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Biomedical subjects

J L Abraham

Publications and source records attributed to J L Abraham.

At least 55 records · Page 3Linked to original sources

Factitial cutaneous ulcers and nodules: the use of electron-probe microanalysis in diagnosis.

Two cases are reported in which persistent nodular or ulcerative skin lesions with granulomatous histology suggested possible injection of foreign material. Electron-probe microanalysis was used to determine the presence and nature of foreign materials present in the skin. This technic identified specific agents used as fillers in tablets, indicating the injection of pulverized tablet material. The patients were counseled regarding this evidence, and psychotherapy and drug rehabilitation were recommended in each instance. This technic provides a valuable tool for accurate identification of foreign substances in the skin.

Adult↗

Identification and quantitative analysis of tissue particulate burden.

The analysis of particles in tissue samples, especially in lung tissue samples, has been of great use diagnostically and in the search for more precise information on the etiology of occupational/environmental diseases. There is a strong need for an interdisciplinary approach involving patients, epidemiologists, clinicians, pathologists, toxicologists, and microscopists if advancement in the recognition, diagnosis, and prevention of disease is to proceed.

Asbestosis↗

Experimental pericardial inflammation evaluated by computed tomography.

Experimental pericardial inflammation was evaluated with ungated and cardiac gated computed tomography (CT) in 12 dogs, including 2 controls. All were studied during and after contrast infusion; in addition, several were sequentially imaged for up to six weeks after inducing inflammation by instilling toxic materials into the pericardial space. All dogs with inflammation had contrast enhancement of the parietal and visceral pericardium; this could be demonstrated within one week of the pericardial insult and for up to six weeks and was frequently associated with effusion. Increased pericardial density was not seen in controls or animals with pericarditis prior to contrast infusion. This technique may be useful in evaluating acute pericardial inflammation.

Animals↗

Hypoxanthine and oxygen induced lung injury: a possible basic mechanism of tissue damage?

Lung injury was induced in young rats by a continuous infusion of hypoxanthine intravenously and breathing 100% oxygen for 48 h (group 1). Control animals were rats infused glucose and breathing 100% oxygen (group 2), rats infused hypoxanthine in room air (group 3), and untreated rats (group 4). In group 1 rats interstitial and alveolar edema was found with a tendency toward marked margination of polymorphonuclear neutrophils in small vessels (P less than 0.025 compared with group 2). The main elastase inhibitor alpha 1-antitrypsin (alpha-1-PI) was significantly elevated in group 1; 2-, 3- and 5-fold, respectively, when compared with groups 2, 3, and 4. The surfactant phospholipids from alveolar lavage were normal in all groups. The protein-rich fraction of the lavage fluid from group 1 rats inactivated, however, the surface properties of lung surfactant. Minimum surface tension in group 1 rats was 14.5 dyn/cm compared with 7.0 dyn/cm in group 2, 2.9 dyn/cm in group 3 and 3.5 dyn/cm in group 4 (P less than 0.05, group 1 and 2 versus 4). We conclude that the combination of hypoxanthine and high levels of oxygen causes lung injury, possibly via free oxygen radicals. We discuss the possibility that these findings demonstrate a basic pathogenetic mechanism for the hypoxic-hyperoxic insult and can contribute to the understanding of pathogenesis of a variety of diseases both in pediatrics and adult medicine.

Animals↗

Occupational lung diseases.

Clinical evaluation of a patient with occupational lung disease requires determining the pathophysiologic process, identifying the agent that is or was responsible, determining the prognosis and level of disability, assessing how the disease can be controlled or limited, and investigating the extent to which other workers may be affected. These conditions include the pneumoconioses, toxic inhalation, occupational asthma, hypersensitivity pneumonitis, industrial bronchitis, fume fevers and cancer. The family physician is in a good position to recognize these problems in the community.

Family Practice↗

Fibrogenic potential of welding fumes.

A search of 3600 indexed pathology cases has disclosed pulmonary fibrosis in 29 welders. Scanning electron microscopy of biopsy material revealed macrophages laden with inorganic particulates which have characteristics compatible with welding aerosols. In order to establish a possible relationship between fibrotic reaction and welding-fume exposure, the fibrogenic potential fo some 11 different welding fumes and metallic aerosols, considered to be reference standard surrogates for the commonly used welding technologies and applications responsible for 70% of welders exposure, were screened using the Rat Peritoneal Macrophage in vitro bioassay. Only one class of fumes, that from the manual metal arc welding of stainless steel, showed distinct fibrogenic potential. This fume is, however, not common to more than four or five of the heretofore 90 cases of pulmonary fibrosis reported among welders. Thus, although insoluble Cr(VI) is probably the active fibrogen in stainless steel fumes, an etiological factor common to all fibrogenic welding exposures must be sought. It is tentatively proposed to be NO2, a potential experimental in vivo fibrogen copiously produced by certain welding processes and ubiquitous at low concentrations in the welding environment.

Adult↗

Angiosarcoma of the lung with fatal pulmonary hemorrhage.

A patient with fatal pulmonary hemorrhage was found to have angiosarcoma of the lung at postmortem examination. This case, occurring in a man with a prior history of industrial exposure in South African copper mines, is the third well-described primary occurrence of this tumor in the lung.

Aged↗

Diagnosis of early human myocardial ischemic damage with electron probe microanalysis.

We determined the Na/K x-ray intensity ratio in frozen sections of myocardial tissues obtained at autopsy from patients who died from various causes, using electron probe analysis. We have been able to distinguish between the ischemically injured and normal cells. The method is simple, fast, and dependable even when the duration of ischemia is only 30 minutes.

