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Biomedical subjects

A B Abt

Publications and source records attributed to A B Abt.

At least 19 recordsLinked to original sources

Familial lobular glomerulopathy.

A family with an unusual lobular glomerulopathy is described. Renal tissue from three males and one female in two successive generations was available for review. The glomerulopathy was characterized by a marked lobular accentuation with only a modest increase in mesangial cellularity. Immunofluorescence in two patients showed focal or diffuse staining with immunoglobulins G, A, M, and C3 in the mesangium and along the glomerular capillary basement membranes. Ultrastructural study showed amorphous granular subendothelial material distending capillary loops and mesangial regions. This material accounted for the pronounced lobular accentuation. The patients in this family presented with proteinuria, hematuria, and hypertension. Three of the four patients have sustained cerebral vascular accidents and two have died. This family is compared with a previously reported family that showed similar glomerular pathology.

Adolescent

Results of aortic anastomoses made under tension using polydioxanone suture.

After early repair of congenital cardiovascular defects, such as coarctation of the aorta, late stenosis may become a problem. Use of absorbable sutures has been shown to be superior to use of nonabsorbable sutures in allowing growth of an anastomotic site along with the individual. Some concern has been raised, however, about the potential for aneurysm formation at the site of anastomosis when absorbable sutures are used. This study was undertaken to observe the effects of longitudinal tension on anastomoses made with absorbable polydioxanone suture in growing animals. Six piglets (aged 3 to 4 weeks) underwent a 1-cm resection of the infrarenal aorta and reanastomosis with polydioxanone suture. One animal died prematurely of respiratory illness. The 5 remaining animals were killed after 6 months. The excised aortas demonstrated no stenosis, no dilatation, and no burst-test failure to 250 mm Hg. Histological examination showed disrupted elastic laminae without thinning of aortic wall in all samples of aorta. We conclude that polydioxanone suture is a suitable suture material for vascular anastomoses made under tension where growth of the anastomotic site is expected.

Anastomosis, Surgical

An improved method for mounting frozen-section specimens.

We describe an efficient method for embedding frozen-section specimens. Transparent tape is used to produce a well on the surface of the tissue holder ("chuck"). This well contains a quantity of nonmotile mounting media in which a tissue specimen can be easily oriented. After freezing, the tape is removed, leaving a relatively smooth surface.

Specimen Handling

Lectin histochemistry of adenomatous polyps. Not a predictor of metachronous lesions.

The binding characteristics of fluorescein isothiocyanate conjugated lectins to normal colonic mucosa, and 43 adenomatous polyps were studied by fluorescence microscopy. The lectin, Dolichos biflorus agglutinin (DBA) stained intensely to upper crypt cells of the sigmoid colon and rectum but to a lesser degree to proximal colonic crypts or lower crypt cells distally. Peanut agglutinin (PNA) and Ulex europaeus agglutinin (UEA) did not bind to the theca of proximal or distal colonic crypts. The lectin Griffonia simplicafolia agglutinin (GSA1) bound intensely to upper and lower crypt cells of both regions. PNA binding was noted in 56% of adenomatous polyps, occurred more often in polyps of the distal colorectum, and increased with polyp size and villous histology. UEA bound to 26% of adenomatous polyps, 42% of proximal polyps, and 17% of distal polyps. DBA staining was noted in 72% of polyps without regional preference. GSA1 stained all polyp specimens. To determine if the lectin binding characteristics of an index (initial) polyp might serve as a predictor of metachronous lesions, 20 patients (29 polyps) without a history of polyps or cancer and who had at least one surveillance colonoscopy 1 to 3 years after the initial polypectomy were studied. The presence or absence of PNA, UEA, or DBA binding in an index polyp did not predict the occurrence of metachronous lesions. Five of the six patients with more than one index polyp had metachronous polyps at follow-up surveillance colonoscopy.

Colonic Polyps

Transitional cell carcinoma in an ileal conduit.

A 73-year-old man with a history of invasive transitional cell carcinoma of the urinary bladder developed synchronous recurrent transitional cell carcinoma at the ureteroileal anastomosis and the right renal pelvis. Hematuria was the presenting sign in six of the seven previously reported patients with ileal conduit cancer. The pathologic findings, diagnostic procedures and treatment are briefly reviewed.

