A qualitative histological assessment of various storage conditions on short term preservation of human split skin grafts.

This paper provides a qualitative description of the histological appearances and changes occurring in human split skin grafts stored at 4 degrees C in various configurations over a 4-week period. During the storage time, changes were seen in all layers of the epidermis and dermis. The most notable early features were nuclear and cellular swelling and pleomorphism. After 7 days nuclear and cellular shrinkage, halo formation and pyknosis became evident. The most worrying histological feature was the development of dermo-epidermal blebs. These were evident by day 7 and progressed to cleavage of, and ultimately complete separation of, the epidermis from the dermis.A comparison of these features in human split skin grafts stored as sheets or meshed 1(1)(2):1, stored either rolled or flat, at either strictly or roughly 4 degrees C revealed differences. We conclude that the viability of stored skin is improved if it is stored at a uniform 4 degrees C as rolled sheets.

Deficient colour vision and interpretation of histopathology slides: cross sectional study.

OBJECTIVE: To determine whether histopathologists with deficient colour vision make more errors in slide interpretation than those with normal colour vision. DESIGN: Examination of projected transparencies of histopathological slides under standardised conditions by subjects whose colour discriminating ability was accurately assessed. SETTING: Departments of histopathology in 45 hospitals in the United Kingdom. SUBJECTS: 270 male histopathologists and medical laboratory scientific officers. MAIN OUTCOME MEASURES: Number of slides correctly identified by subjects whose colour vision was measured on the Ishihara, City University, and Farnsworth-Munsell 100 hue tests. RESULTS: Mean (SD) scores (out of 10) for doctors with colour deficient vision were 9.4 (0.7) v 9.9 (0.4) for controls (P < 0.01) and 7.5 (1.6) v 9.4 (0.7) for scientific officers (P < 0.001). When subjects with colour deficient vision were categorised into severe, moderate, or mild, there was a significant trend towards those with severe deficiency making more mistakes (P < 0.001). CONCLUSIONS: Histopathologists and medical laboratory scientific officers should have their colour vision tested; if they are found to have a severe protan or deutan deficiency, they should be advised to adopt a safe system of working.

Pathological findings in breast reduction surgery.

A retrospective analysis of pathological findings in 157 female patients undergoing breast reduction is presented. In 33 months 295 breasts were reduced. 25.6% of these patients had an abnormal pathology report, but no cases of premalignant disease or breast cancer were found. A postal questionnaire sent to consultant members of the British Association of Plastic Surgeons in 1994 found 89% routinely sent breast reduction tissue for pathological study. 42% had seen at least one case of breast cancer reported from this tissue. Recommendations for the use of pathology in breast reduction surgery are proposed.

Cardiovascular regulation during head-out water immersion exercise.

Head-out water immersion is known to increase cardiac filling pressure and volume in humans at rest. The purpose of the present study was to assess whether these alterations persist during dynamic exercise. Ten men performed upright cycling exercise on land and in water to the suprasternal notch at work loads corresponding to 40, 60, 80, and 100% maximal O2 consumption (VO2max). A Swan-Ganz catheter was used to measure right atrial pressure (PAP), pulmonary arterial pressure (PAP), and cardiac index (CI). Left ventricular end-diastolic (LVED) and end-systolic (LVES) volume indexes were assessed with echocardiography. VO2max did not differ between land and water. RAP, PAP, CI, stroke index, and LVED and LVES volume indexes were significantly greater (P less than 0.05) during exercise in water than on land. Stroke index did not change significantly from rest to exercise in water but increased (P less than 0.05) on land. Arterial systolic blood pressure did not differ between land and water at rest or during exercise. Heart rates were significantly lower (P less than 0.05) in water only during the two highest work intensities. The results indicate that indexes of cardiac preload are greater during exercise in water than on land.

Positive Kveim reaction in eosinophilic pneumonia.

The Kveim test is generally regarded as highly specific for sarcoidosis. We report two patients with pulmonary eosinophilia who had positive Kveim reactions. This association has not been previously reported.

Tricuspid valve perforation by a permanent pacing lead in a patient with cardiac amyloidosis: case report and brief literature review.

Tricuspid valve injury is a rare complication of transvenous pacemaker placement. We report such an injury in an elderly patient with cardiac amyloidosis. Because serious complications may result from such an injury, tricuspid valve perforation should be considered, along with the more common causes of new murmurs, in patients with pacemakers.

