Browse Health
Psychiatrist
19 years of experience
Accepting new patients

Education ?

Medical School Score
University of Arkansas (1991)
  • Currently 2 of 4 apples

Affiliations ?

Dr. Quinn is affiliated with 4 hospitals.

Hospital Affilations

Score

Rankings

  • UT Southwestern University Hospital - Zale Lipshy
    5151 Harry Hines Blvd, Dallas, TX 75235
    • Currently 4 of 4 crosses
    Top 25%
  • UT Southwestern University Hospital - St. Paul
    5909 Harry Hines Blvd, Dallas, TX 75235
    • Currently 4 of 4 crosses
    Top 25%
  • Parkland Health & Hospital System
    5201 Harry Hines Blvd, Dallas, TX 75235
    • Currently 1 of 4 crosses
  • Parkland Hospital
  • Publications & Research

    Dr. Quinn has contributed to 82 publications.
    Title Pediatric Anaplastic Large Cell Lymphoma Presenting As Generalized Lymphadenopathy.
    Date December 2010
    Journal Oncology (williston Park, N.y.)
    Excerpt

    Because a finding of generalized lymphadenopathy can be associated with such a wide range of diseases and conditions, determining its cause can sometimes be challenging. Infectious causes are the most common; however, it is important also to consider other entities in the workup. Here we present the case of a 3-year-old girl with generalized lymphadenopathy and fever, in whom the cause of the symptoms was initially thought to be infectious. Ultimately, however, anaplastic large cell lymphoma (ALCL) was diagnosed. Using this case as a backdrop, we discuss the wide range of systemic illnesses that the differential diagnosis of generalized lymphadenopathy encompasses--including infectious, autoimmune, and oncological disorders. We discuss the different findings typically seen in the various entities that figure prominently in the differential, and we outline investigations that can help narrow it. Finally, we present an overview of ALCL, one of the more rare pediatric malignancies.

    Title Reconsolidation of a Cocaine-associated Stimulus Requires Amygdalar Protein Kinase A.
    Date April 2010
    Journal The Journal of Neuroscience : the Official Journal of the Society for Neuroscience
    Excerpt

    Drug addiction is a chronic disorder associated with recurrent craving and relapse often precipitated by the presence of drug-associated stimuli. Pharmacological and behavioral treatments that disrupt drug-associated stimulus memories could be beneficial in the treatment of addictive disorders. Memory restabilization (or reconsolidation) following retrieval of drug-paired stimuli depends upon the amygdala. Here we assessed whether amygdalar PKA is required for the reconsolidation of an appetitive, cocaine-paired stimulus. Rats were trained to lever press for intravenous cocaine infusions paired with a light/tone conditioned stimulus. After 12 d of acquisition, rats either underwent lever extinction (8-12 d) followed by light/tone reactivation and subsequent cue-induced and cocaine-induced (15 mg/kg, i.p.) reinstatement testing or were subsequently tested to assess the ability of the light/tone stimulus to serve as a conditioned reinforcer in the acquisition of a new instrumental response (nose poking). Bilateral intra-amygdalar infusions of the PKA inhibitor Rp-cAMPS (18 microg per side) given immediately following light/tone stimulus reactivation decreased subsequent cue-induced reinstatement and responding with a conditioned reinforcer, while having no effect on cocaine-induced reinstatement. Intra-amygdalar infusions of Rp-cAMPS made 3 h following reactivation or immediately following no stimulus reactivation had no effect on subsequent cue-induced reinstatement. These data show that memory reconsolidation for a cocaine-paired stimulus is retrieval dependent and time limited and critically depends upon amygdalar PKA.

    Title Targeting Extinction and Reconsolidation Mechanisms to Combat the Impact of Drug Cues on Addiction.
    Date April 2009
    Journal Neuropharmacology
    Excerpt

    Drug addiction is a progressive and compulsive disorder, where recurrent craving and relapse to drug-seeking occur even after long periods of abstinence. A major contributing factor to relapse is drug-associated cues. Here we review behavioral and pharmacological studies outlining novel methods of effective and persistent reductions in cue-induced relapse behavior in animal models. We focus on extinction and reconsolidation of cue-drug associations as the memory processes that are the most likely targets for interventions. Extinction involves the formation of new inhibitory memories rather than memory erasure; thus, it should be possible to facilitate the extinction of cue-drug memories to reduce relapse. We propose that context-dependency of extinction might be altered by mnemonic agents, thereby enhancing the efficacy of cue-exposure therapy as treatment strategy. In contrast, interfering with memory reconsolidation processes can disrupt the integrity or strength of specific cue-drug memories. Reconsolidation is argued to be a distinct process that occurs over a brief time period after memory is reactivated/retrieved - when the memory becomes labile and vulnerable to disruption. Reconsolidation is thought to be an independent, perhaps opposing, process to extinction and disruption of reconsolidation has recently been shown to directly affect subsequent cue-drug memory retrieval in an animal model of relapse. We hypothesize that a combined approach aimed at both enhancing the consolidation of cue-drug extinction and interfering with the reconsolidation of cue-drug memories will have a greater potential for persistently inhibiting cue-induced relapse than either treatment alone.

    Title Dorsal Hippocampus Involvement in Delay Fear Conditioning Depends Upon the Strength of the Tone-footshock Association.
    Date August 2008
    Journal Hippocampus
    Excerpt

    The hippocampus is important for the formation of spatial, contextual, and episodic memories. For instance, lesions of the dorsal hippocampus (DH) produce demonstrable deficits in contextual fear conditioning. By contrast, it is generally agreed that the DH is not important for conditioning to a discrete cue (such as a tone or light) that is paired with footshock in a temporally contiguous fashion (delay conditioning). There are, however, some reports of hippocampus involvement in delay conditioning. The present series of experiments was designed to assess the conditions under which the hippocampus-dependent component of delay fear conditioning performance may be revealed. Here, we manipulated the number of conditioning trials and the intensity of the footshock in order to vary the strength of conditioning. The results indicate that the DH contributes to freezing performance to a delay conditioned tone when the conditioning parameters are relatively weak (few trials or low footshock intensity), but not when strong parameters are used. The results are discussed in terms of two parallel memory systems: a direct tone-footshock association that is independent of the hippocampus and a hippocampus-dependent memory for the conditioning session.

