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A R Hudson

Publications and source records attributed to A R Hudson.

At least 19 recordsLinked to original sources
PubMed2001

Reassessment of lymphocytic atypia in the diagnosis of mycosis fungoides.

The manifestations of mycosis fungoides in its early stage may mimic clinically and histologically those of many benign inflammatory dermatoses. Therefore, the diagnosis of mycosis fungoides remains a major challenge for dermatologists and dermatopathologists. For many years, it has been proposed that atypical lymphocytes within the epidermis constitute one of the diagnostic features in mycosis fungoides. Presence of dermal atypical lymphocytes remains controversial as a diagnostic criterion. We reassessed the feasibility of applying lymphocytic atypia within epidermis and dermis as diagnostic criteria discriminating between mycosis fungoides and spongiotic dermatitis. Thirty cases of mycosis fungoides and 30 cases of spongiotic dermatitis were retrieved from archival hematoxylin and eosin-stained histologic sections. Punch biopsy sections were examined by light microscopy; epidermal and dermal lymphocytes were photographed at 1000x (oil immersion). A total of 92 ektachrome slides (35 mM) were developed, coded, and ordered randomly. For each slide, cells were interpreted as typical or atypical lymphocytes by seven pathologists. Atypical epidermal lymphocytes were judged to be present in 9 +/- 2 out of 16 (56%) cases of mycosis fungoides photographed as compared with 8 +/- 3 out of 16 (50%) in spongiotic dermatitis. Dermal lymphocytic atypia was thought to be present in 14 +/- 6 out of 30 (47%) patients with mycosis fungoides. Thirteen +/- 6 out of 30 (43%) patients with non-mycosis fungoides also displayed dermal lymphocytic atypia. No statistical significance was observed in these comparisons (t test, P >.05). Furthermore, atypia of lymphocytes was deemed to be present in 41, 38, 59, 70, 23, 47, and 40 out of 92 slides examined by the investigators, suggesting that observer variation is a very significant factor in our present study. We conclude that it is not possible to distinguish mycosis fungoides from spongiotic dermatitis merely based on lymphocytic atypia within epidermis or dermis.

Dermatitis↗
PubMed1999

Immunohistochemistry in diagnostic dermatopathology.

This article briefly reviews many immunohistochemical stains that have been in use for years, emphasizing their diagnostic use and potential pitfalls. Several newer immunostains are described in a more comprehensive fashion, including brief summaries from recently published studies.

Biomarkers, Tumor↗
PubMed1999

Increased p53 staining in normal skin of posttransplant, immunocompromised patients and implications for carcinogenesis.

The p53 tumor suppressor gene is a transcriptional activator involved in control of cell cycle. Nonmelanoma skin cancers and premalignant lesions in transplant patients have been associated with an increased rate of p53 mutation. It is possible that normal skin in transplant patients also has a more labile p53 tumor suppressor gene, predisposing them to the development of nonmelanocytic cutaneous malignancies. To test this hypothesis, we looked at p53 expression in normal skin from posttransplant, immunocompromised patients and compared this to p53 expression in normal skin from immunocompetent patients. Twenty-three skin biopsies of normal, non-sun-exposed skin from 23 immunosuppressed transplant patients and 6 skin biopsies of normal, non-sun-exposed skin from 3 immunocompetent patients were stained for p53 immunoreactivity. The skin biopsies from the immunocompromised patients showed increased staining for p53 when compared to the skin biopsies from the immunocompetent patients (mean = 7.52/mm for the immunocompromised patients and mean = 1.05/mm for the normal control group). Background levels of p53 mutation may be increased in normal skin of posttransplant immunocompromised patients. This background increase in p53 expression could reflect mutation of the gene, which may play a role in the subsequent development of cutaneous malignancies in this subgroup of patients.

Bone Marrow Transplantation↗
PubMed1995

Isolated suprascapular nerve palsy: a review of nine cases.

BACKGROUND: In nine patients, suprascapular nerve palsy followed serious accidents associated with fractures of the cervical vertebrae, clavicle or scapula and after weight lifting, wrestling and a fall on the elbow or shoulder. METHOD: All patients were examined as to muscle wasting, weakness and shoulder fixation. EMG examination was done in all cases and six patients underwent surgical exploration. RESULTS: The palsy was incomplete on clinical and EMG examination in all patients. On exploration, scarring, entrapment, tethering or kinking at the suprascapular notch was four and two had post-traumatic neuromas. CONCLUSIONS: In contrast to published studies, none of our patients presented with shoulder pain, a spontaneous onset nor with involvement limited to the infraspinatus muscle. The differential diagnosis should include C5 root lesion, brachial plexus neuritis, frozen shoulder and tear of the rotator cuff.

