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Biomedical subjects

M Leader

Publications and source records attributed to M Leader.

At least 73 records · Page 4Linked to original sources
PubMed1993

Partial hydatidiform mole: a common but underdiagnosed condition. A 3-year retrospective clinicopathological and DNA flow cytometric analysis.

This retrospective study reports the incidence of hydatidiform mole in a population of 19,457 pregnancies over a 3-year period. During the study period all "products of conception" from first and second trimester abortions were referred for pathological examination. Coded histologic sections were reviewed using the published histologic criteria for hydatidiform mole. Ploidy was estimated by DNA flow cytometry. Clinical data were retrieved from maternal case notes. Thirty-eight cases were confirmed as hydatidiform mole, 10 (26%) as complete mole, and 28 (74%) as partial mole. Twenty-three cases of partial mole (88%) were triploid, and nine of 10 complete moles were diploid. The incidence of hydatidiform mole was 1:512 pregnancies, (complete mole, 1:1,945; partial mole, 1:695). Only one case (3.5%) of partial mole was suspected clinically. One case of persistent gestational trophoblastic disease occurred following a complete mole. No sequelae were encountered following partial mole. We conclude that hydatidiform mole is a common condition and the majority of cases are partial moles. Quantitatively imprecise morphologic criteria contribute to the inaccuracy in reporting of partial mole; analysis of ploidy is useful in the evaluation of problem cases. Follow-up of partial mole is warranted because its true biological potential is as yet unclear.

Abortion, Spontaneous↗
PubMed1992

DNA quantification of squamous cell carcinoma of the oesophagus by flow cytometry and cytophotometric image analysis using formalin fixed paraffin embedded tissue.

This is the first comparative study of DNA quantification of oesophageal squamous cell carcinoma by flow cytometry (FCM) and image cytometry (ICM) using formalin fixed paraffin embedded tissue. The potential advantages of ICM include the identification of a reliable control cell population; avoidance of non-tumour stromal and inflammatory cell nuclei, nuclear fragments, degenerate cell nuclei and doublets, triplets etc., which are not possible with FCM using archival tissue. Twenty-eight cases, all of the same stage (stage 2a) and similar grade (well or moderately differentiated) were analysed. The cases were separated into two groups, those that had succumbed to tumour in less than 18 months (group A) and those that were tumour free at least 18 months post-resection (group B). Using ICM all 28 tumours yielded interpretable histograms by comparison to 25 of 28 using FCM. Aneuploidy was identified in 100% of cases in group A using ICM (in comparison to 73% by FCM) and in 73% of group B using ICM (in comparison to 44% by FCM). Any tumour aneuploid by FCM was also aneuploid by ICM. Nine cases aneuploid by ICM were euploid by FCM. The mean 5C exceeding rate (% of cells whose nuclei contain a DNA mass equivalent to > 5 sets of 23 chromosomes) was 21% in group A and 14% in group B (P < 0.01). Euploidy was confined to tumours of those patients disease free for more than 18 months. The conclusions of this study are that: firstly, ICM is superior in its yield of interpretable histograms to FCM using formalin fixed paraffin embedded tissue; secondly, ICM is more sensitive in the identification of aneuploid stemlines than FCM; and thirdly, euploid tumours (as detected by ICM) appear to have a better prognosis than aneuploid tumours of similar stage and grade.

Adult↗
PubMed1992

Emergency appendicectomy: a one year audit.

A retrospective study of emergency appendicectomy over a one-year period at Beaumont Hospital was carried out. The overall normal appendicectomy rate was 22.8%, and was twice as high in women (31%) as in men (15%). Gangrenous or perforated appendicitis was present in 20% of cases. The overall mean assessment-surgery interval was 16.7 hours. Considerable variation in the use of antimicrobial agents was noted in the study, and many haematological and radiological investigations performed did not appear to improve diagnostic accuracy. Among patients with clinical features typical of appendicitis, 16% proved to have a normal appendix. These results point to a number of aspects of the diagnosis and management of appendicitis where there appears to be room for future improvement.

Acute Disease↗
PubMed1992

DNA ploidy in squamous oesophageal carcinoma.

The role of DNA ploidy in the management of oesophageal carcinoma is unclear. Most studies have employed flow cytometry (FC) for DNA analysis but some have used image analysis (IA) of tissue sections. In this study aneuploidy rates in stage IIa squamous tumours were determined by both FC and IA of cell suspensions and results were compared with outcome in two patient subgroups. Group 1 (n = 15) were patients who died from tumour recurrence within 1 year of surgery while Group 2 (n = 21) were patients who survived tumour free for at least 1 year. Aneuploidy rates differed significantly between techniques; 29 of 36 tumours (81%) were aneuploid by IA compared with 19 of 34 (56%) by FC (P < 0.05). Aneuploidy rates differed significantly between groups 1 and 2 as determined by FC (79%) versus 40%) (P < 0.05) but not by IA (93% versus 71%) (P = ns). Euploid status was a good prognostic indicator; 6 of 7 (86%) patients with euploid tumours by IA and 12 of 15 (80%) by FC (P < 0.05) survived more than 1 year. The sensitivity and specificity of euploidy was 93% and 28.6% for IA compared with 78.6% and 60% for FC. Since 33 (92%) of these tumours exhibited a marked peritumoral desmoplastic or chronic inflammatory reaction IA, being more sensitive to subtle nuclear change, may be a more appropriate technique than FC for evaluation of the role of ploidy in such tumours.