    Title Redefining the Role of Doxorubicin for the Treatment of Children with Hepatoblastoma.
    Date May 2008
    Journal Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
    Excerpt

    PURPOSE: Systemic chemotherapy has improved the survival of patients with hepatoblastoma (HB). INT-0098 Intergroup Liver Tumor Study demonstrated that patients with HB treated with either cisplatin/fluorouracil/vincristine (CFV) or cisplatin/doxorubicin (CD) had a similar survival. The Children's Oncology Group adopted the less toxic CFV as the standard regimen for treating HB. However, international cooperative groups still favor the CD combination. We therefore decided to revisit the role of doxorubicin for the treatment of HB. METHODS: Outcomes of patients with HB on the INT-0098 study were reviewed with an emphasis on the postevent survival time for both regimens to elucidate the role of doxorubicin in their retrieval. RESULTS: Sixty-four of the 173 randomly assigned patients had an event. Of these, 55 experienced progression or recurrence after initial treatment. Eleven (31%) of 36 patients treated with CFV were successfully retrieved with a doxorubicin-containing regimen and surgery and remain alive at last contact, whereas only one (6%) of 18 patients treated with CD was alive after retrieval therapy. CONCLUSION: CFV is effective for stage I or II HB. Doxorubicin can be omitted as part of initial therapy in the majority of these patients, potentially limiting the long-term cardiac toxicities, without compromising outcome. Doxorubicin is effective in rescuing patients with recurrent disease after CFV and should be incorporated as a means of intensifying initial therapy for advanced-stage, nonmetastatic HB. Outcome of patients with metastatic disease at diagnosis is poor, and improving their survival will require new therapeutic approaches.

    Title Impulsivity, Compulsivity, and Habit: the Role of Orbitofrontal Cortex Revisited.
    Date February 2008
    Journal Biological Psychiatry
    Title Sex Chromosome Complement Regulates Habit Formation.
    Date January 2008
    Journal Nature Neuroscience
    Excerpt

    Sex differences in brain function and behavior are regularly attributed to gonadal hormones. Some brain sexual dimorphisms, however, are direct actions of sex chromosome genes that are not mediated by gonadal hormones. We used mice in which sex chromosome complement (XX versus XY) and gonadal sex (ovaries versus testes) were independent, and found that XX mice showed faster food-reinforced instrumental habit formation than XY mice, regardless of gonadal phenotype.

    Title Bidirectional Modulation of Goal-directed Actions by Prefrontal Cortical Dopamine.
    Date January 2008
    Journal Cerebral Cortex (new York, N.y. : 1991)
    Excerpt

    Instrumental actions are a vital cognitive asset that endows an organism with sensitivity to the consequences of its behavior. Response-outcome feedback allows responding to be shaped in order to maximize beneficial, and minimize detrimental, outcomes. Lesions of the medial prefrontal cortex (mPFC) result in behavior that is insensitive to changes in outcome value in animals and compulsive behavior in several human psychopathologies. Such insensitivity to changes in outcome value is a defining characteristic of instrumental habits: responses that are controlled by antecedent stimuli rather than goal expectancy. Little is known regarding the neurochemical substrates mediating this sensitivity. The present experiments used sensitivity to posttraining outcome devaluation to index the action-habit status of instrumental responding. Infusions of dopamine into the ventral mPFC (vmPFC), but not dorsal mPFC, restored outcome sensitivity bidirectionally-decreasing responding following outcome devaluation and increasing responding when the outcome was not devalued. This bidirectionality makes the possibility that these infusions nonspecifically dysregulated vmPFC dopamine transmission unlikely. VmPFC dopamine promoted instrumental responding appropriate to outcome value. Reinforcer consumption data indicated that this was not a consequence of altered sensitivity to the reinforcer itself. We suggest that vmPFC dopamine reengages attentional processes underlying goal-directed behavior.

    Title Cdk5 Modulates Cocaine Reward, Motivation, and Striatal Neuron Excitability.
    Date December 2007
    Journal The Journal of Neuroscience : the Official Journal of the Society for Neuroscience
    Excerpt

    Cyclin-dependent kinase 5 (Cdk5) regulates dopamine neurotransmission and has been suggested to serve as a homeostatic target of chronic psychostimulant exposure. To study the role of Cdk5 in the modulation of the cellular and behavioral effects of psychoactive drugs of abuse, we developed Cre/loxP conditional knock-out systems that allow temporal and spatial control of Cdk5 expression in the adult brain. Here, we report the generation of Cdk5 conditional knock-out (cKO) mice using the alphaCaMKII promoter-driven Cre transgenic line (CaMKII-Cre). In this model system, loss of Cdk5 in the adult forebrain increased the psychomotor-activating effects of cocaine. Additionally, these CaMKII-Cre Cdk5 cKO mice show enhanced incentive motivation for food as assessed by instrumental responding on a progressive ratio schedule of reinforcement. Behavioral changes were accompanied by increased excitability of medium spiny neurons in the nucleus accumbens (NAc) in Cdk5 cKO mice. To study NAc-specific effects of Cdk5, another model system was used in which recombinant adeno-associated viruses expressing Cre recombinase caused restricted loss of Cdk5 in NAc neurons. Targeted knock-out of Cdk5 in the NAc facilitated cocaine-induced locomotor sensitization and conditioned place preference for cocaine. These results suggest that Cdk5 acts as a negative regulator of neuronal excitability in the NAc and that Cdk5 may govern the behavioral effects of cocaine and motivation for reinforcement.

    Title Dentate Gyrus Nmda Receptors Mediate Rapid Pattern Separation in the Hippocampal Network.
    Date July 2007
    Journal Science (new York, N.y.)
    Excerpt

    Forming distinct representations of multiple contexts, places, and episodes is a crucial function of the hippocampus. The dentate gyrus subregion has been suggested to fulfill this role. We have tested this hypothesis by generating and analyzing a mouse strain that lacks the gene encoding the essential subunit of the N-methyl-d-aspartate (NMDA) receptor NR1, specifically in dentate gyrus granule cells. The mutant mice performed normally in contextual fear conditioning, but were impaired in the ability to distinguish two similar contexts. A significant reduction in the context-specific modulation of firing rate was observed in the CA3 pyramidal cells when the mutant mice were transferred from one context to another. These results provide evidence that NMDA receptors in the granule cells of the dentate gyrus play a crucial role in the process of pattern separation.

    Title Dorsal Hippocampus Involvement in Trace Fear Conditioning with Long, but Not Short, Trace Intervals in Mice.
    Date February 2006
    Journal Behavioral Neuroscience
    Excerpt

    Placing a "trace" interval between a warning signal and an aversive shock makes consolidation of the memory for trace conditioning hippocampus dependent. To determine the trace at which memory consolidation requires the hippocampus, mice were trained with 0-s, 1-s, 3-s, or 20-s trace intervals and tested for freezing to context and tone. Posttraining dorsal hippocampus (DH) lesions decreased context conditioning regardless of trace interval. However, DH lesions attenuated only the 20-s trace tone freezing. Like eyeblink conditioning, the DH is necessary for trace fear conditioning only at long trace intervals, but the time scale for the effective interval in fear conditioning is about 40 times longer. Manipulations that alter trace fear conditioning with short trace intervals probably do not reflect altered DH function. Given this difference in time scale along with the use of posttraining DH lesions, hippocampus dependency of trace conditioning is not related to a bridging function or response timing.

