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Biomedical subjects

N J Robertson

Publications and source records attributed to N J Robertson.

31 records · Page 2Linked to original sources
PubMed1997

Carcinosarcoma of the oesophagus showing neuroendocrine, squamous and glandular differentiation.

AIM: A case of oesophageal carcinosarcoma occurring in a previously fit, 64-year-old man is reported. CASE SUMMARY: The carcinomatous component displayed neuroendocrine, squamous and glandular differentiation: the sarcomatous component showed no specific features of differentiation. In-situ squamous carcinoma was present in the adjacent squamous mucosa. The most superficial part of invasive tumour consisted of carcinosarcoma with a predominant neuroendocrine epithelial component. Squamous carcinoma without an accompanying sarcomatous component occupied most of the deeper part of the tumour, suggesting outgrowth of this tumour type by a selective growth advantage. CONCLUSION: We speculate that further tumour growth might have led to complete replacement of the tumour by pure squamous carcinoma, and that other advanced oesophageal squamous carcinomas might have had their origin in a short-lived carcinosarcomatous phase.

Adenocarcinoma↗
PubMed1996

Nasal deformities resulting from flow driver continuous positive airway pressure.

Over a period of six months, seven cases were documented of trauma to the nose as a result of flow driver continuous positive airway pressure in babies of very low birthweight (VLBW). There was a complication rate of 20% in the babies who required it. Deformities consisted of columella nasi necrosis which can occur within three days, flaring of nostrils which worsens with duration of continuous positive airway pressure, and snubbing of the nose which persists after prolonged continuous positive airway pressure. These complications should be preventable by modifications to the mechanism and method of use.

Humans↗
PubMed1992

Liver giant mitochondria revisited.

AIMS: To examine the correlation between the severity of alcohol induced liver damage and the presence of intracytoplasmic red bodies (defined as periodic acid-Schiff diastase negative, globular, hyaline cytoplasmic inclusions larger in size than the hepatocyte nucleolus). To investigate the incidence of intracytoplasmic red bodies (ICRBs) in non-alcoholic liver disease. METHODS: Liver biopsy specimens from 53 patients with alcoholic liver disease and 50 patients with a variety of nonalcohol related liver diseases were examined by light microscopy for the presence of ICRBs. For the 53 patients with alcoholic liver disease an assessment of recent alcohol consumption was made indirectly from measurements of red cell volume (MCV) and plasma gamma-glutamyl transferase (GGT). In addition, 10 liver biopsies with alcohol induced changes and ICRBs were examined by electron microscopy for the presence of mitochondrial aberrations including enlargement. RESULTS: ICRBs were detected in 18 of the 53 liver biopsy specimens showing alcohol induced changes, and were more abundant in those showing more advanced changes. Those patients whose liver specimens contained ICRBs were found to have a significantly higher mean plasma GGT activity and mean MCV than those individuals whose liver biopsy specimens did not contain ICRBs. Two of the 50 liver biopsy specimens showing non-alcohol induced changes contained ICRBs. Giant mitochondria were not detected by electron microscopy, but this may reflect sampling. CONCLUSIONS: The results of this study indicate that ICRBs are definitely associated with alcoholic liver disease and are more likely to be found in liver biopsy specimens showing more advanced alcohol induced damage, and when recent alcohol consumption has been high.

Adult↗
PubMed1985

Fatal overdose from a sustained-release theophylline preparation.

A 26-year-old woman ingested approximately 9 g of theophylline (Theodur). She exhibited agitation, generalized seizures, hyperglycemia, hypokalemia, hypomagnesemia, hypophosphatemia, and diuresis. Later in her hospital course rhabdomyolysis, myoglobinuria, and acute renal failure occurred. Hemodialysis was performed to correct electrolyte imbalance. She subsequently died of intractable shock and hyperkalemia. This case illustrates the metabolic abnormalities which may occur with severe theophylline intoxication.

Adult↗
PubMed1983

Evaluation of regional and nonregional poison centers.