Biological studies with continuous-wave radiofrequency (28 MHz) radiation.

Effects of high-frequency (28 MHz) continuous-wave radiation have been studied in the rat and monkey. No histopathological (rat-125 mW cm-2 for 28 days) or hematological (monkey-25 mW cm-2 for 24 days) changes could be attributed to the radiation. In the monkey (125 mW cm-2 for 11 days) there was an increase in urinary calcium concentration which was most likely due to restricted movement. In the rat (220 mW cm-2 for 13 days) there was reduced uptake of iodine by the thyroid, lower levels of plasma thyroid-stimulating hormone, and reduced ratio of protein bound to nonprotein bound iodine. Food consumption was also decreased. The changes are likely to have arisen as a compensatory response to an induced heat load. A nonthermal effect of continuous-wave high-frequency radiation has not been shown in this study. The effects were likely to be associated with either physiological compensation for induced heating or restriction of movement.

Reduction and glutathione conjugation reactions of N-acetyl-p-benzoquinone imine and two dimethylated analogues.

N-Acetyl-3,5-dimethyl-p-benzoquinone imine, N-acetyl-2,6-dimethyl-p-benzoquinone imine, and N-acetyl-p-benzoquinone imine were synthesized via the oxidation of 3,5-dimethylacetaminophen, 2,6-dimethylacetaminophen, and acetaminophen, respectively. All three quinone imines were rapidly reduced to their corresponding semiquinone imines by NADPH-cytochrome P-450 reductase. All three benzoquinone imines underwent comproportionation with their respective phenols to yield the corresponding semiquinone imines, which in the presence of oxygen gave superoxide. Identification of this latter free radical was based on spin-trapping techniques. Reduced GSH was found to be an excellent nucleophile toward N-acetyl-2,6-dimethyl-p-benzoquinone imine, whereas this thiol behaved as a one-electron reductant toward N-acetyl-3,5-dimethyl-p-benzoquinone imine. Finally, GSH was determined to act as both a nucleophile and a reductant toward N-acetyl-p-benzoquinone imine.

The dielectric properties of the cerebellum, cerebrum and brain stem of mouse brain at radiowave and microwave frequencies.

The relative permittivity and conductivity of the cerebellum, cerebrum and brain stem of mouse brain were measured at a temperature of 37 degrees C over a frequency range of 72 MHz to over 5 GHz using time-domain spectroscopy. An analysis of the data suggests that the water exists in various forms of binding with an average relaxation frequency less than free water.

Drug associated acute interstitial nephritis: clinical and pathological features and the response to high dose steroid therapy.

Nine episodes of drug associated acute interstitial nephritis, in seven patients, were treated between 1972 and 1980. The drugs implicated were cotrimoxazole (three times), ampicillin, Magnapen (ampicillin and flucloxacillin), penicillin, gentamicin, paracetamol and bendrofluazide. The time from exposure to the onset of symptoms ranged from one to 30 days. Presentation was with acute renal failure, which was non-oliguric in five cases, accompanied by rash (four), fever (four), and loin pain (two). Renal biopsy was carried out in all cases, and showed a characteristic interstitial infiltrate comprising substantial numbers of lymphocytes and plasma cells, with a variable number of neutrophils, eosinophils and histiocytes. Immunofluorescence was negative in all four cases studied in the acute phase, and showed scattered deposits of IgG, IgM, IgA and C3 on the tubular basement membrane in one patient during recovery. Significant proteinuria and an abnormal urine deposit were present in all cases, and seven of nine had radiological evidence of enlarged kidneys. Seven episodes were treated with high doses of methyl prednisolone and in all there was a response with a diuresis or spontaneous fall in serum creatinine within 72 hrs, and recovery of virtually normal renal function. Of two cases who did not initially receive steroids, one improved more slowly and one developed chronic renal impairment.

Fatal consequences of local anesthesia: report of five cases and a review of the literature.

The possible hazards of local anesthetic agents in either moderate or large doses are not always fully appreciated. The toxic side effects following rapid systemic absorption may be the unsuspected cause of death following the clinical use of these substances. Data on 15 deaths after the administration of local anesthetic substances are summarized. Five case histories involving lidocaine (lignocaine, Xylocaine) and cocaine are presented in detail, including the results of toxicologic analysis. The literature relevant to similar fatalities is reviewed but contains little information relating to blood and tissue concentrations in fatal cases. It is hoped that this paper may assist in clarifying the cause of death in some previously problematic situations.