    Title Dorsal Hippocampus Nmda Receptors Differentially Mediate Trace and Contextual Fear Conditioning.
    Date September 2005
    Journal Hippocampus
    Excerpt

    The dorsal hippocampus (DH) is critically involved in the acquisition and expression of trace and contextual fear conditioning. NMDA/glutamate receptor-mediated transmission is thought to be one mechanism mediating the plastic changes that support long-term memories in the DH. However, their precise involvement in acquisition and expression processes has not been defined. To examine this issue, the NMDA receptor antagonist, D,L-2-amino-5-phosphonovaleric acid (APV; 10 microg/microl; 0.5 microl), was infused into the DH prior to conditioning and/or testing, using a trace fear conditioning procedure. All rats were tested for freezing to both tone and context in separate, counterbalanced sessions. The three sessions (1 training and 2 test) were separated by approximately 24 h. Using this design, it was possible to assess the role for DH NMDA receptors in the acquisition versus expression of trace and contextual fear conditioning. APV disrupted acquisition, but not expression, of contextual fear conditioning. By contrast, APV attenuated both acquisition and expression of trace fear memories. Thus, DH NMDA receptors appear to contribute to retrieval of some, but not all, fear memories.

    Title Trace but Not Delay Fear Conditioning Requires Attention and the Anterior Cingulate Cortex.
    Date January 2004
    Journal Proceedings of the National Academy of Sciences of the United States of America
    Excerpt

    Higher cognitive functions such as attention have been difficult to model in genetically tractable organisms. In humans, attention-distracting stimuli interfere with trace but not delay conditioning, two forms of associative learning. Attention has also been correlated with activation of anterior cingulate cortex (ACC), but its functional significance is unclear. Here we show that a visual distractor interferes selectively with trace but not delay auditory fear conditioning in mice. Trace conditioning is associated with increased neuronal activity in ACC, as assayed by relative levels of c-fos expression, and is selectively impaired by lesions of this structure. The effects of the ACC lesions are unlikely to be caused by indirect impairment of the hippocampus, which is required for mnemonic aspects of trace conditioning. These data suggest that trace conditioning may be useful for studying neural substrates of attention in mice, and implicate the ACC as one such substrate.

    Title Preponderant Mitotic Activity of Nonleukemic Cells Plays an Important Role in Failures to Detect Abnormal Clone in Childhood Acute Lymphoblastic Leukemia.
    Date August 2003
    Journal Journal of Pediatric Hematology/oncology
    Excerpt

    At diagnosis, clonal chromosomal abnormalities are found in the bone marrow blasts in more than two thirds of children with acute lymphoblastic leukemia (ALL). Practically, however, failure to detect these abnormalities is frequent and usually attributed to poor marrow sampling, inadequate metaphases, and/or a preponderant mitotic activity among nonleukemic cells. The authors applied fluorescence in situ hybridization (FISH) techniques to re-examine 30 cases of karyotypically "normal" childhood ALL to explore the role of preponderant mitotic activities of nonleukemic cells in failures to detect clonal abnormalities. The FISH test were performed using TEL/AML1 fusion gene probe and the centromere probes for chromosome 8 and 10 to detect the t(12;21) translocation and/or hyperdiploidy. Half of the karyotypically "normal" ALL cases examined have been found to have abnormal clones with t(12;21) rearrangement and/or hyperdiploidy by this specially designed FISH assay. Contrary to expectation, the authors found a higher incidence (52%) of clonal abnormalities in cases where over 20 metaphases had been examined than in cases (44%) where fewer than 20 metaphases had been analyzed. These findings suggest that a preponderant mitotic activity of nonleukemic cells plays an important role in failures to detect an abnormal clone by conventional cytogenetic studies. Therefore, karyotypically "normal" childhood ALL patients should undergo FISH studies to rule out the presence of t(12;21) and/or hyperdiploid clone.

    Title Fibrolamellar Hepatocellular Carcinoma in Children and Adolescents.
    Date May 2003
    Journal Cancer
    Excerpt

    BACKGROUND: Children with hepatocellular carcinoma (HCC) were treated on a prospective, randomized trial and were then analyzed to determine whether children with the fibrolamellar (FL) histologic variant of HCC have a more favorable presentation, increased surgical resectability, greater response to therapy, and improved outcome compared with children who have typical HCC. METHODS: Forty-six patients were enrolled on Pediatric Intergroup Hepatoma Protocol INT-0098 (Pediatric Oncology Group Study 8945/Children's Cancer Group Study 8881) between August 1989 and December 1992. After undergoing initial surgery or biopsy, children with Stage I HCC (n = 8 patients), Stage III HCC (n = 25 patients), and Stage IV HCC (n = 13 patients) were assigned randomly, regardless of histology, to receive treatment either with cisplatin, vincristine, and fluorouracil (n = 20 patients) or with cisplatin and continuous-infusion doxorubicin (n = 26 patients). RESULTS: Ten of 46 patients (22%) had the fibrolamellar variant of HCC (FL-HCC). For the entire cohort, the estimated 5-year event free survival (EFS) rate (+/- standard deviation) was 17% +/- 6%. There was no difference in outcome among patients who were treated with either regimen. The 5-year EFS rate for patients with FL-HCC was no different the rate for patients with typical HCC (30% +/- 15% vs. 14% +/- 6%, respectively; P = 0.18), although the median survival was longer in patients with FL-HCC. There was no difference in the number of patients with advanced-stage disease, the incidence of surgical resectability at diagnosis, or the response to treatment between patients with FL-HCC and patients with typical HCC. CONCLUSIONS: Children with FL-HCC do not have a favorable prognosis and do not respond any differently to current therapeutic regimens than patients with typical HCC. Children with initially resectable HCC have a good prognosis irrespective of histologic subtype, whereas outcomes are poor uniformly for children with advanced-stage disease. The use of novel chemotherapeutic agents and the incorporation of other treatment modalities are indicated to improve the dismal survival of pediatric patients with all histologic variants of advanced-stage HCC.

    Title Differential Effects of Adding and Removing Components of a Context on the Generalization of Conditional Freezing.
    Date April 2003
    Journal Journal of Experimental Psychology. Animal Behavior Processes
    Excerpt

    Rats were conditioned across 2 consecutive days where a single unsignaled footshock was presented in the presence of specific contextual cues. Rats were tested with contexts that had additional stimulus components either added or subtracted. Using freezing as a measure of conditioning, removal but not addition of a cue from the training context produced significant generalization decrement. The results are discussed in relation to the R. A. Rescorla and A. R. Wagner (1972), J. M. Pearce (1994), and A. R. Wagner and S. E. Brandon (2001) accounts of generalization. Although the present data are most consistent with elemental models such as Rescorla and Wagner, a slight modification of the Wagner-Brandon replaced-elements model that can account for differences in the pattern of generalization obtained with contexts and discrete conditional stimuli is proposed.

