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Biomedical subjects

D J Pounder

Publications and source records attributed to D J Pounder.

At least 73 records · Page 4Linked to original sources
PubMed1985

Benign senile pyometra, endometrial cholesterol granulomas and adenosquamous carcinoma.

Endometrial curettage of a 78-year-old patient with benign senile pyometra revealed endometrial cholesterol granulomas. Five years later cytological studies were suspicious of malignancy. Hysterectomy disclosed an endometrial adenosquamous carcinoma associated with cholesterol granulomas. We speculate that endometrial cholesterol granuloma, like endometrial xanthogranuloma, represents a rare morphologic variant of benign senile pyometra. Consequently a strong association with carcinoma is to be expected.

Adenocarcinoma↗
PubMed1985

Hepatocellular calcification.

A rare example of hepatocellular calcification is described. The lesion is characterized by the presence of granular calcific deposits within the cytoplasm of hepatocytes. In this instance the calcification was dystrophic, developing on the basis of centrilobular necrosis secondary to cor pulmonale. A transient hyperphosphatemia probably augmented the calcification process. Intracellular calcification was also observed in occasional cardiac myocytes. The intracytoplasmic calcific granules represent mineral-laden mitochondria. Sequestration of calcium by mitochondria is a common biochemical mechanism mediating various forms of toxic cell death. Pathological cellular calcification can be viewed as an uncommon morphological expression of this biochemical process.

Aged↗
PubMed1985

Xanthogranulomatous endometritis associated with endometrial carcinoma.

We studied a case of xanthogranulomatous (XG) endometritis associated with endometrial adenocarcinoma. Isolated XG endometritis is a rare entity that may mimic carcinoma as a consequence of the replacement of the endometrium and the invasion of the myometrium by friable yellowish tissue composed of foamy histiocytes. To our knowledge, it has not previously been described as coexisting with a carcinoma. The XG reaction is characterized by pigment-laden foamy cells. Electron microscopy demonstrated that the foamy cells belong to the macrophage/histiocyte series and are not endometrial stromal cells. Histochemical studies revealed the pigment to be composed of hemosiderin and lipofuscin. The absence of calcispherites or a uniform immunoperoxidase staining reaction for alpha 1-antitrypsin excluded the diagnosis of malacoplakia. We have postulated that XG endometritis has a similar etiopathogenesis to XG pyelonephritis and XG cholecystitis. It is a rare morphologic expression of the clinical syndrome of benign senile pyometrium.

Aged↗
PubMed1985

Uterine leiomyosarcoma with myxoid stroma.

Myxoid leiomyosarcomas present a diagnostic problem. They are said to have low mitotic counts and are considered to be exceptions to the general rule that uterine smooth-muscle tumors with a mitotic rate of less than five per ten high-power fields rarely recur. We present two cases of myxoid leiomyosarcoma, both of which show high mitotic counts. In addition, one of the cases presented initially as a typical leiomyosarcoma, but contained abundant myxoid stroma in the metastases. The role of the myxoid stroma in influencing prognosis in leiomyosarcomas is, as yet, uncertain.

Adult↗
PubMed1985

Coronary artery aneurysms presenting as sudden death 14 years after Kawasaki disease in infancy.

A 17-year-old boy who collapsed and died suddenly was found to have aneurysms of the right and left coronary arteries and evidence of a burned-out arteritis. There was a history, in infancy, of a severe febrile illness and skin rash that, in retrospect, was an acute episode of Kawasaki disease (mucocutaneous lymph node syndrome). The observations support the contention that a previous episode of Kawasaki disease should be entertained as a possible cause of proximal, discrete coronary artery aneurysms presenting in adolescence or adulthood.

Adolescent↗
PubMed1984

"The grave yawns for the horseman." Equestrian deaths in South Australia 1973-1983.

The fatalities associated with the riding and handling of horses in South Australia over the 11-year period 1973-1983 are reviewed. There were 18 deaths, including two sudden natural deaths in the saddle and one drowning. The 15 cases of horse-related trauma represent a death rate of approximately one per million population per annum. Thirteen of the deaths were the result of a head injury after a fall. Nine persons were not wearing protective headgear. The two principal groups at risk were male professional riders with a mean age of 32 years and female amateurs with a mean age of 19 years.

Adolescent↗
PubMed1984

Floppy aortic valve presenting as sudden death.

A previously healthy 34-year-old Dutch immigrant to Australia died unexpectedly in his sleep. At autopsy the only significant finding was a floppy aortic valve (FAV). Histologic, histochemical and electron microscopic studies corroborated the macroscopic diagnosis. Previously described associations of the FAV include the floppy mitral valve, Marfan's syndrome, aortic root dilatation and aortic cystic medial necrosis. None of these features were found in the present case which is the first recorded example of isolated FAV presenting as sudden death. The mechanism of death is obscure, and while it is presumed to be dysrhythmic, a detailed histological examination of the cardiac conducting system revealed no anatomic abnormality.

Adult↗
PubMed1984

Sudden, unexpected death following typhoid-cholera vaccination.

