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Biomedical subjects

T Cooney

Publications and source records attributed to T Cooney.

16 recordsLinked to original sources
PubMed2000

The impact of loading on deformation about posteromedial meniscal tears.

To simulate the effects of partial weight bearing on meniscal repair, full-thickness tears were produced in the posteromedial aspect of seven ACL-intact cadaveric knees. Following suture repair, metal markers were imbedded to index the position of the tear. A radiolucent chamber was used to position and load each knee for computed tomography scanning at flexion angles of 0 degrees, 30 degrees, and 60 degrees with and without a load force of 100 lb. Sutures were removed and the tests repeated. Changes in marker distances were obtained for each test condition. Loading produced average dimensional changes of < or =0.5 +/-0.6 mm in either sutured or unsutured menisci. Based on the Friedman test, neither flexion angle, loading, nor suture exerted a significant impact (P> or =.52). These data support clinical accelerated rehabilitation programs previously published. Therefore, partial weight bearing during convalescence is tenable.

Adult↗
PubMed1994

Melanocytic lesions excised from the skin: what percentage are malignant?

We estimated the diagnostic skill of clinicians managing melanocytic skin naevi by measuring the percentage of malignant melanomas, premalignant and potentially malignant naevi, in 1896 excised melanocytic lesions submitted to a pathology service over 11 weeks. They comprised 8 per cent. The percentage increased with age: 4 per cent in the under-40s, 17 per cent in those aged 40-59, and 30 per cent in those over 60, (P < 0.001, sex-adjusted). Although the percentage was twice as high in males (11 per cent) as females (6 per cent), after adjustment for age the difference was not significant. Invasive melanomas, 3 per cent of the total, were similar: 1 per cent were from under-40s; 7 per cent from those aged 40-59 years; and 14 per cent from those over 60. They comprised 4 per cent of lesions from males and 2 per cent from females. These trends may indicate poor specificity of clinical diagnosis, notwithstanding other reasons for removal of naevi (cosmetic), particularly among patients under 40, and females.

Adolescent↗
PubMed1990

Divorce for women after midlife.

In spite of widespread interest in both aging and divorce, relatively little research has joined these topics. This study used data from the U.S. Census, Vital Statistics, and Current Population Survey to determine current divorce patterns for women aged 40+, project marriage and divorce experiences of future cohorts of elderly women, and consider the socioeconomic correlates of divorce for middle-aged and older women. Given current marriage, divorce, and widowhood rates, the findings indicate a marked decline in the proportion of future elderly women who will be married or widowed, and a dramatic increase in the proportion who will be divorced. Further, the data show that the socioeconomic well-being of divorcées is significantly below that of widowed or married women.

Adult↗
PubMed1987

Partial vs total esophagectomy for advanced carcinoma of the hypopharynx.

Cancer of the hypopharynx is an aggressive disease with a poor prognosis irrespective of the therapeutic regimen instituted. Controversy centers around the extent of surgery required to adequately ablate the advanced cancers, particularly related to the role of esophagectomy. A literature review and analysis of 43 cases of advanced hypopharyngeal cancer treated with total laryngopharyngectomy and partial esophagectomy support the argument that in carefully selected situations, a partial esophagectomy is oncologically an adequate operation.

Aged↗
PubMed1982

IgD kappa plasma cell dyscrasias: extraosseous manifestations including isolated leptomeningitis.

IgD kappa plasma cell Dyscrasias are rare. Two cases with unusual presentations and courses area described. One of these patients had myelomatous pleural effusions, and subsequently experienced myelomatous leptomeningitis. The significance of this combination is discussed and the literature reviewed. The value of immunofluorescent techniques in identifying plasma cells in the cerebrospinal fluid and pleural fluid is emphasized.

Humans↗
PubMed1980

Adenoid cystic carcinoma of the esophagus: a light and electron microscopic study.

The light and electron microscopic appearances of adenoid cystic carcinoma of the esophagus are presented. Typical light microscopic features of adenoid cystic carcinoma were seen, but a unique additional feature was the presence at one edge of the tumor of gland-like structures lined entirely by tumor cells and opening onto an intact esophageal epithelium. Electron microscopy showed cystic spaces containing replicated basement membrane surrounded by epithelial cells with occasional myoepithelial cells at the interface. Rare lumina were seen between the cells with microvilli projecting into them. Occasional epithelial cells contained granules of neurosecretory tape. Both the light and electron microscopic findings strongly support an origin from the intercalated duct of esophageal mucus glands. The paucity of gland lumina may represent a lesser degree of differentiation which would accord well with the known biological aggressiveness of the tumor at this site.

Basement Membrane↗
PubMed1980

Immunohistochemical evaluation of a complex endocrinopathy.

A patient with clinical and biochemical evidence of ectopic ACTH production is described. Autopsy revealed endocrine tumors of bronchus and pancreas with metastases to the liver, kidney, abdominal lymph nodes, and bone. Immunohistochemical methods established that the bronchial and pancreatic tumors were separate primary neoplasms each with its own hormone production; and allowed us to determine that the bronchial carcinoid was the source of ACTH and gave rise to the liver metastases, and that insulin was present in the cells of the pancreatic islet cell tumor. These methods also revealed a mild C-cell hyperplasia of the thyroid gland. We wish to stress the importance of the immunoperoxidase method in the evaluation of this and similar polyendocrine cases.

