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Yang WT, Whitman GJ, Yuen EH, Tse GM, Stelling CB. Sonographic features of primary breast cancer in men. AJR Am J Roentgenol 2001; 176:413-6. [PMID: 11159083 DOI: 10.2214/ajr.176.2.1760413] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The imaging studies of eight men with proven primary breast cancer and preoperative sonography and mammography were reviewed and correlated with final pathology reports. CONCLUSION There were five cases of invasive breast carcinoma and three cases of ductal carcinoma in situ of the papillary subtype. All three cases of papillary ductal carcinoma in situ showed cystic features on sonography. Most (4/5) invasive cancers were solid on sonography. The appearance of a complex cystic mass in the male breast on sonography should suggest the possibility of malignancy and therefore warrants biopsy.
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Downing SW, Cardarelli MG, Sperling J, Attar S, Wallace DC, Rodriguez A, Brown J, Whitman GJ, McLaughlin JS. Heparinless partial cardiopulmonary bypass for the repair of aortic trauma. J Thorac Cardiovasc Surg 2000; 120:1104-9; discussion 1110-1. [PMID: 11088034 DOI: 10.1067/mtc.2000.111055] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We hypothesized that partial cardiopulmonary bypass with a heparin-bonded system would be a technically simple, effective adjunct for reducing paraplegia during repair of traumatic aortic rupture. It avoids the risk of heparin, but, unlike left atrial-arterial bypass, it can heat, cool, oxygenate, and rapidly infuse volume if needed. METHODS A retrospective review was conducted of patients admitted for aortic trauma from July 1994 to December 1999. Bypass consisted of femoral venous (right atrial) cannulation, a centrifugal pump, and an oxygenator-heater/cooler. Arterial return was to the femoral artery or distal aorta. The entire system was heparin-bonded and no systemic heparin was given. RESULTS Heparin-bonded partial bypass was established in 50 patients (mean age 43 +/- 17 years). Crossclamp time was 32 +/- 11 minutes (range 14-70 minutes), mean flow 3.0 +/- 0.8 L/min, and bypass time 64 +/- 43 minutes. During repair, 58% of patients received volume through the system (mean 1.1 +/- 1.9 L). Core temperature rose slightly (35.9 degrees C +/- 0.7 degrees C to 36.3 degrees C +/- 0.8 degrees C). Three of the 15 patients who underwent percutaneous femoral arterial and venous cannulation concomitant with their angiograms had vessel injury, with one limb loss, and this procedure was discontinued. Thirty-five patients underwent percutaneous femoral vein and direct distal aortic cannulation without event. The mortality rate for patients supported by bypass was 10%, and all deaths were due to other injuries. There were no new cases of paraplegia and no worsening of intracranial or pulmonary injuries. CONCLUSIONS Heparin-bonded bypass is technically simple to use and avoids the risk of anticoagulation. Paraplegia was avoided. The ability to correct hypothermia, oxygenate, and rapidly infuse volume may simplify management and improve outcomes.
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Crestanello JA, Doliba NM, Babsky AM, Doliba NM, Niibori K, Osbakken MD, Whitman GJ. Opening of potassium channels protects mitochondrial function from calcium overload. J Surg Res 2000; 94:116-23. [PMID: 11104651 DOI: 10.1006/jsre.2000.5979] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Ischemic preconditioning (IPC) protects myocardium from ischemia reperfusion injury by activating mitochondrial K(ATP) channels. However, the mechanism underlying the protective effect of K(ATP) channel activation has not been elucidated. It has been suggested that activation of mitochondrial K(ATP) channels may prevent mitochondrial dysfunction associated with Ca(2+) overload during reperfusion. The purpose of this experiment was to study, in an isolated mitochondrial preparation, the effects of mitochondrial K(ATP) channel opening on mitochondrial function and to determine whether it protects mitochondria form Ca(2+) overload. Mitochondria (mito) were isolated from rat hearts by differential centrifugation (n = 5/group). Mito respiratory function was measured by polarography without (CONTROL) or with a potassium channel opener (PINACIDIL, 100 microM). Different Ca(2+) concentrations (0 to 5 x 10(-7) M) were used to simulate the effect of Ca(2+) overload; state 2, mito oxygen consumption with substrate only; state 3, oxygen consumption stimulated by ADP; state 4, oxygen consumption after cessation of ADP phosphorylation; respiratory control index (RCI: ratio of state 3 to state 4); rate of oxidative phosphorylation (ADP/Deltat); and ADP:O ratio were measured. PINACIDIL increased state 2 respiration and decreased RCI compared to CONTROL. Low Ca(2+) concentrations stimulated state 2 and state 4 respiration and decreased RCI and ADP:O ratios. High Ca(2+) concentrations increased state 2 and state 4 respiration and further decreased RCI, state 3, and ADP/Deltat. PINACIDIL improved state 3, ADP/Deltat, and RCI at high Ca(2+) concentrations compared to CONTROL. Pinacidil depolarized inner mitochondrial membrane, as evidenced by decreased RCI and increased state 2 at baseline. Depolarization may decrease Ca(2+) influx into mito, protecting mito from Ca(2+) overload, as evidenced by improved state 3 and RCI at high Ca(2+) concentrations. The myocardial protective effects resulting from activating K(ATP) channels either pharmacologically or by IPC may be the result of protecting mito from Ca(2+) overload.
