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Biomedical subjects

R C Haggitt

Publications and source records attributed to R C Haggitt.

At least 91 records · Page 5Linked to original sources
PubMed1983

A comparative study of generic stains for carcinoid secretory granules.

Generic stains for secretory granules in carcinoid tumors often yield inconsistent and unpredictable results. Consequently, these techniques have been modified and new ones devised; however, very few studies comparing the efficacy of the various methods have been published. To determine which method would most consistently demonstrate carcinoid granules, we applied a battery of six stains to 73 tumors, all morphologically identified as carcinoids, from various sites (17 pulmonary, 13 small intestinal, 20 appendiceal, 18 rectal, five miscellaneous). Stains employed included four argyrophil (Sevier-Munger, Grimelius, Pascual, Churukian-Schenk), one argentaffin (Fontana-Masson), and one non-silver technique (lead hematoxylin). Of the 73 carcinoids, 97% stained positively with the Churukian-Schenk, 82% with the Pascual, 79% with the Grimelius, 74% with the Sevier-Munger, 67% with lead hematoxylin, and 51% with the Fontana-Masson technique. The two cases negative by the Churukian-Schenk technique were also negative with all other stains; thus, this technique most consistently demonstrated secretory granules in carcinoids, including all 18 rectal tumors. The Churukian-Schenk method achieves its superior results by reducing background staining and nonspecific precipitation to a level that permits sparse, small granules to be readily identified. In control sections of normal mucosa and in some tumors, this stain revealed more than one population of argyrophil cells as identified by the size, color, and staining intensity of the granules.

Carcinoid Tumor↗
PubMed1983

Carbamazepine-induced liver injury.

Two patients had carbamazepine-induced liver injury. The clinical, biochemical, and histologic data suggest hepatitis of the idiosyncratic hypersensitivity type with granulomas in one patient; in the other, the liver injury resembles that caused by a hepatotoxin. Both patients showed prompt recovery upon discontinuation of the drug.

Adult↗
PubMed1982

Enzymes of salvage and de novo pathways of synthesis of pyrimidine nucleotides in human colorectal adenocarcinomas.

The activity of uridine-cytidine kinase (Urd-Cyd kinase). a key enzyme in the salvage of pyrimidine nucleosides, averaged 0.86 +/- 0.16 (S.E.M.) nmole uridine phosphates . min-1 . (mg protein)-1 in fifty-three specimens of human colorectal adenocarcinomas. The activity of fluorouracil phosphoribosyltransferase (FUPRTase) in thirty-five carcinoma specimens averaged only 0.19 +/- 0.07 nmole fluorouridine phosphates . min-1 . (mg protein)-1. The activity of the last enzyme in the de novo pathway of biosynthesis of UMP, i.e. orotidine 5'-monophosphate (OMP) decarboxylase, averaged 0.21 +/- 0.04 nmole CO2 . min-1 . (mg protein)-1. The activity of Urd-Cyd kinase was increased approximately 2.3-fold, and that of OMP decarboxylase by about 91%, while that of FUPRTase was increased by only 27%, as compared to that of normal human colonic mucosa. Of the colorectal carcinomas studied, 72% were moderately differentiated, 21% poorly differentiated, and 7% well differentiated. The mean diameter of the fifty-three carcinomas was 5.5 cm, and pathologic staging led to classification of 15% as Dukes' A, 36% as Dukes' B, 47% as Dukes' C, and 2% as carcinoma in situ. No correlations between the level of the enzyme activities studied and any pathologic characteristics of the carcinomas could be discerned.

Adenocarcinoma↗
PubMed1981

Preliminary studies of the uridine kinase activity of human colorectal adenocarcinomas.

