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Biomedical subjects

C Barry-Walsh

Publications and source records attributed to C Barry-Walsh.

7 recordsLinked to original sources

Multiple perifollicular fibromas.

Perifollicular fibroma is a benign mesodermal tumour of the hair follicle. It can occur as a solitary papule or as multiple lesions that are clinically indistinguishable from other tumours of the pilar apparatus. Multiple perifollicular fibromas may be inherited although the pattern remains unclear. Adnexal tumours can be associated with internal malignancy and perifollicular fibromas have been linked with adenomatous colonic polyps. This report describes a patient with multiple perifollicular fibromas with no associated malignancy to date and a family pedigree suggestive of an autosomal dominant pattern of inheritance.

Adult↗

Persistent intraepithelial neoplasia after excision for cervical intraepithelial neoplasia grade III.

OBJECTIVE: To determine the factors associated with subsequent intraepithelial neoplasia among patients who had cervical intraepithelial neoplasia grade III (CIN III) diagnosed on a specimen from previous large-loop excision of the transformation zone. METHODS: We studied all large-loop excisions of the transformation zone performed between May 1991 and December 1993, inclusive. All cases of CIN III were identified. We followed up patients with cytology and colposcopy for 2 years after treatment for high-grade CIN. Findings at follow-up were analyzed. RESULTS: A histologic diagnosis of CIN III was made in 225 patients. The lesion appeared incompletely excised in 105 patients (48.2%). In 76 cases (34.9%), CIN III was found at the endocervical margin. Of the 211 patients reviewed at 6 months, 18 (8.5%) had histologically proven CIN. The incidence of CIN was 16.5% after a report of incomplete excision, compared with 1.9% after a report of complete excision (P < .001). Furthermore, there was no subsequent CIN III in the complete-excision group. Of the 183 patients reviewed at 24 months, seven (3.8%) had histologically proven CIN. All cases of subsequent CIN were associated with dyskaryosis on follow-up cervical cytology. CONCLUSIONS: Positive margins increase the risk of treatment failure. Cytology alone may be adequate for follow-up when CIN III is completely excised.

Adult↗

A comparative analysis of grading systems in renal adenocarcinoma.

While the histological grade of a renal cell carcinoma is of prognostic significance there is poor concordance amongst pathologists in the use of these grading systems. Many grading systems have been described, but none has achieved widespread acceptance. The objective of this study was to assess the degree of interobserver variation amongst four experienced pathologists in their use of four commonly applied grading systems. The pathologists reviewed a series of 88 cases of renal cell carcinoma. Grades were detailed on a proforma which consisted of a breakdown of each grading system. Cohen's kappa was calculated for each pair of observers for each system. The mean kappa scores for each system were compared using the Tukey honestly significant differences method. Mean kappa was highest for the grading system of Syrjanen and Hjelt and this grading system also had a higher mean kappa than two of the other systems tested. The most striking feature of the results was the degree to which the pathologists differed in their assessments. The grading system of Syrjanen and Hjelt was shown to be subject to less interobserver variability than other commonly used classifications and we are of the opinion that it should become the standard method.

Adenocarcinoma↗

Improved wound healing with a modified electrosurgical electrode.

Previous studies comparing standard electrosurgical (ES) electrode and steel scalpel (SS) wound healing have reported poor initial tensile strength, a delay in reaching maximum tensile strength and an increased inflammatory response in the ES wounds. The hypothesis that a smaller needle (modified) electrode would give better wound healing than a standard electrode was tested. Using histology as a parameter of wound healing, incisions created by a modified electrode, a standard electrode and a steel scalpel were compared. Sixty Sha Sha mice were divided into 10 groups. Standardised dorsal skin incisions were made using steel scalpel, standard and modified electrosurgical cutting electrodes. Mice were sacrificed on days 0, 1, 2, 3, 5, 7, 9, 14, 28 and 42. The incised skin was processed for standard and immunohistochemical staining. The standard ES wound had significantly higher numbers of polymorphonuclear leukocytes in comparison to the SS and modified ES wounds (p less than or equal to 0.01). However, macrophage numbers were found to be significantly lower in the ES wounds when compared to the SS wounds on days two and five (p less than or equal to 0.05). The fibroblast response was delayed by up to two days in the ES wounds when compared to the SS wounds. Epithelialisation was completed by day two in the SS and modified ES groups but was only complete by day three in the standard ES group (p less than or equal to 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Intravenous aminobisphosphonate in Paget's disease: clinical, biochemical, histomorphometric and radiological responses.

Intravenous 3-amino-1-hydroxypropylidene-1, 1-bisphosphonic acid (APD) was used to treat 26 patients with Paget's disease. Three daily dosages were studied; 20-30 mg/day in 20 patients, 45 mg/day in three patients and 60 mg/day in three patients, by daily 4-hour infusions for 2-10 days. The fasting urinary hydroxyproline excretion (HypE) declined exponentially, reaching 50% of pretreatment values at 1.92 +/- 0.16 (mean +/- SEM) days. This initial rapid decline was complete by 4 days following treatment to a mean of 28.0 +/- 3.4% of pretreatment values. Thereafter, there was no significant decline in HypE. The initial rate of decline of HypE was unchanged by increasing the daily dose of APD. Transient non-symptomatic hypocalcaemia with secondary hyperparathyroidism occurred in all patients. No adverse changes in the renal handling of calcium or phosphate, as seen with high-dose 1-hydroxyethylidene-1, 1-bisphosphonate (EHDP), were seen in any patient on any daily dose. Fever occurred in 73% of patients in the first 2 days of treatment. Overall, there was a significant fall in the lymphocyte count (P less than 0.005 febrile group, n = 19; P less than 0.02 non-febrile group, n = 7) and a fever-dependent rise in the neutrophil count (P less than 0.005 febrile group only). The occurrence of fever was associated with a more rapid decline in HypE, compared to the non-febrile group, so that HypE was significantly lower in the febrile group by day 5 (P less than 0.025). Seventy-two per cent of patients with bone and/or joint pain reported a reduction in pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Cavitating pulmonary nodules in histiocytosis-X high resolution CT demonstration.

In a case of pulmonary histiocytosis, high resolution C.T. scanning (H.R.C.T) showed multiple small ring shaped peripheral pulmonary lesions. This has not, to our knowledge been previously reported in the radiological literature. The possible pathogenesis of these lesions is described. With the advent of H.R.C.T this appearance should become more widely recognised in the future. H.R.C.T was of considerable assistance in diagnosis of this patient with non-specific findings on the plain chest film.

Adult↗

Sertoli-Leydig cell tumor of the ovary with heterologous elements and carcinoid: an immunohistochemical and ultrastructural study.

A Sertoli-Leydig cell tumor of the ovary is described in which there were heterologous elements consisting of enteric cysts and an evolving carcinoid. Endocrine cells in the cysts and carcinoid were found to contain gastrin and other polypeptide hormones. Aspects of the organization of the enteric epithelium, its histogenesis, and the possible relationship of this tumor to other cystic ovarian neoplasms are discussed.

Adult↗