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Munden RF, Nesbitt JC, Kemp BL, Chasen MH, Whitman GJ. Primary liposarcoma of the mediastinum. AJR Am J Roentgenol 2000; 175:1340. [PMID: 11044037 DOI: 10.2214/ajr.175.5.1751340] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Rubio IT, Mirza N, Sahin AA, Whitman G, Kroll SS, Ames FC, Singletary SE. Role of specimen radiography in patients treated with skin-sparing mastectomy for ductal carcinoma in situ of the breast. Ann Surg Oncol 2000; 7:544-8. [PMID: 10947024 DOI: 10.1007/s10434-000-0544-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Specimen radiography is an important part of breast conservation surgery for ductal carcinoma in situ (DCIS). The objective of this study was to determine whether mastectomy specimen radiography could help in obtaining negative resection margins in patients with DCIS undergoing skin-sparing mastectomy (SSM) with immediate breast reconstruction (IBR). METHODS Of 95 patients treated at our institution with SSM and IBR for DCIS, 35 had specimen radiography. The mastectomy specimen was first examined grossly and then inked, serially sectioned, and sent for radiographic assessment. Tissue slices containing calcifications were identified for pathologic evaluation. Additional tissue was excised if tumor was found near the inked margins or if calcifications were found near the radiographic margins. RESULTS Of the 35 patients who had specimen radiography, the radiographic margins were free of calcifications in 30 patients (86%); of these patients, the margins on the final histologic examination were free of tumor in 27 and within 1 mm in 3. The other five patients (14%) had calcifications close to the radiographic margin; four underwent an intraoperative re-excision, but the margin for one of those four patients was still positive on final histologic examination. Margins were found to be negative by both mastectomy specimen radiography and histology in 77% of the patients. Of the 95 patients with DCIS, three patients (3%), none of whom had specimen radiography, developed local recurrences. One of these was successfully re-treated, one died as a result of synchronous distant metastases, and one was lost to follow-up. At a median follow-up time of 3.7 years, 93 patients (98%) were alive and free of disease. CONCLUSIONS Intraoperative radiography of mastectomy specimens may be useful for assessing margin status and for identifying the location of microcalcifications within tissue slices.
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Kushwaha AC, Whitman GJ, Stelling CB, Cristofanilli M, Buzdar AU. Primary inflammatory carcinoma of the breast: retrospective review of mammographic findings. AJR Am J Roentgenol 2000; 174:535-8. [PMID: 10658737 DOI: 10.2214/ajr.174.2.1740535] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Our goal was to describe the mammographic characteristics of primary inflammatory carcinoma of the breast. MATERIALS AND METHODS We identified the medical records of 43 women who participated in a chemotherapy protocol for primary inflammatory carcinoma of the breast between 1994 and 1997. Mammograms were available for review in 26 women (age range, 34-78 years; mean age, 56 years). Two radiologists independently reviewed the 26 mammograms obtained before patients underwent treatment. A third observer was the final arbiter when needed. RESULTS Mammographic findings included skin thickening in 24 patients (92%), diffusely increased density in 21 patients (81%), trabecular thickening in 16 patients (62%), axillary lymphadenopathy in 15 patients (58%), architectural distortion or focal asymmetric density in 13 patients (50%), and nipple retraction in 10 patients (38%). Malignant-appearing calcifications were seen in six patients (23%), and a mass was seen in four patients (15%). CONCLUSION Diffuse mammographic abnormalities such as skin thickening, increased density, trabecular thickening, and axillary lymphadenopathy are common at presentation in patients with primary inflammatory carcinoma of the breast. Mammographic masses and malignant-appearing calcifications are uncommon manifestations of this disease.