    Title Translocation (6;14) in Childhood Acute Mixed Lineage Leukemia.
    Date March 2003
    Journal Cancer Genetics and Cytogenetics
    Title Post-training Excitotoxic Lesions of the Dorsal Hippocampus Attenuate Forward Trace, Backward Trace, and Delay Fear Conditioning in a Temporally Specific Manner.
    Date March 2003
    Journal Hippocampus
    Excerpt

    The present study sought to determine whether post-training excitotoxic lesions of the dorsal hippocampus would disrupt retention of fear conditioned using a trace procedure. Rats were trained using one of six procedures. Forward trace conditioning consisted of 10 trials in which a 16-s tone conditional stimulus (CS) was followed by a 28-s stimulus-free trace interval and then a mild footshock unconditional stimulus (US). We used two forms of delay conditioning where the tone and footshock co-terminated. Short delay used a 16-s tone and long delay used a 46-s tone. Backward trace conditioning was the same as forward trace, except that the order of the CS and US was reversed. CS-only and US-only were similar to forward trace except that the footshock or tone, respectively, was eliminated. One day later, animals received either an N-methyl-D-aspartate (NMDA)-induced lesion of the dorsal hippocampus or sham surgery. One week later, the rats were tested for freezing to the tone in a novel context. The next day, they were tested for freezing to the original training context. Hippocampal lesioned trace conditioned rats showed significantly less freezing during the tone compared with their sham lesioned controls. The lesion did not affect freezing during the tone in delay conditioning, nor in the other training conditions. During the 1-min period after tone offset, there was a trend in all hippocampal lesioned animals toward a deficit in freezing, compared with their corresponding sham lesioned controls, although only short delay, forward and backward trace groups showed a significant deficit. Hippocampal lesions also attenuated contextual conditioning. Thus, the hippocampus is critical for the consolidation and/or expression of a trace fear conditioned stimulus.

    Title Hepatocellular Carcinoma in Children and Adolescents: Results from the Pediatric Oncology Group and the Children's Cancer Group Intergroup Study.
    Date July 2002
    Journal Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
    Excerpt

    PURPOSE: To determine surgical resectability, event-free survival (EFS), and toxicity in children with hepatocellular carcinoma (HCC) randomized to treatment with either cisplatin (CDDP), vincristine, and fluorouracil (regimen A) or CDDP and continuous-infusion doxorubicin (regimen B). PATIENTS AND METHODS: Forty-six patients were enrolled onto Pediatric Intergroup Hepatoma Protocol INT-0098 (Pediatric Oncology Group (POG) 8945/Children's Cancer Group (CCG) 8881). After initial surgery or biopsy, children with stage I (n = 8), stage III (n = 25), and stage IV (n = 13) HCC were randomly assigned to receive regimen A (n = 20) or regimen B (n = 26). RESULTS: For the entire cohort, the 5-year EFS estimate was 19% (SD = 6%). Patients with stage I, III, and IV had 5-year EFS estimates of 88% (SD = 12%), 8% (SD = 5%), and 0%, respectively. Five-year EFS estimates were 20% (SD = 9%) and 19% (SD = 8%) for patients on regimens A and B, respectively (P =.78), with a relative risk of 1.2 (95% confidence interval, 0.60 to 2.3) for regimen B when compared with regimen A. Outcome was similar for either regimen within disease stages. Events occurred before postinduction surgery I in 18 (47%) of 38 patients with stage III or IV disease, and tumor resection was possible in two (10%) of the remaining 20 children with advanced-stage disease after chemotherapy. CONCLUSION: Children with initially resectable HCC have a good prognosis and may benefit from the use of adjuvant chemotherapy. Outcome was uniformly poor for children with advanced-stage disease treated with either regimen. New therapeutic strategies are needed for the treatment of advanced-stage pediatric HCC.

    Title Butyrate Upregulates Stromelysin-1 Production by Intestinal Mesenchymal Cells.
    Date November 2000
    Journal American Journal of Physiology. Gastrointestinal and Liver Physiology
    Excerpt

    Nutritional factors and resident bacteria participate in the pathogenesis of intestinal inflammation. However, the ways in which bacteria and complex diets might modulate matrix metalloproteinase (MMP) production are unknown. We hypothesized that butyrate might enhance production of MMPs, thus amplifying their response to signals in inflammatory conditions. Human mesenchymal cells were incubated with butyrate and then stimulated with cytokines. MMPs and inhibitors were studied by Western blotting and quantitative RT-PCR. Acetylation of histones was examined in Triton X acetic acid-urea gels by PAGE. We showed that butyrate selectively enhanced the protein production and mRNA expression of stromelysin-1 in tumor necrosis factor-alpha- or interleukin-1beta-stimulated mesenchymal cells. Butyrate alone did not induce any change in MMP production or mRNA expression. It increased the acetylation of histones in mesenchymal cells. Furthermore, acetylation of histones (induced by trichostatin A) reproduced the effects of butyrate. Although butyrate is a major source of nutrient for the colonic epithelial cells, it modulates intestinal inflammation through the secretion of stromelysin-1 in stimulated stromal cells via the inhibition of histone deacetylase.

    Title Randomized Comparison of Cisplatin/vincristine/fluorouracil and Cisplatin/continuous Infusion Doxorubicin for Treatment of Pediatric Hepatoblastoma: A Report from the Children's Cancer Group and the Pediatric Oncology Group.
    Date July 2000
    Journal Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
    Excerpt

    PURPOSE: Previous studies demonstrated that chemotherapy with either cisplatin, vincristine, and fluorouracil (regimen A) or cisplatin and continuous infusion doxorubicin (regimen B) improved survival in children with hepatoblastoma. The current trial is a randomized comparison of these two regimens. PATIENTS AND METHODS: Patients (N = 182) were enrolled onto study between August 1989 and December 1992. After initial surgery, patients with stage I-unfavorable histology (UH; n = 43), stage II (n = 7), stage III (n = 83), and stage IV (n = 40) hepatoblastoma were randomized to receive regimen A (n = 92) or regimen B (n = 81). Patients with stage I-favorable histology (FH; n = 9) were treated with four cycles of doxorubicin alone. RESULTS: There were no events among patients with stage I-FH disease. Five-year event-free survival (EFS) estimates were 57% (SD = 5%) and 69% (SD = 5%) for patients on regimens A and B, respectively (P =.09) with a relative risk of 1.54 (95% confidence interval, 0.93 to 2.5) for regimen A versus B. Toxicities were more frequent on regimen B. Patients with stage I-UH, stage II, stage III, or stage IV disease had 5-year EFS estimates of 91% (SD = 4%), 100%, 64% (SD = 5%), and 25% (SD = 7%), respectively. Outcome was similar for either regimen within disease stages. At postinduction surgery I, patients with stage III or IV disease who were found to be tumor-free had no events; those who had complete resections achieved a 5-year EFS of 83% (SD = 6%); other patients with stage III or IV disease had worse outcome. CONCLUSION: Treatment outcome was not significantly different between regimen A and regimen B. Excellent outcome was achieved for patients with stage I-UH and stage II hepatoblastoma and for subsets of patients with stage III disease. New treatment strategies are needed for the majority of patients with advanced-stage hepatoblastoma.

