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Biomedical subjects

H S Cooper

Publications and source records attributed to H S Cooper.

71 records · Page 4Linked to original sources
PubMed1981

Colonic "precancer" in Crohn's disease.

Two patients with longstanding Crohn's disease, who developed colonic carcinoma and showed associated "precancer" identical to that seen with ulcerative colitis, are reported. The first patient developed rectal adenocarcinoma at age 42 yr, 27 yr after the onset of symptoms while the second patient had a clinically silent small colonic carcinoma at the time of colectomy, 40 yr after the onset of disease. Both patients had characteristic Crohn's disease. In both patients, in addition to the carcinoma, there was multifocal "precancer" characterized by (a) epithelial dysplasia and (b) adenomatous growth pattern and villiform proliferation of the mucosa. These changes were identical to those associated with ulcerative colitis and, in both cases, were present adjacent to and distant from the infiltrating carcinomas. It is important to note that such epithelial changes, termed "precancer" in the setting of longstanding ulcerative colitis, can also occur in association with longstanding Crohn's disease. Further studies are needed to define the incidence of such precancerous changes in Crohn's disease more clearly and to evaluate the relationship between these changes and carcinoma. Careful evaluation of patients with longstanding Crohn's disease and "precancer" is warranted to exclude concomitant carcinoma.

Adenocarcinoma↗
PubMed1980

Immunohistologic study of blood group substances in polyps of the distal colon. Expression of a fetal antigen.

Forty-four polyps and 14 adenocarcinomas of the left colon from 28 patients were studied for the presence of blood group substances of the A, B system, using the method of specific erythrocytic adherence. Forty-one percent of all polyps and 57% of all cancers were found to have reactivity for blood group substances. Fifty-four percent of villous adenomas (seven of 13), 39% of tubular adenomas (five of 13), 14% of mixed tubulovillous adenomas (one of seven), and no hyperplastic polyps (zero of four) showed reactivity for blood group substances. Lesional blood group substance reactivity, when present, was the same as that for the patient's own blood group type, with the exception of two patients of B blood group type, whose lesions had A-blood group substance reactivity. Cytologic atypia showed no correlation with the presence of blood group substances. Polyps with blood group substance reactivity were seen more frequently in patients with cancer. Twelve patients had both a cancer and a polyp studied, with both polyp and cancer showing similar blood group substance reactivity for nine of these patients. A, B, H-blood group substances in the left colon are normally absent in the adult and present only in the fetus. The reappearance of these fetal antigens in both polyps and cancers adds immunologic evidence to the theory that colonic adenocarcinoma evolves through a polyp-cancer sequence.

ABO Blood-Group System↗
PubMed1980

Ultrasound findings in hepatitis.

A retrospective study of ultrasound images of the liver in patients with hepatitis was undertaken. Two distinct ultrasound patterns were detected. In acute hepatitis, the predominant findings were accentuated brightness and more extensive demonstration of the portal vein radicle walls and overall decreased echogenicity of the liver. Chronic hepatitis primarily revealed decreased brightness and number of portal vein radicle walls and verall increased liver echogenicity. In addition, the pathological severity closely paralleled these ultrasound patterns. A prospective study confirmed the same acute hepatitis ultrasound findings with close correlation to the clinical severity. These distinct ultrasound patterns will help to evaluate patients with suspected acute and chronic hepatitis and more accurately define intrahepatic causes of jaundice.

Acute Disease↗
PubMed1979

Adenomatous and carcinomatous changes within hyperplastic colonic epithelium.

Hyperplastic colonic polyps are benign, nonneoplastic proliferations; unlike tubular and villous adenomas, they do not predispose the patient to colonic cancer. Theoretically, these hyperplastic polyps, like normal colonic epithelium, should be able to undergo adenomatous transformation and possibly develop into cancer. In this report, we discuss an unusual case of a patient with numerous hyperplastic polyps, in which adenomatous changes occurred and cancer developed. We also discuss the significance of these changes as they relate to the polyp-cancer sequence.

