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Biomedical subjects

N Doshi

Publications and source records attributed to N Doshi.

35 records · Page 2Linked to original sources
PubMed1987

Necrotizing tracheobronchitis in intubated newborns: a complication of assisted ventilation.

This report describes a newly recognized iatrogenic lesion in newborns that we have termed necrotizing tracheobronchitis (NTB). Although it is related to assisted ventilation, it is different from previously described tracheal lesions in that it is most severe distal to the tip of the endotracheal tube and manifests a characteristic basophilic necrosis of the tracheal mucosa. Sloughing of tracheal mucosa, which occurs in the later stages, can cause respiratory obstruction. The lesion occurs over a wide range of gestational ages and birth weights as well as ventilatory rates, pressures, and supplemental oxygen concentrations. The severity of the lesion is related to the duration of ventilation. We believe NTB to be related to airflow through the endotracheal tube rather than to the effects of the tube itself because the lesion is worst beyond the end of the tube and extends into the major bronchi. A grading system is presented.

Bronchitis↗
PubMed1984

Comparison of the Vi indirect fluorescent antibody test with the Widal agglutination method in the serodiagnosis of typhoid fever.

The indirect fluorescent antibody test using a whole Salmonella typhi Vi suspension as the antigen has been evaluated for the diagnosis of typhoid fever. Results using sera from 140 patients with S typhi infections proved on culture show the test to have good sensitivity. The test appears to be highly specific, although it has not yet been investigated with respect to typhoid vaccination or in the context of infections due to salmonellas other than S typhi.

Agglutination Tests↗
PubMed1983

Morphologic anomalies in triploid liveborn fetuses.

Analysis of the morphologic features of 43 complete and 11 mosaic triploid infants delivered at or after 22 weeks of gestation revealed, in addition to well-delineated gross features, a number of new or previously little emphasized histopathologic features. These included testicular Leydig cell hyperplasia, increased levels of hematopoiesis, and ovarian, adrenal, and pulmonary hypoplasia. Some of these findings appeared to be linked to partial hydatidiform mole replacing the normal placenta, which was present in about 70 per cent of the triploid cases. It is important to recognize the breadth of the triploidy spectrum, which ranges from near normalcy to multisystem involvement, and to pay special attention to the placenta. The importance of correct morphologic diagnosis of triploidy is stressed in view of the fact that its occurrence apparently does not prejudice the future reproductive performance of the parents.

Adolescent↗
PubMed1981

Increased amnionic fluid alpha-fetoprotein due to a holoacardium amorphous twin.

Amnionic fluid alpha-fetoprotein measurement was employed as a screening test for neural tube defects in a pregnancy only at risk due to advanced maternal age. The alpha-fetoprotein concentration was elevated more than 10 standard deviations above the mean and was found to be caused by a holoacardium amorphous twin. A normal female fetus was also present. Various causes of elevated alpha-fetoprotein concentration in amnionic fluid are discussed.

Abnormalities, Severe Teratoid↗
PubMed1981

Yellow hyaline membrane disease. Identification of the pigment and bilirubin binding.

The distinguishing feature of yellow hyaline membrane disease (YHM) in the newborn is the presence of nonfading, bright yellow membrane lining the luminal aspects of conventional pink hyaline membranes (HM). Examination of yellow membranes, stained and unstained, under fluorescent microscopy reveals on orange-red fluorescent material heterogeneously dispersed within the membranes. Homogenates of lungs with YHM and HM were extracted with chloroform and tested spectrophotometrically, by thin layer chromatography, and for diazotized sulfanilic acid reactivity. Spectrophotometric profiles of YHM differed from those of HM by a unique absorption shoulder at 454 nm. in the former. This shoulder corresponded to the absorbance of unconjugated bilirubin. This profile could be reproduced by adding purified unconjugated bilirubin to non-YHM lung homogenate prior to extraction. Thin layer chromatography of the extracted YHM material produced two unique spots not found in extracts prepared from normal or HM-diseased lungs. These spots could be duplicated by thin layer chromatography using pure unconjugated bilirubin. The spots also fluoresced orange-red, the same color initially observed in the membranous preparations under fluorescent microscopy. Additional in vitro binding studies suggest that polymyxin, a decapeptide antibiotic used in endotracheal irrigation of newborn infants, binds bilirubin in pH-dependent, small molecular ratios. Although subsequent clinical studies disproved the etiologic significance of this particular drug, the unique properties of the bilirubin present in the YHMD lungs strongly suggest that the bilirubin there is bound by some yet unelucidated mechanism.

Bilirubin↗
PubMed1980

Ascending transcervical herpes simplex infection with intact fetal membranes.

A case of herpes simplex infection in the placenta and in an immature infant delivered to a mother with proved genital herpes infection is discussed. Infection occurred without premature rupture of membranes. Viral transmission could be attributed to ascending transcervical infection based on evidence of necrotizing chorioamnionitis in absence of villitis plus extensive and severe involvement of the skin and lungs. Such distinct documentation of transcervical infection in the presence of intact fetal membranes makes it obvious that delivery by cesarean section cannot prevent all cases of neonatal herpes infection.

Adult↗
PubMed1980

Pulmonary yellow hyaline membranes in neonates.

