ABSTRACT
The Armanni- Ebstein lesion was first reported in 1877 and has been associated with deaths due to diabetic ketoacidosis. The lesion consists of subnuclear vacuolation of the kidneys, which contain fat. We report a case of the Armanni- Ebstein lesion in a non-diabetic child with documented ketoacidosis who died of starvation.
Subject(s)
Cause of Death , Child Abuse/mortality , Diabetic Ketoacidosis/mortality , Forensic Pathology/methods , Starvation/mortality , Autopsy/methods , Child, Preschool , Diabetic Ketoacidosis/pathology , Female , Humans , Kidney/abnormalities , Starvation/pathologyABSTRACT
OBJECTIVE: To determine whether aortic medial changes are more severe in patients who require aortic valve replacement of congenitally bicuspid aortic valves (BAV) than in patients who require replacement of tricuspid aortic valves and acquired valvular disease (AVD). DESIGN: Aortas from autopsies of 14 patients with BAV and 25 with AVD were histologically assessed by two 'blinded' cardiovascular pathologists and analyzed independently with computer-aided morphometry. The aortic valves were examined for valvular fibrosis and calcification. SETTING: The patient population was from a tertiary-care facility. PATIENTS: Patients were selected by retrospective review of autopsy records for patient deaths after aortic valve replacement, over the period 1984 to 1995. RESULTS: There were no significant differences in age (P=0.89), sex (P=0.94), prevalence of systemic arterial hypertension (P=0.37), valvular degenerative changes (P=0.10 and P=1.0) or heart weights (P=0.60) between the two groups. Histological scores for aortic medial degenerative changes including elastic fragmentation, fibrosis and medionecrosis were not statistically different between the groups. However, morphometry demonstrated less elastic tissue in patients with BAV (P=0.003). CONCLUSION: Routine microscopy shows no significant difference in the degree of aortic medial degenerative changes between patients with BAV and AVD. However, morphometry shows less elastic tissue in the aortas of BAV patients. This may explain the anecdotal increase in aortic fragility and propensity for aortic dissection in these patients.
Subject(s)
Aorta, Thoracic/pathology , Aortic Valve/abnormalities , Heart Valve Diseases/congenital , Aged , Aged, 80 and over , Aortic Valve/pathology , Aortic Valve/surgery , Cadaver , Calcinosis/pathology , Female , Fibrosis , Heart Valve Diseases/pathology , Heart Valve Prosthesis Implantation , Humans , Male , Middle Aged , Necrosis , Photomicrography , Retrospective StudiesABSTRACT
OBJECTIVE: The natural evolution of atypical glandular cells of undetermined significance (AGUS) within a dysplasia clinic population has not yet been studied. The purpose of this study was to determine the outcome of cervico-vaginal smears with the diagnosis of AGUS from dysplasia clinic patients. MATERIAL AND METHODS: The cytopathological files of the Ottawa Civic Hospital were reviewed retrospectively from January 1993 to December 1995. In 59 dysplasia clinic patients, AGUS was diagnosed on one or more cervico-vaginal smears. Histological follow-up was available from 34 patients. Cytological follow-up was available on an additional 17 patients. RESULTS: Nineteen patients had clinically significant lesions. In eight patients, squamous intraepithelial neoplasia was diagnosed; in five, adenocarcinoma in situ; in another five, adenocarcinoma; and, in one patient, endometrial hyperplasia with atypia. In 15 patients, follow-up was negative. CONCLUSION: In a dysplasia clinic population in whom there was a cytological diagnosis of AGUS, we found 32% had significant pathology. Of these patients, 53% had glandular pathology. Based on our experience, histological assessment of the endocervix is suggested in these patients.