Adenoma↗
PubMed1979

Low-grade mucoepidermoid carcinoma of the breast.

Two cases of primary breast carcinoma morphologically identical to low-grade mucoepidermoid carcinoma of salivary gland origin occurred. To our knowledge, this article represents the first description of this tumor type in the breast. Both lesions were well circumscribed, wholly or partially cystic, and composed of intimately associated, well-differentiated, squamous and mucinous glandular epithelium. It is suggested that these may represent an indolent tumor type in the breast analogous to their behavior in the salivary gland.

Aged↗
PubMed1978

Tubular carcinoma of the breast.

Retrospective pathologic review of 636 breast carcinomas from 611 patients revealed twelve tumors which were pure low grade tubular carcinoma (TC) and nineteen tumors with features combining both low grade tubular carcinoma and invasive duct carcinoma (T&D). A control group of 23 cases consisted of invasive duct carcinoma with at least a third of the tumor surface area showing tubular formation, but without the low grade features of tubular carcinoma. Life table analysis at 15 years showed a 100%, 72%, and 33% survival for TC, T&D, and controls, respectively. Eight percent of TC and 21% of T&D had axillary metastases compared to 67% for controls. Axillary metastases had no detrimental effect on TC or T&D survival. There were no recurrences in the TC group. Patients with T&D with tumor diameter 1.0 cm or less with 50% or greater low grade tubular carcinoma component are alive and well. The mean age of T&D was 7 years greater than TC. The combined TC and T&D group showed a significant incidence of multiple cancers in the ipsilateral breast and a significant trend toward bilateral cancers when compared to controls. Tubular carcinoma has an inherently low malignant potential with a histological and biological spectrum.

Adenocarcinoma↗
PubMed1978

Blood group substances as tumor antigens in the distal colon.

Adenocarcinomas of the sigmoid colon and rectum were studied for the presence of blood group substances of the A, B, H system using the method of specific erythrocytic adherence. Of 17 adenocarcinomas studied, eight were found to have reactivity for blood group substances. All eight tumours showing reactivity for blood group substances were from patients of the blood group type A, whereas no blood group substances reactivity could be found in any of the adenocarcinomas from patients of the B blood group type. The epithelial cells of the entire colon contain blood group substances in the fetal period; however, shortly after parturition the epithelial cells of the distal colon and rectum rapidly lose the substances. The reappearance of the substances in adenocarcinomas of the distal colon suggests that these neoplastic cells are expressing certain characteristics of fetal colonic epithelial cells.

ABO Blood-Group System↗
PubMed1977

Cytomegalovirus inclusions in patients with ulcerative colitis and toxic dilation requiring colonic resection.

Microscopic examination of 50 colon resection specimens from 46 patients with ulcerative colitis revealed 6 patients whose colons contained intranuclear inclusions characteristic for cytomegalovirus (CMV). All patients were male, 47 years of age or older, and all had marked severe and fulminating courses. Five of the 6 patients had toxic dilation of the colon. Three of our patients had received no steroid therapy before their toxic dilation, however, all received steroids during attempts at medical management. Two other patients were found to have toxic dilation of the colon among our 46 patients, however, no evidence of CMV could be found in these 2 cases. There were 6 patients without toxic dilation whose colon specimens showed destructive inflammation and granulation tissue extending into the muscularis propria or transmurally. None of the colons from these 6 patients contained CMV inclusions. In our patients, the finding of CMV may be coincidental, but it is suggested that in our group of patients with ulcerative colitis, the CMV may play a role in altering the clinical course of these patients.

Aged↗
PubMed1976

Primary malignant lymphomas of the salivary glands.

Primary malignant lymphomas of the salivary glands are rare, and only 43 possible cases have been reported. Four new cases from the Johns Hopkins Hospital are described, including clinical presentation, histologic findings, and subsequent course. The literature on this subject is reviewed, including cases arising in preexisting benign lymphoepithelial lesion with or without Sjögren's syndrome. Although the number of reported cases with complete documentation and follow-up information is too small for significant statistical analysis, these patients appear to have a better prognosis than the usual lymphoma patient. The possible reasons for this are discussed.