Aged

Pelvic fibromatosis: case report and review of literature.

The case report of a patient with pelvic fibromatosis is described. Excision of the tumor without sacrificing organs or major vessels was performed. Although not malignant, this tumor can be life-threatening due to its locally invasive properties. A variety of therapeutic options are discussed.

Adult

Morphology of the uvula in obstructive sleep apnea.

Alterations in pharyngeal structure and function are considered fundamental in the pathogenesis of obstructive sleep apnea (OSA). However, little is known about morphologic features of the pharynx in patients with OSA. We therefore studied the tissue composition of the uvula (midsagittal section) in patients with OSA, using a quantitative, morphometric point-counting technique. Uvula tissue was obtained by uvulopalatopharyngoplasty (UPPP) in 33 patients (mean number of apneas per hour of sleep = 32.7 +/- 5.2) and by autopsy in 22 normal subjects not known to have OSA. All statistical comparisons were controlled for differences caused by age and body mass index. Patients with OSA had a significantly greater percentage of muscle in the uvula (18.1 +/- 1.9% versus 9.3 +/- 2.1%, p = 0.02) than did normal subjects. A significant difference in fat content was also found (9.5 +/- 1.4% in patients versus 4.0 +/- 1.0% in normal subjects, p less than 0.02). These differences between patients with OSA and control subjects could not be accounted for by anthropometric or sex differences. The percentage of uvula fat tissue was significantly related to the frequency of apneas and hypopneas in sleep (r = 0.43, p less than 0.01). Uvula morphology in 6 nonapneic snorers undergoing UPPP was similar to that of patients with OSA. We conclude that the uvula in patients with OSA contains more muscle and fat than the uvula in control subjects, possibly contributing to pharyngeal narrowing in OSA.

Female

Peutz-Jeghers syndrome: a clinicopathologic survey of the "Harrisburg family" with a 49-year follow-up.

Of the original Peutz-Jeghers families reported by Jeghers, the "Harrisburg Family" has now been followed for 49 yr. Their 12 affected family members comprise the largest Peutz-Jeghers kindred reported. The course of this family illustrates that Peutz-Jeghers syndrome is not a benign disease. One family member developed a duodenal carcinoma in a hamartoma with adenomatous changes; this progression in the duodenum has not previously been reported. Ten patients underwent 75 polypectomies. One patient developed short bowel syndrome. Three patients died in young adulthood. The development of gastrointestinal malignancy in 2 of 12 affected patients suggests that Peutz-Jeghers syndrome may be a premalignant condition. Consequently, even asymptomatic gastric, duodenal, and colonic polyps should be removed endoscopically. If surgical intervention is necessary, intraoperative endoscopy with polypectomy may prevent the development of a short bowel syndrome. Colonoscopic screening of patients and their family members may be beneficial and surveillance for extraintestinal malignancy appears to be warranted.

Adolescent

Drug-induced interstitial nephritis. Coexistence with glomerular disease.

Drug-induced interstitial nephritis is being recognized with increasing frequency. Pharmacologic agents responsible for inducing this entity include antibiotics, diuretics, and nonsteroidal anti-inflammatory drugs. We recently examined five patients with glomerular disease and drug-induced interstitial nephritis. In three patients prior biopsy specimens documented their glomerular disease (membranous nephropathy, crescentic glomerulonephritis, and presumptive lipoid nephrosis). A second biopsy specimen showed acute interstitial nephritis and the glomerular lesion. Two additional patients had single biopsy specimens demonstrating acute interstitial nephritis and either membranous nephropathy or crescentic glomerulonephritis. Our cases emphasize the need for recognizing this complex pattern of renal disease and the difficulties encountered in rendering a proper diagnosis.

Adult

Hepatic enzymes in Hodgkin's and non Hodgkin's lymphoma.

Serum alkaline phosphatase levels in patients with Hodgkin's and non-Hodgkin's lymphoma were studied. The findings were correlated with clinical stage, particularly hepatic involvement, and histologic findings. Serum levels of other hepatic enzymes (SGOT, 5,N and gamma GT) were also measured. The usefulness of these studies for clinical staging was described, as well as speculation on the observed differences in Hodgkin's and non-Hodgkin's patients.

