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M K Heatley

Publications and source records attributed to M K Heatley.

71 records · Page 4Linked to original sources
PubMed1995

A critical evaluation of the use of the Schiller test in selecting blocks from the uterine cervix in suspected intraepithelial neoplasia.

The value of dipping cervical cone biopsy specimens in iodine (the Schiller test) as a method of deciding which areas should be selected for histological examination was assessed. Schiller positive and negative areas were recorded in macroscopic specimen images from fifty specimens of cervix. The results were compared with the histological presence or absence of cervical intraepithelial neoplasia (CIN) or invasive malignancy. In 84% of cases the test was a reliable means of predicting the presence or absence of squamous CIN; in two cases it was positive in association with endocervical adenocarcinoma in situ. A false positive and false negative Schiller's test was present in three cases (6%) each. Had this method been adopted as the sole means of selecting blocks for histological examination the areas of CIN would have been missed in 6% of cases. Therefore it is not a sound alternative to the submission of all tissue for histological examination.

Biopsy↗
PubMed1992

Acute pancreatitis: a comparison of the severity of illness in cases first diagnosed before and after death, using a modified prognostic index.

The severity of disease in a series of patients in whom acute pancreatitis was diagnosed at autopsy was assessed by the retrospective application of a standard prognostic index modified for post-mortem use. The results were compared with cases dying of acute pancreatitis which was recognized during life and appropriately treated. No difference in disease severity could be identified between the two groups. This suggests that patients dying of acute pancreatitis unrecognized during life have a severe form of the disease and do not die because a mild attack is treated inappropriately. The condition appears to be unrecognized in such patients because it presents with atypical features.

Acute Disease↗
PubMed1991

Retrospective application of prognostic indices to pancreatitis discovered at necropsy.

Six prognostic indices, which were developed to assess inpatients with acute pancreatitis, were evaluated for possible retrospective application. When applied to a series of 14 cases in whom pancreatitis was first diagnosed at necropsy, the index devised by Jacobs et al was found to be the most useful, because in nine of these cases eight or more of the variables required were available for assessment from the case records. In the other indices evaluated fewer than eight of the required variables were available for retrospective assessment in most cases. Although undiagnosed pancreatitis is probably uncommon as a sole cause of death, the retrospective use of one or more of these indices may help assess the severity of the patient's condition on admission to hospital.

Acute Disease↗
PubMed1990

The blood alcohol concentration at post-mortem in 175 fatal cases of alcohol intoxication.

The mean blood alcohol concentration (BAC) in 175 fatal cases of acute alcohol intoxication was found to be 355 mg/100 ml. This figure is less than that quoted in many standard textbooks on forensic medicine. The BAC in fatal cases of acute alcohol intoxication complicated by aspiration was lower than in those cases where there was no evidence of aspiration at autopsy. In those individuals with a previous history of alcohol abuse the BAC causing death was found to be significantly higher than in those without a history of prolonged heavy alcohol consumption suggesting that a degree of tolerance to the effects of alcohol may be induced.

Adult↗
PubMed1990

Acute pancreatitis--the correlation between pathogenesis and histological findings at autopsy.

Acute pancreatitis is a commonly encountered acute inflammatory condition which involves the pancreas. It has been suggested that the distribution of necrosis and inflammation seen histologically depends on whether the pancreatitis occurs as a result of ductal obstruction or following an interruption in the supply of blood to the pancreas. A histological review of 27 pancreata removed at post-mortem from patients dying with acute pancreatitis confirms that the distribution of inflammation seen in the pancreas is characteristic of the pathogenic mechanisms giving rise to the disease. The findings of experimental and autopsy series are reviewed and provide support for the hypothesis.

Acute Disease↗
PubMed1990

A clinicopathological review of spinal ependymomas in Northern Ireland.

Of eighty-three tumours of ependymal origin diagnosed in the twenty years 1969-1988 in Northern Ireland, fifteen were located within the spine. Two were in children, 13 in young adults with a mean age of 33 years. 70% presented with back pain and 60% had weakness of the lower limbs. Survival was found to correlate well with histological grading (WHO classification). The mean time of survival for tumours graded 1/2 was six years; there were three long-term survivors of 13, 17 and 18 years; 90% of the patients survived 2.5 years.

