer Applications and Data Processing Committee surveyed recently a random sample of participants in the CAP Survey Program to determine the current status of data processing in clinical laboratories. The results of the study, which confirm that laboratory computerization is a still new but growing movement, are presented in the following pages.
We conducted a controlled comparison to determine if subcapsular orchiectomy is as effective as conventional total orchiectomy in lowering serum testosterone in male rats. Both methods were effective. Our data refute earlier clinical reports and substantiate recent clinical studies.
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A case of hereditary hemorrhagic telangiectasia, occuring in a 61-year-old male, presented as an ulcerating antral mass lesion and hepatosplenomegaly. The antral mass was demonstrated to be composed of a proliferation of blood vessels and is an unusual presentation for hereditary hemorrhagic telangiectasia of the gastrointestinal tract.