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Biomedical subjects

E J Popek

Publications and source records attributed to E J Popek.

25 records · Page 2Linked to original sources
PubMed1990

Embryonal remnants in inguinal hernia sacs.

Inguinal herniorrhaphy is the most common general surgical procedure performed on the neonate or young pediatric patient. The vas deferens and epididymis are vulnerable to damage, including transection during inguinal exploration or hernia repair. Occasionally the surgical pathologist encounters glandular or tubular epithelial-lined structures in hernia sac tissue. Significant medicolegal implications arise when embryonal remnants are mistakenly identified as true vas deferens or epididymis. This study evaluates the incidence and morphology of these embryonal remnants in hernia sacs from patients of The Children's Hospital, Denver, CO. Embryonal remnants were found in 1.5% of 599 hernia sacs from 427 consecutively operated males aged 37 weeks gestation to 19 years. True vas deferens and epididymis were each identified once for an incidence of 0.33%. The remnants resemble either vas deferens or epididymis. The average remnant diameter is 0.17 mm, and did not change significantly with age. Remnants are surrounded by varying amounts of condensed mesenchyme, trichrome-negative for muscle. The testes and vasa differentia from 32 autopsy cases, ranging in age from 26 weeks gestation to 7 years of age, were used to evaluate normal development and morphology of the vas deferens, epididymis and embryonal remnants. The vas deferens is well developed by 26 weeks gestation. The surrounding smooth-muscle coat does not stain with trichrome until 32 weeks gestation. The vas deferens increases in diameter in a linear fashion during gestation, and continues to increase in diameter in the postnatal period. The vas deferens at 4 months of age is 1.2 to 1.4 mm in diameter; this is also the age of highest incidence of bilateral herniorrhaphies and presence of remnants.

Adolescent↗
PubMed1985

Leiomyosarcoma metastatic to the brain: case report and literature review.

An intracerebral hematoma (ICH) developed in a patient during diagnostic evaluation for hemoptysis and guaiac-positive stools. Tissue obtained from colonic polyps, a pregastric mass, and cerebrum had features of poorly differentiated leiomyosarcoma. Only three other cases of pathologically confirmed cerebral metastasis of leiomyosarcoma are reported in the literature. The presence of cerebral metastasis at the time of the initial diagnosis of leiomyosarcoma and the associated ICH are features unique to this case.

Biopsy↗
PubMedDate not supplied

Histopathologic effects of meconium on human umbilical artery and vein: in vitro study.

OBJECTIVE: To determine the histopathologic effects of meconium on human umbilical artery and vein. METHODS: Umbilical cords from six patients with uncomplicated, singleton, term gestations were obtained immediately after delivery. One centimeter segments from each cord were flushed, isolated, placed in either modified Krebs solution alone or modified Krebs solution with various concentrations (1%, 10%, or 25%) of fresh meconium, and then incubated at pH 7.2, temperature 37 degrees C, PCO2 50-55 mmHg, PO2 40-45 mmHg for 1, 6, 12, or 24 h. The specimens were then fixed, stained, and examined under light microscopy. RESULTS: Umbilical arteries exhibited focal vacuolation of the endothelium after exposure of the cord to meconium. Umbilical veins revealed: 1) endothelial loss proportionate to the meconium concentration at all intervals (P < 0.05), 2) increased density or focal absence of the internal elastic lamina, and 3) focal loss of myocyte nuclei. Rare nonpigmented macrophages and increased mast cells were identified in the Wharton's jelly. CONCLUSIONS: Exposure to meconium in vitro results in histopathologic changes in the umbilical artery and vein.

Cell Nucleus↗
PubMedDate not supplied

Prostate development in prune belly syndrome (PBS) and posterior urethral valves (PUV): etiology of PBS--lower urinary tract obstruction or primary mesenchymal defect?

Prune belly syndrome (PBS) has been recognized since 1950 as the triad of absent abdominal wall musculature, undescended testes, and urinary tract anomalies. The etiology, however, remains uncertain. Theories of mesenchymal maldevelopment, obstruction, and genetic origin have been proposed. To evaluate the role of lower urinary tract obstruction as it relates to prostatic development and PBS, we studied the lower urinary tract of 15 cases of PBS, 8 cases of posterior urethral valves (PUV), and 34 age-matched controls. It is generally accepted that prostatic growth and development are dependent on mesenchymal-epithelial interactions. We evaluated the mesenchymal and epithelial differentiation and relationships, and found distinctly different and consistent abnormalities between PBS and PUV as compared with one another and controls. The findings suggest that in PBS, prostatic growth and development are hindered because of destruction or absence of the appropriate primitive mesenchyme. Our studies could not definitely exclude very early obstruction as a cause of the findings because of lack of appropriate fetal material.

Adult↗
PubMedDate not supplied

In utero development of pulmonary artery calcification in monochorionic twins: a report of three cases and discussion of the possible etiology.

Pulmonary artery (PA) calcification is unusual in children, reportedly occurring only in conjunction with severe underlying valvular disease. Three newborns were found by chest X-ray study to have thin calcified rings of the PA. Two were pump twins in twin reversed arterial perfusion (TRAP) sequences, each with an acardiac cotwin, and the third was the recipient in a twin transfusion syndrome (TTS). Both twin pairs with TRAP sequence were premature, each pump twin presenting with cardiac decompensation. One remained well at 5 months of age, the other died at 5 1/2 months of age. The third, the premature recipient of twins with TTS, died at 24 h of age, and the donor cotwin died at 2 h of age. The two hearts were structurally normal at autopsy. Subtle intimal wrinkling was seen above the pulmonary valve leaflets, and the media was yellow and granular on cut section. Hyperplasia of the intima and media with disruption and calcification of the elastic fibers of the media was seen microscopically. These three cases of PA calcification occurring in utero were not related to structural valvular abnormalities but were presumably due to increased cardiac output in utero as each occurred in the volume-overloaded twin of the twin pair. Comparison of the weight differences between these three twin pairs with PA calcification suggests a relationship between the presence of PA calcification and the severity of the cardiac volume overload. In utero cardiac damage may contribute to the high morbidity and mortality rate seen in infants with TRAP sequence and TTS.

Adult↗