Relatively low uridine-cytidine kinase activities in 22 surgical specimens of human colorectal adenocarcinomas have been demonstrated, in comparison with those of other neoplasms studied. The kinase activities averaged 1.1 nmoles/min/mg of protein; however, four of the specimens exhibited significantly higher levels of enzyme activity than the average, a deviation that could not be correlated with any properties of the tumors. Of the 22 neoplasms, 86% were moderately differentiated; and 14% were poorly differentiated. Staging disclosed 9% Dukes' A neoplasms, 41% Dukes' B, and 50% Dukes' C. The moderately differentiated group included four mucinous tumors; the poorly differentiated only one; none was of the signet-ring cell type. The kinetic characteristics of the uridine kinase activity of one colonic adenocarcinoma were studied in detail; the apparent Michaelis constants for uridine and adenosine 5'-triphosphate were 0.37 x 10(-3) M and 1.07 x 10(-3) M, respectively, and the enzyme required Mg2+ for maximal activity (at 30-42 C).

Adenocarcinoma↗
PubMed1980

Pericentral hepatic fibrosis and intracellular hyalin in diabetes mellitus.

Five patients with maturity-onset diabetes mellitus and hepatomegaly were studied. This group in cluded moderately obese females in whom hepatomegaly and abnormal liver studies were associated with a marked elevation in the erythrocyte sedimentation rate. Liver biopsies from all 5 showed fatty steatosis and pericentral fibrosis. In 3 of the 5, fibrous bridging between central veins and portal tracts was present. Collagen surrounded swollen hepatocytes, some of which contained intracellular hyalin indistinguishable from Mallory's hyalin. Polymorphonuclear neutrophils and regenerating nodules were not present. None of the patients had a history of alcohol use, and in 2 followed closely for 2 yr, alcohol was never detected in random blood samples. The recognition of this morphologic lesion may help to clarify the significance of this finding as an intermediate lesion between fatty steatosis and cirrhosis in diabetics.

Adult↗
PubMed1980

Mucoepidermoid and adenoid cystic carcinomas of the esophagus.

Four case reports of patients with tumors of the esophagus resembling those of salivary gland origin are presented with a review of the cases published to date. These tumors arise in the submucosal glands in the esophagus and are histologically similar to adenoid cystic and mucoepidermoid carcinomas of the salivary glands. The mucoepidermoid variety occurs more frequently in men than in women, and the adenoid cystic carcinomas are equally distributed between the sexes. In most of the cases reported the tumors were resectable but the overall survival rate is poor and is similar to the rates found with the more frequent squamous cell cancer of the esophagus.

Adult↗
PubMed1978

Esophageal epithelial response to gastroesophageal reflux. A quantitative study.

Exposure of the distal esophageal mucosa to acid gastric juice was quantitated by 24-hr pH monitoring in 100 individuals and was correlated with morphologic data derived from esophageal biopsies. The degree of acid exposure to the distal esophagus correlated directly with increases in both relative and absolute length of the subepithelial papillae and to relative basal zone hyperplasia. Both papillary length and basal zone hyperplasia decreased after antireflux surgery had reduced acid exposure to normal. Reflux in the recumbent position resulted in prolonged exposure of the mucosa to acid because of poor acid clearing from the esophagus. This caused longer papillae than did upright reflux, where there were more frequent reflux episodes, but with rapid acid clearance. The presence of a hiatal hernia was associated with longer papillae, lower DES pressure, increased reflux frequency, and prolonged recumbent acid clearance. Twenty-four hour pH monitoring correlated better with papillary length than did symptoms or other clinical measures of gastroesophageal reflux.

Esophagus↗
PubMed1978

Adenocarcinoma complicating columnar epithelium-lined (Barrett's) esophagus.

Prolonged reflux esophagitis leads to replacement of the esophageal squamous epithelium by columnar epithelium in some patients. This columnar epithelium resembles gastric or intestinal mucosa and has been implicated as a precursor of esophageal adenocarcinoma. A review of 14 cases of primary esophageal adenocarcinoma disclosed that 12 (86%) arose in a columnar epithelium-lined (Barrett's) esophagus. Ten of the 12 patients had a hiatal hernia or symptoms of reflux esophagitis or both. In ten patients the columnar epithelium adjacent to and remote from the invasive adenocarcinoma showed a spectrum of abnormalities ranging from mild dysplasia to carcinoma in situ. These data support the concept that esophageal adenocarcinoma is one complication of a columnar epithelium-lined esophagus, and suggest that the invasive carcinoma evolves through a sequence of epithelial dysplasia and carcinoma in situ in most cases. Esophageal biopsy and cytology can detect this dysplasia, and should provide an effective means for monitoring patients with Barrett's esophagus for impending malignancy.

