Biomedical subjects

J Rode

Publications and source records attributed to J Rode.

At least 37 records · Page 2Linked to original sources

PubMed1993

p53 expression in laryngeal carcinoma.

The expression of the nuclear phosphoprotein, p53, was studied in 21 cases of squamous cell carcinoma of the larynx and 16 benign laryngeal lesions using the polyclonal rabbit antibody, CM1 (Novocastra Laboratories Ltd). Fourteen of the carcinomas showed nuclear staining whereas only one of the benign lesions exhibited presence of the protein. This suggests that, as with squamous cell carcinoma of the lung, p53 plays a role in the development of malignant disease of the larynx.

Adult↗

PubMed1993

Ligneous (pseudomembranous) inflammation of the female genital tract. A report of two cases.

Two women, aged 28 and 32, presented with primary infertility and severe dysmenorrhea. The younger woman developed recalcitrant and recurrent firm vaginal, cervical and possibly endometrial lesions over a period of six years; the older patient had similar material in the cervix, endometrium and a fallopian tube. The lesions were composed of amorphous eosinophilic hyaline or necrotic material, shown by histochemical and immunoperoxidase stains to be partly fibrin. Pathologic examination showed that the lesions were similar to those of ligneous (pseudomembranous) conjunctivitis, a rare disease that may occasionally affect the lower female genital tract. However, neither patient had eye disease, and ligneous conjunctivitis has not previously been reported to involve the upper genital tract. Endometrial and tubal involvement could readily explain primary infertility and dysmenorrhea in these patients.

Adult↗

PubMed1992

Small cell carcinoma of the ampulla of vater.

Primary small cell carcinoma of the periampullary region is rare. Only four patients have been reported previously. The authors examined a patient with ampullary small cell carcinoma using a range of immunocytochemical stains. This tumor shows morphologic and neuroendocrine features similar to its pulmonary and extrapulmonary counterparts.

Aged↗

PubMed1992

Autopsy rate and a clinicopathological audit in an Australian metropolitan hospital--cause for concern?

OBJECTIVES: To determine the annual autopsy rates at five major Melbourne teaching hospitals between 1979 and 1989; to investigate the cause(s) of the decline in autopsy rates during that period; and to assess the importance of autopsies at the index hospital by a clinicopathological audit. DESIGN: Retrospective data for annual autopsy rates (i.e. all patients undergoing autopsy as a ratio of the total number of deaths) were obtained for five hospitals and, for the index and one other hospital, demographic data for autopsy rates within certain ethnic and religious groups for 1988. For the clinicopathological audit, clinical diagnoses from hospital charts and death certificate diagnoses were compared with the major findings for all autopsies in 1988. SETTING: The index and the other four hospitals are major Melbourne metropolitan teaching hospitals. PATIENTS: For the index hospital in 1988, demographic data for age, sex, death in a surgical or medical unit were obtained for 643 deceased patients, of whom 124 underwent a hospital autopsy. Data of ethnic background and religion were available for 557 of 643 deceased patients. At another hospital, religious affiliation was obtained for all patients who died in hospital (543) for 1989. RESULTS: Between 1979 and 1989, the autopsy rate declined from 47% to 19% at the index hospital, by relative levels of 50% at three hospitals, and showed a smaller decline at the fourth. At the index hospital in 1988, permission for autopsy was sought in 84% of deceased patients, but was granted in only 22%. The audit showed that major misdiagnoses occurred in 18 of 124 cases (14.5%), with relevance to patient management in eight cases (6%). CONCLUSIONS: The falling autopsy rate at five major teaching hospitals could be attributed to the relatively low status of the autopsy among clinicians and pathologists and the high refusal rates by relatives of the deceased since the introduction in 1983 of the Human Tissue Act 1982 (Vic.). The audit corroborated the importance of autopsies as a diagnostic tool.

Attitude↗

PubMed1992

Minimal change chronic pancreatitis.

In patients with severe abdominal pain, of pancreatic origin, there are a few with minimal or equivocal findings on pancreatic investigation and in whom the aetiology of their pancreatic disease is elusive. The findings and outcome in 16 of these patients (four men and 12 women) who underwent resection are reported. Pancreatic imaging showed minimal or equivocal findings in all 16; pancreas divisum was present in five. All were managed conservatively at first but resection was required for progression of symptoms. A drainage procedure was performed initially in five patients but relief of pain was at best transitory before further surgery was required. Partial resection was needed in 12, of whom eight required subsequent completion pancreatectomy and four had a one stage total resection. Nine patients are currently pain free after resection or are very much improved, while six are no better and one patient has died from an unrelated cause. Histology of resected specimens showed chronic inflammatory changes accompanied by subtle non-inflammatory changes in all but one. These changes include duct proliferation, duct complex formation, adenomatous nodules, and acinar cell atrophy, the significance of which is unclear. These findings suggest a syndrome of minimal macroscopic and radiological change chronic pancreatitis with pain as its chief clinical feature and a distinct histology, the aetiology of which is unclear. It seems that there is a distinct syndrome of minimal change pancreatitis, among the group of patients which presents with the clinical features of chronic pancreatitis.

