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Biomedical subjects

S Ritchie

Publications and source records attributed to S Ritchie.

47 records · Page 3Linked to original sources
PubMed1989

Kidney biopsy in SLE. I. A clinical-morphologic evaluation.

The relationship between renal morphology and clinical disease was analysed in 148 patients with SLE attending a lupus clinic. Patients were not selected for renal disease. Renal tissue was assessed according to the World Health Organization classification of lupus nephritis, the presence of active and chronic lesions was recorded and disease activity was measured according to a standard protocol. All sections of the classification were represented in this group of patients. Active and chronic lesions were more likely to occur among patients with Class III/IV (proliferative glomerulonephritis), than in any other category. Patients with Class III/IV biopsy were more likely to have evidence of clinical renal disease than patients in Class II (mesangial). However, almost half of the Class II patients had some evidence of renal disease, including elevated serum creatinine, as well as important non-glomerular lesions. Without biopsy they might have been thought to have proliferative lesions and been treated more aggressively. Two patients with proliferative glomerulonephritis had no clinical evidence of renal disease. Thus, at the time of biopsy results renal histological examination did not uniformly correlate with clinical renal disease.

Adolescent↗
PubMed1986

Renal and systemic kappa light chain deposits and their plasma cell origin identified by immunoelectron microscopy.

Kappa light chain determinants were identified by immunoelectron microscopy in nodular glomerulosclerotic lesions and systemic interstitial deposits from a man who died several years after the onset of proteinuric renal failure treated by hemodialysis. He developed adrenal and hepatic failure preterminally but not overt malignant myeloma. Specific labeling was most concentrated over the inner aspect of glomerular basement membrane and the mesangium, which suggested that the protein was nonfiltrable. Tubular basement membrane labeling was densest over the outer aspect, which suggested that the protein perfused from the interstitium rather than from the tubular lumen. We identified the source of the protein as a population of plasma cells present within bone marrow and renal interstitium; these showed specific immunogold labeling for kappa light chain protein over organelles concerned with protein synthesis, secretion, and storage. This appears to be the first identification of light chain determinants in human interstitial para-amyloid deposits with the use of immunogold ultrastructural techniques in tissues prepared for electron microscopy by standard methods and stored as epoxy resin blocks.

Adrenal Glands↗
PubMed1981

Spread of rectal cancer within veins. Histologic features and clinical significance.

Histologic evidence of venous invasion was demonstrated in 52 percent of 703 cases of rectal carcinoma. Quantitation of venous invasion and follow-up study showed that invasion of extramural veins was associated with a low 5 year survival rate (33 percent), whereas invasion limited to intramural veins was not. Spread into thick-walled extramural veins carries a very poor prognosis (15 of 91 patients survived 5 years). The corrected 5 year survival rate for stage C patients with invasion of thick-walled extramural veins was only 8 percent. Host reactions in and around the walls of invaded veins increase the survival rate; inflammatory damage to the vein walls and endarteritis obliterans are particularly important in this respect.

Adenocarcinoma↗
PubMed1981

Invasion of veins by carcinoma of rectum: method of detection, histological features and significance.

Histopathological material from operation specimens of rectal adenocarcinoma was reviewed and invasion of veins identified in 51.9% of 703 cases. The extent of venous invasion, thickness of the walls of invaded veins and various other histological features were examined in detail. By follow-up studies recurrence rates, incidence of distant metastases and corrected 5-year survival rates were obtained; correlation with the histopathological results showed that invasion of extramural and thick-walled veins is associated with a poor prognosis independent of the degree of differentiation of the adenocarcinoma. Prognosis is not significantly related to the presence of necrosis of intravenous tumour and a clearly defined stroma in the intravenous growth all appear to exert a protective influence on patient survival. Whereas permeation of capillaries in vein walls, the presence of loose clumps of tumour cells in veins and direct contact between tumour cells and venous blood appear to adversely affect survival. Venous invasion is shown to be related to local invasiveness of rectal carcinoma. Suggested modes of venous spread and interaction with host tissues are proposed, with implications for general attitudes to the spread of cancer and metastasis.

Adenocarcinoma↗
PubMed1981

Correlation of intrahepatic pressure with collagen in the Disse space and hepatomegaly in humans and in the rat.

