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Biomedical subjects

Josephine Wyatt-Ashmead

Publications and source records attributed to Josephine Wyatt-Ashmead.

10 recordsLinked to original sources

Pregnancy loss after first-trimester viability in women with sickle cell trait: time for a reappraisal?

OBJECTIVE: The purpose of this study was to evaluate the obstetric outcomes and pathologic findings in women with sickle cell trait. STUDY DESIGN: In this retrospective case control study, pregnant women with sickle cell trait were studied over a 4-year period (2001-2005). The women who were delivered at > 16 weeks of gestation were compared with a cohort group of subjects with normal hemoglobin levels, and the placentas were sent for pathologic evaluation. RESULTS: A total of 180 pregnancies were studied with a like number of control patients. Subjects who had sickle cell trait demonstrated shorter average duration of pregnancy (233 +/- 45 days vs 255 +/- 34 days; P < .001) and lower birth weight (2114 +/- 1093 g vs 2672 +/- 942 g; P < .001). The rate of fetal death was significantly higher among study group patients (3.5% vs 9.7%; P = .015) when compared with the control group. Additionally, in study women, acute ascending amniotic infection and meconium histiocytosis were noted much more frequently. Sickling in the intervillous space and decidual vessels that were not associated with artifactual change was also found among patients sickle cell trait. CONCLUSION: Patients with sickle cell trait appear to be at increased risk for fetal loss compared with women with normal hemoglobin levels, and placental abnormalities may play a causal role.

Abortion, Spontaneous↗

Rash.

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Biopsy↗

Colonic chicken-skin mucosa in children with polyps is not a preneoplastic lesion.

Colonic polyps are common both in adults and children; however, the malignant potential varies according to the type of polyp. Most childhood polyps are solitary juvenile polyps, which have negligible malignant potential. Chicken-skin mucosa (CSM) is an endoscopic finding initially described associated with adenomatous polyps and adenocarcinoma, suggesting a preneoplastic lesion. Subsequently, CSM was described in association with juvenile polyps, suggesting that this mucosal finding is not a precursor to dysplasia. To determine whether CSM represents a preneoplastic lesion, we studied endoscopic colonic mucosal biopsies for markers of cell replication (Ki-67) and malignant transformation (p53) in mucosal biopsies of CSM, normal colonic tissue, tubular adenomas, and adenocarcinomas. Samples were subjected to immunostaining for the presence of Ki-67 and p53. The degree of Ki-67-positive staining cells was similar for CSM and normal colonic tissue, whereas there was significantly increased staining for both tubular adenomas and adenocarcinomas. There was no evidence of p53 staining in CSM and normal colonic mucosa, whereas there was varying degrees of staining in tubular adenomas and adenocarcinomas. The association of CSM with benign juvenile polyps and the absence of histologic markers for increased replication and malignant transformation support the notion that this endoscopic finding is not preneoplastic. Rather, CSM arises in proximity to polyps of all histologic types because of local mucosal damage.

Adenocarcinoma↗

Pediatric hepatic angiosarcoma: case report and review of the literature.

Pediatric hepatic angiosarcoma (PHAS) is a rare tumor, which usually presents as a rapid enlargement of the liver. To date, surgery, chemotherapy, and radiotherapy have not improved the poor prognosis of PHAS with only three survivors reported. The histology of PHAS is distinct from adult angiosarcoma, because PHAS displays hypercellular whorls of sarcomatous cells, or "kaposiform" spindle cells, in addition to the general features of angiosarcoma. We report a case of PHAS that was treated with vascular ablation, chemotherapy, and liver transplantation. Lung metastases occurred 14 months posttransplant.

Antineoplastic Agents↗

Maternal infection-induced white matter injury is reduced by treatment with interleukin-10.

