Biomedical subjects

K B Shilkin

Publications and source records attributed to K B Shilkin.

77 records · Page 5Linked to original sources

PubMedDate not supplied

Primary biliary cirrhosis: clinicopathological characteristics and outcome.

Thirty-five patients with primary biliary cirrhosis were seen between 1974 and 1989. The median mean age at presentation was 53 years (range: 30-77) and the female to male ratio was 7.8:1. Thirteen (37%) were asymptomatic and nine (26%) had associated auto-immune disorders. Pruritus and hepatomegaly were present in half of the patients. Advanced histological stages of disease (Stages 3 and 4) were present in 57% of patients. The median period of follow-up was 5 years (range: 0.1-20). Twelve patients died, nine from hepatic causes and three from non-hepatic causes. One has undergone liver transplantation. A Kaplan-Meier curve estimated the median survival to be 11 years. Asymptomatic patients developed progressive disease and survival was similar to that of symptomatic patients. Using Cox's proportional hazards model, age, serum bilirubin and serum albumin were found to be independent prognostic variables correlating with reduced survival.

Female↗

PubMedDate not supplied

Primary sclerosing cholangitis: clinical and immunopathological review of 21 cases.

Twenty-one patients with primary sclerosing cholangitis were seen during 1979-87. The mean age at onset of disease was 51.7 years (range: 13-78 years) with a male: female ratio of 2.5:1. Six (29%) were asymptomatic at the time of diagnosis. Eleven patients (52%) had ulcerative colitis. Cholangiography demonstrated abnormalities limited to the intrahepatic ducts in 10 cases, with both intrahepatic and extrahepatic involvement in 11. Histological features on liver biopsy included: portal tract inflammation and cholestasis in all; paucity of bile ducts in 56%; piecemeal necrosis in 19% and cirrhosis in 6%. Circulating autoantibodies and elevated serum immunoglobulins were found in half of the patients and HLA-B8 was detected in 53%. A deficiency of circulating CD3 and CD8 cells was not found in the 12 patients tested. The mean follow-up was 51 months (range: 3-180 months). Three patients died from non-hepatic causes and another has received liver transplantation. A Kaplan-Meier curve predicted 70% survival at 72 months.

Autoantibodies↗

PubMedDate not supplied

The cytology of malignant mesothelioma in Western Australia.

The cytology of malignant mesothelioma seen in 12 patients associated with the mining of crocidolite asbestos in Western Australia is described. Two main patterns of mesothelioma were observed: the spindle cell and epithelial varieties. In the more common epithelial variety, five features were found to be of particular value in making a cytologic diagnosis. These include the finding of cell aggregates, multinucleation, the presence of brush-like borders, the close apposition of cell borders, and a characteristic cytoplasm. A diagnosis of malignant mesothelioma may be established by cytologic examination of effusions. The awareness of the possible occurrence of such a primary malignant neoplasm with the features outlined may be helpful in this regard.

Asbestos↗

PubMedDate not supplied

Fine needle aspiration cytology of malignant mesothelioma.

The results of fine needle aspiration (FNA) cytology in 19 cases of malignant mesothelioma are presented. Adequate material for a diagnosis of malignancy was obtained in 17 cases, and in 8 cases a specific diagnosis of mesothelioma could be made. In four other cases, the findings were either consistent with or suggestive of mesothelioma; in four, accurate distinction from other neoplasms was not possible, and in two cases, adenocarcinoma was suggested. The spectrum of cytologic findings ranged from neoplasms of purely epithelial appearance through more pleomorphic biphasic neoplasms to anaplastic tumors. A combination of epithelial-like cell clusters, pavement-like sheets of epithelial cells with well-defined cell borders and prominent cell separation, dispersed angular cells with dense cytoplasm and some spindle-cell forms was the most specific cytologic pattern for mesothelioma. In four neoplasms, ultrastructural examination of aspirated material provided the additional evidence for a definitive diagnosis. The identification of hyaluronic acid within intracytoplasmic vacuoles, either in smears or in cell blocks, confirmed the diagnosis in three tumors. Only in one case, with a strong clinical background suggesting mesothelioma, was the cytologic preparation sufficient for diagnosis without ancillary diagnostic methods. FNA is of particular value in the diagnosis of pleural mesothelioma in patients who do not present with a pleural effusion. Obtaining material for cell block preparations, cytochemistry or ultrastructural study is generally necessary for definitive tumor typing.

Adult↗

PubMedDate not supplied

Cytologic and tissue culture characteristics of asbestos-induced mesothelioma in rats.

Mesotheliomas were induced in rats by the intrapleural injection of Western Australia crocidolite asbestos. Over a two-year period, 10 of 18 animals in which implants were established developed mesotheliomas, for a 56% success rate. Histologically, most mesotheliomas were biphasic although predominantly spindle celled. Pleural fluid was examined in five of these malignant cases: three had a papillary epithelial picture, one had mainly anaplastic cells, and one contained predominantly spindle-shaped cells. Three types of cell aggregates occurred: classical collagen-containing papillary clusters, spindle-cell aggregates and cystlike spheres. These last structures corresponded to microcystic or adenomatoid growth present in four mesotheliomas. Two of the effusions were cultured successfully; the growth pattern was typically mesothelial, with in vitro production of collagen. Ultrastructurally, long, slender microvilli, cell junctions and intermediate filaments confirmed the mesothelial nature of these asbestos-induced rat malignancies.

Animals↗