Search PubMedSearch

Biomedical subjects

A H Qizilbash

Publications and source records attributed to A H Qizilbash.

At least 19 recordsLinked to original sources

Investigation of an outbreak of bloody diarrhea: association with endoscopic cleaning solution and demonstration of lesions in an animal model.

UNLABELLED: OUTBREAK INVESTIGATION: An outbreak of diarrhea, bloody diarrhea, and abdominal cramps occurred among persons undergoing flexible sigmoidoscopy at a branch clinic of a local health center. Illness was associated with use of sigmoidoscopes cleaned by one clinic assistant and appeared to be caused by 2% glutaraldehyde disinfectant solution left in the instruments after cleaning. ANIMAL STUDIES: In subsequent animal studies, colonic instillation of 2% glutaraldehyde solutions caused bloody diarrhea and a distinctive pattern of mucosal damage; similar changes were seen in a review of pathologic samples from other human cases of glutaraldehyde disinfectant-associated diarrhea. CONCLUSION: Our data indicate that improper endoscopic reprocessing can result in serious illness and underscore the importance of adequate training and quality control in this area.

Animals

Intussusception of the appendix. A report of four cases and review of the literature.

The clinical and pathologic features of four cases of intussusception of the appendix are reported and the literature is reviewed. All patients had vague abdominal symptoms. The diagnosis of intussusception of the appendix was not made preoperatively in any of these cases. All four patients were females who ranged from 37 to 70 years of age (mean age, 46 years). Examination of the surgical specimens showed tow appendixes that had completely inverted, one with a polyp attached at the base of the appendix forming the intussusceptum and the other with inversion of the appendiceal tip. Three cases were associated with endometriosis and one with a tubulovillous adenoma. Radiologically and endoscopically, the intussuscepted appendix may mimic a neoplastic lesion. Since intussusception may be caused by both benign and malignant conditions, appropriate management will depend on the associated cause.

Adult

An immunohistochemical study of pleomorphic adenomas of the salivary gland: glial fibrillary acidic protein-like immunoreactivity identifies a major myoepithelial component.

An immunohistochemical study of 34 pleomorphic adenomas of the major salivary glands demonstrated phenotypic differences among the various morphologic regions in these tumors. The phenotypes expressed were comparable to those of normal salivary gland cells. In the normal glands, myoepithelial cells were immunoreactive for glial fibrillary acidic protein (GFAP), S-100 protein, and keratin; acinic cells exhibited strong, predominantly nuclear S-100 staining and weaker keratin staining; intercalated ducts had both cytoplasmic and nuclear S-100 positivity; and several epithelial antigens were observed throughout the ductal system. In the tumors, the presence of classic epithelial markers (including carcinoembryonic antigen, epithelial membrane antigen, secretory component, and keratin) in the luminal cells of ducts and the intense immunoreactivity with GFAP (with weaker keratin and S-100 staining) in periductal and stromal cells indicated distinct epithelial and myoepithelial differentiation. Solid epithelioid areas consisted phenotypically of intercalated duct/acinic cells and/or myoepithelial cells, the former exhibiting predominant nuclear S-100 positivity. The presence of GFAP-like immunoreactivity in normal myoepithelial cells strongly supports the extensive involvement of this cell in pleomorphic adenomas. The spectrum of phenotypes expressed adds weight to existing evidence for pleomorphism rather than a mixed origin of this tumor. The combination of keratin, S-100, and GFAP immunostaining is particularly useful in identifying the component cells in pleomorphic adenomas of the salivary glands.

Adenoma

Composite glandular-carcinoid tumors of the colon and rectum. Report of two cases.

Composite glandular-carcinoid tumors of the large bowel are rare. We describe two cases that appeared to be at a relatively early stage in their development. Each of these cases was a composite colorectal adenoma-carcinoid--an entity that has not previously been described. There was no evidence of inflammatory bowel disease (IBD) in either of these cases; and a review of the literature on composite adenocarcinoma-carcinoid neoplasms of the colon and rectum revealed only two cases that arose in a background of IBD. Thus, despite the association of IBD, especially long-standing ulcerative colitis, with epithelial dysplasia and mucosal endocrine cell hyperplasia, respectively, we believe that other factors more significant than IBD may be operative in the genesis of composite glandular-carcinoid tumors of the large bowel. Further documentation of these tumors is needed in order to better appreciate their clinicopathologic manifestations and associations.

Adenoma

Hepatic adenomata in type Ia glycogen storage disease.

Liver adenomata are common in young adults and adults with type Ia glycogen storage disease. Complications that may arise in these patients include acute hemorrhage and malignant transformation. With appropriate dietary therapy, they may partially or completely regress. We describe a young woman with type Ia glycogenosis who developed liver adenomata. Because of its persistence and the significant potential of malignant transformation, liver transplantation was performed. This case is discussed in light of a review of the literature on the subject.

Adenoma

Sebaceous carcinoma of the face following irradiation.

Malignant neoplasms of sebaceous glands are uncommon but generally occur about the head and neck, where these glands are concentrated. The sites of most frequent occurrence are the ocular adnexae, where sebaceous carcinoma presents as an infiltrating malignancy with a poor prognosis. Cutaneous sebaceous carcinoma is rare at other sites but has a better prognosis. We have located eight cases in the literature of sebaceous carcinoma arising in a previously irradiated field: five in the ocular adnexae and three elsewhere on the face. We here report a fourth case of recurrent sebaceous carcinoma with metastases that occurred on the face of an 82-year-old woman who had received radiation to the area for cosmetic epilation 35 years previously.

Adenocarcinoma

Pathological features and mucin histochemistry of primary gastric stump carcinoma associated with gastritis cystica polyposa. A study of six cases.

