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Cellular injury throughout the lungs in neonatal hyaline membrane disease
Pathology (1969), 1, pp. 153-65
ABSTRACTSOF PAPERSPRESENTED AT THE SCIENTIFIC MEETING OF THE COLLEGE OF PATHOLOGISTS OF AUSTRALIA HELD IN MELBOU RNE, VICTORIA 22, 23 and 24 August 1968 CELLULAR INJURY THROUGHOUT THE LUNGS I N NEONATAL HYALINE MEMBRANE DISEASE BARTER, R.A. King Edward Memorial Hospital for Women, Subiaco, Western Australia
Pulmonary hyaline membranes commonly found in the lungs of prematurely born infants who succumb soon after birth have been shown to result from necrosis of the epithelial cells lining respiratory bronchioles, and to form in situ. Additional material incorporated into the membranes is assumed to be part of an exudate caused by injury to the bronchiolar walls. Rarer cases of infants surviving for 72-96 hr., instead of the usual 12-24, have provided indirect evidence for injury also to the alveolar linings, indicated by the emergence of a characteristic cuboidal epithelium similar to that which can be readily induced experimentally. The initial changes in alveoli cannot be observed with the light microscope but they are suggested to be the cause of the loss of surfactant, which has been repeatedly demonstrated by other means. Terminal bronchioles in a large proportion of affected infants also show patchy necrosis of the columnar lining. Further evidence of more widespread injury has come from cases surviving longer than 96 hr. The lung of an infant born 6 wk. prematurely (by dates) who suffered from respiratory distress since birth and died aged 5 days showed lesions in alveoli, bronchioles and even in bronchi. Typically, there are hyaline membranes in respiratory bronchioles, collapse of alveolar tissue and congestion, but additionally the bronchioles and bronchi show necrosis of the epithelial lining and there are also reparative changes in the alveolar lining. Detailed consideration of the purely morbid anatomical changes is wanting and their significance in regard to the pathogenesis of the disease, particularly of the early stages, remains to be fully evaluated. The idea that alveolar epithelial injury occurs and is the cause of the collapse through loss of surfactant makes much clearer the apparent paradox of an identical clinical syndrome occurring with or without hyaline membranes in the lungs. A progressive necrosis ascending the respiratory passages and dependent on the duration of survival seems the most probable basis of the disease. TUMOURS OF THE SMALL BOWEL GWYNNE, J. F. Uninersity of Otago Medical School, Dunedin, New Zealand
A series of small bowel neoplasms was reviewed from the Otago Medical School and Dunedin Hospital Departments of Pathology and Surgery. The series comprised a total of 55 cases occurring between 1954 and 1968, and the material was obtained from both necropsies and surgical resections. There were 41 malignant and 14 benign lesions. Clinical features and behaviour were reviewed briefly; intussusception was a common presenting feature.
ABSTRACTSOF PAPERSPRESENTED AT THE SCIENTIFIC MEETING OF THE COLLEGE OF PATHOLOGISTS OF AUSTRALIA HELD IN MELBOU RNE, VICTORIA 22, 23 and 24 August 1968 CELLULAR INJURY THROUGHOUT THE LUNGS I N NEONATAL HYALINE MEMBRANE DISEASE BARTER, R.A. King Edward Memorial Hospital for Women, Subiaco, Western Australia
Pulmonary hyaline membranes commonly found in the lungs of prematurely born infants who succumb soon after birth have been shown to result from necrosis of the epithelial cells lining respiratory bronchioles, and to form in situ. Additional material incorporated into the membranes is assumed to be part of an exudate caused by injury to the bronchiolar walls. Rarer cases of infants surviving for 72-96 hr., instead of the usual 12-24, have provided indirect evidence for injury also to the alveolar linings, indicated by the emergence of a characteristic cuboidal epithelium similar to that which can be readily induced experimentally. The initial changes in alveoli cannot be observed with the light microscope but they are suggested to be the cause of the loss of surfactant, which has been repeatedly demonstrated by other means. Terminal bronchioles in a large proportion of affected infants also show patchy necrosis of the columnar lining. Further evidence of more widespread injury has come from cases surviving longer than 96 hr. The lung of an infant born 6 wk. prematurely (by dates) who suffered from respiratory distress since birth and died aged 5 days showed lesions in alveoli, bronchioles and even in bronchi. Typically, there are hyaline membranes in respiratory bronchioles, collapse of alveolar tissue and congestion, but additionally the bronchioles and bronchi show necrosis of the epithelial lining and there are also reparative changes in the alveolar lining. Detailed consideration of the purely morbid anatomical changes is wanting and their significance in regard to the pathogenesis of the disease, particularly of the early stages, remains to be fully evaluated. The idea that alveolar epithelial injury occurs and is the cause of the collapse through loss of surfactant makes much clearer the apparent paradox of an identical clinical syndrome occurring with or without hyaline membranes in the lungs. A progressive necrosis ascending the respiratory passages and dependent on the duration of survival seems the most probable basis of the disease. TUMOURS OF THE SMALL BOWEL GWYNNE, J. F. Uninersity of Otago Medical School, Dunedin, New Zealand
A series of small bowel neoplasms was reviewed from the Otago Medical School and Dunedin Hospital Departments of Pathology and Surgery. The series comprised a total of 55 cases occurring between 1954 and 1968, and the material was obtained from both necropsies and surgical resections. There were 41 malignant and 14 benign lesions. Clinical features and behaviour were reviewed briefly; intussusception was a common presenting feature.