Letter: Pathologists at the crystal ball.
Explore the source record for details and available documents.
Education, Medical↗
Biomedical subjects
I J Cook
Publications and source records attributed to I J Cook.
A laboratory study of spontaneous platelet aggregation.
During studies on platelet aggregation using the EEL platelet aggregation meter, 8% of the individuals tested were found to have platelets which aggregated spontaneously when citrated, platelet-rich plasma was stirred at 37 degrees C. The EEL aggregation meter differs from other machines in that it incorporates a vertical stirrer which subjects platelets to greater mechanical force. When using this machine it is suggested that spontaneous platelet aggregation is related to increased mechanical fragility of the platelets and low levels of plasma ADP-inhibitor.
Adenine Nucleotides↗
Measurement of A.D.P.-induced platelet aggregation and A.D.P.-splitting enzymes in plasma.
Explore the source record for details and available documents.
Adenine Nucleotides↗
Structural abnormalities of the cricopharyngeus muscle in patients with pharyngeal (Zenker's) diverticulum.
Recent manometric and radiological studies suggest that the upper oesophageal sphincter has poor compliance in patients with a pharyngeal (Zenker's) diverticulum. To test the hypothesis that this phenomenon is related to structural changes within the cricopharyngeus muscle we examined, histologically, muscle strips from 14 patients with a Zenker's diverticulum and compared them with control tissue obtained at autopsy from 10 non-dysphagic individuals. The cricopharyngeus muscle from patients and controls differed from inferior constrictor muscle by virtue of type 1 fibre predominance and greater fibre size variability. Ragged red fibres and nemaline bodies are a normal finding in the cricopharyngeus. Marked differences were observed in the cricopharyngeus muscle of Zenker's patients which demonstrated fibro-adipose tissue replacement and fibre degeneration. It is concluded that these structural changes may account for the observed diminished upper oesophageal sphincter opening and dysphagia in patients with Zenker's diverticulum.
Aged↗
Investigative techniques in the assessment of oral-pharyngeal dysphagia.
Oral-pharyngeal dysphagia is a common problem with a high morbidity and mortality. In general, it is not managed as well as esophageal dysphagia by gastroenterologists. A number of techniques are now available for the assessment of oral-pharyngeal dysphagia. However, a careful clinical assessment followed by a video barium swallow is all that is required for the diagnosis and management in the majority of patients. Pharyngeal manometry is likely to play an increasingly important role in the assessment of difficult or atypical cases in whom it can provide functional information not achievable with videoradiography alone. Videolaryngoscopy is a quick and simple way of detecting structural lesions and of assessing deglutitive airway protection. Videolaryngoscopy is non-invasive and easily performed in an office setting. Ultrasonography is a convenient way of assessing lingual function, but provides no more information than the video barium swallow. Pharyngeal scintigraphy is likely to assume a greater clinical relevance as a means of quantifying swallow efficiency and response to therapy.
Barium↗
The role of brushing cytology in the diagnosis of gastric malignancy.
The results of endoscopic biopsy and brushing cytology in 234 consecutive patients with established histologic diagnoses of discrete gastric lesions were analyzed. A histopathologic diagnosis of malignancy, established by independent means, was made in 74 patients. Brushing cytology was positive for malignancy in 63, a diagnostic sensitivity of 85%. Endoscopic biopsy was positive in 64, a diagnostic sensitivity of 86%. The sensitivity for combined cytology and biopsy was 91%, which was not significantly greater than for biopsy alone (P = .6). Cytology yielded false-positive results in 5 of 160 patients (3.1%) with confirmed benign disease. There were no false-positive biopsy reports. Although both brushing cytology and biopsy have high diagnostic sensitivities, based on the findings of this study, the routine addition of cytology to biopsy in the endoscopic evaluation of gastric lesions is not recommended. Cytology could be reserved for situations in which difficulty is encountered in obtaining adequate tissue for histologic examination and for cases with a high suspicion of malignancy that have yielded negative biopsies.
Adenocarcinoma↗