Adolescent↗

Lead poisoning from hair spray ingestion.

A 37-year-old alcoholic woman was poisoned by lead from drinking hair spray mixed with water. Laboratory and pathologic findings showed changes due to lead poisoning. Further analysis by Scanning Electron Microscopy (SEM) and Energy Dispersive X-Ray Analysis (EDXA) confirmed the presence of lead in both the tissues and the hair spray. The significance of these findings is discussed.

Adult↗

A guinea pig model to study effects of persistent intrabronchial antigenic stimulation and inflammation.

Chronic antigenic stimulation and inflammation of the bronchial tree occurs in several diseases involving microbial airway colonization. We developed a guinea pig model to study the effects of persistent intrabronchial antigenic stimulation with keyhole limpet hemocyanin (KLH). Sepharose beads 200 to 300 micron in diameter conjugated with 300 micrograms KLH were injected via a tracheostomy catheter, causing them to lodge in the bronchial tree. When lung sections from these animals and animals given uncoupled sepharose beads were examined histologically, it became apparent that in this model the persistent antigenic stimulus is accompanied by local inflammation caused by an irritant effect of the beads. To determine how the intrabronchial antigen was distributed locally and systemically, 125I labeled KLH-coupled beads were administered. Radioactivity remained predominantly in the lung, where 13 +/- 5% of the administered dose was still detectable by Day 30. Autoradiographs of Day 30 lung sections demonstrated that the radioactivity was concentrated on the individual beads, indicating that it largely represented KLH persisting in the bronchial tree. Minute amounts of radioactivity were detected systemically and in the regional lymph nodes (LN). A radioimmune assay of serum collected on Day 1 demonstrated that some of the circulating radioactivity represented antigenic KLH. When anti-KLH antibody-forming cells (AFC) were measured in lung homogenate, regional LN, blood, and spleen cell preparations after KLH-coupled bead administration, they were initially detected only in the spleen. Significant concentrations appeared in the lung homogenate, regional LN, and spleen by Day 10 and thereafter through Day 20.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Quantitative analysis of inorganic particulate burden in situ in tissue sections.

Quantitative information on tissue particulate burden is essential for investigation of relationships of particulates to several aspects of disease, such as exposure, physiology, radiology and pathology. We have developed a method for quantitative analysis of inorganic particulate burden in situ in tissue sections using scanning electron microscopy (SEM) with backscattered electron (BSE) imaging and energy dispersive x-ray analysis (EDXA) or the ion microprobe mass analyzer (IMMA). Our data show reproducible results for concentrations above 10(6) particles per cm3 of tissue. Samples of less than one microgram can be analyzed. Standard 5 microns paraffin sections of formalin fixed tissue are mounted on carbon discs, deparaffinized and examined in the SEM under standardized conditions. Fields of view comprising 10,000 microns3 are searched and all particles visible in the BSE image are counted and individually analyzed by EDXA. Location, number, size and types of particles are tabulated. Previous work showed correlation of quantitative SEM/EDXA with bulk analysis for Ni (r = 0.64), and IMMA with bulk analysis for Be (r = 0.999). Analytical results on exogenous and endogenous particles in 40 lungs (greater than 6000 fields searched and greater than 5700 particles analyzed), and the pathology observed in the tissue, may serve as baseline for future studies on all types of inorganic particles in normal and abnormal lungs. Observed concentrations ranged from 3 X 10(6) to 2 X 10(9) exogenous particles per cm3 of tissue.

Asbestosis↗

Cysticercosis of the fallopian tube: histology and microanalysis.

The authors identified a degenerated, focally calcified cestode larva (cysticercus) in the fallopian tube of a 50-year-old woman with endometriosis. The physiologic reaction to the larva was minimal, with some focal granulomatous salpingitis. No other focus of infection was detected. The differential diagnosis included trophoblastic tissue, foreign material, and parasites. Scanning electron microscopy and x-ray microanalysis of the organism revealed concentration of iodine in the subcuticular connective tissue of the larva and confirmed the calcium phosphate composition of the calcareous corpuscles. The presumed source of the iodine was the continued exposure of the larva to an environment rich in iodide secreted by the epithelium of the fallopian tube.

Cysticercosis↗

Treatment of mixed-dust pneumoconiosis with whole lung lavage.

A patient with silicosis and progressive dyspnea on exertion is described in whom open lung biopsy revealed active chronic inflammation with many macrophages filling alveolar spaces. Because of the extensive involvement by the disease of small air spaces, bilateral whole lung lavage was performed. The lung lavage effluent was striking in its blackish brown color. It was composed predominantly of macrophages containing silica, silicates, and graphite. Particles in the tissue and lavage were analyzed using scanning electron microscopy and energy dispersive X-ray analysis. The dry weight of the material removed was approximately 25 g, of which an estimated 135 mg was silica. The procedure resulted in immediate symptomatic improvement in the patient. Although his pulmonary function did not change significantly, it is hoped that removal of this material will improve his long-term prognosis.

Biopsy↗

Pulmonary hypertension. Its association with hepatic cirrhosis and iron accumulation.

A 62-year-old white woman was found to have pulmonary hypertension; a short time later hepatic insufficiency developed. At the time of autopsy, hepatic cirrhosis, "primary" pulmonary hypertension, and evidence of increased iron absorption and storage were found. Pulmonary hypertension is an unusual complication of portal hypertension that is being reported increasingly often.

Female↗