Death from amniotic fluid embolism and disseminated intravascular coagulation after a curettage abortion.
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Biomedical subjects
Publications and source records attributed to S Holck.
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A 70-year-old woman presented with signs of hypothyroidism and struma, which were produced by a massive polyclonal plasma cell infiltration, thereby fulfilling the established histologic criteria of plasma cell granuloma.
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The value of the double forceps patency test in microvascular surgery is limited. It can only tell the surgeon if there is "some flow" or "no flow" through an anastomosis. An experimental study of microvascular anastomoses in the rat femoral vein and artery was designed to correlate the percentage reduction of the vessel luminal area with the clinical assessment of vessel patency. It was found that even with a proved thrombotic reduction of the luminal area by 75-95%, almost 50% of the anastomoses were classified as fully patent using the traditional patency test.
The morphological features of a functional parathyroid carcinoma in a 34-year-old female are presented. The case was unique in the high frequency of mitotic figures permitting a tentative diagnosis of malignancy already on frozen sections. The parathyroid nature of the lesion was established ultrastructurally by demonstration of secretory granules, glycogen particles and lipid material within the cytoplasm. Also noteworthy was the presence of annulate lamellae, denoting rapidly growing tissue. Few examples of this lesion are at hand, and ultrastructural studies which provide valuable information regarding the site of origin, have previously been recorded in only 6 publications.
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The end-to-end anastomotic technique and the telescoped anastomotic technique were compared in a paired experimental study of 200 primarily patent anastomoses in the femoral arteries and veins of rats. It was found that the arterial telescoped anastomosis was faster and simpler to perform and had a significantly lower frequency of late thrombotic deposition (13%) than the arterial end-to-end anastomosis (41%), although the patency rates at 1 week were equal (88%). Aneurysms at the site of the anastomosis were not observed in the arterial telescoped anastomoses, while initial stages of probable aneurysms were observed in 24% of the arterial end-to-end anastomoses. The venous telescoped anastomoses were also less time-consuming and simpler to construct. Although equal patency rates at 1 week were obtained (84%-88%), the venous telescoped anastomoses displayed a significantly more pronounced incidence of thrombotic deposition at the site of the anastomosis.
Fifty benign epithelial neoplasms were encountered during the examination of more than 30,000 appendectomy specimens in the Laboratory of Surgical Pathology, Columbia University. In 44 cases, the neoplasms were papillary cystadenomas; in 11 of these cases, there were complications, all thought to have been caused by abnormal accumulations of mucus. We have reported a unique case of an incarcerated intussusception, and attempted to explain the pathogenesis of this unusual complication. We have also summarized the existing medical literature on the subject of intussusception of adenomatous lesions of the appendix.
Nonspecific acid alpha-naphthyl acetate esterase (ANAE) activity has previously been evaluated with the sheep erythrocyte (E) rosette assay and found to be a useful T-cell marker in cell suspension studies. T-lymphocytes display a solitary red brown nodule of reaction product (T-pattern) which can be readily distinguished from the diffuse, cytoplasmic staining of monocytes (M-pattern). Freshly obtained human tissue blocks were fixed with buffered formal sucrose and maintained in Holt's syrup; cryostat sections were cut and incubated under conditions appropriate for the histochemical demonstration of lymphocyte acid alpha-naphthyl acetate esterase activity. The results clearly demonstrate that T-pattern ANAE+ lymphocytes populate the paracortical and interfollicular regions of normal lymph nodes and tonsils and the periarteriolar sheaths of normal spleen, T-cell zones, while nearly every germinal center (B-cell area) lymphocyte is ANAE-. Macrophages and dendritic reticulum cells display diffuse cytoplasmic ANAE activity (M-pattern). Nodular malignant lymphomas (B-cell origin) are ANAE-; an E+ diffuse, cutaneous lymphoma was ANAE+. The histochemical demonstration of ANAE activity may represent the first reproducible, routine technique to localize T-lymphocytes in tissue sections.
When an area of giant pseudopolyp formation resulted in intussusception in a patient with known ulcerative colitis, operative intervention was required. The double contrast barium enema and fiberoptic colonoscopy were valuable complimentary diagnostic techniques in the evaluation of such a patient.
BACKGROUND: Glomus tumors are usually small, painful, subungual nodules causing no diagnostic difficulties. Less obvious is the characterization of the solid, deep-seated variant. CASE: A 32-year-old female presented with a solid, painless tumor in the right axillary region. A fine needle aspirate was initially interpreted as ectopic breast tissue. Subsequent morphologic studies on the lumpectomy specimen revealed a solid glomus tumor. CONCLUSION: The cytologic appearance of glomus tumors is at most suggestive. Whenever the diagnosis is considered, appropriate immunohistochemical studies should be added to consolidate it.
The immunoprofile of 76 human pituitary adenomas was studied with particular reference to the occurrence of entrapped, non-neoplastic pituitary cells. This phenomenon was defined as unevenly distributed, usually peripherally located cells forming less than 1% of the total cell population. The stellate contour of such passively incorporated cells departed from the more rounded shape of most principal, neoplastic cells. Thirty-six of the adenomas studied comprised one or more types of entrapped elements. According to the hormone produced, prolactin-(PRL-)cells most commonly occurred as a minor "foreign" component (seen in 23 of the adenomas), whereas growth hormone-(GH-) and adrenocorticotropic hormone-(ACTH-)cells rarely were trapped (seen in 5 and 4 of the adenomas. Entrapped follicle stimulating hormone-(FSH-), luteinizing hormone-(LH-), and thyroid-stimulating hormone-(TSH-)cells assumed an intermediate position (seen in 14, 17 and 15 of the adenomas, respectively).
Clinical trials of norethisterone enanthate (NET-EN), a long-acting, injectable progestogen, have demonstrated its short-term safety and effectiveness as a method of contraception in a controlled trial setting. Family planning programs interested in providing NET-EN need information on its efficacy and acceptability under usual field conditions. This first field study of NET-EN was conducted in family planning clinics in rural areas of Mexico. Women admitted to the study were followed up at two-month intervals to receive an injection of 200 milligrams of NET-EN, and to be asked about possible side effects of the drug. Among the 5,792 women recruited, the overall life-table discontinuation rate was 57.0 per 100 women at 12 months and 69.0 at 18 months. The single most common reason for discontinuation was amenorrhea, followed by bleeding problems. Women who were older and who already had several children were most likely to continue using NET-EN. Nine pregnancies were reported during the study, with a cumulative pregnancy rate of 0.3 per 100 women at 18 months. NET-EN appears to be an effective method of contraception that is acceptable to a substantial proportion of women from rural areas in Mexico who choose to use it, when it is provided through a national family planning program.