Adolescent↗

PubMed1992

Atrial myxoma: a tumour in search of its origins.

OBJECTIVE: To determine whether atrial myxomas express antigens suggesting a neural origin. DESIGN: A retrospective analysis based on immunohistochemical examination of myxoma tissue. SETTING: Atrial myxomas excised by two tertiary referral cardiothoracic surgical units. SUBJECTS: 24 excised atrial myxomas. Three were from known cases of familial myxoma syndrome. METHODS: Immunohistochemical identifications of three neuroendocrine markers (protein gene product (PGP) 9.5, neurone specific enolase (NSE), synaptophysin) and S100 antigen; CD34 and von Willebrand factor; and chi smooth muscle actin to identify possible Schwann cell differentiation, endothelial cells, and smooth muscle cells respectively. RESULTS: The myxoma cells were PGP 9.5 positive in 18, S100 positive in 16, and NSE positive in 12. Of the 12 NSE positive myxomas seven were synaptophysin positive. All tumours that were NSE positive were also S100 and PGP 9.5 positive. The tumour surface was partially covered by myxoma cells, partly by endothelial cells. CONCLUSION: The histological appearances of myxomas with stellate cells embedded within a loose connective tissue stroma, abundant basophil cell infiltration, and the presence of pericellular type IV collagen are similar to nerve sheath tumours (neurofibromas) at other sites. A significant proportion of myxomas also express Schwann cell and neuroendocrine differentiation markers. These features cannot prove the origin of myxomas because tumours may develop aberrant phenotype expression but they do accord with the view that myxomas originate from endocardial sensory nerve tissue.

Antigens, Neoplasm↗

PubMed1992

Age, site and distribution of subepithelial neurosecretory cells in the appendix.

The appearance of subepithelial neurosecretory cells (SNC) was investigated by studying completely sampled appendices of 50 children, adolescents and adults. The cells were demonstrated using lead hematoxylin, a selective stain for neurosecretory cells. Additional routinely sampled specimens were also studied for comparison. In children up to the age of 9 yrs only occasional SNC were found. After this age, however, SNC were present in most appendices and in greater numbers. The majority of SNC were located in the distal portion of the appendix, with only small numbers of these cells being present in the proximal segment. Occasional SNC-like cells were identified in the appendiceal submucosa in all regions of the appendix at all ages. This lends support to the hypothesis that a correlation exists between the presence of increased numbers of SNC, patient age and the site distribution of both acute appendicitis and appendiceal carcinoid tumors.

Adolescent↗

PubMed1992

Wake up to managing customer relationships.

A survey of 50,000 American households on their habits in purchasing healthcare services shows that healthcare marketers need to "wake up" to managing their customer base more effectively before they miss critical opportunities to capture and retain business.

Attitude to Health↗

PubMed1991

Nuclear DNA profiles in primary melanomas and their metastases.

DNA-aneuploid primary melanomas are said to show a greater propensity to metastasize than those without an aneuploid profile. A higher aneuploid rate has also been reported in metastatic melanomas than in primary lesions. The ploidy profile was determined of 26 primary melanomas and their first subsequent secondaries on Feulgen-stained sections from routinely processed material using a computerized video image-analysis system. In 18 of 26 cases, both primary and secondary tumor showed similar corresponding DNA patterns. These were aneuploid in 13 of 18 of the cases. A hyperdiploid pattern was present in one case in both the primary and its metastasis, and a diploid pattern was seen in four cases. There were only eight cases in which a disparity between the nuclear ploidy profile in the primary and secondary tumor was evident. Although the results suggest that ploidy studies are not useful for predicting the metastatic potential of a primary melanoma, the maintenance of similar DNA profiles in the metastases in most of these cases was interesting in regard to tumor biology.

Aneuploidy↗

PubMed1991

Changes in neurons, neuroendocrine cells and nerve fibers in the lamina propria of irradiated bowel.

