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Biomedical subjects

U Henriques

Publications and source records attributed to U Henriques.

At least 19 recordsLinked to original sources

A patient with Edwards syndrome caused by a rare pseudodicentric chromosome 18 of paternal origin.

We present an unusual case of trisomy 18 due to a pseudodicentric chromosome 18 of paternal origin. The karyotype was: 46,XY, -18, +psu dic(18)(qter-->cen-->p11.31::p11.31-->psucen-->qter). The origin of the abnormal chromosome was verified by FISH with a painting probe from chromosome 18. Absence of short-arm telomeres was shown by multicolor FISH, and the results of DNA analysis showed monosomy for loci D18S59 and D18S170 as well as paternal inheritance of the aberrant chromosome. The child's phenotype was characteristic of trisomy 18.

Centromere↗

Postmortem blood cultures. Evaluation of separate sampling of blood from the right and left cardiac ventricle.

Postmortem blood cultures were obtained by separate puncture of the right and left side of the heart during autopsy of 18 patients with solid cancer and 26 patients with non-neoplastic diseases. Concordant isolates were obtained from the right and left side in six patients (14%, 95% confidence limits: 5-28%). Growth was unilateral in 7 patients and cardiac aspirates were sterile in 31 patients (70%, 95% CL: 55-83%). One patient had been treated for Staphylococcus aureus bacteraemia and eight patients had negative premortem blood cultures. Separate culture of blood from the right and left side of the heart may add to the information gained by postmortem blood culture.

Bacteremia↗

[Objective histological grading of squamous and adenosquamous lung cancer].

The prognostic value of quantitative histopathological parameters was evaluated in 55 consecutively treated patients with operable lung carcinoma of squamous and adenosquamous cell type. Using a projection microscope, estimates were obtained of mean nuclear volume (vV(nuc)), mean nuclear profile area, nuclear profile density, nuclear volume fraction, and mitotic profile frequency. Patient sex, age, and clinical stage was recorded. Single-factor analyses showed a prognostic significance of clinical stage and patient age (2p < or = 0.03), whereas sex was marginally significant (2p = 0.09). Of the quantitative histopathological parameters only estimates of vV(nuc) were of prognostic significance (2p = 0.02), in that small nuclear volumes were associated with the worst prognosis. In a multivariate Cox analysis, clinical stage, age, and vV(nuc) were found to be of significant, independent prognostic value. Thus, the present study indicates that vV(nuc) is of prognostic value, independent of clinical stage. The parameter is highly reproducible and easily obtained using unbiased stereology, and may be of future importance in the management of lung cancer patients.

Adult↗

Histamine releasing cells of the newborn. Mast cells from the umbilical cord matrix and basophils from cord blood.

The cellular branch of the immune defence in the newborn has been shown to differ from adults in a number of ways. This report presents new data on the functions of the histamine-secreting cells of the newborn. Mast cells of the newborn were obtained from the human umbilical cord by enzymatic dispersion. The granules of the mast cells of the umbilical cord were found to contain both chymase and tryptase by immunohistochemical staining, and the presence of cell-bound IgE on the mast cell surface was demonstrated by staining sections of umbilical cord with peroxidase-conjugated anti-IgE. The enzymatic dispersion yielded 12,660 mast cells per gram umbilical cord (median), range 2,500-60,300 (n = 48). The mast cells were found to constitute 3.1% of the total nucleated cells in the dispersate (median), range 1.5-3.8%. The histamine release from these cells was measured using a glass microfibre-based method. Both the umbilical cord mast cells and the cord blood basophils released histamine stimulated with anti-IgE, concanavalin A and the calcium ionophore A23187. In contrast to mast cells from adult tissue, the phorbol ester TPA was found to be an efficient secretagogue in both mast cells and basophils from the newborn. After maximal stimulation with anti-IgE and phorbol ester the quantity of histamine released per millilitre of blood was significantly higher in cord blood than in adult blood. The spontaneous histamine release from cord blood basophils was also significantly higher than from adult blood basophils. The mast cells found in the umbilical cord matrix and the cord blood basophils represent a readily available source of metabolically active histamine releasing cells for exploration of the role of histamine-secreting cells in newborn immune defence.

Adult↗

Objective malignancy grading of squamous cell carcinoma of the lung. Stereologic estimates of mean nuclear size are of prognostic value, independent of clinical stage of disease.

