Risk of occult carcinomas in patients undergoing orthotopic liver transplantation for end-stage liver disease secondary to primary sclerosing cholangitis.
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Adenoma, Bile Duct↗
Biomedical subjects
P Bhatia
Publications and source records attributed to P Bhatia.
Colonic mucosal mast cell distribution at line of demarcation of active ulcerative colitis.
We examined the distribution of colonic mucosal mast cells in 25 patients with active ulcerative colitis, with a clear line of demarcation separating active inflammation from normal mucosa. Biopsies, at least one adjacent to the line of demarcation, one in inflamed mucosa, and one above were obtained during colonoscopy. Eight patients had elevated mast cells throughout the colon, and 12 had increased numbers at the line of demarcation of disease. Mean numbers of mast cells from these patients were 6.3 (+/- 2.1 SD) in active inflammation, 19.5 (+/- 7.1 SD) at the line of demarcation, and 15.8 (+/- 8.4 SD) in normal mucosa. Histologic inflammation decreased as mast cells increased. The accumulation of mast cells at the visible line of demarcation between normal and abnormal mucosa suggests mast cells play a critical role in either accelerating the process of inflammation or in suppressing continued extension of the disease.
Adult↗
Clonal karyotypic aberrations in enchondromas.
Enchondromas, benign cartilaginous tumors arising within the medullary cavity of bone, are frequently difficult to differentiate from their malignant counterpart. In this study, cytogenetic analysis was performed on seven cases of solitary enchondroma. Normal karyotypes were observed in five cases. Clonal abnormalities were detected in two cases. An isochromosome of the short arm of chromosome 6 characterized one case, and t(12;15)(q13;q26) in addition to random numerical and structural abnormalities such as telomeric association was observed in the other case. An i(6p) and structural rearrangements involving 12q13 previously have been described in chondrosarcoma. Our findings suggest that similar clonal karyotypic abnormalities exist in benign and malignant cartilaginous neoplasms.
Adolescent↗
Ras mutations in United Kingdom examples of oral malignancies are infrequent.
Point mutations in codons 12, 13 or 61 of the oncogenes Ha-ras, Ki-ras or N-ras have been identified in human malignancies of many types. Using the PCR (polymerase chain reaction) technique for DNA amplification in vitro and stringent probing of the amplified DNA on dot blots with a library of specific oligonucleotides, we have screened for the presence of ras mutations in oral and para-oral malignancies and some associated lesions. The material, from UK patients, consisted of 22 oral squamous-cell carcinomas including 5 neck metastases, 1 oral mucosal dysplasia, 1 proliferative verrucous leukoplakia, 1 antral and 1 tonsillar carcinoma, 1 basal-cell carcinoma, 1 salivary adenocarcinoma, 1 salivary adenoid cystic carcinoma and 1 lung adenocarcinoma metastatic to the gingiva. Genomic DNA was extracted from tissues which were fresh or preserved in liquid nitrogen. Two DNA samples contained point mutations in codon 61 of Ki-ras. One of these mutations was in the lymphocytes infiltrating a retromolar SCC. The other mutation (CAA to CAU; substitution of glutamine by histidine) was in the lung adenocarcinoma metastasis. The absence of ras mutations in the epithelium of primary oral squamous-cell carcinomas is of considerable interest as other work in our Department on Indian cases of oral carcinomas associated with chewing tobacco (quid) revealed that 35% of these had a codon 12, 13 or 61 mutation in Ha-ras. While ras activations arising from point mutations may occur in a high proportion of oral malignancies associated with chewing tobacco (quid), this was not the case in UK oral malignancies, even where tobacco was smoked.
Aged↗
Case report 695: Cementifying fibroma of the proximal end of the tibia.
A case of a cementifying fibroma in the proximal end of the tibia in a 31-year-old woman is presented. The lesion was expanding but well-defined with amorphous central calcification. The unique, calcified, cementum-like particles in a fibrous stroma have been reported in only four previous cases in long bones. The histological and radiographic differences between a cementifying fibroma, bone cysts with cementum, and a true cementoma are discussed. The radiological differential diagnosis of fibrous dysplasia, giant cell tumor, and low grade central osteosarcoma was considered.
Adult↗
Infrared thermometry of newborn infants.
