Infantile embryonal carcinoma in children.
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Castration↗
Biomedical subjects
A O Fayemi
Publications and source records attributed to A O Fayemi.
Acute radiation pneumonitis.
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Acute Disease↗
Failure of serum ferritin levels to predict bone-marrow iron content after intravenous iron-dextran therapy.
The relation between serum ferritin levels and stainable-iron deposits in the liver, spleen, and bone marrow was investigated in 36 patients with chronic renal failure who died after being on haemodialysis for 1-103 months. Elemental iron (mean, 5450 mg) had been given intravenously as iron dextran to patients in a long-term subgroup, who had been on dialysis for more than 3 months. The results of semiquantitative histochemical assessment of tissue iron in slides obtained at necropsy (scale 0 to 4+) were confirmed by chemical analyses of tissue iron. Serum ferritin levels correlated well with the degree of hepatosplenic siderosis but did not always correlate with bone-marrow iron stores in these patients. Serum ferritin concentrations were raised in 10 marrow-iron-depleted subjects (mean, 1336 ng/dl). The paradoxical association of hepatosplenic siderosis with marrow iron depletion was observed in most of the patients on dialysis for less than 40 months. The histochemical data show that the bulk of intravenously injected iron dextran is taken up by the liver and spleen; that the hepatosplenic stores fail to be mobilised to the bone marrow; and that intravenous iron-dextran therapy, by-passing the intestinal mechanism for the regulation of iron absorption, carries a high risk of long-term hepatosplenic siderosis.
Aged↗
Immunochemical CK-MB assay for myocardial infarction.
The diagnostic efficiency of an immunochemical assay for CK-MB (I-MB) was compared with that of an electrophoretic procedure for this isoenzyme (E-MB) in 215 consecutive patients in whom acute myocardial infarction (MI) was clinically suspected. All patients were investigated with a standard protocol consisting of serial assays of total creatine kinase (CK) and lactic dehydrogenase (LD) activities, CK-MB and LD1 isoenzymes, and electrocardiograms. Technetium pyrophosphate cardiac scans were obtained for eleven patients; autopsy was performed in six cases. The diagnosis of acute MI was established in 45 patients. The coefficients of variation for the intra-assay and interassay precision of I-MB assay ranged from 2.05%-7.2%. Concordance between the I-MB and E-MB results at the decision values for acute MI was observed in 203 of 215 patients (94.4%). At the cut-off point of 10 U/L, the I-MB assay was 95.5% sensitive and 95.3% specific for acute MI; the corresponding rates for the E-MB test were 93.3% and 94.7% respectively. The test efficiency rate for I-MB assay was 95.3% and that of E-MB procedure 94.4%. A complete time-based isoenzyme protocol for the diagnosis of acute myocardial infarction has several variables; the need for interpretation of individual profiles and for the preparation of a formal report is discussed.
Clinical Enzyme Tests↗
Dissociation between hepatosplenic and marrow iron in liver cirrhosis.
Histochemical study of tissue iron in the various parts of the reticuloendothelial system in 15 subjects with cirrhosis was performed. Stainable iron in the liver and spleen sections, generally in large quantities, was found in 13 of 15 cases. Paradoxical association of hepatosplenic siderosis with depletion of marrow iron reserves was observed in seven subjects. In all seven, gross gastrointestinal blood loss had occurred during life and the source of bleeding from one or more anatomic lesions was identified at the time of autopsy. Depletion of marrow iron reserves in these seven subjects can be attributed to two factors: first, the available marrow iron stores were used for erythropoiesis; second, the ample hepatosplenic iron deposits could not be mobilized for transport to the bone marrow. Thus, hepatosplenic iron in cases of cirrhosis seems to be sequestered from its normal metabolic pathways.
Adult↗
Dissociation between stainable marrow and liver iron following iron-dextran therapy.
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Adult↗
Primary signet-ring cell carcinoma of the urinary bladder: review of the literature and report of a case.
A case of primary signet-ring carcinoma of the urinary bladder treated with total cystectomy and clinically disease-free three years and nine months after surgery is described. The signet-ring cell carcinoma of the bladder is a rare neoplasm; among the five cases found in the literature, the neoplasms pursued a fulminant course, diffusely invaded the bladder wall without forming intraluminal growths, and could not be controlled by segmental resection, radiotherapy, and chemotherapy alone or in combinations. The pathogenesis of mucus-producing signet-ring cell carcinoma in the urinary bladder, an organ that normally contains no mucogenic elements, is discussed. The histologic evidence for the origin of this neoplasm from the totipotent urothelium is illustrated.
