Malacoplakia of bone: a case report.
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Bone Diseases↗
Biomedical subjects
L Dreyer
Publications and source records attributed to L Dreyer.
Subcutaneous phycomycosis caused by Basidiobolus haptaosporus (Drechsler, 1947).
Subcutaneous phycomycosis in a Black child is reported, together with clinical, histological and mycological studies. This is the first case, to our knowledge, to be identified mycologically in South Africa. Oral potassium iodide gave an excellent therapeutic result.
Child, Preschool↗
The incidence of dysplasia and associated epithelial lesions in the oesophageal mucosa of South African Blacks.
Necropsy specimens of the oesophagus from 110 South African Blacks and from a control group of 110 Whites were examined for dysplasia and associated lesions of the epithelium, using the 'Swiss roll' technique. In 4 Black males (3,3%) focal areas of moderate to severe dysplasia were found. This means that the incidence of dysplasia is far higher than that of carcinoma, which seems to indicate that dysplasia is probably a reversible lesion. Parabasal cell hyperplasia was found in 44,5% of Blacks and in 29% of Whites. Keratohyaline granules in superficial epithelium also occurred more frequently in Blacks (49%) than in Whites (29%). These two conditions might be the result of chronic irritation and would probably not be significant markers in a screening programme for carcinoma. However, the presence of exfoliative dysplastic cells almost certainly indicates premalignant change in the epithelium.
Adolescent↗
Postoperative Clostridium septicum dermatitis simulating toxic epidermal necrolysis.
Widespread detachment of the epidermis as a result of Clostridium septicum infection after a laparotomy for intestinal obstruction is described. A clinicopathological picture, hitherto undescribed, is outlined.
Aged↗
Microsatellite instability in uterine sarcomas.
Studies have shown a 15-30% frequency of microsatellite instability in endometrial cancer. In addition, we found a 21% frequency of microsatellite instability in endometrial cancer. Our aim was to investigate the presence of microsatellite instability and loss of heterozygosity in uterine sarcomas. The records of 69 women referred to Kalafong Academic and Pretoria Academic Hospital with a primary diagnosis of uterine sarcoma were reviewed. At histological review of 43 cases with a primary diagnosis of leiomyosarcoma, diagnosis of mitotically active leiomyoma was made in 21. Diagnosis of carcinosarcoma was made in 21 cases and endometrial stromal sarcoma in five. In all cases, genomic DNA was extracted from normal myometrium and tumor and analyzed for microsatellite instability and loss of heterozygosity. High-frequency microsatellite instability was absent in leiomyosarcoma, endometrial stromal sarcoma, and mitotically active leiomyomas and was observed in 1 (5%) carcinosarcoma. Loss of heterozygosity for chromosome 11 was present in 8/48 (17%) of uterine sarcomas, equally distributed between leiomyosarcomas (4/22 = 18%) and carcinosarcomas (4/21 = 19%). There was no loss of alleles in endometrial stromal sarcoma nor mitotically active leiomyomas. In conclusion, it is suggested that tumor suppressor genes may play a role in the tumorigenesis of uterine mesenchymal cells, whereas mismatch repair genes contribute to the carcinogenesis of endometrial cancer.
Carcinosarcoma↗
Diabetes care practices in primary care: results from two samples and three measurement sets.
PURPOSE: There has been substantial recent interest in diabetes disease management interventions, guidelines, and care practices. As the vast majority of diabetes care occurs in primary care settings, it makes sense to evaluate current levels of recommended practices in different primary care settings. METHODS: We report on two separate studies that included a combined total of 389 patients seen by over 30 different providers. Three different sets of recommended practices were assessed: (1) the ADA provider recognition measures, (2) the proposed Diabetes Quality Improvement Project measures, and (3) the state of Oregon Population-Based Guidelines for Diabetes. RESULTS: In general, there was only a moderate level of adherence to recommended practices, and adherence was much lower for behavioral or patient-focused practices as contrasted with laboratory tests. There was considerable variability across providers and across different guidelines activities. CONCLUSIONS: Policy and quality improvement implications and future research issues are discussed, including the need for studying different measurement approaches for evaluating guidelines adherence.
Diabetes Mellitus↗
Identification and care of substance-dependent neonates.
Identification and care of substance-dependent neonates requires a holistic, family-centered approach to care, starting in the prenatal period and continuing long after the infant is born. Interventions useful in working with families of substance-dependent neonates include psychological support, substance abuse treatment, and physiologic support in the form of nonpharmacologic and pharmacologic therapies. The nurse can play a powerful role in determining the fate of each family. Early recognition of the problem and appropriate, decisive intervention is necessary if the long-term outcomes of substance dependence are to be improved.
Female↗
The suitability of paraffin-embedded material to predict metastatic potential of oral squamous cell carcinoma.
BACKGROUND: The presence of regional metastasis in oral squamous cell carcinoma (OSCC) is an important prognostic factor. This study was undertaken to identify histological features and biological markers from paraffin-embedded primary OSCC that may predict the presence of regional metastases. MATERIALS AND METHODS: Fifty-three en-bloc primary OSCC resections were divided into two groups, 26 with lymph node metastases and 27 without metastases. The pattern of infiltration, presence of vascular or perineural infiltration and tumour necrosis were evaluated while expression of p53, p21 and Rb were assessed in the two groups. DNA ploidy status was also determined with a flow cytometer. RESULTS: The presence of DNA aneuploidy was found to be the only statistically significant predictor of regional metastases. Seventy-seven per cent of the primary OSCC with lymph node metastases showed DNA aneurploidy. CONCLUSION: DNA flow cytometry obtained from archival material could be used as a parameter to predict regional metastases.
Aneuploidy↗
The role of DNA ploidy and Ki-67 in the grading of mucoepidermoid carcinomas.
BACKGROUND: The grading of mucoepidermoid carcinomas (MEC) is based on subjective microscopic evaluation of the prevalence of cell types as well as features of atypia and aggressiveness. Our study was aimed at evaluating the role of high-resolution DNA flow cytometry and Ki-67 expression in the grading of MEC. MATERIALS AND METHODS: Fifty-five cases of intraoral and major salivary gland tumours, diagnosed as MEC, were retrieved and the grading system proposed by Brandwein et al. applied. RESULTS: Forty-nine per cent of our sample was graded as high, 35% as intermediate and 16% as low. Eighty-nine per cent of the high-grade MEC showed aneuploid DNA cell populations, while 88% of the diploid tumours were graded as intermediate or low. The mean Ki-67 positivity was significantly different between the high and intermediate grade tumours and between the aneuploid and diploid tumours. CONCLUSION: This study showed that high-resolution DNA flow cytometry of archival paraffin-embedded tissue is accurate in the grading of MEC and can be used with Ki-67 expression as an additional diagnostic tool.
Carcinoma, Mucoepidermoid↗