A previously healthy 33-year-old Australian male died suddenly and unexpectedly 8 h after a typhoid-cholera vaccination. Such fatalities are extreme rarities and the present case is the first in which postmortem measurement of serum immunoglobulins has been undertaken. The clinical course and necropsy findings suggest that death was the result of a slowly evolving systemic anaphylactic reaction which terminated in hypotension and right heart failure. The deceased was probably atopic. The current recommendations for the vaccination of international travellers against typhoid and cholera are discussed.

Adult↗
PubMed1984

Pineal germinoma with syncytiotrophoblastic giant cells: a case with panhypopituitarism and isosexual pseudopuberty.

A previously healthy boy, aged 12 years, developed hypopituitarism due to suprasellar metastases from a pineal germinoma with syncytiotrophoblastic giant cells (SGC). Despite the hypopituitarism, the patient showed pubertal development, which was associated with abnormal levels of human chorionic gonadotropin (hCG) in the cerebrospinal fluid. This case adds support to the theory that precocious puberty in children with pineal germinomas may be due to the secretion of hCG by SGC, a minor component of the germinoma. It also illustrates the point that, although abnormal levels of circulating hCG in children with pineal tumors may indicate a diagnosis of choriocarcinoma with its encumbent poor prognosis, other pineal germ cell tumors may also secrete hCG. Although this patient had abnormal levels of hCG, his cerebral tumor exhibited behavior more commonly associated with pineal germinoma than with choriocarcinoma.

Adolescent↗
PubMed1984

Forensic aspects of aboriginal skeletal remains in Australia.

The assessment of Aboriginal skeletal remains and their distinction from whites is an area of major importance to the Australian forensic pathologist. The Aborigines, the indigenous people of Australia, are a distinct racial group with many characteristic anthropological features. The assessment of race is best made from an examination of cranial traits, 20 which are of value. A characteristic pattern of attrition of the teeth provides a method for establishing a skeleton as pre-European contact Aboriginal or postcontact tribal Aboriginal. The limb proportions of Aborigines differ significantly from other races and provide a useful adjunct to other racial discriminants. Quantifiable sex discriminants in the Aboriginal pelvis and femur differ in their ranges of values from other races. The humerus and shoulder girdle are of no value in making a racial distinction and are of limited value in sexing Aboriginal skeletons. Some pathological changes seen in Aboriginal skeletons are of value in corroborating race. These pathological changes include evulsion of incisor teeth, healed "parry fractures" of the ulnae, tibial squatting facets, treponemal changes, and auditory exostoses. The place and manner of burial together with related artefacts, features, and ecofacts may also provide corroboration.

Australia↗
PubMed1984

Problems in the necropsy diagnosis of alcoholic liver disease.

Problem areas in the necropsy diagnosis of alcoholic liver disease are reviewed, potential sources of confusion delineated, and diagnostic guidelines proposed. The entire spectrum of alcoholic liver disease, including alcoholic hepatitis, may be perfectly mimicked by severe obesity, diabetes, and perhexiline maleate toxicity. Focal fatty change in the liver introduces sampling errors in the assessment of steatosis. Nodular regenerative hyperplasia of the liver mimics a micronodular cirrhosis both clinically and macroscopically. Measurement of the liver iron concentration reliably differentiates between alcoholic liver disease with siderosis and idiopathic hemochromatosis. The evaluation of preexisting fibrosis or cirrhosis in cases of massive hepatic necrosis is aided by stains for elastic fibers. Alcohol abusers taking acetaminophen (paracetamol) in excessive, but not suicidal doses are at risk of developing fatal "late" acetaminophen hepatotoxicity. Fatal viral hepatitis may be overlooked in an alcoholic with preexisting liver disease.

Acetaminophen↗
PubMed1984

Fatal snakebite in Australia.

More than 20 venomous snakes found in Australia belong to the family Elapidae . Although their venom delivery system is less efficient than that of the Viperidae , their venoms are extremely potent. The active components of Australian elapid venoms include neurotoxins, myotoxins , hemolysins, and factors producing hypocoagulability. The groups at particular risk of snakebite are children, agricultural workers, bushwalkers , and herpetologists . A high index of suspicion must be maintained when investigating cases of sudden unexpected death in these groups. The bite wound itself may be particularly easily overlooked as there is little local reaction to many elapid bites. The necropsy findings in fatalities are predictable from the known properties of the venoms of the various species. However, these findings are non-specific and the diagnosis ultimately rests upon the demonstration of the presence of venom by immunoassay. For this purpose swabs from the bite site, the overlying clothing, the excised bite site, the local and regional lymph nodes, urine, and blood may be used.

Adult↗
PubMed1984

Forensic services in Australia.

Australia is comparable in size to the United States without Alaska, but two-thirds of the continent is desert or semidesert. The population of approximately 15 million is largely centered around major cities near the coastline. There is a federal system of government, and independent forensic services are based in the capital cities of each of the six states and two territories. The need to service both the densely populated urban areas as well as sparsely populated outback regions has created logistic problems. The forensic services in each state and territory have evolved independently and have resulted in a diversity of organizational forms. The organization of forensic services in Australia is described and contact addresses are provided.

Australia↗