Adolescent↗
PubMed1989

The relationship between blood and urine alcohol concentrations at autopsy.

The relationship between the blood alcohol concentration and the urine alcohol concentration was studied in 109 routine coroner's autopsies. Although the average ratio for urine alcohol concentration to blood alcohol concentration lay close to the ratio of 4:3 quoted in the literature, the actual ratios determined were widely scattered around this value. Thus the use of this simple ratio to estimate the blood alcohol concentration from the urine alcohol concentration at post-mortem was unreliable. An equation determined by employing linear regression analysis was similarly unhelpful in enabling one to derive a precise value for the blood alcohol concentration from a given urine alcohol concentration. It was concluded that the main value in determining the urine alcohol concentration at autopsy was to exclude the possibility of the alcohol present in the blood sample having been generated during the post-mortem interval.

Autopsy↗
PubMed1989

Solitary cutaneous leiomyomata: a clinicopathological study of 28 cases.

Twenty-eight cases of solitary cutaneous leiomyomata were encountered in a ten-year period. They occurred in nine males and nineteen females, the mean age at presentation being 53 years. The lesions occurred most commonly on the lower limbs and 36% were painful. Solitary cutaneous leiomyomata were found to differ from the better known syndrome of multiple cutaneous leiomyomata, in that they did not recur after excision and were not associated with leiomyomata at other body sites.

Adult↗
PubMed1989

Acute pancreatitis as a cause of sudden or unexpected death in Northern Ireland.

Utilising incomplete data supplied by the Hospital Inpatient Analysis, the annual incidence of acute pancreatitis in Northern Ireland was estimated to be about 170 cases per million population. The annual mortality rate for the years 1974-1983, using figures obtained from the Registrar-General for Northern Ireland, was 12.3 cases per million. An increase in both incidence and mortality from acute pancreatitis was demonstrated during the study. There was 191 deaths from pancreatitis during the study period and in 27 of these the diagnosis was made only at postmortem examination. Of the undiagnosed fatalities, 10 occurred in individuals with a history of alcohol abuse. Eight of the 27 undiagnosed cases had not sought medical attention, five had presented with a systemic complication of acute pancreatitis, and a further five had only minor gastrointestinal tract symptoms prior to death. The diagnosis of acute pancreatitis requires a high index of suspicion and should be considered in acutely ill patients, particularly those with a history of alcohol abuse, who fail to respond to appropriate therapy.

Acute Disease↗
PubMed1988

Cutaneous remnants of the vitellointestinal duct: a clinico-pathological study of 19 cases.

The presence of cutaneous vitellointestinal duct remnants was confirmed histologically in 19 cases in the period 1970-1984. These lesions occurred mostly in males (16 males, 3 females), and 80% in children under the age of five years. One case was identified in an adult, suggesting that these lesions may in some cases cause little inconvenience, and that their true incidence is underestimated.

Abdominal Neoplasms↗
PubMedDate not supplied

Guidelines for gynecological cancer-an audit of current network documents in England and Wales.

The objective of this study was to assess the adequacy of network cancer guidelines paying particular attention to referral criteria, referral routes, tumor diagnosis, staging, and suggested management and care pathways for ovarian and endometrial cancer. Guidelines from 15 regions in England and Wales were analyzed quantitatively and qualitatively as a prospective audit of predefined data items and subsequently agreed management recommendations. Details of unit and center clinicians were included in a minority of documents (2 to 5/15). Multidisciplinary team membership was not usually offered (6/15). Among the least reported data items were histopathology minimum dataset for endometrial cancer and an algorithm for management or summary and clinical symptoms and signs for both cancers. Among the most reported data items were hysteroscopy and ultrasound scanning for endometrial cancer and CA125 and chemotherapy for ovarian cancer. Qualitative analysis revealed differing criteria for the use of endometrial biopsy and radiotherapy in endometrial cancer, for lymphadenectomy and management of recurrent disease in ovarian cancer, and for referral pathways and the use of computed tomography/magnetic resonance (MR) scanning in the assessment of either disease. This study concludes that consideration should be given to the development of national guidelines or templates to ensure consistency of management for gynecological malignancy in England and Wales.

Female↗