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Biomedical subjects

H Starklint

Publications and source records attributed to H Starklint.

At least 37 records · Page 2Linked to original sources
PubMed1991

Preservation of rabbit kidneys using a solution containing hydrolyzed starch.

An organ preservation solution has been developed by combining some features of the hypertonic citrate formulation of Ross, Marshall, and Escott (RME) with some features of UW solution. Specifically the solution (HP16) contains a balance of cations similar to that in RME and the same concentration of citrate, but sulfate is replaced by chloride and mannitol by a starch hydrolysis product (SHP). A gelatin-derived polypeptide (Haemaccel) is included to provide colloid osmotic pressure. The objective was to increase the effectiveness of RME by using a higher-molecular-weight osmoticum than mannitol, but avoiding the expense of raffinose; reducing the osmolality to a more physiological level; and including a colloid to make the solution suitable for continuous perfusion. The effectiveness of the solution was tested by 48-hr hypothermic preservation of rabbit kidneys. The results were compared with those obtained using RME or UW. It was shown that simple hypothermic storage was more effective than continuous perfusion, and that HP16 was more effective than RME and as effective as UW. The improvement over RME was ascribed to the isotonic osmolality and the inclusion of a higher-molecular-weight osmoticum (the SHP), possibly supplemented by the colloid (Haemaccel). Two SHP preparations, both with dextrose-equivalent values of approximately 35, were equally effective. These materials contain a standardized mixture of dextrose, maltose, and tri- and oligosaccharides, and have the osmotic properties of a trisaccharide. The results provide a new, inexpensive preservation solution that is as effective as any so far tested with this model, and they support the importance of appropriate osmotic properties for solutions to be used in organ preservation.

Adenosine↗
PubMed1991

Cutis laxa: autosomal dominant inheritance in five generations.

Cutis laxa is described in three cases: a 17-year-old man, his mother and his maternal grandmother. The onset of skin symptoms occurred from puberty to early adulthood. The skin was loose-hanging, wrinkled and without elasticity. X-ray examination showed numerous gastrointestinal diverticulae in the two older patients, and both had been operated on for abdominal hernia and genital prolapse. There were no cardiopulmonary symptoms. Histopathological investigation showed a reduction in the amount of elastic tissue in the dermis, but normally localized and ultrastructurally normal components. The family history revealed clinically similar cases in at least five generations, consistent with autosomal dominant inheritance.

Adolescent↗
PubMed1991

Flush perfusion of rabbit kidneys with autogeneic, allogeneic and xenogeneic blood.

A simple perfusion model was developed to study the events that lead to rejection of renal xenografts. Flush perfusion of the kidneys of 24 rabbits was carried out with blood from rabbits, cats, or humans. Light microscopy showed alterations with neutrophilic granulocytes margination of the vessels after only 15 min of perfusion. In the experiments with human blood the immunofluorescence microscopy showed deposits of immunoglobulins and complement factor III. This simple method is therefore a useful way of studying perfusion in renal xenografts.

Animals↗
PubMed1990

Hypothermic preservation of rabbit kidneys for 48 hours using low ionic strength solutions.

Microwaves offer the prospect of rapid and uniform heating of frozen organs. This is significant in the context of cryopreservation, and particularly of vitrification, because microwave heating may help to avoid crystallization or recrystallization of ice during warming, minimize any effects of high cell density, and reduce thermal-mechanical stresses. Previous work has established a rationale for reducing the ionic strength of solutions used to prepare tissues for microwave heating, since this permits the use of lower frequencies, which makes heating more uniform, without increasing the risk of thermal runaway (T. P. Marsland, S. Evans, and D. E. Pegg, Cryobiology 24, 311-323, 1987). In this paper we report a study of two possible low ionic strength perfusates, in rabbit kidneys, using 48 hr of hypothermic storage and autotransplantation as the test system. This model was chosen because there is a great deal of basic information about it. Both a single-pass "flush" preservation solution and a solution designed for continuous perfusion gave excellent results. The continuous perfusion system, which would be the more suitable for introducing cryoprotectants, gave five of five surviving animals with peak serum creatinine levels of 353-555 mumol/liter normal histology in three cases, and only very minor damage in the other two. There would therefore seem to be no obstacle to the use of perfusates having a low ionic strength in renal cryopreservations studies.

Animals↗
PubMed1990

Histological evaluation of prostatic cancer. (II): Reproducibility of a histological grading system.

