Biomedical subjects
H Fox
Publications and source records attributed to H Fox.
[Prostaglandins: some effects as observed in two cases of cancer of the bladder (author's transl)].
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Amyloidosis complicating psoriatic arthritis.
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Disseminated histoplasmosis in an English patient with diabetes mellitus.
Histoplasma capsulatum is not endemic in Britain. We report a case of disseminated histoplasmosis in an English man who had not ventured out of northern Europe for 30 years. The disease presented as painful mouth ulcers and hepatosplenomegaly six months after he had developed maturity-onset diabetes. The origin of the infecting fungus may have been from within the United Kingdom or alternatively it may have existed as an intraoral saprophyte for over 30 years.
A possible role for placental lysosomes in the formation of villous syncytiotrophoblast.
An ultrastructural and ultrahistochemical study of first trimester human placentae confirms previous reports that the cytotrophoblastic cells show a spectrum of differentiation, that dissolution of the limiting membrane of the cytotrophoblastic cells occurs and that fragments of free membrane can be found in the syncytiotrophoblast. There is an aggregation of primary lysosomes in the region of approximation of the cytotrophoblast to the syncytiotrophoblast, free lysosomal enzymes are found in the space between the two trophoblastic components, secondary lysosomes have been noted in the vicinity of fragmenting cytotrophoblastic cell membrane and the incorporation of a segment of free membrane into a vesicular structure has been noted. It is suggested that placental lysosomes mediate the dissolution of the cytotrophoblastic cell membranes that is a necessary prerequisite for their full differentiation into syncytiotrophoblast and it is further suggested that one of the principal roles of placental lysosomes is in the structural refashioning of the organ that occurs during the first trimester.
Abnormalities of the local immune system in intestinal neoplasia: a morphological study.
In colonic adenocarcinomata abnormalities have been noted in all morphological aspects of the local immune system of the bowel; thus, in such tumours there is a defective production of secretory IgA, a diminished content of secretory component (SC) and a marked decrease in intraepithelial lymphocytes. By contrast, no such abnormalities were noted in the non-neoplastic areas of the bowel, either immediately adjacent to, or some distance from, the carcinoma. These findings suggest that there is not usually any generalised morphological abnormality of the local immune systems in intestinal neoplasia and that the immunological abnormalities noted within the tumour are a result of the changed nature of the epithelium, thus altering, or interfering with, the normal interactions between epithelial and lymphoid tissue in the gut.
Eosinophilic granuloma of lymph nodes.
Two examples are reported of eosinophilic granuloma presenting as lymphadenopathy and being apparently confined to lymph nodes. The affected nodes were characterized by a striking sinus histiocytosis, a heavy infiltration with mature eosinophils and retention of normal lymphoid follicles. The differential diagnosis of this histological picture is discussed and the prognosis considered.
The clinical significance of marginal and velamentous insertion of the cord.
The claims that marginal and velamentous insertion of the cord are associated with a high incidence of abortion, low birth weight, premature delivery, fetal malformation, fetal hypoxia and intrauterine fetal death have been investigated. A study of 1000 cases has failed to demonstrate any such association.
Syncytial knots and intervillous bridges in the human placenta: an ultrastructural study.
An electron microscopic study has shown that the syncytial knots of the villi of the human placenta contain aggregated nuclei which exhibit marked degenerative changes; within the cytoplasm there is an abundance of cytoplasmic filaments and many stacks of annulate lamellae. It is suggested that syncytial knots are a sequestration phenomenon in which senescent nuclear material is aggregated and removed from metabolically active areas of the syncytiotrophoblast. Intervillous bridges appear to be formed chiefly by fusion of syncytial knots from adjacent villi, and it seems reasonable that the effete material in a syncytial knot should be used for this purpose. The intervillous bridges hava a fine structure which suggests that they have a mechanical function, and this lends support to the theory that they form an internal strut system within the placenta.
Contribution of foodservice programs in preschool centers to children's nutritional needs.
Seven-day nutrient intakes of 517 Head Start and day care children participating in USDA's Special Food Service Programs for Children in Nebraska, Kansas, and Texas were assessed. Protein, vitamin A, and ascorbic acid levels from diets served at the centers were judged to be adequate, while calories and B vitamins were below recommendations but proportional to each other. Calcium intake from center diets did not increase proportionately as the number of meals and snacks increased. Nutrient contributions were only slightly greater from center diets when two meals and two snacks were provided than when one meal and one snack were served. Home diets made substantial contributions to the diets of all children, resulting in little difference in total nutrient intakes between children receiving fewer or more meals and snacks at the centers. Iron was the nutrient supplied in least amount in relation to recommendations, when intakes from home and center were combined.
Treatment of ulcerative colitis with oral disodium cromoglycate. A double-blind controlled trial.
Twelve patients with ulcerative protocolitis were treated for six months with each of oral disodium cromoglycate (2 g/day) and placebo in a double-blind cross-over trial. The active drug significantly improved the patients' sense of well-being and the signoidoscopic and rectal biopsy appearances. Orally administered disodium cromoglycate may have a place in the long-term management of colitis.
An ultrahistochemical study of the distribution of acid and alkaline phosphatases in placentae from normal and complicated pregnancies.