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Sheppard DG, Whitman GJ, Huynh PT, Sahin AA, Fornage BD, Stelling CB. Tubular carcinoma of the breast: mammographic and sonographic features. AJR Am J Roentgenol 2000; 174:253-7. [PMID: 10628489 DOI: 10.2214/ajr.174.1.1740253] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to define specific mammographic and sonographic features of tubular carcinoma of the breast. MATERIALS AND METHODS Seventeen pathologically confirmed cases of tubular carcinoma were characterized retrospectively by two radiologists. Mammograms and sonograms were available for all patients. RESULTS Fifteen of the 17 tubular carcinomas appeared as irregularly shaped masses with spiculated margins on mammography. Sixteen of the 17 masses had central densities. Spicules longer than the diameter of the central lesion were noted in eight (53%) of 15 tubular carcinomas. Eight tubular carcinomas had associated calcifications, with calcifications suspected of being malignant in four cases. On sonography, 15 hypoechoic masses were seen. The margins of the masses on sonography were described as ill-defined in 14 (93%) of the 15 cases. Posterior acoustic shadowing was present in 14 of the 15 cases. CONCLUSION Tubular carcinomas are usually seen on mammography as irregularly shaped masses with central densities and spiculated margins, and most tubular carcinomas can be identified on sonography as hypoechoic masses with ill-defined margins and posterior acoustic shadowing. Although the mammographic and sonographic features of tubular carcinoma are not sufficiently specific to differentiate tubular carcinomas from radial scars, sonography can be useful for guiding biopsies and evaluating for multifocal and multicentric disease.
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Krishnamurthy R, Whitman GJ, Stelling CB, Kushwaha AC. Mammographic findings after breast conservation therapy. Radiographics 1999; 19 Spec No:S53-62; quiz S262-3. [PMID: 10517443 DOI: 10.1148/radiographics.19.suppl_1.g99oc16s53] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Breast conservation therapy for breast cancer involves lumpectomy or segmental mastectomy followed by radiation therapy. Masses, fluid collections, architectural distortion, scarring, edema, skin thickening, and calcifications are posttreatment findings that may mimic or mask local tumor recurrence. Despite the overlap between posttreatment changes and tumor recurrence, the two entities can usually be distinguished by the characteristic mammographic appearances of posttreatment sequelae and by comparing interval findings on successive studies. Postoperative masses and fluid collections slowly diminish in size and usually resolve by 1 year after surgery. Radiation-induced edema gradually resolves; increasing edema may be due to recurrent cancer. Postsurgical scarring usually appears as a poorly marginated soft-tissue mass with interspersed radiolucent areas. Recurrent cancer is usually seen as a mass with no central radiolucent areas. Pleomorphic and granular microcalcifications are important markers for recurrent cancer and can usually be distinguished from the thick, calcified plaques and elongated dystrophic calcifications associated with scarring.
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Abstract
Screening mammography has been shown to reduce breast cancer mortality by detecting small, nonpalpable, early-stage breast cancers. In 1998, several studies were published, reinforcing the value of screening mammography in women aged 40 years and older. Some studies focused on when screening should begin (age 40 years), while others analyzed the process of screening mammography, with particular attention to recall rates and false-positive studies. Other reports emphasized the limitations of mammographic interpretation, the use of computers to aid in mammographic diagnosis, and screening with ultrasound.
