Biomedical subjects
Publications and source records attributed to I D Ansell.
The clinical, histological, and immunohistochemical features of two cases of apparently isolated arteritis of the epididymis are presented. The aetiology and pathogenesis of the condition are discussed. Immunoglobulin and complement were shown in the acute arterial lesions, but this is not conclusive evidence that isolated arteritis is either an immune complex disease or a forme fruste of polyarteritis nodosa.
Thirty-nine patients with ductal prostatic carcinoma have been reviewed. Their mode of presentation, initial stage, plasma phosphatase levels and response to hormone therapy were found to be similar to those in a group of 124 patients with the common acinar prostatic cancer. Histochemical examination demonstrated prostate-specific antigen in all ductal carcinomas.
Six patients with azoospermia due to germinal aplasia are described. It is demonstrated that germinal aplasia may be mistakenly diagnosed as azoospermia due to ductal obstruction.
An elderly patient with nodular regenerative hyperplasia of the liver and hypothyroidism who presented with life-threatening bleeding from oesophageal varices is discussed. Progress has been uneventful following a semi-emergency portocaval shunt 5 years ago with no evidence of hepatic encephalopathy. This is presumably a tribute to the relatively well-preserved hepatic function in this condition.
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Seventy one patients who had had operations on their stomachs over 15 years previously were examined by endoscopy and multiple mucosal biopsy sampling. Sixty six had histologically proved gastritis (56 chronic atrophic gastritis, 10 superficial gastritis), 38 intestinal metaplasia, and 11 epithelial dysplasia. In three cases the epithelial dysplasia was severe (carcinoma in situ). One patient had an infiltrating carcinoma and another, whose biopsy appearances were reported as severe dysplasia, developed a carcinoma of the stomach eight months later. All patients having undergone gastric surgery more than five years previously should be screened endoscopically and any found to have moderate dysplasia subjected to regular endoscopic screening thereafter. Patients with severe dysplasia (carcinoma in situ) should be considered for radical surgery.
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Two cases of peritoneal granulomatous reactions to food starch are described. They followed bowel perforation and clinically mimicked tuberculous and glove-powder starch peritonitis. Their histological differences from corn-starch peritonitis warrant attention in the absence of previous documentation of starch as a component of peritoneal food granulomas. Food-starch granules tend to be larger than those of glove powder, are often oval, and may be extremely resistant to salivary diastase digestion.
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Polypoid tumours of the small and large intestine have been recognized as a complication of the implantation of ureters into the bowel for many years. Some cases could be recurrences of the urothelial tumour which necessitated the original operation or alternatively others may be tumours arising from the bowel epithelium itself. Malignant and benign varieties of such bowel tumours have been reported, although the description of some of the latter have suggested that they were not true tumours but some variety of 'polyp'. We describe here two polyps arising in the colon some 22 years after ureterosigmoidostomy and discuss the probably mixed nature with elements of both juvenile polyp and tubular adenoma.
Three azoospermic infertile men with marked hyperprolactinemia are described. All three men had clinical evidence of distal genital tract obstruction, and one man had evidence of severe spermatogenic arrest. The histology of testicular biopsies taken from each of these men is described and the role of hyperprolactinemia in male infertility is discussed.
A case report is presented of a 22-year-old woman with carcinoma in situ of the vulva in a multicentric pigmented form in association with vulval condyloma acuminata. The aetiology of the disease, varied appearances, malignant potential, and mode of treatment are discussed.
Malakoplakia is an uncommon chronic inflammatory disease characterized by histocytes with intracellular Michaelis-Gutmann bodies. The etiology is uncertain, but it is thought that depressed macrophage phagocytosis of bacteria is important. This presentation describes a case of malakoplakia arising in a cadaver renal transplant. The association of long term immunosuppression and repeated E. coli urinary tract infections is discussed.
Forty subfertile men with oligospermia were treated with a synthetic androgen (Mesterolone). The effect of the drug was evaluated by measuring serum testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and analysing the semen before and after treatment. The results demonstrated that in twenty-three patients treated for 6-9 months there was a significant decrease in serum testosterone (P less than 0.01); the means +/- SEM before and after treatment were 17.05 +/- 0.95 and 14.7 +/- 0.95 (nmol/l serum) respectively. There was a pronounced increase in serum LH (P less than 0.01), the values being 2.73 +/- 0.26 and 3.61 +/- 0.3 (u/l) respectively. However, no significant difference was found in serum FSH before and after treatment. The sperm concentration showed a variable response to treatment. In twenty-one patients there was either no change or worsening in the sperm concentration, whereas in nineteen patients an improvement was observed. The analysis of variance of sperm concentration and motility for the periods before and after treatment, for all the patients, showed no significant difference in the sperm concentration F1.145 = 2.82 (P=0.1).
The measurements of serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone were related to the sperm concentration and testicular biopsy in 137 subfertile men. The biopsies were classified into four histological groups: normal, focal tubular atrophy, maturation arrest and Sertoli-cell-only syndrome. A positive correlation was found between sperm concentration and the histological grade of spermatogenesis. FSH was directly related to the spermatogenesis and the values were significantly raised in maturation arrest and Sertoli-cell-only syndrome. This relationship was present, but to a much lesser extent, for LH. Serum testosterone levels remained unchanged and no relationship between testosterone and either sperm concentration or testicular biopsy was observed. These data indicate the value of FSH in the investigation of the subfertile male, but suggest that the routine measurement of testosterone is unnecessary.
Two patients with cyclophosphamide induced cystitis and co-existent bladder tumour are described. Possible mechanisms for these associated diseases are discussed and the difficulty of diagnosing bladder tumour in patients with haemorrhagic cystitis is stressed.
Explants of human benign hypertrophied prostate were cultured for 8 days. The effect of 5alpha-dihydrotestosterone on the morphology, DNA and glucose utilization of 14 cases was investigated. In four cases proliferation was clearly more extensive in the dihydrotestosterone-treated explants than in the controls. In six explants, there were no morphological differences between those cultured with or without dihydrotestosterone and in half of these, proliferation was present. Four explants were either necrotic or did not contain epithelial cells. The mean DNA content of the treated explants was higher than that of the controls (P smaller than 0.01). There was no significant difference in the rate of glucose utilization by the explants treated with dihydrotestosterone, and by the controls.