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Biomedical subjects

I C Talbot

Publications and source records attributed to I C Talbot.

At least 181 records · Page 10Linked to original sources
PubMed1982

Lack of correlation between metastasis of human rectal carcinoma and the absence of stromal fibronectin.

In a retrospective study we have used an immunoperoxidase procedure to localize the glycoprotein fibronectin in human rectal carcinomas, concentrating on tumour invading thick-walled extramural veins. Fibronectin was present in 29 out of 38 cases, in connective tissue stroma, and was not in direct association with the tumour cells, except in areas of necrosis. We found no correlation between the presence or absence of stromal fibronectin and (1) the degree of cellular differentiation within the tumour, (2) tumour progression (Dukes' classification) (3) the subsequent development of metastases and (4) patient longevity. OUr results do not support the conclusions from in vitro studies (Smith et al., 1979) that the metastatic potential of carcinomas may be partly determined by the ability of tumour cells to synthesize pericellular fibronectin.

Adenocarcinoma↗
PubMed1982

Liver disease in India.

One hundred and twenty-five children with chronic liver disease were seen in Pune in 13 months. Fifty-nine of them, aged 8-39 months, had Indian childhood cirrhosis histologically diagnosed. Their characteristics included an insidious onset of symptoms, a geographical clustering of cases in rural areas north-east of Pune, a high rate of parental consanguinity and affected siblings, and a very high hepatic copper concentration (790-6654 micrograms/g dry weight). Only 8 survived for 6 months, adverse prognostic features being jaundice, ascites, enlargement of the gall bladder, and severe anaemia at presentation. Clinical differentiation from other liver disorders in the same age group was clear in advanced cases but unreliable in earlier cases. Four asymptomatic siblings with hepatomegaly had a benign course. The need for non-invasive methods to diagnose early cases in the community is demonstrated. The other major diagnostic categories were: unresolved hepatitis (12); chronic active hepatitis (7); cryptogenic cirrhosis (6); neonatal hepatitis and biliary atresia (8).

Adolescent↗
PubMed1982

Granulomatous mastitis: a report of seven cases.

The clinical history and histological features of seven cases of granulomatous mastitis are presented. The lesion occurs in young parous women as a tender extra-areolar breast lump. Histologically, non-caseating discrete granulomas are present, confined to breast lobules with, in three cases, coalescence of the granulomas and microabscess formation. Pathogenesis of the changes is discussed. It is thought that granulomatous mastitis is an entity morphologically distinct from duct ectasia/plasma cell mastitis and the commoner forms of granulomatous breast diseases.

Adult↗
PubMed1982

Massive bleeding from the ileum: a late complication of pelvic radiotherapy.

Recurrent massive hemorrhage from the ileum as a late complication of radiotherapy has not previously been documented. We describe two patients with a history of pelvic radiotherapy 18 months and 11 yr before, in whom the source of melena was localized to the small bowel preoperatively. Characteristic serosal appearances of ileal radiation injury were present at laparotomy and resection of the terminal ileum controlled the hemorrhage. Pathological study revealed no ulceration but multiple telangiectatic vessels in the tips of mucosal villi. This cause should be considered in patients with obscure gastrointestinal bleeding previously exposed to pelvic radiotherapy.

Aged↗
PubMed1981

Spread of rectal cancer within veins. Histologic features and clinical significance.

Histologic evidence of venous invasion was demonstrated in 52 percent of 703 cases of rectal carcinoma. Quantitation of venous invasion and follow-up study showed that invasion of extramural veins was associated with a low 5 year survival rate (33 percent), whereas invasion limited to intramural veins was not. Spread into thick-walled extramural veins carries a very poor prognosis (15 of 91 patients survived 5 years). The corrected 5 year survival rate for stage C patients with invasion of thick-walled extramural veins was only 8 percent. Host reactions in and around the walls of invaded veins increase the survival rate; inflammatory damage to the vein walls and endarteritis obliterans are particularly important in this respect.