Adenocarcinoma, Mucinous↗
Immunochemical LD1 assay for myocardial infarction.
The diagnostic efficiency of an immunochemical assay for LD1 (I-LD1) was compared with an electrophoretic procedure for this isoenzyme (E-LD1) in 100 consecutive patients hospitalized for a clinical suspicion of acute myocardial infarction (MI). All patients were investigated with a standard protocol including serial determinations of total creatine kinase (CK) and lactic dehydrogenase (LD) activities, CK and LD isoenzymes, and electrocardiograms. Thirty-two patients were diagnosed to have acute MI on the bases of positive CK-MB or EKG or both. The coefficients of variation for the intraassay and interassay precision of I-LD1 assay ranged from 3.12% to 7.69%. Direct correlation between the I-LD1 and E-LD1 was very satisfactory (r = .961; P = less than .001). When the results of these two procedures were compared in terms of decision values for acute MI, there was agreement between them in 87 patients. At the cut-off point of 90 U/L, I-LD1 assay was 100% sensitive and 89% specific for acute MI; the corresponding figures for E-LD1 were 81% and 91%, respectively. The diagnostic efficiencies of the I-LD1 and E-LD1 procedures were 93% and 88%, respectively. A substantial saving in technologist time with the I-LD1 assay over the E-LD1 procedure was documented in this study.
Acute Disease↗
Hemosiderosis in hemodialysis patients. An autopsy study of 50 cases.
The distribution of stainable iron stores was investigated in various organs of 50 hemodialysis patients with chronic renal disease. Massive iron deposits were found in the liver and spleen. Among 18 patients with severe hepatosplenic siderosis, iron deposits were abundant in the adrenal glands, lymph nodes, and lungs and were sparse in the heart, kidneys, and pancreas. There was an absence or scarcity of stainable iron in bone marrow of 19 pats. In five of these marrow-iron-depleted patients, serum concentrations of ferritin were high. In long-term hemodialysis patients, a variety of factors make massive iron overloads of various organs a likely occurrence, severe hepatosplenic siderosis may occur in marrow-iron-depleted patients, and serum ferritin levels in this setting may not always accurately reflect the status of marrow iron store.
Adult↗
Intraventricular thrombosis in polycythemia vera: A cause of intractable cardiac failure.
The occurrence of thrombotic events is central to the course of polycythemia vera. Myocardial, cerebral, peripheral, and pulmonary infarctions are frequent and are consequences of throbmoses in small and medium caliber arteries. Thrombosis in large caliber arteries is a rare event. Thrombosis within the chambers of the heart has not been hitherto reported. This report documents the occurrence of massive left ventricular thrombosis in a patient with polycythemia vera. The throbmus reduced the left ventricular capacity by about 75% and caused intractable congestive heart failure.
Aged↗
Acquired renal cysts and tumors superimposed on chronic primary kidney diseases. An autopsy study of 24 patients.
Acquired cystic disease of the kidneys was found at autopsy in 24 of 80 patients with chronic renal insufficiency maintained on intermittent hemodialysis for periods ranging up to 7 years. The architecture of the kidney was significantly distorted by the cysts, some of which were multiloculated. These cysts may be regarded as exaggerated "retention" type that have progressed and become widespread as a result of prolongation of life by hemodialysis. Their pathogenesis may be related to obstructive, ischemic and/or toxic factors. Renal tumors, usually multiple, were found in 8 patients. Another patient had metastatic renal adenocarcinoma. No patient died of causes directly attributable to the renal cysts.
Adenocarcinoma↗
Assay of IgE antibodies against June and Timothy grasses by an immunoperoxidase technique.
The results of eighty assays for serum IgE antibodies against June and Timothy grass antigens with a solid-phase immunoperoxidase technique are correlated with those obtained with the RAST procedure. The allergens were insolubilized in polystyrene microtitre plates. After allowing the allergen-specific IgE antibodies in the test serum to bind the allergen, the plates were incubated with horseradish peroxidase-conjugated rabbit antihuman IgE. The enzyme bound to the plates was assayed spectrophotometrically using o-phenylene diamine as the substrate. The coefficients of variation for within-batch reproducibility ranged from 4.57 to 11.97%, and those for between-batch variance from 8.25 to 13.7%. The slope of absorbance values of the immunoperoxidase assay is shallower than that of the bound radioactivity in the RAST technique. Notwithstanding, the immunoperoxidase method allows separation of non-atopic controls from the sera containing specific IgE antibodies and categorization of positive sera into weakly, moderatley, and strongly positive results. Free of the disadvantages inherent in the use of radioactive material, this assay offers an alternative to the RAST test for the assay of allergen-specific IgE antibodies.