Adenocarcinoma↗
PubMed1978

Intranuclear inclusions of the human vas deferens.

Intranuclear inclusions in epithelial cells of the human vas deferens have not been well characterized or widely recognized. We studied their prevalence in an adult male population by light microscopy and characterized them using the techniques of histochemistry, electron microscopy, and electron microprobe analysis. They occurred in all cases studied, consisted of electron dense globules, contained neutral mucosubstances, and occasionally were single membrane bound. Epithelial intranuclear inclusions routinely occur in the vas deferens of sexually mature males, do not disappear with advancing age, and should not be interpreted as a pathologic finding.

Aged↗
PubMed1977

Ileostomy complications requiring revision: Lahey clinic experience, 1964-1973.

From 1964 to 1973, 50 patients who initially underwent ileostomy for inflammatory bowel disease at the Lahey Clinic required 84 revisions. The commonest reason for revision was stenosis. Fistula, prolapse, and retraction followed in order of frequency. Patients with Crohn's disease seemed to have a higher incidence of revision, but this was not statistically significant. Other reasons for revision were analyzed, and recommendations for treatment were discussed. Retrospective study revealed that 50% of ileostomy revisions were performed for probably preventable complications.

Adolescent↗
PubMed1977

Gastric cancer. Contemporary aspects.

Records of 403 patients with gastric cancer seen between 1957 and 1966 at the Lahey Clinic Foundation have been analyzed. While the operability rate was 94 per cent and the resectability rate was 58 per cent, the cure rate was only 11 per cent and was unchanged from the previous decade. Significant correlation occurs with location, clinical type, histologic type, size of tumor, and number of lymph node metastases. The surgical approach is aggressive in exploration and in treating extensive but resectable cancers but is conservative for the average cancers and does not include resection of spleen, omentum, pancreas, and total stomach if possible. The histologic differentiation into diffuse and intestinal varieties provides additional prognostic information as well as clues to the etiology of varieties of gastric cancer.

Aged↗
PubMed1976

Postgastrectomy syndromes.

Postgastrectomy syndromes requiring further operation are fortunately uncommon, as the symptoms are disabling and the results of corrective surgery are, at times, disappointing. Our sixty-six patients underwent a total of seventy-six procedures with forty-one successful results and thirty-five failures. Among the secessful group, only fourteen results were graded as excellent. (Table V.) Our experience, like that of others, demonstrates the necessity of accurate evaluation of the patient and of accurate syndrome classification. This not only allows the appropriate operation to be chosen but also helps to indicate those in whom operation should be avoided. Where more than one surgically remediable syndrome exists, simultaneous correction should be undertaken. Treatment of the mechanical problems of obstructed afferent loop by jejunojejunostomy and of stomal obstruction by complete stomal reconstruction provides satisfactory results. Roux-en-Y anastomosis is effective in patients with alkaline gastritis, but we caution against the use of this procedure in patients with vague symptoms and minimal endoscopic changes. Antiperistaltic jejunal reversal is the procedure of choice in managing severe postvagotomy diarrhea. Although most patients with dumping can be managed conservatively, a small number with severe symptoms and nutritional problems cannot and require further operation. Our experience with conversion from Billroth II to Billroth I and with isoperistaltic interposition, although minimal, has been reasonably satisfactory. Four groups of patients remain with symptoms of chronic vomiting, late postvagotomy atonic stomach, dumping "plus," and miscellaneous symptoms. These patients have complaints that are difficult to define and usually have poor results with further operations. We believe that surgery should be avoided in these patients and that conservative measures be continued.

Adult↗