    Title Butyrate Switches the Pattern of Chemokine Secretion by Intestinal Epithelial Cells Through Histone Acetylation.
    Date January 2000
    Journal Molecular Medicine (cambridge, Mass.)
    Excerpt

    BACKGROUND: Butyrate, a fermentation product of intestinal bacteria, modifies chromatin structure through histone acetylation, thereby altering gene transcription. IL-8 and MCP-1 are chemokines, expressed by intestinal epithelial cells, which attract neutrophils and monocytes, respectively. We hypothesized that butyrate may alter IL-8 and MCP-1 expression by intestinal epithelial cells through histone acetylation. MATERIALS AND METHODS: IL-8 and MCP-1 expression was measured by ELISA and RNA transfer blots. Acetylated histones were separated on acetic acid-urea-triton gels. Butyrate was compared to Trichostatin-A, a specific inhibitor of histone deacetylase and to other short chain fatty acids. RESULTS: Caco-2 cells constitutively secreted MCP-1 but not IL-8. Butyrate reversibly decreased MCP-1 secretion. In contrast, butyrate increased IL-8 production. The effects of butyrate and Trichostatin-A were greater when cells were stimulated with IL-1beta. Butyrate and Trichostatin-A both increased histone acetylation. Trichostatin-A and other short chain fatty acids altered chemokine secretion according to their effect on histone acetylation. CONCLUSIONS: Butyrate reversibly switches chemokine secretion by epithelial cells through histone acetylation. We speculate that butyrate carries information from resident bacteria to epithelial cells. Epithelial cells transduce this signal through histone acetylation, modulating the secretion of chemokines.

    Title Arsenic Trioxide in the Treatment of a Patient with Multiply Recurrent, Atra-resistant Promyelocytic Leukemia: a Case Report.
    Date December 1998
    Journal Journal of Pediatric Hematology/oncology
    Excerpt

    PURPOSE: Little experience exists with the use of arsenic trioxide in the treatment of recurrent, all-trans retinoic acid (ATRA)-resistant, acute promyelocytic leukemia (APL). The authors report a patient with multiply recurrent APL treated with arsenic trioxide (As2O3), which was administered as recommended in the protocol from the People' s Republic of China. The results of this treatment and its toxicity are discussed. The available literature on arsenic therapy is reviewed. PATIENTS AND METHODS: The patient was a 15-year-old African-American girl with APL that had resisted conventional chemotherapy, ATRA therapy followed by autologous peripheral stem cell transplant, and a second course of ATRA induction therapy administered for relapse after transplant. The patient was treated with 10 mg As2O3 intravenously for 28 days. After a 4-week break, she received a second 28-day course of As2O3 therapy. RESULTS: After completion of the first 28-day course of As2O3 treatment, morphologic and cytogenetic remission occurred. Reverse-transcription polymerase chain reaction demonstrated persistence of the PML-RARalpha fusion transcript. After the second course of As2O3, the patient had a complete remission by morphologic, cytogenetic, and molecular criteria. Approximately 6 months after the end of two courses of As2O3 therapy, the patient again underwent relapse. An additional course of As2O3 achieved a morphologic, although not a cytogenetic or molecular, remission. CONCLUSIONS: As2O3 therapy produced remission in a patient with multiply relapsed, ATRA-resistant APL. Toxic side effects were minimal. The patient underwent relapse 6 months after this therapy. Further investigation will be necessary to determine the proper role of As2O3 therapy in patients with APL.

    Title Butyrate Enhances Interleukin (il)-8 Secretion by Intestinal Epithelial Cells in Response to Il-1beta and Lipopolysaccharide.
    Date February 1998
    Journal Pediatric Research
    Excerpt

    Intestinal epithelial (Caco-2) cells secrete the chemokine, IL-8, after stimulation with IL-1beta, but not after lipopolysaccharide. Butyrate is a short chain fatty acid derived from the metabolism of intestinal contents by gut bacteria. Butyrate concentrations reflect, therefore, the bacterial microenvironment established within the intestine. We hypothesized that butyrate may alter the secretion of IL-8 by intestinal epithelial cells in response to stimulation by IL-1beta or lipopolysaccharide. Caco-2 cells were incubated in varying concentrations of sodium butyrate (0-20 mM) for 24 h before stimulation with lipopolysaccharide or IL-1beta. IL-8 secretion was measured over 24 h by ELISA. IL-8 mRNA accumulation was detected by Northern blots. Lipopolysaccharide induced the secretion of IL-8 only after Caco-2 cells cells had been cultured with sodium butyrate. Furthermore, butyrate significantly enhanced IL-8 secretion by cells stimulated with IL-1beta. Butyrate also increased IL-8 mRNA accumulation in stimulated Caco-2 cells. Intestinal epithelial cells can, therefore, be primed by butyrate to become activated by lipopolysaccharide and proinflammatory cytokines. This may represent a mechanism by which intestinal epithelial cells can regulate intestinal inflammation in response to changes in the intestinal milieu.

    Title Timing and Magnitude of Decline in Alpha-fetoprotein Levels in Treated Children with Unresectable or Metastatic Hepatoblastoma Are Predictors of Outcome: a Report from the Children's Cancer Group.
    Date March 1997
    Journal Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
    Excerpt

    PURPOSE: We analyzed data on 31 children with primary unresectable or metastatic hepatoblastoma (HB) to investigate possible prognostic correlations between the serum level of alpha-fetoprotein (AFP), its changes during treatment, and outcome. PATIENTS AND METHODS: Patients were treated according to the Children's Cancer Group (CCG) protocol 823F, which included an initial surgery before eight courses of chemotherapy that consisted of cisplatin immediately followed by a continuous infusion of doxorubicin. Four courses were given before and four after the second surgery. AFP levels were measured before treatment, before and after second surgery, and at the end of treatment. RESULTS: Twenty-four of 31 patients showed a decline of > or = 1 log in AFP levels before second surgery (early responders). By the end of treatment, there were 16 patients, all early responders, without clinical or radiographic evidence of tumor and with normal AFP levels. Fifteen of those 16 had a decline of > or = 2 logs in AFP before second surgery (large early response). Of the 15 patients who failed to respond to treatment, 10 died, among whom only one patient had a large early response. A large early response was the strongest independent predictor of outcome in a univariate and multivariate Cox regression model, and patients with such a response had the best survival (P < .0001). CONCLUSION: For children with unresectable or metastatic HB, early changes in AFP levels are a reliable predictor of outcome and can be used for identification of poor responders to treatment, ie, patients whose AFP level fails to decrease 2 logs before second surgery should be considered for alternative treatment.

    Title Leech Therapy in Digital Replantation.
    Date January 1996
    Journal Aorn Journal
    Excerpt

    This article presents a protocol for the perioperative care of patients undergoing digital replantation, which is the most common microsurgical procedure performed today. Venous congestion, a common complication of digital replantation, often has been treated through surgical exploration and creation of arteriovenous anastomosis. Leech therapy, however, is experiencing a resurgence among surgeons as an alternative method for treating venous congestion. This article discusses the anatomical, physiological, and clinical indications and methods of leech therapy in digital replantation.