Adolescent

Indomethacin and the nephrotic syndrome.

Treatment of membranous nephropathy and the nephrotic syndrome with 2 mg/kg/day of indomethacin resulted in prompt and sustained reduction in urinary protein excretion and the loss of edema fluid, which allowed the withdrawal of diuretic therapy and liberalization of salt intake. The reduction in proteinuria was paralleled by a decrease in urinary prostaglandin E (PGE) and F (PGF) levels. Plasma PGE and PGF levels did not change appreciably. Withdrawal of indomethacin therapy resulted in an increase in urinary protein and urinary PGE excretion. Reinstitution of therapy resulted in reductions in both values. Indomethacin may provide a useful means of reducing proteinuria and controlling edema in some patients with the nephrotic syndrome.

Adult

Cystic nephroma: an ultrastructural and biochemical study.

A case of a multilocular renal cyst (cystic nephroma) in an 18-month-girl is presented. The light and electron microscopy studies failed to demonstrate nephroblastomatous elements. Analysis of cystic fluid constituents showed levels resembling serum. Measurable levels of prostaglandins E and F also were found. The possible relationship of a cystic nephroma to a nephroblastoma is discussed.

Cytoplasm

Tumor sterilization following high-dose pre-operative irradiation for advanced cancer of the larynx or pyriform sinus.

Twenty-two patients with advanced laryngeal cancer and 5 with advanced pyriform sinus cancer were given 51 Gy (5,100 rad) followed by surgical resection. In 10 (45%) of patients with laryngeal cancer, no tumor was found at the primary site pathologically; 15 (68%) had negative neck specimens. All of those with pyriform sinus cancer had positive specimens. Eighteen patients with laryngeal cancer are free of disease. In contrast, only 1 with pyriform sinus cancer is free of disease; 1 has had a local recurrence and 3 have had metastases. The data suggest that 51 Gy (5,100 rad) are insufficient to sterilize pyriform sinus cancer; higher doses together with adjuvant chemotherapy are needed.

Adult

Netilmicin and tobramycin. Comparison of nephrotoxicity in dogs.

We compared the effects of netilmicin and tobramycin on renal function and histology in dogs. Separate groups, each containing 5 dogs, received control injections, or either netilmicin or tobramycin at doses of 25, 50, or 75 mg per kg of body weight per day for 14 days. Renal function decreased markedly only in the group receiving the 75-mg tobramycin dosage; the serum creatinine levels rose from 1.0 +/- 0.1 to 3.6 +/- 0.9 mg per 100 ml (P less than 0.05) and the endogenous creatinine clearance fell from 42.5 +/- 9.4 to 7.8 +/- 2.2 ml per min (P less than 0.05). Dogs in this group developed glycosuria, proteinuria, and polyuria, and three died before the end of the study, probably from neuromuscular toxicity. Peak drug levels were stable when renal function was normal, but increased when renal failure occurred. Light microscopic changes occurred in all groups receiving either drug, but were most severe in the high-dose tobramycin group. Ultrastructural changes were similar in all groups and identical to changes produced by gentamicin. These results show that, on a weight basis, netilmicin is less nephrotoxic than tobramycin in dogs.

Animals

False positive lymphography in Hodgkin's disease: a histologic-lymphadenographic correlation.

A series of 99 consecutive patients having a staging laparotomy for Hodgkin's disease was reviewed. Negative lymph nodes removed during the laparotomy were correlated with lymphograms reported as positive or suspicious. Four patients had large nodes with a prominent hilar area or irregular cortical fat deposits. In two other patients a cluster of small lymph nodes accounted for the radiologic misinterpretation.

Adult

VCN-releasable sialic acid and gangliosides in human neuroblastomas.

The ganglioside pattern and VCN-releasable sialic acid residues of six human neuroblastomas were studied. There was no correlation between VCN-releasable sialic acid and prognosis. The ganglioside patterns were more complex in those cases with an expected good prognosis as reflected by the presence of trisialoganglioside. The complexity of the ganglioside pattern did not always correlate with the histologic grade of the tumor. These results suggest the ganglioside pattern may serve as a chemical marker for predicting the prognosis in patients with neuroblastomas.

Abdominal Neoplasms