Damage to bowel often complicates radiotherapy for abdominal and pelvic malignancy. The symptoms of chronic irradiation enteropathy, which often include intractable diarrhoea, are generally attributed to vascular injury. We have examined specimens of bowel resected from patients who had been therapeutically irradiated to assess the extent of injury to the enteric nerve plexuses. To facilitate visualisation of nerve fibres and cells of neural or neuroendocrine origin, sections were immunostained with antibodies to neuron-specific enolase or PGP 9.5, widely used markers of nerves and neurons. Electron microscopy was performed in selected cases. In 27 out of 33 specimens the number of nerve fibres in the lamina propria was obviously increased compared to that in control material. Scattered cells with the histological, immunohistochemical and ultrastructural features of ganglion cells were noted within the lamina propria in 23 of the specimens, and in 18 cases so-called neuroendocrine cells, not normally seen in this location, were also present. These radiation-induced changes in the innervation of the bowel may contribute to the symptoms of chronic radiation enteropathy.

Adult↗

PubMed1991

Comparative ploidy studies using cytological and paraffin section preparations.

The ploidy profiles of benign and malignant tumours can be obtained using image analysis. However, the results of ploidy studies have varied according to the type of specimen used. We compared the ploidy profiles of paraffin embedded thin sections, cytospin preparations of disaggregated cells, and cytological smears from the same specimen as defined by image analysis. Ten benign breast lesions, 10 breast carcinomas and 10 malignant melanomas were investigated in this way. Preparations stained by the Feulgen technique were examined using the MD20 video image analysis densitometry system. Ploidy profiles were obtained by measuring the integrated optical density of at least 200 nuclei. By paying proper attention to the quality of fixation and presence or absence of cytoplasm around cells, comparable results were found for all preparations in each case. We therefore conclude that if careful attention is paid to the technical quality of the material, reliable ploidy results can be obtained by image analysis.

Aneuploidy↗

PubMed1991

Laryngeal paragangliomas and neuroendocrine carcinomas.

Forty-eight neuroendocrine tumours of the larynx were studied, of which 41 were classified as large cell neuroendocrine carcinoma. Most of these tumours occurred in the supraglottic larynx and the patients were predominantly male. Exquisite pain was a presenting feature in one third. These carcinomas metastasized, frequently to skin, giving rise to painful secondary lesions, but long-time survival occurred. Histologically, large cell neuroendocrine carcinoma had a number of features seen in neuroendocrine tumours at other sites, including grouping into 'Zellballen' which mimics paraganglioma. Four tumours were definite paragangliomas. These tumours have behaved benignly. There were three cases of small cell neuroendocrine carcinoma, a tumour which is histologically identical to its counterpart in the bronchus and has a very aggressive course. All three types of tumour expressed general neuroendocrine markers, but only large cell neuroendocrine carcinoma marked for both cytokeratin and calcitonin. In the paraganglioma cases sustentacular cells were identified and marked for S-100 protein and glial fibrillary acidic protein. Histological examination, supplemented with immunohistochemistry, helped distinguish these tumours into those requiring different treatment regimens.

Adolescent↗

PubMed1991

Characteristics of mast cells in normal bladder, bacterial cystitis and interstitial cystitis.

An analysis was made of the numbers and characteristics of mast cells in lateral bladder wall biopsies from 22 patients with interstitial cystitis, 6 with bacterial cystitis and 8 normal controls, using toluidine blue stains and computerised video image analysis techniques. A significantly greater number of mast cells were found within the detrusor muscle in interstitial cystitis than in bacterial cystitis or normal controls. Within the urothelium and submucosa, mast cell numbers were significantly greater than in normal controls in both interstitial and bacterial cystitis. In interstitial cystitis mast cells were significantly larger within the detrusor than in the urothelium/submucosa and they appeared to degranulate predominantly within the superficial layers. Differential staining techniques, using long and short toluidine blue stains, failed to reveal statistically significant evidence of mast cell heterogeneity within the bladder wall in interstitial cystitis.

Bacterial Infections↗

PubMed1991

Analysis of adhesion molecules in the immunopathogenesis of giant cell arteritis.