    Title Pancytopenia in Allogeneic Marrow Transplant Recipients: Role of Cytomegalovirus.
    Date December 1994
    Journal British Journal of Haematology
    Excerpt

    We describe the clinical course of three cytomegalovirus-antibody-positive allogeneic marrow graft recipients who developed progressive pancytopenia during the third month post-transplant. Bone marrow biopsy cores were hypocellular without evidence of disease recurrence. Haemopoietic progenitor assays demonstrated a decrease of all assayable progenitors. Cytomegalovirus was identified from the blood and urine of all three patients. However, none of the patients developed other manifestations of cytomegalovirus infection such as pneumonitis, hepatitis and enteritis. The therapeutic use of ganciclovir and intravenous immunoglobulins resulted in prompt resolution of both viraemia and viruria in all three patients, and of pancytopenia in two patients.

    Title Folate Deficiency and Acute Intermittent Porphyria in a 12-year-old Boy.
    Date August 1993
    Journal Neurology
    Title The Cell-mediated Response to Schistosomal Antigens at the Clonal Level. Iii. Identification of Soluble Egg Antigens Recognized by Cloned Specific Granulomagenic Murine Cd4+ Th1-type Lymphocytes.
    Date March 1993
    Journal Journal of Immunology (baltimore, Md. : 1950)
    Excerpt

    Granulomatous inflammation in schistosomiasis is a consequence of T cell-mediated hypersensitivity to parasite egg Ag. In the present study we used three consecutive independent chromatographic procedures to fractionate and identify the soluble egg Ag recognized by schistosome-specific, cloned, murine, CD4+ Th1-type lymphocytes, which had been shown previously to be capable of mediating granuloma formation in vivo when adoptively transferred to normal syngeneic hosts challenged with an i.v. injection of eggs. The stimulatory activity resided in two acidic egg molecules, with apparent molecular masses of 64 to 68 kDa and 38 to 42 kDa, each of which ran as a single band on SDS-PAGE after purification. Fast performance liquid chromatography and SDS-PAGE performed under reducing conditions suggested that the two molecules are related and that the 38- to 42-kDa molecule is a subunit of the 64- to 68-kDa molecule. Polyclonal lymphoid cells from schistosome-infected mice were similarly stimulated by the purified 64- to 68-kDa and 38- to 42-kDa molecules, implying that these are sensitizing Ag in the natural disease.

    Title Capnocytophaga Bacteremia in a Patient with Hodgkin's Disease Following Bone Marrow Transplantation: Case Report and Review.
    Date July 1992
    Journal Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
    Excerpt

    Capnocytophaga is a gram-negative, capnophilic, facultatively anaerobic bacillus that normally inhabits the oral cavity. We report the case of a patient who developed capnocytophaga bacteremia following autologous bone marrow transplantation for Hodgkin's disease, and we review other reported cases of capnocytophaga bacteremia in immunocompromised patients. In our case infection followed pretransplantation conditioning and was associated with severe oral mucositis and neutropenia. Antibiotic therapy resulted in clinical resolution of infection. Capnocytophaga bacteremia should be included in the differential diagnosis of febrile neutropenia in immunocompromised patients (e.g., those undergoing bone marrow transplantation) especially in the presence of mucositis and gingival bleeding.

    Title Effective Treatment of Unresectable or Metastatic Hepatoblastoma with Cisplatin and Continuous Infusion Doxorubicin Chemotherapy: a Report from the Childrens Cancer Study Group.
    Date January 1992
    Journal Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
    Excerpt

    The Childrens Cancer Study Group (CCSG) undertook a study (CCG-823F) to test the feasibility of administering continuous infusion doxorubicin (CI DOX) and cisplatin (CDDP) in patients with unresectable or incompletely resected hepatoblastoma (HB) or hepatocellular carcinoma (HCC). Chemotherapy consisted of CI DOX 20 mg/m2/d for days 1 to 4 and CDDP 100 mg/m2 on day 1 followed by a 21-day rest period. Second-look surgery was performed after the administration of four chemotherapy courses. Forty-seven (47) assessable patients were entered on study, 33 with HB and 14 with HCC; of these, 34 (26 HB and eight HCC) completed the initial four courses of chemotherapy. Of the 26 HB patients, 25 were evaluated as responding to chemotherapy before the scheduled second-look procedure and were considered surgically resectable at that time. Surgery was performed on 22 patients; three patients refused the second-look surgery. Nine patients had no evidence of residual malignant disease, seven underwent surgical resection of remaining tumor, four were left with microscopic residual disease, one had a partial resection with gross tumor left behind, and one remained unresectable. Nine HCC patients completed four chemotherapy courses. Eight patients achieved a partial remission and second-look surgery was attempted on seven. Only two had all malignant disease removed at the second procedure. Data from 225 courses of chemotherapy were evaluated for toxicity. Neutropenia (absolute granulocyte count less than 500/mL) was observed in 68 courses, and five of these episodes were associated with sepsis. Severe mucositis was documented in 21 courses, and hypomagnesemia (magnesium less than 1.2 mg) was noted in 30 patients. Two patients developed decreased left ventricular shortening fraction, which resolved when chemotherapy was discontinued. In summary, CI DOX plus CDDP is a well-tolerated and effective regimen in inducing surgical resectability in HB patients who are unresectable at diagnosis and significantly improves survival for this group of patients to 66.6%.

    Title Septicemia in Pediatric Oncology Patients: the Significance of Viridans Streptococcal Infections.
    Date April 1990
    Journal Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
    Excerpt

    One hundred nine consecutive episodes of septicemia were retrospectively evaluated in 61 children with malignancy. In addition, the records of all pediatric oncology patients who received high-dose cytarabine (HDAC) chemotherapy were reviewed. Gram-positive organisms accounted for 82.6% of the septicemic episodes. In the total group, coagulase-negative staphylococci and viridans streptococci accounted for 35.8% and 28.4% of the episodes, respectively. In granulocytopenic patients, viridans streptococci were the most common pathogens (36.8%). In the subset of patients who received HDAC, 62.5% of the septicemic episodes were caused by viridans streptococci. Pulmonary complications developed in nine (29%) of the total cases of viridans streptococcal sepsis, whereas these complications occurred in only eight (10.3%) of the septic episodes caused by other organisms. In patients who had viridans septicemia, prior treatment with HDAC did not increase the incidence of pulmonary complications. In septic children with malignancy, our results demonstrate a high incidence of gram-positive organisms, including viridans streptococci, which were once regarded as culture contaminants.