Adenocarcinoma↗
PubMed1981

Invasion of veins by carcinoma of rectum: method of detection, histological features and significance.

Histopathological material from operation specimens of rectal adenocarcinoma was reviewed and invasion of veins identified in 51.9% of 703 cases. The extent of venous invasion, thickness of the walls of invaded veins and various other histological features were examined in detail. By follow-up studies recurrence rates, incidence of distant metastases and corrected 5-year survival rates were obtained; correlation with the histopathological results showed that invasion of extramural and thick-walled veins is associated with a poor prognosis independent of the degree of differentiation of the adenocarcinoma. Prognosis is not significantly related to the presence of necrosis of intravenous tumour and a clearly defined stroma in the intravenous growth all appear to exert a protective influence on patient survival. Whereas permeation of capillaries in vein walls, the presence of loose clumps of tumour cells in veins and direct contact between tumour cells and venous blood appear to adversely affect survival. Venous invasion is shown to be related to local invasiveness of rectal carcinoma. Suggested modes of venous spread and interaction with host tissues are proposed, with implications for general attitudes to the spread of cancer and metastasis.

Adenocarcinoma↗
PubMed1980

The clinical significance of invasion of veins by rectal cancer.

A histopathological study of 703 surgical specimens from patients with adenocarcinoma of the rectum revealed invasion of veins by primary growth in almost 52 per cent. Follow-up studies on the patients showed that the corrected 5-year survival rate was significantly worse and liver metastases developed more frequently when venous invasion was present. Invasion of extramural veins was particularly significant whereas spread confined to intramural veins was less important. Invasion of large (thick-walled) veins was of greater consequence than invasion of small (thin-walled) veins and spread into thick-walled extramural veins had the greatest adverse influence of all. Venous spread of tumour takes place in parallel with local spread as measured by the Dukes' stage but exerts an influence on prognosis independent of the Dukes' stage. Similarly, vein invasion parallels the number of lymph node metastases but appears to exert an independent influence on prognosis. Observation of venous spread provides a precise assessment of the likely behaviour of rectal carcinoma and supplements, but does not replace indices such as the Dukes' stage or the number of lymph node metastases in routine use. The implications for surgical technique and management are discussed.

Adenocarcinoma↗
PubMed1979

Gilbert's syndrome: evidence of morphological heterogeneity.

Hepatic ultrastructure was examined by electron microscopy in 25 patients with Gilbert's syndrome and the changes in the smooth endoplasmic reticulum quantified by grid technique. Thirteen patients showed gross hypertrophy of the smooth endoplasmic reticulum (SER). These were designated Gilbert's EM Positive. The remaining 12, designated Gilbert's EM Negative, did not differ significantly from normal controls. The EM Positive group showed a significantly greater percentage response to caloric restriction (P less than 0.01) and an exaggerated response to nicotinic acid stimulation when compared with the EM Negative group and normal controls. These results suggest that SER hypertrophy is not, as previously suggested, a constant feature of Gilbert's syndrome but rather a characteristic of a distinct subpopulation.

Adolescent↗
PubMed1976

Frequency of arrhythmias and other cardiac abnormalities in fulminant hepatic failure.