The aim of this study was to evaluate the reproducibility, expressed by kappa coefficients, of the histological grading system of prostatic cancer as proposed by Schroeder, Hop, Blom and Mostofi in 1985. This grading system has five prognostic groups based on combinations of growth pattern, mitoses and nuclear anaplasia. All histological slides from 85 cases of prostatic carcinoma were blindly evaluated on two independent occasions by each of four pathologists. The overall INTER-observer agreement and mean INTRA-observer agreement regarding "prognostic group" were 0.55 and 0.69 respectively, whereas the kappa coefficients were 0.38 and 0.57 respectively. An acceptable level of INTER-observer reproducibility of prognostic group I (kappa = 0.70), of the parameter "growth pattern" (kappa = 0.60) and of "slight nuclear anaplasia" (kappa = 0.62) was found. A low overall kappa coefficient of "mitoses" and "nuclear anaplasia" was found. Based on the well reproducible parameters a simplified grading system is proposed.

Anaplasia↗
PubMed1990

Histological evaluation of prostatic cancer. (III): Reproducibility of assessment of tumour volume and its possible significance for prognosis.

The aim of this study was to evaluate the INTER- and INTRA-observer reproducibility of prostatic cancer volume defined as the percentage of chips with carcinoma in transurethrally resected tissue. All histological slides from 80 consecutive cases of prostatic cancer were blindly evaluated on two independent occasions by each of four pathologists. The correlation was expressed by Spearman's rank correlation coefficient (R). Both the overall INTER- and mean INTRA-observer correlation of tumour volume were high with R being respectively 0.905 and 0.918. With reference to stage A1 and A2, data were transformed to an ordinal scale with 2 categories (less than = 5%, greater than 5%). The overall INTER- and mean INTRA-observer agreement of this classification were 0.926 and 0.943 respectively--the corresponding kappa coefficients being 0.68 and 0.74. It is concluded that in transurethrally resected tissue a highly reproducible index of the resected prostatic cancer volume can be given by the percentage of chips with tumour. The prognostic significance of this parameter is discussed.

Humans↗
PubMed1990

Intra-osseous pressure and oxygen tension in avascular necrosis and osteoarthritis of the hip.

The intra-osseous pressure, PO2, and PCO2 were measured in 32 hips (21 patients) which were painful but showed no severe degenerative changes. Pre-operative scintigraphy and radiography was performed in all patients. Thirteen hips showed early osteoarthritis, eight had early osteonecrosis, and 11 had no changes. Core biopsies were performed and the bone was examined histologically and graded for necrosis. Histologically, necrosis was present in 27 specimens. Scintigraphic findings did not correlate with the histological results but were more closely related to the radiographic findings. The intra-osseous pressure in hips with histological necrosis (mean 47 mmHg) was significantly higher than in hips without necrosis (mean 26 mmHg). The PO2 was lower in bone with histological necrosis (mean 44 mmHg) than in bone without (mean 71 mmHg). PO2 increased and intra-osseous pressure decreased after decompression. The results confirm that ischaemia plays a central role in the development of necrotic changes in bone. Histological necrosis was found in hips with radiographic signs of osteonecrosis and in those with osteoarthritis. Radiography, and scintigraphy are shown to be insensitive methods for differentiating between those disorders.

Adult↗
PubMed1990

Hope for successful xenografting by immunosuppression with monoclonal antibody against CD4, total lymphoid irradiation and cyclosporine. Six months' survival of hamster heart transplanted into rat.

Hamster hearts were transplanted to rats, and the effects of combinations of total lymphoid irradiation (TLI), cyclophosphamide, cyclosporine A (CyA) and monoclonal antibodies (MAB) were investigated. Controls not immunosuppressed rejected their xenograft in 3 to 5 days, while combination immunosuppression including MABs against CD4 or IL-2-receptors extended graft survival significantly. In one case, the graft was still functioning 180 days after transplantation, which is the longest survival seen in this model. The use of specific MABs may open a new era for both xeno- and allo-transplantation.

Animals↗
PubMed1989

Nephrogenic adenoma. Reports of two cases.

Nephrogenic adenoma is a rare lesion of the urinary tract. Two cases in the urinary bladder are described. Histologically the tumor consists of cystic and tubular structures resembling the distal part of the nephron. The etiology and pathogenesis are discussed and a new etiologic theory is presented.

Adenoma↗
PubMed1989

Reproducibility of histomorphologic diagnoses with special reference to the kappa statistic.