    Title Severe Hyponatremia After Repeated Intravenous Administration of Desmopressin.
    Date December 1989
    Journal American Journal of Hematology
    Excerpt

    Desmopressin (DDAVP) has recently been found to improve hemostasis in patients with congenital or acquired disorders of coagulation and to reduce operative blood loss in patients with normal hemostasis undergoing certain surgical procedures. Despite its potent antidiuretic effect, severe hyponatremia after the intravenous administration of DDAVP is felt to be rare. We report four cases of severe hyponatremia with serious clinical sequelae occurring in patients with underlying coagulopathies who were treated prophylactically with DDAVP to improve hemostasis prior to surgical procedures. Each patient received multiple (3-22) doses of DDAVP and was given intravenous hydration with hypotonic solutions before developing clinical signs and laboratory evidence of hyponatremia. We believe that the risk of significant hyponatremia after treatment with intravenous DDAVP may be higher than is generally appreciated and that patients undergoing surgical procedures, who often receive multiple doses of DDAVP and intravenous hydration, are at particular risk for this complication. Hypotonic intravenous solutions should be avoided and serum sodium levels should be monitored frequently in those patients receiving multiple doses of DDAVP.

    Title Schistosoma Mansoni: the Host Immune Response to Egg Antigens. I. Partial Characterization of Cellular and Humoral Responses to Pi Fractions of Soluble Egg Antigens.
    Date April 1989
    Journal Journal of Immunology (baltimore, Md. : 1950)
    Excerpt

    Soluble egg Ag (SEA) were separated according to charge by agarose-IEF (A-IEF) in order to partially characterize those antigenic determinants that may elicit the granulomatous response in schistosomiasis mansoni. Coomassie blue-stained A-IEF gels of SEA showed that this technique was able to resolve multiple isobands. A-IEF gels were sliced into 18 or 36 fractions from anode to cathode, and the SEA components from the isoelectric point (pI) fractions were eluted from gels in a manner that allowed for their direct utilization in both cellular and in humoral immunoassays. Only Ag in two distinct pI ranges consistently elicited lymphoproliferative responses, with the major stimulatory fractions being in the acid (3.5 to 5.0) range. Lymphocytes from mice infected for 10 wk had higher proliferative responses to both SEA and fractionated Ag in this acid pI range when compared to lymphocytes from mice infected for 25 wk; however, the latter had an enhanced response to Ag with a pI range of 6.2 to 6.4. In contrast to the cellular responses, the corresponding sera from these mice, or from schistosome-infected patients, recognized Ag in all pI fractions as determined by ELISA. However, although protective and nonprotective mAb (which recognize an egg Ag that cross-reacts with a 38-kDa schistosomular Ag) bound to most acidic fractions, only the nonprotective mAb (which also recognize determinants on keyhole limpet hemocyanin), bound, in addition, to fractions in the basic range. Finally, the m.w. of Ag in the various pI fractions were determined by SDS-PAGE analysis.

    Title Antibody Response to Immunization with Haemophilus Influenzae Type B Polysaccharide Vaccine in Children with Cancer.
    Date December 1987
    Journal The Journal of Pediatrics
    Title Evidence That a Protective Membrane Epitope is Involved in Early but Not Late Phase Immunity in Schistosoma Mansoni.
    Date March 1987
    Journal Journal of Immunology (baltimore, Md. : 1950)
    Excerpt

    An anti-egg monoclonal antibody E.1, which is partially protective in passive transfer experiments, is shown in this study to recognize a membrane epitope on cercariae, schistosomula, and the ciliary plates of miracidia. E.1 did not bind to the surface membranes of lung or adult worms, or recognize secreted egg antigen in infected liver tissue. The E.1 epitope was present in the glycocalyx of cercariae, as well as on the syncytial membrane as determined by electron microscopy. Immunoprecipitation of iodinated surfaces of cercariae and schistosomula demonstrated E.1 binding to a high m.w. moiety in cercariae, which corresponds to the glycocalyx because it was not immunoprecipitated from schistosomula. In addition, a band at 38,000 daltons was immunoprecipitated from both cercariae and schistosomula. When compared with in vitro cultured parasites, schistosomula that were obtained from mice 1 to 24 hr after tail vein injection showed significant loss of E.1 binding. Consistent with the rapid loss of antigen in vivo, E.1 antibody was unable to passively transfer protection to naive mice when administered 5 days after cercarial challenge.

    Title Adriamycin and Cisplatin for Hepatoblastoma.
    Date October 1985
    Journal Cancer
    Excerpt

    Four consecutive infants and children with hepatoblastomas were treated with a combination of Adriamycin (doxorubicin) and cisplatin. Three patients had unresectable tumors and in each there was a dramatic decrease in tumor size and serum alpha-fetoprotein (AFP) levels. The tumors of two of these patients, including one with pulmonary metastases which cleared, were rendered resectable. The third patient's tumor remained unresectable but his AFP level returned to normal following radiotherapy. All three patients are disease-free, and both without metastases are off therapy from 9 to 24 months. A fourth child received the combination as adjuvant therapy following resection of an embryonal hepatoblastoma and he remains disease-free 7 months after its discontinuation. Therapy was tolerable in all patients and its principal toxicities were myelosuppression and magnesium wasting. Adriamycin and cisplatin in combination were very effective in these patients and deserve further trials, especially in unresectable and metastatic hepatoblastomas.

    Title Video Microscopy of Swimming and Secreting Cercariae of Schistosoma Mansoni.
    Date April 1985
    Journal The Journal of Parasitology
    Title Hatching, Chemokinesis, and Transformation of Miracidia of Schistosoma Mansoni.
    Date December 1984
    Journal The Journal of Parasitology
    Excerpt

    Hatching, chemokinesis, and transformation of miracidia of Schistosoma mansoni were examined with a light microscope equipped with a video recording system. Saline, linearly and reversibly, inhibited miracidial hatching and swimming. Both hatching and swimming were inhibited at 4 C and 12 C and accelerated at 34 C relative to rates at 22 C. Hatching was an explosive event that began with ciliary beating when the egg was placed in artificial pond water (APW) and culminated in the parasite's escape from the shell in 100 to 300 msec. Broken egg shells had sharp, complementary edges. Neither miracidia nor eggs swelled prior to hatching. Accumulation of miracidia in a spot of snail conditioned water (SCW) occurred rapidly due to a 60-75% decrease in the exit rate from the spot, rather than by an increase in the entry rate. The turning rate in SCW increased tenfold and the time spent in the spot was 6 times that of controls. Eserine sulfate inhibited miracidial turning and accumulation in SCW. Parasites accumulated in a spot of serotonin by increasing their rate of turning. Miracidia transformed to sporocysts in either complex media containing serum, RPMI-1640, Hanks' salts or phosphate buffered saline, but not in amino acids or vitamins. Transformation was inhibited when miracidia were incubated with serotonin or when miracidia had not been exposed previously to APW.