OBJECTIVE: The purpose of this study was to test the hypothesis that interleukin-10 can prevent white matter injury in neonatal rats that are born to infected dams. STUDY DESIGN: Timed pregnant rats (day 17) were assigned to the following treatment groups: (1) saline control (n = 5 rats), (2) Escherichia coli- infected (n = 10 rats), and (3) E coli + interleukin-10 (n = 5 rats). E coli was administered at a titer of 1 x 10(7) colony-forming units by intrauterine inoculation just above the cervix at the bifurcation of the uterine horns. Rat interleukin-10 was administered intravenously at a dose of 1 microg/kg of body weight. After delivery, the pups were maintained with dams until day 8, at which time they were placed under general anesthesia and perfused with saline solution followed by 10% paraformaldehyde. The brains were removed, placed in 30% sucrose solution, and then frozen at -20 degrees C until the preparation of the frozen sections. Standard hematoxylin/eosin staining was performed, and the brains were evaluated for matter necrosis, apoptotic cells, and ventricular swelling. RESULTS: In pups that were born to infected dams, 11 of 38 pups (29%) displayed symmetric lesions around the lateral ventricles. These lesions were characterized by marked looseness/edema of the neuropil, foamy-appearing histiocytes, and granular neuropil breakdown. None of the pups (n = 17) that were born to interleukin-10-treated infected dams displayed this pattern of severe white matter injury. CONCLUSION: These results suggest that maternal interleukin-10 therapy could provide neuroprotection for infants who are born to mothers with intrauterine infection.

Animals↗

Recurrent neuroblastoma with gastric invasion.

The authors present an unusual manifestation of neuroblastoma in a young child: upper gastrointestinal bleeding due to erosion of the tumor into the stomach. Included are reviews of gastrointestinal manifestations of neuroblastoma and gastric tumors in children.

Child, Preschool↗

Renal cell carcinoma in long-term survivors of advanced stage neuroblastoma in early childhood.

BACKGROUND: Renal cell carcinoma (RCC) is rare in children and comprises only 1-3% of all pediatric primary renal tumors. Recently, several case reports have described RCC developing in patients previously treated for advanced stage neuroblastoma (NB). METHODS AND RESULTS: Our experience with four patients treated for advanced stage NB during early childhood who developed RCC later in life are added to 14 others in the literature. CONCLUSION: These patients and our review of the literature suggest an association between RCC and NB that warrants further study.

Adolescent↗

Cytogenetics in pediatric low-grade astrocytomas.

BACKGROUND: Cytogenetic analysis in certain tumors is a vital part of classification and assignment of prognosis. Few studies have examined the value of cytogenetic analysis in pediatric brain tumors. This is especially true of low-grade astrocytomas (LGA) of childhood. This study examines the correlation between cytogenetic abnormalities and survival in children with low-grade astrocytomas. The literature on adults with LGA suggest better survival for those whose tumors have normal cytogenetics compared to those with abnormal. We hypothesized this would also be true of children with low-grade astrocytomas. PROCEDURE: A retrospective study was performed of children presenting between 1980 and 1998 to The Children's Hospital, Denver, who had LGA and on whose tumors informative cytogenetics had obtained. RESULTS: One hundred and forty-nine children were diagnosed with histologically proven LGA. Twenty-nine had successful cytogenetic analysis. One or more chromosomal abnormalities were observed in eight tumors while normal karyotypes were observed in 21 tumors. Actuarial progression-free survival at 5 years was 87.5% for the eight children with abnormal cytogenetics and 43% for those with normal (P=0.56). Overall survival at 5 years was 83% for those with abnormal cytogenetics and 78% for those with normal (P=0.8). The differences in progression-free survival and overall survival between these two groups were not significant. Those children with WHO Grade I tumors had significantly superior progression-free and overall survival than those with Grade II tumors. CONCLUSIONS: It appears unlikely that, for children with LGA, those with normal cytogenetics have a better prognosis than those with abnormal. Histologic grade is a better predictor of outcome than cytogenetics.

Adolescent↗

Benign müllerian papilloma of childhood.

Benign müllerian papilloma of the female reproductive tract is a rare childhood tumor that can easily be mistaken by those unfamiliar with the entity for botryoid rhabdomyosarcoma. Ultrastructural findings have been mentioned only in two individual case reports, and these both were issued many years ago. The aim of this update is to familiarize the reader with the clinical, light, and electron microscopic features associated with this distinctive entity, and thereby hopefully preclude the risk of making a serious diagnostic error. Two cases are illustrated, one very typical in its presentation and the other less so.

Child↗