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Whitman GJ, Venable SL, Stelling CB, Kushwaha AC, Harrington A, Lifshitz O. Process mapping boosts mammography's efficiency and quality. DIAGNOSTIC IMAGING 1999; 21:53-5. [PMID: 10623318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Whitman GJ, Hart JC, Crestanello JA, Spooner TH. Uniform safety of beating heart surgery using the octopus tissue stabilization system. J Card Surg 1999; 14:323-9. [PMID: 10875584 DOI: 10.1111/j.1540-8191.1999.tb01003.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Minimally invasive coronary artery bypass grafting (CABG) has been facilitated by the introduction of the Octopus Tissue Stabilization system (OTS). OTS improves exposure immobilizing the heart with minimal hemodynamic effects allowing multivessels off cardiopulmonary bypass (CPB) CABG. The purpose of this study was to compare the utilization and clinical outcome of the OTS in three geographically distinct centers. METHODS 239 patients who underwent OTS-CABG at Allegheny University Hospital/Medical College of Pennsylvania, Harrisburg Hospital, and Park Nicollet Clinic/HealthSystem Minnesota were reviewed. Age, acuity of patients, and number and type of vessels bypassed were recorded. Complications, mortality, length of hospital stay, incidence of conversion to CPB and blood transfusions, and operating room costs were compared to risk matched control patients who underwent CPB CABG during the same period. RESULTS Results were similar in all three centers. The average age was 62.3 years. Emergent operation was necessary in 7%-10% of patients, the operations averaged 1.8 grafts/patient. Arteries bypassed were LAD, DIAG, OM, RCA, PDA, and RPLB. There were 96% of operations completed without CPB. Morbidity was low (12%). Atrial fibrillation and blood transfusion rate were decreased. Mortality was 0 compared with a predicted mortality of 1.6%. Hospital length of stay was shorter and operating room costs were 61% lower. CONCLUSIONS OTS provides predictable reproducible immobilization allowing the performance of single and multiple off-pump CABG to almost all coronary branches with minimal morbidity and decreased costs in a variety of patients. Similar findings from three different centers suggests that these results are easily reproducible.
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Kushwaha AC, Whitman GJ, Williamson JD. Radiologic-pathologic conferences of the University of Texas M.D. Anderson Cancer Center. Mucinous carcinoma of the breast. AJR Am J Roentgenol 1999; 173:290. [PMID: 10430121 DOI: 10.2214/ajr.173.2.10430121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abstract
We report on a 51-year-old man with severe two-vessel coronary disease and an ejection fraction of 15% who presented with myocardial ischemia and heparin-induced thrombocytopenia after coronary angioplasty. Before coronary bypass surgery, the antithrombin agent argatroban was used for anticoagulation and an intraaortic balloon pump was inserted. Direct coronary bypass surgery was performed to the left anterior descending artery and to the posterior descending artery using the 'Octopus' tissue stabilization device (Manfrotto, Feltre, Italy). The postoperative course was uneventful and associated with normal platelet counts. The patient was discharged on the 6th postoperative day.
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Whitman GJ, Venable SL, Downs RL, Garza D, Levy S, Ophir KJ, Spears KF, Sprinkle-Vincent SK, Stelling CB. Process mapping in screening mammography. J Digit Imaging 1999; 12:208. [PMID: 10342216 PMCID: PMC3452920 DOI: 10.1007/bf03168805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Successful screening mammography programs aim to screen large numbers of women efficiently and inexpensively. Development of an effective screening mammography program requires skilled personnel, solid infrastructure, and a robust computer system. A group of physicians, technologists, computer support personnel, and administrators carefully analyzed a growing screening mammography program as a series of steps, starting with the request for the examination and ending with the receipt of a hard-copy consultation. The analysis involved a detailed examination of every step and every possible outcome in the screening process. The information gained through process mapping may be used for identification of systemic and personnel problems, allocation of resources, modification of workplace architecture, and design of computer networks. Process mapping is helpful for those involved in designing and improving screening mammography programs. Viewing a process (i.e., obtaining a screening mammogram) as a series of steps may allow for the identification of inefficient components that may limit growth.