Brachial Plexus↗
PubMed1995

A persistent median artery causing carpal tunnel syndrome in a patient with chronic renal failure: case report.

A 63-year-old woman presented with carpal tunnel syndrome 6 years after being diagnosed as having chronic renal failure and 1 year after the start of hemodialysis treatment. Symptoms were in the hand contralateral to the side of the arteriovenous fistula used for hemodialysis. During surgery, a large, patent, noncalcified median artery was found pulsating in the carpal tunnel; this pulsation was causing the compression of the median nerve. The flexor retinaculum was decompressed, and the median artery was transposed. This is the first reported case of a persistent median artery in a hemodialysis patient who has symptoms contralateral to the vascular access. The pathophysiology and epidemiology of carpal tunnel syndrome in chronic renal failure patients is reviewed. In addition, the role of the median artery in the vascularization of the hand and the management of a persistent median artery causing carpal tunnel syndrome are reviewed.

Arteries↗
PubMed1994

Aggressive fibrous tissue lesions in the upper extremity: treatment and results.

The oncologic and functional results of treatment of aggressive fibromatosis were reviewed in 16 patients. Five had undergone previous resections. Complete surgical excision, the recommended primary treatment modality for aggressive fibromatosis tissue lesions, could only be performed in five patients. Radiation was administered in 13 patients and mainly used when the resection margins were positive. One patient required reoperation for recurrence. Complete detailed follow-up data were available in 15 patients. Functional analysis revealed 11 good-excellent, 2 fair, and 2 poor results using the Enneking classification. Local control was achieved with a combination of surgery and radiation, maintaining good-excellent function in most patients. The local nature of this tumor can be controlled with surgery and radiation while preserving function in the upper extremity.

Adult↗
PubMed1992

Clinical application of peripheral nerve transplantation.

Surgical reconstruction of extensive peripheral nerve injuries frequently exhausts the patient's own source of expendable autogenous nerve grafts. Nerve allografts would offer a limitless supply of graft material. A 23-cm, 10-cable sciatic nerve allograft was performed in an 8-year-old boy in September of 1988. The patient was managed with Cyclosporin A for 2 years. Forty-four months after the transplant surgery and 19 months after the cessation of Cyclosporin A therapy, the patient has evidence of nerve regeneration across the allograft with recovery of functional sensibility in his foot. In the selected patient with an otherwise irreparable nerve injury, consideration can be given to the use of a nerve allograft.

Child↗
PubMed1992

The peripheral nerve allograft in the primate immunosuppressed with Cyclosporin A: I. Histologic and electrophysiologic assessment.

Nerve regeneration across peripheral nerve allografts and control autografts in primates immunosuppressed with Cyclosporin A was quantitatively evaluated by electrophysiologic and histologic methods. Twelve cynomolgus monkeys received 3-cm autografts and allografts in contralateral ulnar nerves. They were immunosuppressed with Cyclosporin A at 25 mg/kg per day or placebo vehicle. Morphometric analysis of nerve graft and distal nerve segments was assessed at 1 year after engraftment. Quantitative electrophysiologic studies were performed percutaneously at 6 and 12 months, and compound action potentials were measured directly across the nerve grafts at 1 year. Excellent regeneration was seen across autografts and allografts in Cyclosporin A-treated and placebo-treated recipients.

Action Potentials↗
PubMed1992

Arteriovenous malformation of the pyriformis muscle manifesting as a sciatic nerve tumor.

We present a patient with an intramuscular pelvic arteriovenous malformation that was initially diagnosed as a tumor of the sciatic nerve sheath. Endovascular embolization, attempted as a preoperative maneuver, was complicated by diffuse pulmonary emboli and death. To our knowledge, this is the first such reported case. Its presentation here broadens the differential diagnosis of sciatic nerve sheath tumors, emphasizes the diagnostic and management issues of masses presenting as peripheral nerve tumors, and provides clinicopathological evidence regarding the cause of neurological symptoms.

Angiography↗