The purpose of this study was to determine whether regional poison centers handle a particular poisoning situation better than nonregional centers do. Informed consent was obtained from 15 regional and 15 nonregional poison centers. A case involving salicylate ingestion by a three-year-old child was presented twice (one day call and one night call) to each center. Those answering the phone at the regional centers asked more information-gathering questions than did those at the nonregional centers (P less than 0.01) and were more proficient in their history taking (P less than 0.01). Nonregional centers did not consider the potentially toxic ingestion (220 mg per kilogram of body weight) important enough to treat or were not willing to handle the poisoning in one third of the calls. The nonregional centers recommended manual stimulation to induce emesis in 30 per cent of the calls, whereas none of the regional centers recommended this treatment. Four calls to the nonregional centers resulted in recommendations of inappropriate emetics--e.g., saltwater, raw eggs, or mustard water. The chance of obtaining incorrect recommendations for poisoning treatment from the nonregional centers was determined to be nine times greater than that from the regional centers. Indications of intention to follow up were twice as frequent among regional as among nonregional centers. These data strongly suggest that regional poison centers provide better and more consistent poison information than do nonregional centers.

Child↗
PubMed1982

Amphibian organ culture in experimental toxicology: the effects of paracetamol and phenacetin on cultured tissues from urodele and anuran amphibians.

Organ cultures of various tissues from urodele amphibians deacetylate paracetamol to p-aminophenol, which polymerises to form a brown precipitate. Paracetamol addition results in a loss of glycogen and lactate dehydrogenase (LDH) from urodele liver cultures and an increase in glucose release, and in LDH loss from kidney cultures. Organ cultures from anuran amphibians are unable to metabolise paracetamol and are not affected by its presence in the culture medium. The addition of unpolymerised p-aminophenol resulted in a loss of LDH from urodele and anuran organ cultures, whilst the addition of polymerised p-aminophenol had no such effects. This suggests that the toxic effects which follow the addition of paracetamol to urodele organ cultures are caused by unpolymerised p-aminophenol, a known toxicant in mammals. Cultures from both urodele and anuran amphibians are able to deacetylate phenacetin to p-phenetidine, but p-phenetidine was found to be much less toxic to amphibian tissues than p-aminophenol, causing LDH loss from kidney cultures only at very high dose levels.

Acetaminophen↗
PubMed1981

Collaborative clinical pharmacokinetic services.

A program for routine pharmacokinetic interpretation of serum analyses of gentamicin, tobramycin, amikacin, phenytoin, phenobarbital, theophylline, lidocaine, digoxin, quinidine, and procainamide at the Medical University of South Carolina Hospital is described. Results of all analyses of serum for the drugs listed are evaluated by a pharmacist trained in clinical pharmacokinetics. Patient variables relevant to the determination of drug serum concentrations, drug elimination, distribution, and dosage are given appropriate consideration in each evaluation. A summary of the pharmacokinetic interpretation and any necessary modification of drug dosage regimens are then written into the progress notes of the patients' medical records. Approximately 12 patients and 20 drug concentrations are evaluated each day. The average charge for te service is +35. This service, which is reimbursed by third-party carriers, has resulted in improved use of laboratory personnel, equipment, and time and has provided a framework for education and research as well as a mechanism for direct contributions to patient care by the pharmacist.

Hospital Bed Capacity, 500 and over↗
PubMedDate not supplied

Fetal and placental pathology in two cases of maternal varicella infection.

We describe the fetal and placental pathology in two cases of maternal varicella infection. Varicella in pregnancy is uncommon, and although sporadic cases of fetal involvement are described very little regard has been paid to placental features. Only one previous report describes the changes in both the fetus and its associated placenta. In both our cases the placenta showed chronic villitis with with granuloma formation, and occasional cells with nuclear viral-like inclusions were detected. Cells with similar inclusions were found in the lung interstitium, and foci of dystrophic calcification were present in the liver.

Adult↗