Adolescent↗
PubMed1976

Glue sniffer's neuropathy.

Progressive sensorimotor neuropathy developed in two patients exposed to prolonged (chronic) inhalation of n-hexane (glue sniffing). Sural nerve biopsies showed loss of axons; remaining axons were either normal or showed accumulation of filaments of 90 to 100 A thick, widened nodes of Ranvier, and focal enlargements. The muscle biopsy revealed neurogenic atrophy. Intramuscular nerve twigs and end-plates, studied in one patient, showed loss of axons and nerve terminals. Unmyelinated axons also showed accululation of 60 to 100 A thick filaments. The similarities between the pathologic findings in the peripheral nerve of these patients and those with acrylamide neuropathy suggest that the n-hexane inhalation produces a dying back neuropathy.

Adult↗
PubMedDate not supplied

Cloacogenic carcinoma of the anorectum in homosexual men: an observation of four cases.

Cloacogenic carcinoma of the anorectum is an uncommon neoplasm which arises from the transitional zone (cloacogenic) epithelium. The transitional zone epithelium is derived from the embryonic cloacogenic membrane as is the epithelium of the vagina and uterine cervix in the female. Four cases of cloacogenic carcinoma in male homosexuals who have engaged in longstanding receptive and anal intercourse have been observed. This observation, along with the realization that the anorectal transitional zone shares a common embryologic origin with the uterine cervix, a site of cancer long known to be associated with factors related to sexual intercourse, leads to the serious question of the etiologic potential of receptive anal intercourse in the development of cloacogenic carcinoma.

Adult↗
PubMedDate not supplied

Effect of preoperative chemoradiotherapy on surgical margin status of resected adenocarcinoma of the head of the pancreas.

We examined the effect of preoperative chemoradiotherapy on the ability to obtain pathologically negative resection margins in patients undergoing pancreaticoduodenectomy for adenocarcinoma of the head of the pancreas. Between 1987 and 2000, 100 patients underwent Whipple resection with curative intent for primary adenocarcinoma of the head of the pancreas. Pathologic assessment of six margins (proximal and distal superior mesenteric artery, proximal and distal superior mesenteric vein, pancreas, retroperitoneum, common bile duct, and hepatic artery) was undertaken by either frozen section (pancreas and common duct) or permanent section. A margin was considered positive if tumor was present less than 1 mm from the inked specimen. Margins noted to be positive on frozen section were resected whenever possible. Of the 100 patients treated, 47 (47%) underwent postoperative radiation and chemotherapy (group I) and 53 (53%) received preoperative chemoradiotherapy (group II) with either 5-fluorouracil (32 patients) or gemcitabine (21 patients). Patient demographics and operative parameters were similar in the two groups, with the exception of preoperative tumor size (CT scan), which was greater in group II (P < 0.001), and number of previous operations, which was greater in group II (P < 0.0001). Statistical analysis of the number of negative surgical margins clear of tumor was performed using Fisher's exact test. All patients (100%) had six margins assessed for microscopic involvement with tumor. In the preoperative therapy group, 5 (7.5%) of 53 patients had more than one positive margin, whereas 21 (44.7%) of 47 patients without preoperative therapy had more than one margin with disease extension (P < 0.001). Additionally, only 11 (25.6%) of the 47 patients without preoperative therapy had six negative margins vs. 27 (50.9%) of 53 in the group receiving preoperative therapy (P = 0.013). Survival analysis reveals a significant increase in survival in margin-negative patients (P = 0.02). Similarly, a strong trend toward improved disease-free and overall survival is seen in patients with a single positive margin vs. multiple margins. Overall, we find a negative impact on survival with an increasing number of positive margins (P = 0.025, hazard ratio 1.3). When stratified for individual margin status, survival was decreased in patients with positive superior mesenteric artery (P = 0.06) and vein (P = 0.04) margins. However, this has not yet resulted in a significant increase in disease-free or overall survival for patients receiving preoperative therapy (P = 0.07).

Adenocarcinoma↗