Systems for classification and grading used in pathology should ideally be biologically meaningful and at least be reproducible from one pathologist to another. A statistical method to evaluate reproducibility (non-chance agreement) for several observers using nominal or ordinal categories has been developed and refined over the past few decades--the kappa statistic. A high level of observed agreement among different pathologists can either signify a high level of reproducibility, if agreement by chance is low, or express a low level of reproducibility, if agreement by chance is almost as high as the observed agreement. Therefore, the observed agreement says nothing in itself, unless it is low. The kappa value, however, indicates how much better the observers are compared to a throw of the dice, and therefore gives the real credit to the agreement which was found. We have developed a user-friendly computer program for calculating inter- and intra-observer agreement of 2 or more observers. By calculating associations between different categories and different observers, the statistic furthermore obtains a function close to the parameter of accuracy. We recommend the use of the above method before a set of nominal or rank scale parameters are used for deciding prognosis and treatment of patients. By submitting a diskette the computer program will be available at no cost.

Histological Techniques↗
PubMed1989

Histological evaluation of prostatic cancer. 1. Reproducibility of tumour type.

It has been claimed that the histological type of prostatic carcinoma bears influence on the prognosis of the patient, and that different treatments have to be considered for different types of tumours. The primary aim of this study was to evaluate the reproducibility of the histological criteria for the ordinary acinic adenocarcinoma and ductal adenocarcinoma. From 85 prospective and consecutive cases of prostatic carcinoma all histological slides were examined on two independent occasions by each of 4 pathologists. The overall inter observer agreement and mean intra observer agreement were 0.69 and 0.74, respectively. The kappa coefficients of these inter and mean intra observer agreements were 0.39 (S.E. = 0.02) and 0.48 (S.E. = 0.08), respectively. Considering a dichotomous classification of pure acinic versus all other types of prostatic carcinoma, an overall inter observer agreement of 0.78 and mean intra observer agreement of 0.84 were found. The kappa coefficients of this dichotomous classification were 0.51 (S.E. = 0.03, inter) and 0.61 (S.E. = 0.11, intra), respectively. It is concluded that the criteria for differentiation between different histological types of prostatic carcinoma need to be improved.

Carcinoma↗
PubMed1989

Intraosseous pressure, oxygenation, and histology in arthrosis and osteonecrosis of the hip.

We compared intraosseous pressure, partial pressure of oxygen and carbon dioxide, and histopathology in 10 hips with arthrosis and in seven hips with nontraumatic necrosis of the femoral head. Hypoxia of the subchondral bone was present in both conditions. In arthrosis the intraosseous pressure was normal, whereas intraosseous hypertension was present in necrosis. Partial pressure of carbon dioxide was normal in both conditions. Identical signs of subchondral medullary and trabecular necrosis were found in both conditions.

Adult↗
PubMed1988

Introduction and removal of cryoprotective agents with rabbit kidneys: assessment by transplantation.

Rabbit kidneys were perfused with up to 4 M glycerol or propane-1,2-diol (propylene glycol, PG) in three vehicle solutions: one normokalemic and made hypertonic with mannitol (HP5), one hyperkalemic but without mannitol (HP6), and one hyperkalemic and with mannitol (HP7). Subsequent function was assessed by autotransplantation. Up to 3 M glycerol in HP5 was well tolerated but not in HP6 or HP7. Conversely, up to 3 M PG in HP7 was compatible with excellent post-transplant function, but the same concentration in HP5 was severely damaging. PG (4 M) in either solution was severely injurious and no kidneys survived perfusion with this concentration. Vascular resistance was well controlled by the vehicle solutions with mannitol, but it was generally higher during perfusion with the hyperkalemic HP7 compared with the normokalemic HP5. No kidneys perfused with 3 M solutions of either of the cryoprotective agents and cooled briefly to -6 degrees C without freezing had any post-transplant function, and neither did kidneys perfused with 3 M PG or 4 M glycerol tolerate slow cooling to -80 degrees C and warming. The need to optimize perfusate composition for the CPA being used is clear, and the dramatic increase in toxicity of PG when the concentration exceeds 3 M supports the suggestion that mixtures of PG and glycerol should be considered. The observation of damage at high subzero temperatures, before freezing has occurred, requires further detailed study.

Animals↗
PubMed1988

Adult, acquired reactive perforating collagenosis. Report of a case including ultrastructural findings.

A case of reactive perforating collagenosis in an adult male patient with chronic renal failure. Pruritic, umbilicate papules, showing extrusion of collagen fibers through the epidermis were detected histopathologically. Electron microscopy showed absence of basal membrane beneath the perforation and collagen fibers with preserved periodicity passing through widened intercellular spaces with islands of cytoplasmic material.

Aged↗