An infrared thermometer, the FirstTemp, was tested among newborn infants by comparing tympanic membrane temperature measurements in three operating modes, "Cal-tympanic," "Cal-surface," and "Cor-tympanic," with nearly simultaneous tympanic membrane, rectal, and axillary temperature measurements using other standard methods. The FirstTemp underestimated other measurements of body temperature in the "Cal-tympanic" mode and overestimated them in the "Cor-tympanic" mode. In the "Cal-surface" mode, the First-Temp readings were significantly lower than tympanic membrane temperatures measured with a thermistor probe and electronic thermometer (mean difference 0.2 degrees C) but not significantly different from rectal or axillary temperatures. According to these results, the FirstTemp can be used reliably in the "Cal-surface" mode but not in the "Cal-tympanic" or "Cor-tympanic" mode. Its speed and ease of operation offer significant advantages over traditional clinical methods of temperature measurement.
Axilla↗
Secondary biliary cirrhosis as a consequence of graft-versus-host disease.
A 9-yr-old white girl with acute monoblastic leukemia received an HLA-identical, mixed lymphocyte culture-nonreactive bone marrow transplant from her sister. Twelve days after the transplant, a diffuse, pruritic, maculopapular rash involving the entire body surface (including the palms and soles) developed. Subsequent skin biopsy was consistent with cutaneous graft-versus-host disease, and biopsy-proven hepatic involvement manifested by severe, unremitting cholestatic jaundice soon followed. The patient's biliary status as monitored by serial liver biopsies demonstrated progression from chronic graft-versus-host disease to cirrhosis, culminating in death secondary to liver failure 25 mo after transplant.
Bone Marrow Transplantation↗
Variability of abdominal circumference of premature infants.
Serial measurements of abdominal circumference were made in 27 premature infants 1 hour before feeding, immediately before and after feeding, and 1 and 2 hours after feeding. In some infants these measurements were repeated for 2 (n = 18) or 3 (n = 3) consecutive days. All 258 measurements were performed by the same examiner; 124 were also repeated blindly by another examiner to test interobserver reliability. The coefficient of variation of repeated measurements of any one infant by the same examiner on a single day was 2.7%. Ninety percent of repeated measurements agreed within 1.5 cm. The interobserver reliability was 0.99. Abdominal circumference was positively correlated with birth weight (P = .0001) and time from last defecation (P = .0001) and negatively correlated with time from last feeding (P = .04). Increases in abdominal circumference of less than 1.5 cm occur normally and, in the absence of other clinical signs, should not be considered indicative of disease.
Abdomen↗
Predictive value of brainstem evoked response in the diagnosis of acoustic neuroma.
Predictive value positive is the probability that a positive test result represents a true positive finding. Twenty-six patients with brainstem evoked response findings characteristic of retrocochlear hearing loss were studied. Four acoustic neuromas were diagnosed in this group after radiologic workup. The predictive value in this population was 15%. Statistical considerations are presented.
Evoked Potentials, Auditory, Brain Stem↗
Laser de-epithelialization of muscle-based flaps.
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Animals↗
Gastric mucosal nodules due to cytomegalovirus infection.
We report a patient who developed cytomegalovirus infection after receiving a heart transplant. Nodular gastric lesions were noted on radiologic and endoscopic examinations. Endoscopic biopsy provided early evidence of cytomegalovirus infection.
Aged↗
Increased colonic mucosal mast cells associated with severe watery diarrhea and microscopic colitis.
A patient with microscopic colitis, clearly identifiable by its histologic characteristics, is presented in whom the histology also revealed large numbers of mast cells. The patient was treated with H1 antagonists with prompt resolution of the diarrhea. The histologic and therapeutic findings in this case suggest the diarrhea and inflammation of microscopic colitis may be mediated by the degranulation of excessive numbers of mast cells in the colon and small bowel.
Chronic Disease↗
Efficacy of oral oxpentifylline in the management of idiopathic tinnitus.
A prospective single-blind, placebo-controlled trial was effected in 30 patients presenting to an out-patient clinic complaining principally of tinnitus. Over a 6-week period, the subjects were assessed by routine audiometry and subjective reporting of change in their symptoms. A treatment group received the xanthine derivative, oxpentifylline (Hoechst UK), while a control group received identically presented inactive placebo. There was no significant difference between the placebo and treatment groups for any of the parameters measured, and, therefore, oxpentifylline cannot be recommended in the management of idiopathic tinnitus.
Administration, Oral↗
Primary orbital lymphomas.
Between 1950 and 1982, seventeen patients with primary orbital lymphoma were treated at the University of Kansas Medical Center. There were 10 males and 7 females with a median age of 61 years. Four patients had bilateral disease, seven patients had disease involving the conjunctiva, and in ten patients, the disease involved paraocular structures. Fourteen patients received radiation with a median dose of 3500 cGy (range 2250 cGy to 4250 cGy) given in about 3 1/2 to 5 weeks. Median follow-up was 10 years (range 5 to 31 years). Local control was 100% and 5-year survival was 76%. Three patients are living with no evidence of lymphoma; three patients died from progression of the disease, and others died from unrelated causes. Radiation treatment for localized primary orbital lymphomas appears to be the primary treatment of choice.
