Biomedical subjects

H J Porter

Publications and source records attributed to H J Porter.

24 records · Page 2Linked to original sources

PubMed1987

Value of perinatal necropsy examination.

In a retrospective study of 150 stillbirths and 150 neonatal deaths carried out between 1981 and 1985 the necropsy findings were compared with the clinical diagnoses, which had been obtained from the postmortem request form, and the case notes completed before the necropsy was performed. In all cases the necropsy comprised macroscopic findings and histological examination of all organs, with microbiology, radiology, and cytogenetics where appropriate. Clinically important differences between clinical and pathological diagnoses in 54 of 150 cases (36%) were noted in the cases of stillbirth. Of the neonatal deaths, examination showed clinically important information that had not been recognised during life in 66 cases (44%). Histological examination of tissues was essential for making or confirming the pathological diagnosis in 20% of all perinatal deaths.

Autopsy↗

PubMedDate not supplied

Correlation of antenatal ultrasonography and pathological examinations in 153 malformed fetuses.

Findings in 153 abnormal fetuses diagnosed by antenatal ultrasound and subsequently examined by a pediatric pathologist were reviewed. The primary diagnoses in the 153 cases were 67 nervous system anomalies, 19 gastrointestinal system anomalies, 18 genitourinary system anomalies, 13 chromosomal abnormalities, 10 skeletal system anomalies, and 26 other abnormalities. Forty-six percent of the total number had multiple abnormalities. In 67 cases (44%), autopsy showed further anomalies or altered the ultrasonographic diagnosis. However, in only 36 (25%) were there autopsy findings that altered management. Errors in ultrasound diagnosis were most commonly associated with the presence of multiple anomalies and oligohydramnios. Expert pathological examination remains an essential tool in the management of fetal anomaly.

Abnormalities, Multiple↗

PubMedDate not supplied

Placental lesions: is growth a predictor of bad outcome?

Placental lesions are difficult to assess because there is often a discrepancy between the ultrasound findings, clinical diagnosis and pathology. Large placental lesions especially when solid and echogenic on ultrasound may be associated with a high maternal serum alpha-fetoprotein, intrauterine growth retardation or uteroplacental insufficiency. We report three cases in which mainly solid placental lesions were noted to increase in size during the second trimester and the placental weights at birth were relatively heavy when compared to the fetal weight. In all cases there were serious pregnancy complications. Pathological examination showed infarction, haematoma or both. We suggest that the growth of placental lesions during pregnancy may be an important sign related to the severity of the disease and therefore poor outcome.

Adult↗

PubMedDate not supplied

Case selection and outcome of radical perineal prostatectomy in localized prostate cancer.

Radical prostatectomy continues to play a central role in the management of localized prostate cancer. The majority of patients diagnosed with prostate cancer will undergo radical prostatectomy. A decrease in the morbidity of this surgical procedure has been accomplished through an improved understanding of pelvic anatomy and a greater understanding of the natural history of prostate cancer. Recently, minimally invasive techniques have been applied to radical prostatectomy (laparoscopic prostatectomy) in order to further decrease the morbidity of this operation. What remains to be determined is whether this approach confers the same long term surgical outcomes as the open approach. One method which offers known long term outcomes coupled with decreased morbidity is the radical perineal prostatectomy. The purpose of this paper is to review the criteria for patient selection as well as outcomes of the radical perineal prostatectomy.

Journal Article↗

PubMedDate not supplied

Lethal arthrogryposis multiplex congenital (fetal akinesia deformation sequence, FADS).

Arthrogryposis multiplex congenital (AMC) is the presence at birth of multiple congenital contractures in an intact skeleton. The severity of the condition is highly variable and the possible underlying causes are numerous. Fetal immobility and lesions of the brain, spinal cord, peripheral nerves and muscle, along with mechanical restriction of the fetus in utero are the pathogenic mechanisms that need to be considered. Etiological factors that have been implicated in the development of AMC include genetic conditions, infections, drugs, toxins, maternal hyperthermia, and maternal illness. This review will concentrate on the severe end of the spectrum of AMC that results in disease that is lethal pre- or postnatally, and will discuss the pathology, pathogenesis, etiology, and practical approach to this diversely expressed condition.

Arthrogryposis↗

PubMedDate not supplied

Nephrogenic rests and renal abnormalities in Brachmann-de Lange syndrome.

We report renal abnormalities found in four cases of Brachmann-de Lange syndrome (BDLS). In two there were nephrogenic tests and renal cortical cysts, a further case showed cortical cysts, and the fourth had dilated collecting ducts. The literature describing renal abnormalities in BDLS has been reviewed, and this includes a report of one individual with BDLS who developed Wilms tumor. The genetic basis of BDLS has not been elucidated, although a submicroscopic abnormality of chromosome 3 seems likely. Nephrogenic rests may be Wilms' tumor precursor lesions and are seen in syndromes associated with Wilms' tumors. Mutations of genes on chromosome 11 are the most common genetic abnormalities associated with Wilms' tumor, but other chromosomes have also been implicated. The frequency of renal abnormalities in the BDLS suggests that the involved gene may be important in renal development and also possibly in Wilms' tumors.

De Lange Syndrome↗