    Title The Effect of Chemotherapy on Hepatoblastoma.
    Date April 1984
    Journal Archives of Pathology & Laboratory Medicine
    Excerpt

    A 15-month-old girl had a case of mixed hepatoblastoma. The unresectable tumor became surgically resectable after treatment with doxorubicin hydrochloride and cisplatin, which was also continued postoperatively. This regimen had a remarkable necrotizing effect on the fetal epithelial component of the hepatoblastoma. The patient's high alpha-fetoprotein level and extreme thrombocytosis, which resolved with treatment, were used as indicators of the disease's activity. An unaffected mesenchymal component and a few microscopic foci of undisturbed embryonal hepatoblastoma were found. The finding of a mature intestinal epithelial island in this case is unique.

    Title Acute Pancreatitis in Association with Cytosine Arabinoside Therapy.
    Date May 1982
    Journal Cancer
    Excerpt

    This paper reports the association of acute pancreatitis coincident with cytosine arabinoside (Ara-c) therapy in a single patient on at least two occasions. The patient had previously received L-asparaginase, but the last dose had been given 4 months prior to the onset of pancreatitis. A literature review provided two more cases of pancreatitis associated with Ara-c therapy in patients previously treated with L-asparaginase. In view of th extreme rarity of pancreatitis in patients receiving Ara-c, the possibility arises that prior treatment with L-asparaginase may predispose the pancreas to this complication.

    Title Serum Lactic Dehydrogenase, an Indicator of Tumor Activity in Neuroblastoma.
    Date August 1980
    Journal The Journal of Pediatrics
    Title The Multiple Hematologic Manifestations of Neuroblastoma.
    Date June 1980
    Journal The American Journal of Pediatric Hematology/oncology
    Excerpt

    The hematologic manifestations of neuroblastoma are numerous and varied. Bone marrow invasion by tumor cells may cause leukoerythroblastic changes or depression of one or more of the cell lines in the peripheral blood; occasionally bone marrow involvement may be so extensive that tumor cells may be released into the peripheral blood and lead to an erroneous diagnosis of leukemia. Anemia in neuroblastoma patients may result not only from bone marrow involvement, but also from bleeding into a tumor mass or from the hemolysis accompanying a consumption coagulopathy. A specific morphologic abnormality, the cogwheel erythrocyte, has been reported in patients with neuroblastoma. Neuroblastoma may also be associated with elevation of the platelet count or a hypercoagulable state. Recognition of these protean hematologic manifestations may facilitate diagnosis in children with atypical presentations of this highly malignant tumor.

    Title Childhood Leukemia and Lymphoma: Correlation of Clinical Features with Immunological and Morphological Studies.
    Date March 1980
    Journal Medical and Pediatric Oncology
    Excerpt

    Malignant cells from 49 children with lymphoid neoplasms other than Hodgkin disease were evaluated by surface marker and morphologic studies. We classified the patients into three groups: 36 patients (74%) with acute lymphocytic leukemia; 7 (14%) classified as convoluted lymphocytic lymphoma/leukemia; and 6 (12%) with small noncleaved follicular center cell lymphoma/leukemia. Diffuse marrow involvement was present at diagnosis in some patients in the latter two groups, but their clinical course was not characteristic of the patients with acute lymphocytic leukemia. Male predominance, poor prognosis, and high incidence of central nervous system disease characterized patients in the convoluted lymphocytic and follicular center cell lymphoma/leukemia groups. Clinical presentation in these two groups differed. Proliferations of convoluted lymphocytes were associated with mediastinal masses and proliferations of follicular center cells with intraabdominal tumors. The high incidence of CNS disease in children with neoplasms of convoluted lymphocytes and follicular center cells suggests that these processes have a predilection for the CNS and that patients with them may benefit from CNS prophylaxis.

    Title Childhood Lymphoma-leukemia. I. Correlation of Morphology and Immunological Studies.
    Date September 1978
    Journal Cancer
    Title Theory of the Lateral Surface Magnetoplasmon in a Semiconductor Superlattice.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Screened Coulombic Impurity Bound States in Semi-infinite Multiple-quantum-well Systems.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Plasmons in Semiconducting Superlattices with a Complex Unit Cell.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Plasmon Bands in Periodic Conducting Heterostructures.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Excitons in Semimagnetic Semiconductor Quantum-well Systems: Magnetic Polaron Effects.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Optical Properties of Polytype Semiconductor Superlattices: Bulk and Surface Plasmons, Raman and Electron-energy-loss Spectra, and Finite-size Effects.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Inelastic Light Scattering by Collective Charge-density Excitations in Gaas-ga1-xalxas Superlattices.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Magnetoplasma Modes of Semiconductor Superlattices with Integral Landau-level Filling.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Surface Collective Charge-density Excitations of a Semiconductor Superlattice.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Critical Plasmons of a Fibonacci Semiconductor Superlattice: Spectrum and Optical Properties.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Plasma Modes of a Two-dimensional Electron Gas with a Two-dimensional Modulation of the Charge Density.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Theory of Surface Magnetoplasmon Polaritons in Truncated Superlattices.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Many-body Effects in a Layered Electron Gas.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Surface Magnetoplasmon Polaritons in Truncated Semiconductor Superlattices.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Collective Excitations of a Multiple-quantum-well System with Barrier of Finite Height.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Quasiparticle Lifetime of Excited Carriers in a Semiconductor Superlattice.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Multipole Edge Plasmons of Two-dimensional Electron-gas Systems.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Edge Magnetoplasmons of Two-dimensional Electron-gas Systems.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Anyonic Ions, Energy Bands, and Photoluminescence of Fractional Quantum Hall Systems.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Energy Spectra of Anyonic Ions and Anyonic Excitons in Fractional Quantum Hall Systems.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Composite-fermion Excitations and the Electronic Spectra of Fractional Quantum Hall Systems.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Charge and Spin Response of the Spin-polarized Electron Gas.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Composite Fermions on a Haldane Sphere: Quasielectron-quasihole Symmetry.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Exact Analytic Dispersion Relations for Dipolar Magnetostatic and Magnetoretarded Modes in Finite Magnetic Superlattices.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Tunneling in a Periodic Array of Semimagnetic Quantum Dots.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Correlated Charge-density-wave States of Double-quantum-well Systems in a Strong Magnetic Field.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Hydrogenic Impurity States in Quasi-two-dimensional Electron-gas Systems.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Magnetoexcitons in a Gasb-alsb-inas Quantum-well Structure.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Transition Energies of D- Levels in Quantum-well Structures.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Collapse of Fractional Quantum Hall States in Double-quantum-well Systems.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Collective Excitations of an Electron Wigner Lattice in Double-quantum-well Systems.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Critical Plasmons of a Quasiperiodic Semiconductor Superlattice.
    Date
    Journal Physical Review Letters
    Title Excitonic Charge-density-wave Instability of Spatially Separated Electron-hole Layers in Strong Magnetic Fields.
    Date
    Journal Physical Review Letters
    Title Numerical Study of Fractional Quantum Hall Electron-hole Systems: Evidence of Stable Anyonic Ions.
    Date
    Journal Physical Review Letters
    Title "fermi Liquid" Shell Model Approach to Composite Fermion Excitation Spectra in Fractional Quantum Hall States.
    Date
    Journal Physical Review Letters

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