In 70 alcoholic patients the amount of collagen in the space of Disse was compared, using an electron microscopic graded score, to the height of the intrahepatic pressure. A highly significant correlation was found between the amount of collagen and intrahepatic pressure in the group as a whole (r = 0.84; p < 10(-6)), as well as in subgroups of 30 alcoholic patients with normal livers or steatosis (r = 0.83; p < 10(-6)), 9 patients with alcoholic hepatitis (r = 0.81; p < 0.01), and 31 with cirrhosis (r = 0.86; p < 10(-6)). A nonparametric correlational analysis for the complete group also showed a significant relationship (rho = 0.85; p < 10(-6)) between collagen scores and intrahepatic pressure. In 60 patients hepatocyte surface area was measured in the biopsies. In these, hepatocyte surface area significantly correlated with intrahepatic pressure (r = 0.68; p < 10(-7)). No correlation was found between intrahepatic pressure and fat, alcoholic hyalin, or terminal hepatic vein sclerosis. Only with necrosis (r = 0.38; p < 0.001) and inflammation (r = 0.29; p < 0.05) was there a significant relationship with intrahepatic pressure. Chronic ethanol administration for 4 wk in liquid diets to young Wistar rats produced a 50% hepatomegaly due to an increase in hepatocyte size. Intrahepatic pressure in the rats receiving alcohol (19.3 +/- 2.3 mmHg) was significantly higher than in the controls on sucrose (10.4 +/- 0.9 mmHg) (p < 0.01). A highly significant correlation was found between hepatocyte surface area and intrahepatic pressure (r = 0.70; p < 0.005). There was no increase in collagen in the Disse space in these animals. Therefore, hepatomegaly in the absence of an increase in collagen in the Disse space may result in increased intrahepatic pressure. These studies may indicate a sequence of events: hepatomegaly, portal hypertension, and collagenization in the Disse space, which could occur in alcoholic liver disease.

Alcoholism↗
PubMed1980

The clinical significance of invasion of veins by rectal cancer.

A histopathological study of 703 surgical specimens from patients with adenocarcinoma of the rectum revealed invasion of veins by primary growth in almost 52 per cent. Follow-up studies on the patients showed that the corrected 5-year survival rate was significantly worse and liver metastases developed more frequently when venous invasion was present. Invasion of extramural veins was particularly significant whereas spread confined to intramural veins was less important. Invasion of large (thick-walled) veins was of greater consequence than invasion of small (thin-walled) veins and spread into thick-walled extramural veins had the greatest adverse influence of all. Venous spread of tumour takes place in parallel with local spread as measured by the Dukes' stage but exerts an influence on prognosis independent of the Dukes' stage. Similarly, vein invasion parallels the number of lymph node metastases but appears to exert an independent influence on prognosis. Observation of venous spread provides a precise assessment of the likely behaviour of rectal carcinoma and supplements, but does not replace indices such as the Dukes' stage or the number of lymph node metastases in routine use. The implications for surgical technique and management are discussed.

Adenocarcinoma↗
PubMed1977

Adenosine-5'-d: rotational conformation of the 5'-carbinol group.

A synthesis of adenosine-5'-d (4), and its p.m.r. spectral characteristics, are described. The presence of deuterium in 4 gives rise to a 2:1 mixture of R and S configurations at C-5, thereby permitting specific assignments for the resonances of the residual 5'-protons. From the observed spin-spin coupling between the latter and H-4', an estimate has been made of the rotamer population of the exocyclic 5'-carbinol group. It is shown that the gauche-gauche rotamer is preponderant (approximately 70%) and the gauche-trans one of minor importance (approximately 20%) in aqueous solution, which contrasts markedly with the preference for the latter rotamer exhibited by adenosine in the solid state.

Adenosine↗
PubMedDate not supplied

Community health nursing assessment of neurodevelopment in high-risk infants.

All infants discharged from designated perinatal center neonatal intensive care units in Illinois are referred for follow-up home visits by community health nurses. These visits provide parental support, teaching, and anticipatory guidance plus physical and developmental assessment of the infant. The maternal and child nursing consultants who coordinate this follow-up program are frequently called upon to assist the community health nurses in physical/developmental assessment techniques. The neurodevelopmental component of the assessment, including areas of alertness, tone, head circumference, vision and hearing screening, plus primitive reflexes, is described.

Attention↗