The subcellular localisation of acid and alkaline phosphatase has been studied in the trophoblast of placentae from both normal and complicated pregnancies. In placentae from uncomplicated pregnancies the number of trophoblastic acid-phosphatase-containing organelles decreases progressively as gestation proceeds whilst alkaline-phosphatase activity, although abundant at term, could not be demonstrated during the early stages of pregnancy. The acid-phosphatase-containing organelles are of two types; one is a small round body which is probably a lysosome whilst the other is a multivesicular body. The alkaline phosphatase is distributed mainly on the syncytial microvilli and plasma-membrane. It is suggested that the marked lysosomal activity during early pregnancy is related to the architectural refashioning of the placenta during this period and that there are two phosphatase-linked transfer systems in the trophoblast, one dependent upon acid-phosphatase-containing multivesicular bodies and being utilised during early pregnancy and the other reliant upon alkaline phosphatase and dominating during the second half of gestation. In placentae from prolonged pregnancies there is a further decrease in trophoblastic acid phosphatase and, usually, a continuing increase in alkaline-phosphatase activity. In placentae from babies of low birth weight this trend is sometimes reversed and alkaline-phosphatase activity either disappears or its reaction product diffuses throughout the syncytium; this is usually accompanied by a marked increase in the number of acid-phosphatase-containing multivesicular bodies. Placentae from women with pre-eclampsia show no loss of alkaline-phosphatase activity but are characterised by an increased number of lysosomal bodies.
An ultrastructural and ultrahistochemical study of the placenta of the diabetic woman.
An ultrastructural and ultrahistochemical study has been made of placentae from seven women, all of whom were established diabetics before the onset of pregnancy. None of these women had suffered from any of the hypertensive complications of pregnancy. Patchy focal syncytiotrophoblastic necrosis was evident and indirect evidence of syncytial damage was seen in the form of marked cytotrophoblastic hyperplasia. The syncytial necrosis appeared to be lysosomally mediated, possibly as a result of altered intracellular pH. Occasional cytotrophoblastic cells also showed degenerative changes. Most of the villous trophoblast was, however, morphologically normal and showed features suggestive of normal or increased synthetic, transfer and excretory activity. Focal thickening of the villous trophoblastic basement membrane was seen and this did not appear to be due to deposition of immune complexes. The endothelial cells of the villous capillaries appeared unduly immature but no evidence was seen of immune complex deposition in these vessels or of diabetic angiopathy. It is concluded that the diabetic's placenta shows a consistent pattern of abnormalities which appear to be a direct result of the diabetic state.
Adenosquamous carcinoma of the endometrium.
An adenosquamous carcinoma of the endometrium is one which contains both malignant glandular and malignant squamous components; such tumours are considered rare in Britain but are thought to account for nearly one-third of all endometrial neoplasms in the United States. A survey of 675 cases of endometrial cancer seen during the period 1956-75 showed that the incidence of adenosquamous carcinoma was 5%, an incidence that remained static during this 20-year period. The principal difficulties encountered in the diagnosis of these neoplasms are in identifying the squamous component as such and in differentiating it from benign metaplastic squamous epithelium. The prognosis for patients with an endometrial adenosquamous carcinoma is very much worse than for women with a pure adenocarcinoma, and because these neoplasms are often wrongly identified it is possible that the currently accepted prognoses for both pure adenocarcinoma and adenoacanthoma of the endometrium may have to be revised. There appears to be a true variation in the incidence of this neoplasm between Britain and the United States.
The aetiology and pathology of endometrial cancer.
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The problems of the venereal diseases in general practice.
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The histopathology of placental insufficiency.
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Chronic Q fever.
Sixteen cases of chronic Q fever are described. In eight there was a history of exposure to infection from farms or farm products. All had valvular heart disease, involving the mitral valve in nine and the aortic valve in seven. Infection occurred on a prosthetic valve in two patients. Arterial embolism was common. Venous thrombosis occured in three patients, and pulmonary embolism occurred in three other patients. Complement fixing antibodies to phase 1 antigen were found in a titre of 1:200 or greater in all except two patients. In one of these post-mortem examination revealed rickettsial bodies in mitral valve vegetations, and in the other Coxiella burneti was isolated from heart valve tissue. The majority presented with infective endocarditis but two presented primarily with liver disease. All patients had evidence of liver involvement and in one this led to death from cirrhosis. Abnormal tests of liver function, particularly hyperglobulinaemia, raised alkaline phsophatase and abnormal bromsulphthalein retention were found in all patients. Hepatic histology was abnormal in all eight patients in whom it was studied. The commonest features were mononuclear cell infiltration of the portal tracts and prominence of the sinusoidal Kupffer cells. Patchy focal necrosis of parenchymal cells, granulomata, fatty change, and eosinophilia of the sinusoidal walls were also noted in several patients and cirrhosis developed in one. Six patients had a purpuric rash, and in 12 there was thrombocytopenia. It is suggested that the presence of hepatomegaly and liver involvement and thrombocytopenia may help to differentiate Q fever endocarditis from bacterial endocarditis. Raised serum IgM and IgA levels occured frequently, but with only a moderate dominance of IgM. Sheep cell agglutination and latex fixation tests for rheumatoid factor were occasionally positive. Several features of the disease suggest the possibility that immune-complex mechanisms may play a role in chronic Q fever. Treatment was with prolonged courses of tetracycline usually combined with lincomycin. Seven patients underwent valve replacement surgery for haemodynamic reasons. Five patients died; two from heart failure, one from cirrhosis, one seven days after valve replacement and one from intraperitoneal haemorrhage following percutaneous liver biopsy. Three patients have survived for more than five years, and another six for more than three and a half years after diagnosis. Of these nine patients, three received medical therapy alone and six required valve replacement as well. Antibiotics have been discontinued in four patients who have had valve surgery and three others. Six patients had received antibiotics for continuous periods varying from 29-62 months. In the period after stopping therapy varying from 15-21 months, no relapse has occured. A seventh patient, who had received antibiotics for four months prior to valve replacement, has survived 43 months after the withdrawal of antibiotics...