To explore the role of adhesion molecules in mediating mononuclear cell localisation, development of the granulomatous reaction, and cell mediated damage to the arterial wall in giant cell arteritis, 17 temporal artery biopsy specimens were examined. Eleven showed the histological features of giant cell arteritis and six showed no evidence of arteritis. All were examined for the expression of LFA-3, ICAM-1 and its receptor LFA-1, and HLA-DR. Temporal arteries with early features of arteritis, as well as histologically unaffected skip areas, showed a regional induction of ICAM-1 expression, but not HLA-DR, on smooth muscle cells of the media. ICAM-1 expression was detected in areas where a clinically important mononuclear cell infiltrate had not yet developed. In more florid cases of giant cell arteritis there was an additional widespread induction of ICAM-1 expression on intimal myofibroblasts. Strong expression of ICAM-1, HLA-DR, and LFA-3 was found on macrophages, epithelioid cells, and giant cells comprising the granulomatous lesion. The pattern of expression of these adhesion molecules suggests that they have a role in leucocyte traffic into the vascular lesion as well as in mediating the intercellular interactions which constitute the granulomatous response.

Aged↗

PubMed1991

Occult carcinoma in an adult choledochal cyst.

The complications of choledochal cyst are avoidable if diagnosed early, and adequate resection undertaken. This case report describes the long history of right subcostal pain in a young man of 26 who had a squamous carcinoma in a choledochal cyst diagnosed after serial section of the excised cyst. Subsequent resection of the head of the pancreas showed histological residual tumour from which he died 4 months later. This case illustrates the need for complete early excision of a choledochal cyst to prevent this complication.

Adenocarcinoma↗

PubMed1991

Nuclear ploidy in neuroendocrine neoplasms of the larynx.

Seventeen neuroendocrine neoplasms of the larynx were examined for DNA ploidy. Twelve tumours were atypical carcinoids, four paragangliomas and one a small cell neuroendocrine carcinoma. Seven atypical carcinoids were aneuploid, one diploid and one tetraploid, with metastasis being aneuploid. In three cases only skin metastases were available for study, which were aneuploid. The small cell neuroendocrine carcinoma was aneuploid. Two of the paragangliomas were aneuploid and two diploid. Like other sites, neuroendocrine neoplasms of the larynx have a high rate of aneuploidy. Determination of DNA ploidy did not provide useful diagnostic or prognostic information.

Aged↗

PubMed1990

S100 protein, neurone specific enolase, and nuclear DNA content in Spitz naevus.

The differentiation between Spitz naevus and melanoma is at times difficult. The present study was undertaken to define means to positively identify such melanocytic tumours of doubtful malignancy. Immunohistochemical staining intensity for S100 protein and neurone specific enolase (NSE) was measured in sections of 35 Spitz naevi using a microcomputer image analysis system. The data were compared with results previously obtained from 19 cases of malignant melanoma and 16 benign compound naevi. Disaggregated cells from paraffin-embedded material were stained by the Feulgen technique for DNA estimation. The nuclear DNA content distributions were measured using the same image analysis system. Compared with the malignant cases, the Spitz naevi showed significantly lower staining intensity for both S100 protein (P less than 0.0001) and NSE (P less than 0.0001). When compared with the benign compound naevi, the staining intensity was significantly lower for S100 protein (P = 0.003). The nuclear DNA distribution in Spitz naevi proved to be a normal diploid pattern in 31 cases. Four cases showed a small proportion of hyperdiploid nuclei. The results show that Spitz naevi can be significantly distinguished from malignant melanoma by staining intensity for S100 protein and NSE. A normal diploid DNA content distribution appears to be typical for Spitz naevi. Spitz and benign compound naevi show dissimilar expression of S100 protein which may indicate different patterns of differentiation in these two types of lesion. The image analysis equipment used in this study is accurate, simple to use, produces results rapidly, and is economic. Therefore, it is clinically practicable.

Biomarkers, Tumor↗

PubMed1990

Nerve fibre proliferation in interstitial cystitis.

The aetiology of pain in interstitial cystitis is not understood, although it has been reported to be due to release of mediators from mast cell granules. Cystolysis and intravesical instillation of dimethyl sulphoxide have been shown to relieve pain in this condition. We have studied the nerve population within the bladder wall using immunohistochemical stains for protein gene product 9.5. A group of 18 cases of chronic interstitial cystitis and 12 controls; neuropathic bladder (n = 1), chronic bacterial cystitis (n = 3), systemic lupus erythematosus cystitis (n = 2) and normals (n = 6), were investigated. There were significantly more nerve fibres within the sub-urothelial and detrusor muscle layers in chronic interstitial cystitis than there were in normals. Patients with chronic cystitis of other aetiology did not have a significant increase in nerve fibre density within the bladder wall suggesting a specific association between nerve fibre proliferation and interstitial cystitis. Cystolysis is shown to deplete selectively the submucosal nerve plexuses without altering the nerve density within detrusor muscle. This finding explains the desensitisation of the bladder without impairment of detrusor function after this procedure.

Cell Division↗