The recent increase in the occurrence of pulmonary yellow hyaline membranes correlates with improved therapy for premature infants with the respiratory distress syndrome and with their prolonged survival. We compared the clinicopathologic features in 54 cases with pulmonary yellow hyaline membranes with those in 56 cases with conventional hyaline membranes seen during the same interval at Magee-Womens Hospital. Kernicterus, intraventricular hemorrhage, intrahepatic bile stasis, pulmonary hemorrhages, and disseminated intravascular coagulation were significantly frequent in the yellow hyaline membrane group. Clinical problems of hypoglycemia, hypocalcemia, jaundice, and endotracheal hemorrhages and also treatment with endotracheal intubation, ventilatory assistance, and phototherapy were much more common in the yellow hyaline membrane cases. The yellow pigment was identified as unconjugated bilirubin by histochemical and biochemical techniques. A plausible hypothesis for the pathogenesis is presented wherein intrapulmonary hemorrhages lay an important role. The frequent association of yellow membranes and kernicterus in premature infants at relatively low serum levels of bilirubin is significant.

Birth Weight↗
PubMed1978

Oligohydramnios and fatal pulmonary hypoplasia without amnion nodosum.

Two cases of fatal pulmonary hypoplasia associated with hydrorrhea gravidarum are presented. Amnion nodosum was present in one case but not the other. The pathogenesis of amnion nodosum is reviewed, and the clinical implications of this pathologic finding are discussed in relation to whether the underlying pathology is renal agenesis or amniorrhea.

Amnion↗
PubMed1977

Vaginal adenosis and polycystic ovaries during infancy and childhood.

A histologic study of 40 postmoretem specimens of vagina, uterus, and ovaries obtained from fetuses, infants, and children revealed vaginal or ectocervical adenosis in eight cases (20.0%) and polycystic ovaries in 13 cases (32.5%). All cases of adenosis were associated with polycystic ovaries and moderate to marked theca luteinization. Five patients who had adenosis died of diseases of the central nervous system (CNS) such as cerebral injury and hydrocephalus. A total of seven of 13 cases or 53.8% with polycystic ovaries had CNS diseases. The possible roles of neurogenic and hormonal factors in the pathogenesis of these conditions are discussed.

Adolescent↗
PubMed1977

Primary clear cell carcinoma of the ovary. An analysis of 15 cases with review of the literature.

The clinical and pathological findings in 15 primary "pure" clear cell carcinoma of the ovary included in the Magee-Womens Hospital Tumor Registry from 1947 through 1974 are discussed. The ages of the patients ranged from 35 to 75 years (mean 53). The most common clinical finding was an abdominal mass in 14 cases. At surgery, five patients had extraovarian spread, one accompanied by ascitis. The tumors varied in diameter from 4 cm to 17 cm (mean 10.5 cm); grossly, about one-third were cystic, one-third solid and one-third had combined cystic and solid areas. Microscopically, four basic patterns were seen: papillary, tubular, solid, and cystic, and in several an admixture of the above. Clear cells predominated in 48% of the cases and 23% displayed hobnail cells. Most patients were treated by TAH & BSO or variants thereof, some followed by radiation or chemotherapy. Four patients died with cancer within 35 months after diagnosis; two others died of unrelated causes three and 12 years later. The actuarial survival was computed as 55% at five years. Five patients were stages as IIb (FIGO classification); four died with tumor and the remaining patient is alive with recurrent tumor in the pelvis 18 months after the original diagnosis. Three patients with tumors displaying the cystic pattern are still alive; two with a predominantly papillary pattern and vascular permeation are dead. It is suggested that survival rates in these 15 cases may be related more to the extent of the lesion at the initial presentation than to the gross or microscopic pattern.

Adenocarcinoma↗
PubMedDate not supplied

Yellow hyaline membrane disease in neonates: clinical diagnosis by tracheal aspiration cytology.

Yellow hyaline membrane disease (YMH) of the neonate may be diagnosed clinically by tracheal aspiration cytology, an easily accessible, noninvasive, and safe technique. Since the frequent association of yellow membranes and kernicterus in premature infants at relatively low levels of serum bilirubin is significant, this means of diagnosis during life may be useful in identifying infants at risk for kernicterus. We also suggest use of this technique in evaluating the role of possible factors in the pathophysiology of yellow hyaline membranes.

Bilirubin↗
PubMedDate not supplied

Tracheal aspiration cytology in neonates with respiratory distress: histopathologic correlation.

This report evaluates the use of tracheal aspiration cytology in the differential diagnosis of respiratory distress in neonates by correlating cytologic features with histopathologic findings in 72 infants who died and were autopsied at Magee-Womens Hospital. It is concluded that the common causes of respiratory distress in neonates, including hyaline membrane disease (conventional and yellow), pneumonia, aspiration syndrome, pulmonary hemorrhage and bronchopulmonary dysplasia, may be diagnosed in adequate smears by this easily accessible, noninvasive, safe and repetitive method.

Birth Weight↗
PubMedDate not supplied

Psammoma bodies and detached ciliary tufts in a cervicovaginal smear associated with benign ovarian cystadenofibroma.

Psammoma bodies and detached ciliary tufts, or ciliocytophthoria, were present in a cervicovaginal smear from a 38-year-old woman with a benign cystadenofibroma of the left ovary. This case demonstrates that psammoma bodies in cervicovaginal smears may occur in association with nonmalignant conditions of the female genital tract and that detached ciliary tufts may originate from the ovarian epithelium.

Adenofibroma↗