Allergens↗
Müllerian adenosarcoma of uterine cervix. Report of a case with rapidly fatal outcome.
Müllerian adenosarcoma of the uterus has been regarded as a neoplasm of low-grade malignancy; notwithstanding frequent local recurrences, sometimes after long intervals, the overall prognosis of the three dozen or so tumors reported in the literature has been good. This report documents an unusual clinical course of an adenosarcoma of uterine cervix occurring in an 80-year-old patient. Following clinically disease-free period of 25 months after hysterectomy, the tumor recurred in vaginal vault, grew with devastating rapidity, and proved fatal within 4 months. At autopsy, massive sarcomatosis peritonei and discrete tumor nodules involving the stomach and bowel were found.
Aged↗
Correlation of the diagnostic skin test with the immunoperoxidase assay in ragweed hypersensitivity.
The results of the diagnostic skin test are correlated with those obtained with an immunoperoxidase (IP) assay in 17 patients with positive histories for ragweed hay fever. The IP assay, a version of the ELISA technique, employs polystyrene microtiter plates as the solid-phase, horseradish peroxidase as the enzymatic label and O-phenylene diamine as the enzyme substrate. Concordance between the results of these two diagnostic techniques was observed in 66 patients (86%). Among the 11 patients with discordant results the modified RAST test was in agreement with the IP assay in seven and with the diagnostic skin test in four patients. In these latter four patients ragweed-specific IgE antibodies were detected by the IP or the modified RAST assays in low titers. The coefficients of variation for the IP assay ranged from 8% to 14.3%. The pros and cons of the use in vitro tests (the IP and the RAST test) and the diagnostic skin test in clinical practice of allergy are discussed.
Adsorption↗
Nonbacterial thrombotic endocarditis and myocardial infarction.
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Endocarditis↗
Intrarenal vascular alterations in hemodialysis patients. A semiquantitative light microscopic study.
The intrarenal arterial and arteriolar changes in the kidneys of 80 patients with chronic renal insufficiency maintained on hemodialysis were studied semiquantitatively by light microscopy and histochemistry. Intimal proliferation was common and accounted for thickening of vessel walls and luminal narrowing. Fibrocollagenous and fibroelastotic intimal changes were located predominantly in the interlobular and arcuate arteries, whereas the fibromucinous intimal lesion was found mainly in the interlobar arteries. Thickening of the media was encountered in 25 per cent, and adventitial fibrosis in 20 per cent of the kidneys. Necrotizing arterial of arteriolar lesions were not seen. The significance of these alterations as a possible cause of renal ischemia and their role in the perpetuation of hypertension are discussed.
Adolescent↗
Fibromatosis of the breast.
Two cases of fibromatosis of the female mammary gland treated by local excision and with a follow-up of 11 and 3 years, respectively, are described. Fibromatosis confined to the breast and not involving the underlying fibroaponeurotic fascia is a rare lesion. Among the handful of cases reported in the literature, diagnostic errors are known to have led to unnecessary mastectomy. In the breast, fibromatosis behaves in the same fashion as in the soft tissues: an aggressive infiltrative lesion with a proclivity for local recurrence following inadequate excision but without potential for distant metastasis. Clinically, it may simulate carcinoma; when suspected histologically during frozen section study, surgical resection should be limited to wide local excision and a definitive plan of therapy deferred until the lesion can be examined carefully with permanent sections.
Adult↗
Metastatic carcinoma simulating linitis plastica of the colon. A case report.
Reported herein is the case of a 70-year old woman with metastatic breast carcinoma presenting as linitis plastica of the ascending colon. The breast tumor was diagnosed nine years previously. The clinical, roentgenographic and pathologic features of colonic linitis plastica and the preoperative diagnostic difficulties are discussed. There is no difference in the morphologic features of primary and secondary linitis plastica. The latter may result from anaplastic carcinoma of the stomach, gallbladder or breast.
Adenocarcinoma, Scirrhous↗