BACKGROUND: The prognostic value of quantitative histopathologic parameters was evaluated in 55 consecutively treated patients with operable lung carcinoma of squamous (N = 39) and mixed, adenosquamous (N = 16) cell type. Patients alive were followed for at least 12 years. METHODS: Using a projection microscope and a simple test system in fields of vision systematically selected from the whole tumor area of one routine section, five quantitative histopathologic variables were estimated: the mean nuclear volume, the mean nuclear profile area, the density of nuclear profiles, the volume fraction of nuclei to tissue, and the number of mitotic profiles per 10(3) nuclear profiles. For each patient, information was recorded regarding sex, age at diagnosis, and clinical stage of disease. RESULTS: Single-factor analyses showed that a favorable prognosis was associated with early clinical stages (Stages I and II) and young age (P < or = 0.03), and that females tended to do better than males (P = 0.09). Estimates of the mean nuclear volume were of prognostic significance (P = 0.02), small nuclei being associated with the worst prognosis. In a multivariate Cox analysis, clinical stage, age, and mean nuclear volume were found to be parameters of significant, independent prognostic value. CONCLUSIONS: The present feasibility study indicates that estimates of the mean nuclear volume are of prognostic value, independent of the clinical stage of disease. This quantitative histopathologic variable is highly reproducible and easily obtained using an unbiased stereologic method. Thus, the mean nuclear volume may be a parameter of future importance in the clinical management of patients with carcinoma of the lung.

Aged↗

Placental vascular malformation with mesenchymal hyperplasia and a localized chorioangioma. A rarity simulating partial mole.

We here report a case of placental vascular malformation with mesenchymal hyperplasia of the villi and a localized chorioangioma. After an uneventful pregnancy our patient delivered a non-malformed live female infant. The placenta was grossly enlarged, and macroscopically it was characterized by strongly enlarged varicous chorionic vessels. On the maternal plate vesicle-like structures, giving the impression of partial mole, were seen. At microscopy level, areas of normal looking tissue alternated with areas of excessively enlarged villi, in which the ground substance contained large amounts of acid mucopolysaccharide, corresponding to "mesenchymal hyperplasia". Moreover, a localized chorioangioma was found. In none of the histological sections were cisterns, abnormal trophoblastic proliferation, stunted ramification or stromal trophoblastic inclusions observed. In week 15 maternal se-AFP was elevated to 3.03 multiples of the median. Genetic analyses revealed a normal female karyotype and biparental genomic contributions to 7 unlinked loci. Placental vascular malformation with mesenchymal hyperplasia is a differential diagnosis to partial mole which should be considered when vesicle like placental enlargement is observed along with a living fetus.

Adult↗

The value of bone marrow examination in small cell carcinoma of the lung.

Of 668 consecutive patients with SCLC, 472 underwent bone marrow examination for staging. In 330 patients a triple examination (sternal aspiration, iliac crest aspiration and biopsy) was performed, otherwise a single procedure. Bone marrow infiltration (MI) was found in 37% of the patients with extensive disease, and the frequencies of a positive finding in single and triple examination were not statistically different. In the group having triple examination performed iliac crest aspiration alone disclosed MI in 32%. When all three procedures were included still more patients with MI were found (42%) but the two values were not significantly different. In 6.6% of patients who would have been classified as 'limited' did bone marrow examination change the stage to extensive disease. Based on these results we recommend iliac crest aspiration, but not triple examination with iliac crest biopsy, in the staging of SCLC.

Biopsy, Needle↗

Fetal and perinatal infections. A consecutive study.

118 cases of second trimester abortions, stillbirths, and perinatal deaths together with the placentas and case records were studied histologically and microbiologically to evaluate the incidence of infection and to assess possible correlations to certain clinical parameters. The infection rate was 39.4%, highest in the second trimester abortions (58.2%), where infection was also considered the most frequent cause of death (45.5%), though mostly without maternal signs of infection. 36.6% of cases with histological inflammation exhibited positive culture results. The value of ordinary culture of the placenta and fetus is questionable, at least if not performed immediately after delivery. A significant correlation between infection and vaginal bleeding during pregnancy, ruptured membranes of more than 24 hours duration, and spontaneous labour was found. No protective effect of intact membranes was found.

Abortion, Spontaneous↗

Estimation of the total number of mast cells in the human umbilical cord. A methodological study.

The aim of the present study was to estimate the total number of mast cells in the human umbilical cord. Using 50 microns-thick paraffin sections, made from a systematic random sample of umbilical cord, the total number of mast cells per cord was estimated using a combination of the optical disector and fractionated sampling. The mast cell of the human umbilical cord was found in Wharton's jelly, most frequently in close proximity to the three blood vessels. No consistent pattern of variation in mast cell numbers from the fetal end of the umbilical cord towards the placenta was seen. The total number of mast cells found in the umbilical cord was 5,200,000 (median), range 2,800,000-16,800,000 (n = 7), that is 156,000 mast cells per gram umbilical cord (median), range 48,000-267,000. Thus, the umbilical cord constitutes an adequate source of mast cells for further investigation of these cells in the newborn, e.g. for describing their functional and secretory characteristics and possible clinical relevance in relation to the development of allergic, inflammatory and immunological diseases in infancy and childhood.