Adult↗
PubMed1992

Specificity of colon specific antigen and colon ovarian tumour antigen.

Sections (5 microns thick) from 101 primary adenocarcinomas (including ovarian, colorectal, gastric, breast, oesophageal, prostatic, pancreatic, endometrial and gall bladder) were incubated wtih anticolon specific antigen (CSA) and anticolon ovarian tumour antigen (COTA) antibodies using the peroxidase antiperoxidase technique with positive and negative controls. Anti-CSA positivity was seen in 19 of 20 colonic adenocarcinomas, but it was also seen in a large number of the other tumours. While anti-COTA staining was positive in 16 of 20 colonic adenocarcinomas and 20 of 30 ovarian adenocarcinomas, it was also positive in a large number of the tumours. Anti-CSA and anti-COTA are not adequately specific in the identification of a colonic or ovarian origin of an adenocarcinoma and cannot reliably be applied to the identification of a metastatic adenocarcinoma of unknown primary site.

Adenocarcinoma↗
PubMed1992

DNA quantitation of Wilms' tumour (nephroblastoma) using flow cytometry and image analysis.

AIMS: To compare flow cytometry (FCM) with image analysis (IA) in the DNA quantitation of Wilms' tumour (WT) and to correlate data so obtained with recognised clinical and pathological prognostic parameters. METHODS: Thirty six patients with histologically proved WT diagnosed between 1980-89 were investigated. Fifteen patients had stage I disease, 10 stage II, six stage III, two stage IV and three stage V. Suspension of nuclei obtained by pepsin digestion of paraffin wax embedded tumour tissue was analysed using a FAC-Scan flow cytometer, and a CAS-100 image analyser. RESULTS: Tumours were concordant in most instances, however, IA identified aneuploidy in two tumour samples which were diploid by FCM. Aneuploidy was detected in 5/33 tumours with favourable histology and 3/3 with unfavourable histology. Three of 28 patients with Stage I, II and V disease and 5/8 patients with stage III and IV had aneuploid tumours. All patients with unfavourable histology died of disease. In the group with favourable histology, 4/5 patients with aneuploid tumours developed recurrent disease compared with 1/27 diploid tumours (p less than 0.0001). CONCLUSIONS: Ploidy may be a useful additional prognostic indicator in Wilms' tumour with favourable histology. Larger scale studies are needed to confirm the relation of ploidy to survival in early stage WT.

Child↗
PubMed1992

Image analysis in the determination of ploidy and prognosis in renal cell carcinoma.

The usefulness of ploidy determination by flow cytometry in renal cell carcinoma is disputed. An alternative technique for DNA quantitation, computerised static image analysis, has several advantages over flow methods. Tissue from 90 cases of primary renal cell carcinoma was analysed by image analysis. Cases were assigned a histological grade and staged and stratified by the TNM system. Fifty-two cases were diploid, 28 were aneuploid and 9 were tetraploid (1 was unanalyzable). Heterogeneity of ploidy was noted in 4 cases. The degree to which nuclear DNA content exceeded that of normal nuclei from the same block was also calculated (5C exceeding rate). Stage and grade provided independent prognostic information. Aneuploidy was associated with higher mortality but neither ploidy nor 5C exceeding rate were prognostic indicators. Image analysis is a useful and accurate method for ploidy determination and provides additional data on DNA quantitation but this information is not predictive of the clinical outcome.

Adult↗
PubMed1991

Soft tissue and visceral sarcomas in Irish patients. A preliminary report from the Dublin Soft Tissue Tumour Panel.

Sarcomas of the soft tissues and viscera are a diverse group of uncommon neoplasms that often present difficult diagnostic and management problems. The Dublin Soft Tissue Tumour Panel prospectively reviewed pathology material from 137 patients of four Dublin teaching hospitals between January 1989 and August 1990. The prevalence of sarcomas in Irish patients was found to be similar to that estimated for the United States. The most common sarcoma of soft tissues was malignant fibrous histiocytoma (14) and the most common visceral sarcoma was leiomyosarcoma (10). The most problematic diagnoses were 3 peripheral neuroepitheliomas (extraskeletal Ewing's sarcomas) which occurred in patients aged 19-27 years, distinctly younger than the typical adult sarcoma patient. Clinical follow-up is in progress and will be combined with the findings of a linked retrospective study, to facilitate evaluation of all aspects of management.

Abdominal Neoplasms↗
PubMed1991

Improved wound healing with a modified electrosurgical electrode.