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Whitman GJ. Breast biopsies with a needle gun. Acad Radiol 1999; 6:81; author reply 82. [PMID: 9891159 DOI: 10.1016/s1076-6332(99)80071-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Niibori K, Wroblewski KP, Yokoyama H, Crestanello JA, Whitman GJ. Bioenergetic effect of liposomal coenzyme Q10 on myocardial ischemia reperfusion injury. Biofactors 1999; 9:307-13. [PMID: 10416045 DOI: 10.1002/biof.5520090228] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The antioxidant and bioenergetic effects of CoQ10 are well known but its clinical utility is limited by the requirement for enteral administration. A newly developed liposomal CoQ10 (CoQ) is water soluble and capable of intravenous administration. The purpose of this study is to determine the mechanism by which acute administration CoQ protects myocardium from reperfusion (Rp) injury. Rats were pretreated with CoQ 10 mg/kg i.v. 30 min prior to the experiment. Control rats were pretreated with liposome only. Hearts were excised and subjected to equilibration, 25 min of normothermic ischemia and 40 min of Rp on a Langendorff apparatus. At end Rp, CoQ hearts recovered 74 +/- 5% of their DP vs. 50 +/- 9% in control (p < 0.05). Aerobic efficiency was maintained (0.66 +/- 0.02 vs. control, 0.5 +/- 0.04, p < 0.003) and CoQ hearts lost less CK activity vs. control (p < 0.02). PCr and ATP were higher than control (p < 0.05, 0.02, respectively). Results show that i.v. CoQ improves recovery of function, aerobic efficiency, CK activity, and recovery of PCr and ATP after Rp. This suggests that acute administration of liposomal CoQ improves myocardial tolerance to I/R via its role as an antioxidant as well as improving oxygen utilization and high energy phosphate production.
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Niibori K, Yokoyama H, Crestanello JA, Whitman GJ. Acute administration of liposomal coenzyme Q10 increases myocardial tissue levels and improves tolerance to ischemia reperfusion injury. J Surg Res 1998; 79:141-5. [PMID: 9758729 DOI: 10.1006/jsre.1998.5411] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
UNLABELLED The antioxidant and bioenergetic effects of CoQ10 (CoQ) suggest it might be ideal therapy for acute myocardial ischemia. Its utility is limited by the requirement for enteral administration. This study related the administration of a new liposomal suspension of CoQ given intravenously to (1) serum and myocardial [CoQ] and (2) recovery of function, myocardial efficiency, and oxidant injury after cardiac ischemia and reperfusion (I/R). Rats (n = 8/group) were given liposomal CoQ 10 mg/kg iv or placebo (Control), 15 min (C-15), 30 min (C-30), and 60 min (C-60) before (1) measurement of serum and myocardial CoQ or (2) Langendorff perfusion of hearts subjected to 15 min equilibration, 25 min ischemia (37 degrees C), and 40 min reperfusion (RP). Developed pressure (DP) was measured via an intraventricular balloon and coronary flow was measured by a digital flow meter. Myocardial efficiency was defined as DP/MVO2 where MVO2 = microl O2 consumed/min/gram LV. At end RP hearts were assayed for CK, an oxidant sensitive enzyme. Maximum preischemic CoQ levels in serum and myocardium occurred 15 and 30 min after administration, respectively. At end reperfusion, C-30 hearts improved the most, recovering 75 +/- 4% of their preischemic DP while Control recovered only 52 +/- 6% (P < 0.03) as well as maintaining better myocardial efficiency (0.69 +/- 0.02 vs Control, 0.43 +/- 0.05) (P < 0.001). C-15, C-30, and C-60 groups all lost less CK activity after RP vs Control (P < 0.04). CONCLUSION (1) Serum and myocardial levels of CoQ can be raised acutely by iv liposomal CoQ. (2) Myocardial CoQ levels correlate best with I/R protection. (3) Acute iv CoQ improves function and efficiency and decreases oxidant injury after I/R. Intravenous CoQ may be effective clinically for acute cardiac ischemic syndromes.