Cell Count↗

Bacteriological autopsy. I. A methodological study.

The two aims of this investigation were: 1. To compare a swab culture technique with an imprint method in bacteriological autopsy. 2. To examine the influence of body manipulation on culture. Specimens were taken from the lungs and the spleen in 42 autopsies. For imprint a piece of sterile blotting paper was used. Point 1. Good qualitative agreement was found between the two methods. Print cultures enabled a quantitation at low numbers of bacteria. However, in most cases when growth was present the colonies were confluent, which did not allow counting. The lung cultures were 67%/69% positive (swab/print). For the spleen, the positive rate was 21%/42% (swab/print). In the cases representing the difference, only a few colonies grew on the print plates. Culture by means of a swab was found to give the same information as culture by imprint. Swabs are easier to handle but should be processed within a couple of hours. Point 2. In ten autopsies, cultures were taken with organs in situ after the organ block was removed and after an ordinary autopsy had been performed. A scoring system was used to compare the results. There was a clear correlation between positive cultures and manipulation of the organs. The specimens should be taken with the organs in situ.

Autopsy↗

Bacteriological autopsy. II. Comparison of a group of cancer patients with a control group.

A study of the results of bacteriological autopsy in a group of cancer patients compared with a control group was carried out. Autopsy was performed on 42 bodies within 24 hours of death. Thirty-two patients had died with a cancer and the remaining ten had died of cardiovascular disease. Tissue for microscopy and material and culture were taken from the same sites. The results of the inoculations were semiquantified, resulting in a culture score, and the results of the microscopy were classified according to presence of bacteria and kind of inflammation. Furthermore, grading was done according to the degree of inflammation and whether bacteria were seen at microscopy. The culture scores were significantly higher in the cancer group than in the control group. We found a significant correlation between score and presence of acute inflammation. Likewise, a significant correlation was found between score and presence of bacteria at microscopy. As a difference between the cancer group and the control group was seen, further research on bacteriological autopsy seems worthwhile.

Adult↗

[Transabdominal chorion villus biopsy following abnormal ultrasonic findings in the second trimester].

If oligohydramnios, growth retardation or foetal malformations are demonstrated by ultrasonic scanning in the second or third trimesters, this implies that the risk of chromosome anomalies is significantly increased. In cases such as these, determination of the foetal karyotype may therefore be indicated. Until recently, amniocentesis has been employed for this but the results of the chromosome investigation are not available until two to three weeks after the intervention. The delay between amniocentesis and the result of chromosome investigation imposes a mental strain on the pregnant woman. Three patients with abnormal ultrasonic findings in the second trimester were, therefore, submitted to transabdominal chorion villus biopsy and, in all three cases, a karyotype was available within 48 hours. Chorion villus biopsy in the second (and third) trimester is indicated in pregnancies in which oligohydramnios, growth retardation or foetal malformations have been demonstrated by ultrasonic scanning, in cases where referral for antenatal diagnosis is very late and when chromosome investigation after amniocentesis proves unsuccessful and repeated amniocentesis would result in an unacceptably late result.

Chorionic Villi Sampling↗

Group B streptococci in the lower urogenital tract and late abortions.

The occurrence of group B streptococci in the lower urogenital tract of 150 women with signs of abortion and 100 women with uncomplicated pregnancy was studied. Group B streptococci appeared significantly more frequently in the urine (p less than 0.001) and in the uterine cervix (p less than 0.01) of women with abortion. Delivery resulted in 85% of patients with group B streptococci in the urine and in 42% of patients with no group B streptococci (p less than 0.001). Group B streptococci were cultured from amniotic fluid from three of eight women with intact membranes and were isolated from the urine and cervix. These bacteria were antibody coated as demonstrated by an immunofluorescence technique. Group B streptococci were recovered from blood or liver in six fetuses, including two who had group B streptococci in the amniotic fluid. The study demonstrates an association between the occurrence of group B streptococci in the urine and cervix and late abortions.

Abortion, Spontaneous↗

Histological technique in routine histopathology. An opinion.

"Routine technique" means fixation in aqueous formaldehyde, embedding in paraffin, and staining with hematoxylin and eosin. A wide variety of procedure are included within this frame, some resulting in excellent preparations, others, although sometimes presented in scientific publications, giving slides which are virtually useless for the purpose of differential diagnostic evaluation. All patients, whether suffering from as yet unclassified but surely most interesting conditions or merely presenting with lesions of ordinary lethal disease, should benefit from investigations conducted at the highest technical level at disposal. Proper fixation, including postfixation; dehydration and embedding ensuing minimal distortion; and staining providing maximum differentiation of tissue components, are essential for the solution of problems posed by modern histopathological investigations. Some points relevant to this conception are discussed.

Histological Techniques↗