Intrathoracic lymphadenopathy and HIV infection.
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Biomedical subjects
Publications and source records attributed to J R Salisbury.
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An investigation was made into the characteristics of an experimental chronic alcoholic myopathy in the young rat. Male Wistar rats were fed a diet for 6 weeks in which ethanol comprised 36% of total energy. Controls were pair-fed the same diet except ethanol was substituted by isoenergic glucose. Soleus (type I fibre-rich) and plantaris (type II fibre-rich) muscles were examined by light microscopy, histochemistry and electron microscopy. Muscles from ethanol-fed rats showed a low-grade myopathy and the diameters of individual type II fibres were reduced. Infrequent atrophic fibres were necrotic and undergoing phagocytosis. Ultrastructurally, there were no observable differences in the subcellular organelles of the alcohol-fed and control rats. It was concluded that alcohol causes a specific myopathic process in the rat, selectively affecting type II fibres. These changes correlate well with the abnormalities seen in human chronic alcoholic myopathy.
Intimal hyperplasia is a significant cause of vascular graft failure. To investigate the potential uses of low molecular weight heparins (LMWHs) as prophylactic agents against graft thrombosis in humans, the anti-proliferative effects of a regimen of subcutaneous LMWH have been studied in an experimental model. Aortic intimal hyperplasia was created in 30 New Zealand White rabbits by endothelial denudation using an embolectomy balloon catheter technique. Three groups of ten animals were randomized to act as controls or to be treated with subcutaneous LMWH once or twice daily for 4 weeks. At 4 weeks all animals were killed and the aortas were harvested for analysis. The degree of intimal hyperplasia was measured using a computerized image analysis system and was expressed as an intimal:medial area ratio and also as percentage luminal reduction. A 60 per cent reduction in the degree of intimal hyperplasia was seen following treatment with LMWH. Heparin-treated animals had considerably less luminal reduction (daily LMWH 8 per cent and twice-daily LMWH 10 per cent) compared with untreated controls (26 per cent) (P less than 0.001). There was a similar difference seen in the intima:media area ratios, daily LMWH 0.38, and twice-daily LMWH 0.44, versus controls, 1.11 (P less than 0.001). In an experimental model, subcutaneous LMWH therapy effectively inhibits intimal hyperplasia.
It has been suggested that the occurrence of abnormal localization of immature precursors (ALIP) in the bone marrow biopsy (BMB) may be of diagnostic and prognostic significance in myelodysplastic syndromes (MDS). The recognition of ALIP has been based exclusively on bone marrow histological appearances. During the last decade technical advances have led to the widespread use of various immunophenotypic markers for the diagnostic and prognostic purposes which has contributed enormously in understanding the development of haemopoietic cells and the cellular origin of various haematological malignancies. In addition proliferation antigens, growth factors, oncogenes, anti-oncogenes and other biological discoveries have opened new vistas to our knowledge of the normal and neoplastic growth processes. Despite this, the precise nature of ALIP and their significance in relation to the aetiopathogenesis and evolution of MDS remains unclear. Indeed the diagnostic value of ALIP in MDS is debatable. Furthermore, the precise cell lineages which comprise ALIP are not defined. The purpose of this review is to address these issues and to incorporate our new findings on the histological and immunophenotypic characterization of immature cell aggregates.
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A 63-year-old man developed linear, annular and accuminate lesions which showed the histological features of porokeratosis. The lesions cleared spontaneously, recurred several months later and ulcerated, then cleared again. The spontaneous resolution and recurrence of the lesions is a hitherto undescribed pattern of porokeratosis.
(1) We examined the possibility that enhanced fragility of the bony skeleton in alcohol abusers may be a consequence of a reduction in collagen composition. Male rats were fed a liquid diet containing 36% of total calories as ethanol; controls were pair-fed iso-caloric glucose. At 3, 7 and 14 days of treatment, collagen contents of tibia were unaltered, but small and significant reductions (15-30%) were observed at 28 and 42 days of treatment. Urinary hydroxyproline excretion was increased by 40-60% at 42 days of treatment, suggesting enhanced collagen degradation. (2) Bones of rats treated with ethanol for 42 days had significantly reduced mineral content (approximately 20%) with accompanying reductions in phosphate, calcium, copper and magnesium, but not sodium or potassium. Water content was unaltered, but tibial zinc and iron were increased by approximately 15%. (3) Histomorphometric analysis of bones taken at 42 days showed significant reductions in cortical bone thickness of lower tibia (by 28%). The thickness of the upper cortices and cancellous bone of the tibia was unaffected. Reductions in trabecular bone volume (approx. 25%) did not achieve statistical significance. (4) These observations are consistent with the known enhanced fragility of bones in alcoholic rats. The regional susceptibility of the tibia may be related to reduced load bearing as a result of muscle atrophy.
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We report a patient with gastric epithelioid leiomyosarcoma and multiple pulmonary chondromata who remains asymptomatic 38 years after initial resection of the gastric tumour and 4 years after representation with recurrent tumour and multiple liver metastases. This represents an incomplete form of Carney's Triad, and illustrates the unusually indolent natural history of the gastric tumour in this condition. The radiological appearances are described.
