Biomedical subjects

J T Stocker

Publications and source records attributed to J T Stocker.

43 records · Page 3Linked to original sources

PubMedDate not supplied

Immediate postmortem cultures in an intensive care nursery.

The results of several published studies suggest that bacterial infection plays an important role in the mortality of Neonatal Intensive Care Unit (NICU) patients. To evaluate more thoroughly this role we have routinely performed postmortem cultures of blood and cerebrospinal fluid on all infants who die in our NICU. During a 5-year review period 25.9% of infants who died had one or both cultures positive for an organism considered to be pathogenic in the neonate. The organisms most commonly cultured were Klebsiella pneumoniae, Escherichia coli and Group B Streptococcus. Of those infants who had positive postmortem cultures and who had an autopsy, 95% had histologic evidence of infection. Forty-three percent of our infants with positive postmortem cultures were not suspected of having a serious infection and had not received antibiotics before death. Postmortem cultures appeared to be helpful in identifying NICU patients in whom serious infection may have played a role in mortality. Unsuspected serious infection is a common finding in infants who die in a neonatal intensive care setting.

Bacterial Infections↗

PubMedDate not supplied

Intralobar sequestration: radiologic-pathologic correlation.

Intralobar sequestration accounts for 75% of pulmonary sequestrations. The lesion consists of lung tissue that lacks normal communication to the tracheobronchial tree, has systemic arterial supply, and shares the pleura of the parent lobe. The majority of intralobar sequestrations are probably acquired lesions. Patients usually present before the age of 20 years with recurrent infection. At pathologic examination, intralobar sequestration is characterized by inflammation and fibrosis. At radiologic examination, intralobar sequestration typically appears as a consolidation or mass, with or without cavitation, within a lower lobe. In many cases, cystic change may be present within the affected lobe. Identification of a systemic arterial supply supports the diagnosis. Patients are treated with surgical excision, and prognosis is favorable.

Bronchopulmonary Sequestration↗

PubMedDate not supplied

Mesenchymal hamartoma of the liver: report of 30 cases and review of the literature.

Thirty cases of mesenchymal hamartoma of the liver are presented and compared with 42 previously published cases. The patients, 69% male, range in age from newborn to 10 years (average age 15 months, median age 10 months). Except for occasional cases in which the lesion is an incidental finding at autopsy, most present with progressive abdominal enlargement over a period of days to months. Physical and radiologic examinations are nonspecific except for the demonstration of a mass within or attached to the liver. The masses are large, averaging 1311 g, and frequently contain cysts filled with clear fluid or gelatinous material. Histologic examination shows a mixture of loose mesenchymal tissue, bile ducts, connective tissue, and hepatocytes along with cysts formed either from degenerative areas of mesenchyme or from dilated bile ducts and lympathics. Treatment is partial or total excision of the lesion. Mortality (7-17%) is related to intraoperative or postoperative complications. Recurrence or malignant transformation has not been noted.

Child↗

PubMedDate not supplied

Hepatoblastoma: the prognostic significance of histologic type.

The clinicopathologic features of 105 hepatoblastomas accessioned to the Armed Forces Institute of Pathology between 1967 and 1987 were reviewed. DNA content was analyzed by flow cytometry. A multivariate analysis using the Cox proportional hazards model was performed to evaluate the effect of stage, histologic type, and DNA content on the prognosis for survival. The relative risks of death for a given stage compared to the other stages combined were 0.1637, 0.5672, 2.8742, and 3.5148 for stages I-IV, respectively. The relative risk of death for a given histologic type adjusted for age, sex, and stage compared to the other types was 1.0739 (p = .8850) for the fetal pattern, 1.7409 (p = .1662) for the embryonal pattern, 0.5292 (p = .0754) for the mixed pattern, 1.1980 (p = .7729) for the macrotrabecular pattern, and 3.7096 (p = .1061) for the small-cell undifferentiated pattern. Of 19 hepatoblastomas analyzed for DNA content, 5 were DNA diploid and 11 were DNA aneuploid; 3 could not be classified. The stage of disease at presentation proved to be a significant prognostic factor, whereas histologic type and DNA content did not have a significant effect.

Aneuploidy↗

PubMedDate not supplied

Angiosarcoma of the liver in childhood: a clinicopathologic and follow-up study of 10 cases.

The clinical, morphologic, and follow-up findings in 10 cases of childhood hepatic angiosarcoma are reported. Six patients were female and four were male. The age range was 18 months to 7 years, with a mean of 3.7 years. The usual presenting feature was an abdominal mass, with or without associated symptoms. The histologic pattern of childhood hepatic angiosarcoma typically consists of large hypercellular whorls of spindled sarcoma cells intermingled with bile ducts, vessels, and collagen. Factor VIII staining of tumor cells is focal, cytoplasmic, and weak in character. Intracellular eosinophilic, PAS-positive globules are present in most cases and may be abundant. The prognosis is poor; follow-up available in seven cases showed only one to be alive 32 months after diagnosis. The remaining six patients had died 0-27 months (mean 10 months) after diagnosis.

Adrenal Gland Neoplasms↗

PubMedDate not supplied

Congenital cystic adenomatoid malformation within an extralobar pulmonary sequestration.

A type II congenital cystic adenomatoid malformation (CCAM II) occurring within an extralobar pulmonary sequestration (ELS) is described. This large malformation and accompanying pulmonary hypoplasia were diagnosed prenatally by ultrasound examination at 24-25 weeks gestational age. Based upon this diagnosis, the pregnancy was terminated. Autopsy revealed a 40.5 g supradiaphragmatic sequestration, severely hypoplastic lungs, and a hypoplastic heart. Morphologic and clinical features of both CCAM and ELS are compared. CCAM occurring within an ELS has been reported on at least twelve occasions. All the malformations in which the type was reported were of the less differentiated types II or III. We offer an explanation of this fact based on the timing of the embryologic maldevelopment.

Adult↗

PubMedDate not supplied

Focal peliosis hepatis, a sequela of asphyxial death?

Focal peliosis hepatis seen incidentally in five children succumbing to an asphyxiating death is described. The patients include four females and one male, with age range from 10 months to 15 years. Autopsy liver findings include speckled yellow foci to large (multiple centimeters) yellow tumor-like tissue, which fade upon standing. Microscopically, the lesions are composed of multiple cystic lacunae, which appear to be dilated hepatic sinusoids, lined by reticulin fibers, Kupffer cells, and hepatocytes. Immunohistochemical stains for factor VIII-related antigen and Ulex europaeus are negative. The lesion may represent an early form of peliosis; the possibility of interstitial/sinusoidal air cannot be ruled out.

Adolescent↗