Adult↗
Unchanged concentrations of plasma fibronectin in Alzheimer's disease.
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Adult↗
Fetal liver infusion in aplastic anaemia.
Forty patients with severe aplastic anaemia received an intravenous infusion of 0.004 to 11.1 x 10(8) (median: 8 x 10(8) hematopoietic cells prepared from the fetal livers of 8-32 week old abortuses. Five patients, who died within 15 days of fetal liver infusion, are excluded from analysis. Twenty-two of the 35 evaluable patients (62%) responded favourably. Six of the 7 patients with good response were alive after 9 to 44 months (median: m = 20); one died 106 months after fetal liver infusion due to renal lithiasis. Four of the 7 with moderate response were alive after 9 to 31 months; 3 died within 16 months. Of 8 patients with minimal response, one was lost to follow-up and the others died in 3.4 to 10 months (m = 6). Median survival of responders was 15.7 months. Bone marrow cellularity became normal in 12 patients following fetal liver infusion. In seven patients, there was a relapse; 6 regained a normal bone marrow cellularity after a second or third fetal liver infusion. These data strongly suggest a role of fetal liver infusion in inducing bone marrow recovery. Of 13 non-responders, 4 were lost to follow-up and 9 died within 20 days-4.3 months (m = 1.6). Fetal liver infusion appears to be an effective therapy in patients with severe aplastic anaemia.
Anemia, Aplastic↗
Studies on engraftment following fetal liver infusion.
Studies to find engraftment following fetal liver infusion (FLI) in aplastic anaemia (AA) and acute myeloid leukaemia (AML) were carried out in 24 patients (17 AA and 7 AML patients) out of the 56 who received FLI. HLA studies done in 13 patients (3 AA and 5 AML), repeatedly after FLI, showed no significant change in HLA antigen pattern before and after FLI. Red cell antigen studies were done in five (1 AA and 4 AML) patients, 3 weeks to 7 months after FLI. One patient with AML who was Rh negative prior to reinduction chemotherapy became Rh positive two months after FLI; six months later he was Rh negative again. In the remaining patients there was no change in red cell antigen pattern after FLI. Radio-immuno-assay to detect alpha-fetoprotein levels, carried out in 10 (8 AA and 2 AML) patients repeatedly after FLI, demonstrated no increase. In 13 patients (8 AA and 5 AML) in whom there was a sex difference between donor and recipient, bone marrow cultures for sex chromosomes revealed mixture of XX and XY cells in 3 male patients with aplastic anaemia. One male patient with AML demonstrated complete engraftment after induction chemotherapy and FLI: all the mitoses studied were of XX pattern. Engraftment was however temporary as repeated studies revealed reversion to XY pattern. The present work suggests that infusion of fetal liver cells may sometimes induce temporary chimerism or engraftment in an adult host; in the majority of cases, however, engraftment could not be established.
Anemia, Aplastic↗
Establishment of a rat placental cell line expressing characteristics of extraembryonic membranes.
A cell line was derived from midgestation chorioallantoic placental explants of the outbred Holtzman rat. The cell line was found to express characteristics of extraembryonic membranes and to grow when introduced into allogeneic hosts. Growth in allogeneic hosts was detected following intraperitoneal injection of the cells but not following subcutaneous injection. The transplanted cells grew as cystic structures free in the peritoneum and as solid masses adhered to various abdominal organs. Cystic structures had a homogeneous morphology consisting of an epithelial-like cell layer surrounding a fluid-filled sac. Solid masses had a heterogeneous morphology, containing parts resembling normal components of the extraembryonic membranes (trophoblast, parietal, and visceral yolk sacs). Biochemical analysis of the placenta-derived cell line and transplanted structures derived from the cell line indicated that the cells had the potential to produce a variety of proteins characteristic of extraembryonic tissues. Cultured cells and both types of in vivo transplants produced the basement membrane protein, laminin. Peritoneal cystic structures also contained alpha-fetoprotein mRNA and very high levels of c-fos mRNA. Solid masses demonstrated elevated alkaline phosphatase activity, a marker of trophoblast cells. Cells grown in vitro expressed elevated c-myc mRNA levels, whereas, c-myc mRNA levels were reduced in the in vivo transplants. The behavior of the cell line in vitro and following in vivo transplantation suggests it contains elements capable of differentiation toward various components of the extraembryonic membranes. The results indicate that the rat placental cell line will be valuable for future studies on the differentiation of trophoblast cells and other components of the extraembryonic membranes.
Alkaline Phosphatase↗