The acute effects of ethanol (75 mmol/kg body weight, intraperitoneal) on rates of protein synthesis in bone tibia) and skin of young (approximately 100 g body weight) laboratory rats was investigated. Plasma ethanol levels were raised to approximately 40 mmol/liter. At 2.5 hr, rates of protein synthesis were measured with a flooding dose of L-[4-3H]phenylalanine. In bone the protein-bound specific radioactivities, fractional synthesis rates, and synthesis rates relative to RNA and DNA were significantly reduced by approximately 30%. In skin these variables similarly decreased in response to ethanol treatment, by approximately 25%. The reduction in absolute rates of protein synthesis in bone (delta, 0.7 g protein/day/kg body weight) and skin (delta, 3.4 g protein/day/kg body weight) were comparable to the reductions in liver and skeletal muscle in response to acute ethanol. As bone and skin contribute to a quarter of whole body protein synthesis, it was concluded that these observations may have important implications for whole body protein homeostasis.
Chronic intussusception is a rare but completely correctable cause of failure to thrive in infants and children. The presenting features differ from acute intussusception. We present the case of a 16 month old boy presenting with a three week history of anorexia, diarrhoea, and weight loss with subsequent delayed diagnosis.
Cases of Castleman's disease, a disorder affecting lymphoid organs, which is largely benign in nature, are rare in the pediatric period. This report describes one such case, occurring in a 5-year-old boy, and reviews the published cases of Castleman's disease presenting in childhood and adolescence. The purpose of this review was to compare the features of this disease process in children with the much fuller documentation that exists for Castleman's disease in adults. In children, Castleman's disease usually presents in the abdomen, chest (mediastinum or lung hilum), or neck and may be either asymptomatic or present with systemic symptoms of which anemia and fever are the most frequent. The disease is curable by surgical excision.
A case study of multicentric reticulohistiocytosis is presented with extensive immunohistochemical studies of the infiltrate in both paraffin and cryostat sections. These studies showed that the cells are of monocyte/macrophage origin. B- and T-cell gene rearrangement analysis of multicentric reticulohistiocytosis was also performed and showed a germline configuration.
Obstructive jaundice was the presenting feature in 12 patients with benign, non-traumatic strictures of the extrahepatic bile ducts. Ages at presentation ranged from 1.5 to 60 years and 11 were initially referred with diagnoses of malignant strictures. Histological examination, however, showed benign changes of chronic inflammation, with ulceration in seven, which were distinct from those of primary sclerosing cholangitis. All of the patients remain well from 3 to 14 years after surgery. The aetiology of the strictures is not known.
The development of unusual melanocytic lesions after exposure to UVA tanning beds has been reported recently. We studied one such case with the use of light and electron microscopy and found the appearance similar to the lentigines that may occur after psoralen photochemotherapy. Histologically, some melanocytes showed mild nuclear atypia. Ultrastructural examination showed features similar to those of other forms of lentigo.
Nuclear measurements using image analysis largely depend upon the quality of the image presented for digitization. To investigate the effects of nuclear stains on image segmentation of nuclei, serial sections of kidney were stained by eleven different methods and presented to an IBAS 2000 interactive image analysis system (Kontron Bildanalyse) via a Zeiss IIIRS microscope at x 800 magnification and a Siemens K30 video camera. Digitised grey level images of each field were processed by an interactive technique and by an automatic segmentation procedure (thresholding). Nuclear areas were measured by each method and the results compared. We conclude that of the stains assessed the uncounterstained haematoxylins offer the best image segmentation for nuclear measurements. Thresholding techniques are suitable for performing measurements using these stains, particularly when additional interactive techniques are used to reject unwanted structures and to separate overlapping nuclei after segmentation. Comparable areas stained with five of the stains were studied to see if the staining techniques themselves affected nuclear area. Our results show that the use of different stains will substantially affect measurements of nuclear dimensions.
Rats were pair-fed either a nutritionally complete liquid diet containing 36% of total calories as ethanol or isovolumetric amounts of the same diet in which ethanol was substituted by isocaloric glucose. Chronic ethanol feeding caused a preferential decline in the wet weight of the plantaris (predominantly Type II muscle fibres) which was accompanied by a reduction in the total DNA content. The soleus (a predominantly Type I fibre muscle) was relatively unaffected. Chronic ethanol exposure had no effect on the biochemical index of cell size (protein/DNA ratio) in either the plantaris or soleus. Quantitative histochemistry of Type II fibres in the plantaris demonstrated that ethanol caused an increase in the proportion of fibres with smaller diameters. Similar effects were observed for Type II fibres in the soleus. In contrast, ethanol exposure was associated with an increase in the relative proportion of Type I fibres with higher diameters, in both plantaris and soleus. Light microscopic examination of myopathic muscle sections demonstrated that lesions occurred without evidence of inflammation, fibrosis or other infiltration by non-muscle cells. It is concluded that chronic exposure of rats to ethanol is associated with skeletal muscle atrophy. The lesion appears to be specific for Type II fibres, irrespective of the predominant fibre type in the particular muscle.
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