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Biomedical subjects

T J Stephenson

Publications and source records attributed to T J Stephenson.

At least 91 records · Page 5Linked to original sources

Assessment of osteopenia at autopsy.

Osteoporosis is a common problem for the pathologist in the elderly female population where pathological fractures particularly of the neck of femur are frequent. Yet how should we assess osteoporosis at autopsy? This study reports on autopsy assessment of osteopenia, comparing our subjective findings of rib fracturability and vertebral compressibility with histological and histomorphometric assessment on a bone biopsy. We have shown a poor correlation between gross autopsy and histological techniques. There is good correlation between two gross autopsy techniques and these methods have been shown to be reproducible between observers. We believe that the most useful test of whether a patient's bones are likely to break is to assess the fracturability of the ribs (and possibly the vertebral bodies) at autopsy. This should be supplemented with undecalcified histology sections from the iliac crest where possible. Further studies are clearly warranted in this area.

Aged↗

Effects of altering umbilical flow and umbilical free fatty acid concentration on transfer of free fatty acids across the rabbit placenta.

The transfer of free fatty acids across the placenta perfused in situ was studied in anaesthetized rabbits in late gestation. In the first series of experiments, umbilical flow rate was varied between 0.6 and 4.0 ml/min in nine rabbits. Although increasing umbilical flow rate significantly decreased the free fatty acid concentration in the umbilical venous effluent (P = 0.0001), placental clearance of free fatty acids from the maternal circulation was not significantly changed by alterations in umbilical flow rate. In the second series of experiments, the materno-fetal free fatty acid concentration gradient was varied between + 1.58 mmol/l and -2.81 mmol/l in eight rabbits. There was a significant relationship between increasing materno-fetal gradient and increasing transfer of free fatty acids across the placenta (P less than 0.001). Moreover, net transfer of free fatty acids into the umbilical circulation was observed even with zero concentration gradient. Net transfer of free fatty acids from fetus to mother occurred when umbilical arterial free fatty acid concentration exceeded maternal arterial concentration by 1.3 mmol/l.

Analysis of Variance↗

D(+)-glyceric aciduria: etiology and clinical consequences.

A family comprising mother, father, and five children is described. Four of the children were found to excrete massive amounts of D(+)-glyceric acid in their urine. This was verified by gas chromatography-mass spectrometry and the configuration determined by capillary gas chromatography of O-acetylated menthyl esters. The excretion ranged from 10.8 to 19.9 mmol/24 h. The remaining child and the parents showed no evidence of this unusual metabolite. The virtual absence of clinical manifestations in this family was particularly interesting. Only two of the children showed any clinical abnormality and this was limited to mild microcephaly and speech delay; the other two children found to excrete large amounts of D(+)-glycerate were healthy and developmentally normal at 7 y and 9 y of age. There was a marked increase in the excretion rate of D(+)-glycerate in response to both oral fructose and serine loading. These results are consistent with a deficiency of D(+)-glycerate kinase and indicate the potentially benign nature of this disorder.

Administration, Oral↗

Maternal to fetal transfer of free fatty acids in the in situ perfused rabbit placenta.

The transfer of free fatty acids (FFA) across the placenta perfused in situ was studied in anaesthetised rabbits in late gestation. [14C]Palmitic acid and antipyrine were infused into 11 pregnant rabbits and samples collected for up to 90 min from the mother and the umbilical vessels. Levels of total FFA, radioactivity and antipyrine, a marker of placental integrity, were measured. Net FFA flux across the placenta increased with maternal FFA concentrations, confirming observations made using different methods. The specific activity of [14C]palmitic acid in perfusate also related to maternal levels and indicated that almost half of the FFA crossing the rabbit placenta must be derived from sources other than circulating maternal FFA. The composition of the perfusate FFA had a profile similar to that of circulating maternal FFA, except for an increase in a number of long chain, polyunsaturated fatty acids. These findings are consistent with maternal triacylglycerol as the other fatty acid source, with the placenta adding the longer chain, polyunsaturated fatty acids.

Animals↗

Short-term effects of extracorporeal shock wave lithotripsy on the human gallbladder.