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Crestanello JA, Lingle DM, Millili J, Whitman GJ. Pyruvate improves myocardial tolerance to reperfusion injury by acting as an antioxidant: a chemiluminescence study. Surgery 1998; 124:92-9. [PMID: 9663257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND There is indirect evidence that pyruvate improves myocardial tolerance to ischemia by scavenging oxygen radicals during reperfusion. The objectives of this study were to evaluate (1) lucigenin-enhanced chemiluminescence (LEC) as a method to measure oxygen radical (OR) production in vitro and in vivo and (2) the antioxidant effect of pyruvate during myocardial reperfusion. METHODS LEC was measured in vitro by adding to lucigenin (1) increasing concentrations of H2O2, (2) H2O2 and different concentrations of catalase, and (3) H2O2 plus pyruvate. Isolated rat hearts perfused with Krebs Henseleit-Lucigenin inside a chemiluminescence chamber were subjected to equilibration, ischemia, and reperfusion without (control) or with pyruvate. Developed pressure, contractility, compliance, and chemiluminescence were recorded. RESULTS In vitro, LEC directly correlated with H2O2 concentrations (r2 = 0.997) and decreased in the presence of catalase or pyruvate. During myocardial reperfusion there was a surge of chemiluminescence that peaked at 4 minutes. Pyruvate decreased the initial reperfusion peak (9.8 +/- 0.3 x 10(3) cpm in pyruvate group vs 12.4 +/- 0.9 x 10(3) cpm in control; p < 0.05) and the total amount of chemiluminescence generated during reperfusion (65.7 +/- 12 x 10(3) in pyruvate group vs 117.1 +/- 8.2 x 10(3) counts in control; p < 0.05). Pyruvate improved recovery of function after ischemia reperfusion. CONCLUSIONS LEC is a sensitive indicator of H2O2 concentrations and can evaluate the effect of antioxidants in vitro. It is a continuous, sensitive, and direct measurement of OR production in vivo. LEC is ideal for the evaluation of antioxidant interventions and provides direct evidence that pyruvate acts as an antioxidant while improving myocardial function during reperfusion.
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Whitman GJ, Kopans DB, McCarthy KA, Stelling CB, Sneige N, Sunku K, Weiss MK. Coaxial core needle biopsy under mammographic guidance: indications and applications. AJR Am J Roentgenol 1998; 171:67-70. [PMID: 9648766 DOI: 10.2214/ajr.171.1.9648766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Abstract
RATIONALE AND OBJECTIVES To determine the limitations of mammography in symptomatic patients. MATERIALS AND METHODS Approximately 20,000 mammograms obtained during a 2-year period were correlated with the results of a retrospective review of the pathology database, which revealed 711 patients with breast cancer. A total of 496 of these patients underwent mammography at the authors' institution. Three observers reviewed the mammograms of patients with "normal" mammograms within 6 months of excisional biopsy. The parenchymal patterns were also assessed. RESULTS Mammographic abnormalities were identified in 481 cases (97%), and 15 mammograms (3%) were interpreted as "unremarkable." Fourteen of the unremarkable cases were available for review, which indicated nine true-negative findings, one technical error, two observer errors, and two combined technical and observer errors. The technical error involved the lower inner quadrant of the breast, adjacent to the chest wall. All 14 mammograms were of dense breasts. CONCLUSION Mammographic abnormalities were identified in nearly all patients with proved breast cancer. Mammograms in which lesions were missed were of dense breasts, but one-third of the lesions were visible in retrospect. When examining symptomatic patients with dense breasts, radiologists should use optimal mammographic techniques and consider using nonmammographic breast imaging modalities.
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Slanetz PJ, Whitman GJ, Halpern EF, Hall DA, McCarthy KA, Simeone JF. Imaging of fallopian tube tumors. AJR Am J Roentgenol 1997; 169:1321-4. [PMID: 9353450 DOI: 10.2214/ajr.169.5.9353450] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The purposes of this study were to investigate the imaging findings in patients with primary fallopian tube neoplasms and to determine whether specific imaging features favor the preoperative diagnosis of fallopian tube tumors (FTT). MATERIALS AND METHODS Computerized search of medical records from 1984 to 1994 identified 20 patients with a discharge diagnosis of primary fallopian tube carcinoma. Medical records, imaging studies, and pathology findings were reviewed. Eleven patients had available preoperative imaging. RESULTS Seventeen of 20 patients with primary FTT had unilateral disease. Of these 17, preoperative imaging was available in nine, showing four solid adnexal masses, four complex cystic adnexal masses, and one normal adnexa. The preoperative imaging of these nine patients included six sonographic and five CT studies. Three patients with primary FTT had bilateral tumors, and preoperative imaging was available for two patients: Two sonographic studies and one CT study showed one complex cystic adnexal mass and three normal adnexa. CONCLUSION Primary FTT commonly presents as an adnexal mass on preoperative imaging and mimics other pelvic malignancies, especially ovarian carcinoma. Making a specific preoperative diagnosis is difficult; however, because primary FTT is unlikely to be confused with a benign process, delay in diagnosis is rare.
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