Six unusual cases of primary gastric stump carcinoma associated with gastritis cystica polyposa and arising in old gastrojejunostomy stomas are presented. The clinical data, the gross and microscopic pathological features, and the histochemical mucin profile of these two lesions are described in detail. A review is undertaken of the most relevant and previously published reports concerning, separately, either primary gastric stump carcinoma or gastritis cystica polyposa. The findings available in these reports are compared with those observed in our six cases. Some aspects of gastritis cystica polyposa are not unlike those seen in the solitary ulcer syndrome of the rectum and Ménétrier's disease. The histological type and mucin profile of primary gastric stump carcinoma parallel those recorded in gastric cancer arising in the unoperated stomach. However, the role of intestinal metaplasia and its histochemical typing appear somewhat different in primary gastric stump carcinoma.

Adenocarcinoma

The pathology of Q fever as seen on liver biopsy.

Granulomatous inflammation was seen in liver biopsy specimens from five patients with Q fever. All patients had a fever of unknown origin with mild abnormalities of liver function. The granulomatous process in the liver was very distinctive, with fibrinoid ring formation seen in four of the five cases. A diagnosis of Q fever was suggested in the five cases on the basis of the characteristic granulomatous inflammation. Results of subsequent complement fixation tests were positive in all five patients.

Adult

Pathologic studies in colorectal cancer. A guide to the surgical pathology examination of colorectal specimens and review of features of prognostic significance.

The results of a careful and systematic examination of surgical specimens from patients with tumors of the colorectum play an important role in patient care and the assessment of prognosis. An accurate and detailed gross examination of the specimen is important. Photographs and line drawings are very useful. Proper handling of the specimen and fixation for 24 to 48 hours are essential before satisfactory blocks can be taken for sectioning. Lymph nodes adjacent to the lesion and at the point of ligation of the vascular pedicle should be removed for sectioning. Multiple blocks of the tumor and adjacent tissues should be taken for histologic study. All blocks should be appropriately labeled and properly identified. I have found the use of large sections of the entire lesion a very satisfactory method of studying cancers and polyps; in such preparations the anatomic relationships remain undisturbed. The pathology report should include information on the site or sites of tumor, the size, configuration, and circumference of the bowel wall involved, obstruction, distance of the resected margin from the tumor, depth of infiltration, tumor grade, tumor margin, local inflammatory reaction, lymph node involvement and location, and venous and perineural invasions. There is evidence in the literature to suggest that all of the above pathologic features are either essential or desirable for pathology reports and have varying degrees of prognostic value. The literature on the prognostic value of immunomorphologic features in nontumorous regional lymph nodes is contradictory. Cortical, paracortical, and sinus hyperplasia have been reported to be both associated with or to have no relation to prognosis. However, careful documentation of the changes in lymph nodes may in time shed light on their value, if any, with regard to survival. We have found a standardized pathology reporting system very useful in compiling data and evaluating patient prognosis. Moreover, this system of reporting can be used as a method of quality control in establishing minimum standards for data collection, as originally suggested by Buckwalter and Kent. In a regional multiinstitutional study such as ours, differences attributable to subjective variations among different observers are likely to occur, and may have some bearing when different pathologic features are eventually correlated with survival.

Adenocarcinoma

Carcinoma in situ of the male breast.

Two cases of carcinoma in situ of the male breast are described: in one patient it arose as a complication of gynecomastia; in the other, it occurred 'de novo' and proceeded to infiltration with widespread metastases. We reviewed 233 cases diagnosed clinically and histopathologically as gynecomastia to see if we could discover other instances of malignant transformation but none was found. Thirty-two cases of infiltrating male breast cancer were also examined. In 11 there was associated intraduct change. In only one of the 32 cases was there evidence of associated microscopic gynecomastia.

Adult

Thermal injury to the bowel as a complication of laparoscopic sterilization.

Thermal injury to the small bowel occurred four times in a series of 7466 consecutive laparoscopies and tubal cauterization performed for sterilization. The four patients presented with signs and symptoms of delayed bowel perforation 4 to 11 days after the procedure. The perforations were small and involved the antimesenteric border of the terminal ileum. Histologic study of the excised specimen in one case showed full thickness coagulative necrosis of the bowel wall. Potential causes for bowel burn associated with tubal cauterization are discussed. Steps to minimize the occurrence of this complication include proper use of the laparoscope and cautery equipment, good anesthesia and gas distension of the abdomen, correct positioning of the patient and clear visualization of the operative field.

Adult

Goblet cell carcinoid tumor of the appendix. Report of five cases and review of the literature.

Five cases of goblet cell carcinoid tumor of the appendix showed characteristic histologic features that justified classification of these lesions as mucinous variants of carcinoid tumor. The tumor has low-grade malignancy, and metastases are uncommon. Resemblance to mucinous adenocarcinoma of the appendix is striking, and the features that help to differentiate the two lesions are delineated.

Adenocarcinoma, Mucinous

The nonspecific nature of fibrin thrombi in ischemic bowel disease.

Twenty cases of ischemic bowel disease were analysed to determine the frequency and significance of fibrin thrombi in this condition. Fibrin thrombi were present in all 10 patients with occlusive ischemic bowel disease and in 7 of the 10 patients with nonocclusive ischemic bowel disease. In addition, fibrin thrombi were noted in a wide variety of specific and nonspecific inflammatory bowel diseases and in acute appendicitis. We conclude that fibrin thrombi are a nonspecific feature of tissue necrosis and that their mere presence in the bowel should not be regarded as an expression of disseminated intravascular coagulation.

Appendicitis