Previous studies comparing standard electrosurgical (ES) electrode and steel scalpel (SS) wound healing have reported poor initial tensile strength, a delay in reaching maximum tensile strength and an increased inflammatory response in the ES wounds. The hypothesis that a smaller needle (modified) electrode would give better wound healing than a standard electrode was tested. Using histology as a parameter of wound healing, incisions created by a modified electrode, a standard electrode and a steel scalpel were compared. Sixty Sha Sha mice were divided into 10 groups. Standardised dorsal skin incisions were made using steel scalpel, standard and modified electrosurgical cutting electrodes. Mice were sacrificed on days 0, 1, 2, 3, 5, 7, 9, 14, 28 and 42. The incised skin was processed for standard and immunohistochemical staining. The standard ES wound had significantly higher numbers of polymorphonuclear leukocytes in comparison to the SS and modified ES wounds (p less than or equal to 0.01). However, macrophage numbers were found to be significantly lower in the ES wounds when compared to the SS wounds on days two and five (p less than or equal to 0.05). The fibroblast response was delayed by up to two days in the ES wounds when compared to the SS wounds. Epithelialisation was completed by day two in the SS and modified ES groups but was only complete by day three in the standard ES group (p less than or equal to 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Adenosquamous carcinoma of the prostate: a case report.

Mixed types of carcinoma of the prostate are rare. The majority of those described (22 cases) are examples of mixed adenocarcinoma and transitional cell carcinoma. Much more unusual is the mixed adenosquamous carcinoma, of which only three cases have been described. This report presents an additional case of the rare adenosquamous carcinoma of the prostate. It discusses the clinicopathologic features and the possible histogenesis of this tumor and suggests a role for stilbestrol in its development.

Adenocarcinoma↗
PubMed1991

Granulomatous gastritis: part of a vasculitic syndrome.

The previously unreported association of granulomatous gastritis and mononeuritis multiplex occurring in the setting of a vasculitic syndrome is described. The two conditions are considered to be associated and to be immune mediated. The previously accepted concept of isolated granulomatous gastritis is disputed.

Female↗
PubMed1991

A canine model of cyclosporine enhanced ischemic renal injury.

Clinical reports of increased graft primary non function in patients receiving cyclosporine in whom the anastomosis time is prolonged (greater than 30 minutes) suggest a synergism between the nephrotoxic effects of cyclosporine and the ischaemia occurring during transplantation. Using unilaterally nephrectomised greyhound dogs, sixty minutes ischaemia and cyclosporine 10 mg./kg./day we have produced an animal model of cyclosporine enhanced ischaemia renal failure. Structural and functional data suggests the proximal tubule is the main site of injury.

Animals↗
PubMed1991

Prevention of cyclosporine enhanced ischaemic renal injury using induced hypothermia.

Cyclosporine is associated with an increased incidence of graft primary non function and poorer long term graft function in patients with prolonged ischaemia times. We evaluated the role of hypothermia in preventing this synergism between the nephrotoxic effects of cyclosporine and ischaemia in a canine model. Induced renal hypothermia prevented this synergism.

Animals↗
PubMed1991

Mac387: its non-specificity as a tumour marker or marker of histiocytes.

A commercially available monoclonal antibody which detects histiocytes in paraffin sections, Mac387, was reacted with 148 soft tissue sarcomas, 29 carcinomas and 10 malignant melanomas. The soft tissue sarcomas had been previously immunophenotyped. All categories of sarcomas, with the exception of angiosarcomas, were positive. Most showed staining in less than 50% of the tumour cells. Six of 10 adenocarcinomas and three of nine basal cell carcinomas were positive, while squamous carcinomas and malignant melanomas were negative. Normal squamous mucosa and epidermis were also positive. The results of this study suggest that Mac387 is of little value in the differential diagnosis of soft tissue tumours, nor is it a specific histiocytic marker.

Antibodies, Monoclonal↗
PubMed1991

Angiodysplasia and ileal carcinoid.

A case of angiodysplasia, symptomatic for 18 years, is presented. This case highlights the difficulty of establishing a diagnosis. Associated findings included aortic stenosis and a carcinoid tumour of the ileum. Despite transfusion of a total of 1200 units of blood the liver was normal at necropsy.

Angiodysplasia↗
PubMed1990

Review of an Irish cervical smear service.

Cervical cytology material from 5,815 women who presented to General Practitioners throughout Ireland for routine cervical smears were referred to our Pathology Laboratory. The smears were reviewed retrospectively in order to report on the incidence of dyskaryosis and other abnormalities diagnosed on cervical cytology. Evidence of dyskaryosis was found in a total of 2.2% and "borderline" changes in a total of 0.3% of smears. Cytology and subsequent histology were compared in cases of significant cervical intraepithelial neoplasia. Comparison in cases of moderate and severe dyskaryosis showed precise correlation between the diagnosis of cervical intraepithelial neoplasia on biopsy and its prediction on cytology in 30 of 33 cases. Over a third of women screened were in their 4th decade and the highest incidence of dyskaryosis was in this age group. Only 10% of those screened were 50 years or over and a third were aged 40 years and over. These facts are of relevance with regard to the problem of targeting the population at risk in the long term planning of routine cytology screening services in this country.

Adolescent↗