In a series of 106 patients with fulminant hepatic failure and grade 4 encephalopathy, cardiac arrhythmias and other abnormalities occurred in 92 per cent. The most common was sinus tachycardia (75%) and this was the only abnormality in 22 per cent of the patients. Sudden cardiac arrest occurred in 25 per cent, various ectopic beats in 20 per cent, and heart block or bradycardia in 18 per cent. Other electrocardiographic abnormalities, mostly of the T wave and ST segment, were found in 31 per cent. Cardiac and respiratory arrests were usually unrelated to each other and both frequently occurred without warning. Only 7 out of 71 patients with arrhythmias other than sinus tachycardia survived, compared with 15 out of 31 patients without them (P less than 0-005). During the latter part of the series when an arrhythmia computer was used to monitor 38 patients, it was shown that significantly lower arterial oxygen levels occurred in those with arrhythmias, other than sinus tachycardia, than in those without. They were also found to be more acidotic and hyperkalaemic, and a higher number required dialysis and ventilation. Macroscopical cardiac abnormalities including scattered petechial haemorrhages, small pericardial effusions, and fatty, pale, and flabby ventricles, were found at necropsy in 64 per cent of the patients examined. Combinations of these macroscopical abnormalities occurred, particularly in the paracetamol overdose group. Another necropsy finding of possible significance in the pathogenesis of arrhythmias was cerebral oedema, present in 48 per cent of the patients examined, and often associated with coning of the brain stem. However, 7 of the 16 patients who suffered asystolic cardiac arrests had no macroscopical abnormality of either heart or brain. In the management of patients with fulminant hepatic failure continuous cardiac monitoring is essential. Correction of the biochemical and coagulation defects may decrease the frequency of arrhythmias but studies of the mechanism and control of cerebral oedema and its relation to cardiovascular function are urgently needed.

Acetaminophen↗
PubMed1976

Giant cell arteritis presenting as subclavian artery occlusion. A report of two cases.

Two patients with the aortic arch syndrome and biopsy-proved but asymptomatic temporal giant cell arteritis are described. Corticosteroid treatment was followed by the return of peripheral pulsation in these two patients after an interval of a few months. A review of the literature suggests that of patients where giant cell arteritis causes subclavin obstruction there is an undue predominance of women, compared to the sex ratio found in giant cell arteritis overall.

Aged↗
PubMed1975

Histopathological changes in the liver following a paracetamol overdose: correlation with clinical and biochemical parameters.

The histological appearances of the liver damage occurring after a paracetamol overdose are described in liver biopsies from 104 patients, of whom 38 developed fulminant hepatic failure. Confluent centrilobular necrosis of varying extent was followed by rapid disappearance of necrotic cells, leaving areas of reticulin collapse and a usually mild inflammatory reaction. The histological recovery in even the most severe cases was remarkable, and only one of the 17 survivors whose initial biopsy showed the pattern of interlobular bridging necrosis had appreciable residual fibrosis in a follow-up biopsy taken after 1 yr. A quantitative estimate was made of the amount of surviving liver parenchyma using a morphometric technique and the hepatocyte volume fraction (HVF) in biopsies performed within 10 days of the overdose correlated well with the clinical course and both the maximal prolongation of the prothrombin time and the peak plasma bilirubin concentration in the first 10 days. An HVF value (normal 85 +/- 5 per cent.) of less than 40 per cent. in a biopsy taken within 10 days of the overdose was found only in patients who died. However, HVF measurements on biopsies from three survivors taken later than 10 days after the overdose shows that survival is possible below this critical level.

Acetaminophen↗
PubMed1975

Liver disease in infancy: histological features and relationship to alpha-antitrypsin phenotype.

Sixty-nine specimens of liver tissue from 53 infants with neonatal hepatitis or its sequelae were examined without knowledge of the alpha1-antitrypsin phenotype. Distinctive, diastase-resistant, PAS-positive, pure magenta-coloured, sharply defined globules, 2-20 microns in diameter were found in periportal and paraseptal hepatocytes in all liver biopsies from eight alpha1-antitrypsin deficient (PiZZ) infants biopsied after the age of 12 weeks. Such globules were not seen in biopsies from PiZZ individuals aged less than 12 weeks nor in individuals of normal alpha1-antitrypsin phenotype (PiMM). No other specific histological abnormality was found in PiZZ individuals, but in them giant-cell transformation was infrequent and liver damage was more severe, three of 14 cases developing cirrhosis in contrast to four of 27 PiMM subjects. The pathogenesis of liver disease in PiZZ individuals is discussed.

Age Factors↗