Extracorporeal shock wave lithotripsy (ESWL), whereby shock wave energy is focused upon gallstones causing their disintegration into fragments sufficiently small to be passed via the biliary system, offers a promising non-invasive alternative to surgery for gallstone disease. The tissue effects in humans of ESWL are poorly characterized and no systematic study of the tissue effects of ESWL by piezoelectrically generated shock waves has been published. Sixteen patients for elective cholecystectomy were therefore subjected to ESWL before surgery and detailed histology of the gall-bladders (including scanning electron microscopy of the mucosa) was compared with that from 20 age/sex-matched control cases. The gall-bladders treated by ESWL, in addition to showing the histological changes associated with chronic cholecystitis, showed serosal vasodilatation, mural oedema, and serosal and mucosal petechial haemorrhages focally over the entire surface. Between 10 and 90 per cent epithelial denudation was observed, but all cases showed surviving columnar epithelial cells in the crypts. No case showed vascular thrombosis, tissue necrosis, or acute inflammation. These tissue effects are likely to be reversible and unlikely to present a risk of perforation, although the long-term clinicopathological effects await investigation.

Adult↗

C-myc oncogene product P62c-myc in ovarian mucinous neoplasms: immunohistochemical study correlated with malignancy.

The monoclonal antibody Myc 1-6E10 was used to determine the cellular distribution of the c-myc oncogene product p62c-myc in 60 mucinous ovarian tumours. Three patterns of immunostaining were apparent: (i) nuclear staining alone; (ii) staining of the nucleus and basal cytoplasm; and (iii) staining of the entire cell. Of the 21 cases of mucinous cystadenoma, 11 showed nuclear staining alone, and a further case showed additional weak staining of the basal cytoplasm. Nuclear staining alone was not present in any of the 17 borderline mucinous tumours examined. Strong staining of the nucleus and basal cytoplasm was seen in 16 of these borderline cases, six of which also showed focal staining of the apical cytoplasm. All 22 cases of mucinous cystadenocarcinoma showed staining of the cell nucleus and entire cell cytoplasm. Focal staining of the apical cytoplasm in six of 17 borderline mucinous tumours produced a pattern of c-myc immunostaining similar to that of cystadenocarcinoma. Retrospective analysis of the clinical data showed that no significant differences between patients with borderline tumours of these two categories could be defined. Although immunostaining with Myc 1-6E10 can be used in the categorisation of mucinous ovarian tumours, it is concluded that standard histological criteria are more accurate indicators of tumour behaviour than is an assessment of c-myc expression.

Antibodies, Monoclonal↗

Pseudomembranous trigonitis of the bladder: hormonal aetiology.

Fourteen formalin fixed and paraffin wax embedded biopsy specimens from 10 women (age range 34-68) presenting with pseudomembranous trigonitis were studied using a combination of anti-oestrogen receptor monoclonal antibodies in an avidin-biotin immunoperoxidase technique. All epithelial areas showing vaginal metaplasia exhibited staining confined to the nucleus in the basal and parabasal layers of the squamous epithelium while no staining was encountered in adjacent trigonal transitional epithelium included in nine of the biopsy specimens. The selective expression of nuclear oestrogen receptor in trigonal epithelium affected by vaginal metaplasia in a distribution similar to that reported in vaginal epithelium by other workers lends further support to oestrogen mediated aetiology in this condition and is consistent with an embryological derivation of the trigone, distinct from that of the rest of the bladder.

Adult↗

Ulex europaeus agglutinin 1 lectin histochemical staining of dog hepatocellular and bile duct carcinomas.

Ulex europaeus agglutinin 1 (UEA-1) lectin-binding is a feature of canine intrahepatic bile duct epithelial cells but not of canine hepatocytes. In tumours diagnosed histologically as cholangiocarcinomas or hepatocellular carcinomas, UEA-1 staining occurred in tumour cells regardless of histological appearance. The division of primary liver carcinomas into different presumed cell types of origin is not reflected by equivalent differentiation of the tumour cells and is not of diagnostic value.

Adenoma, Bile Duct↗

Stromal cells in cerebellar haemangioblastomas: an immunocytochemical study.

The nature of the stromal cells in formalin-fixed paraffin-embedded material from 23 cerebellar haemangioblastomas was investigated using antisera to intermediate filaments (glial fibrillary acidic protein, vimentin and desmin), histiocytic markers (alpha 1-antitrypsin, alpha 1-antichymotrypsin and lysozyme), glycolytic enzymes (alpha and gamma enolase and aldolase C4) and the endothelial markers, factor VIII related antigen and Ulex europaeus I lectin. Most stromal cells stained positively for vimentin and the glycolytic enzymes. Occasional process-bearing cells within the stroma stained strongly for glial fibrillary acidic protein, alpha 1-antitrypsin and alpha 1-antichymotrypsin. No stromal cell staining for desmin, lysozyme or the endothelial markers was observed, although the latter stained the vascular endothelium within all neoplasms. The findings do not support previous suggestions of an endothelial or histiocytic origin for the stromal cells. They appear to be a heterogeneous population including entrapped reactive astrocytes and locally-derived non-angiogenic cells of neuroectodermal (pial) origin.

Adolescent↗