ACTH Syndrome, Ectopic↗
PubMed1979

Pulmonary carcinoid tumours: a comparative regional study.

Twenty-two pulmonary carcinoid tumours (18 central, 4 peripheral) were seen in this department over an 11-year period. The majority of the tumours displayed a mixed pattern on microscopic examination, and cell-nest formation was a prominent feature in sixteen. The findings are at variance with the results of a similar series reported from Japan and suggest that there is regional variation in the tumour pattern of pulmonary carcinoids. Various aspects of the histopathology are discussed, and a causal relationship between ossification of bronchial cartilage in these tumours and locally produced calcitonin is postulated.

Adult↗
PubMed1978

Mucin-producing atypical bronchial carcinoid.

In a case of atypical mucin-producing bronchial carcinoid in a 40-year-old man covert metastases were present at the time of lobectomy and were revealed at necropsy--a feature highlighting the malignant potential of the atypical carcinoid.

Adult↗
PubMed1978

Paraganglioneuroma of the duodenum: an evolutionary hybrid?

On light microscopy the neural component of a hybrid neural and endocrine duodenal tumour was characterised by ganglion cells and the endocrine component by epithelioid cells which were both argentaffin and argyrophil. Spindle-shaped cells of indeterminant lineage were also present. Electron microscopy revealed 'pale' and 'dark' cells, the former corresponding to the epithelioid cells and containing many membrane-bound neurosecretory granules, the latter probably corresponding to the spindle cells and containing large numbers of neurofilaments. Occasional cells contained both neurofilaments and secretory granules arranged in a consistent pattern in the cytoplasm. These composite cells may have represented an incompletely differentiated precursor of both the neural and endocrine elements of the tumour.

Aged↗
PubMed1977

Dermatitis herpetiformis: a comparative assessment of skin and bowel abnormality.

We reviewed 18 patients with a clinical diagnosis of dermatitis herpetiformis who were being treated with dapsone and were on an unrestricted diet. Diagnosis was confirmed by finding IgA deposits in the dermal papillae of unaffected skin. Dapsone was discontinued and biopsy of affected skin was carried out when the typical rash reappeared. The biopsy findings were graded according to the severity of the histological changes. Small bowel tissue from each patient was examined and graded by stereo- and routine microscopy. Thirteen specimens (72%) were stereomicroscopically abnormal; all 18 showed villous atrophy, either partial or subtotal; and in 13 (72%) the interepithelial lymphocyte count was increased. No correlation was found between the histological severity of the skin and the small bowel lesions. Seemingly the severity of the skin rash in dermatitis herpetiformis is no guide to the degree of small bowel abnormality.

Adolescent↗
PubMed1977

'Pseudocirrhosis' in hereditary haemorrhagic telangiectasia.

Telangiectasia-associated hepatic fibrosis (TAHF) in a 68-year-old woman with hereditary haemorrhagic telangiectasia (HHT) is described. The patient died of oat-cell carcinoma of the lung. In addition to the structural alterations which have been described previously in HHT, the liver exhibited focal midlobular hepatocytic necrosis and tumour metastases. The possibility that treatment of HHT was causally related to some of the hepatic abnormalities found in our patient and the differentiation of TAHF from true cirrhosis are discussed.

Aged↗
PubMedDate not supplied

Mesenchymal cystic hamartoma presenting with spontaneous pneumothorax.

A 53-year-old woman presented with a spontaneous right-sided pneumothorax. Computed tomography chest scan demonstrated a large bulla involving the right middle lobe. Recurrence of the pneumothorax after initial closed chest tube drainage necessitated thoracotomy and wedge resection. Histopathological examination revealed features consistent with a benign mesenchymal cystic hamartoma. Pneumothorax is a recognized complication of mesenchymal cystic hamartoma, a lesion that also has malignant potential.

Female↗
PubMedDate not supplied

Osteochondral lesions of the talus.

We report demographic, clinical, and imaging data on 92 patients with osteochondral lesions of the talus collected in one center between 1981 and 1992. All patients reported pain as their primary symptom. Ninety-four percent of the patients reported pain with activity. Physical examination was unhelpful. Using newer imaging techniques (bone scan and computed tomography) and with increased awareness, we have observed a sevenfold increase in the diagnostic frequency of osteochondral lesions of the talus between the years 1981 to 1986 and 1987 to 1992. Bone scan is an excellent screening tool for patients with chronic ankle pain and has 99% sensitivity in depicting osteochondral lesions. Computed tomography demonstrated a previously unclassified lesion, the radiolucent defect, which accounts for 77% of the lesions in this series. We have therefore modified the Berndt and Harty classification system, basing it on radiographic appearance (principally computed tomography) and adding the radiolucent lesion. Fifty-eight patients were treated surgically. Anterior and midtalar lesions are now approached arthroscopically. Surgical treatment of the radiolucent lesion, consisting of curettage and drilling, gives 42% excellent and 32% good results. Pain relief often occurs within months of surgery, but healing of the lesion requires years, and some may persist indefinitely.

Adolescent↗