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Biomedical subjects

A Berner

Publications and source records attributed to A Berner.

At least 73 records · Page 4Linked to original sources
PubMed1997

HPV 16 infection in a patient with two primary squamous cell carcinomas: of the uterine cervix and the anal mucosa.

A 43-year-old woman presented with metrorrhagia and a polypoid anal tumor. Cervical dilatation and endocervical curettage and resection of the anal tumor revealed two primary squamous cell carcinomas: of the uterine cervix and the anal mucosa. HPV 16 was identified in both tumors using an in situ hybridization technique with probes against HPV 6, 11, 16, 18, 31 and 33. The cervical carcinoma was weakly positive for p53 protein, whereas the anal tumor was p53 protein negative. Five years later a recurrence of the cervical carcinoma was diagnosed and a hysterectomy was performed. Of 3,013 patients with squamous cell carcinoma of either the cervix or the anus registered in our files, only one had a primary carcinoma in both locations. It was concluded hat HPV-16-induced squamous cell carcinoma may occur simultaneously in the cervix and the anus, and carcinoma in either of the two locations has to be ruled out when dealing with HPV infection in the anogenital tract.

Adult↗
PubMed1997

[Reconstruction methods for the continuous digestive tract using surgical stapling after gastrectomy with lymphadenectomy in patients undergoing surgery for stomach cancer. Personal evaluation].

From 1984 to 1994, 152 patients were operated for gastric cancer in Clinical Department of Surgical Oncology, Medical University of Lodz. Patients age ranged from 31 to 82 years (mean age-61.2). The purpose of this study was to evaluate the methods of reconstruction of gastrointestinal tract (GIT) continuity. Our material comprised patients who underwent total gastrectomy for gastric cancer. In 52 patients radical procedure--total gastrectomy--was performed, with reconstruction of gastrointestinal tract continuity. The latter part of surgery was accomplished using different methods: Roux-Y anastomosis-10 patients (19.2%); esophago-jejunal "end to side" anastomosis-8 patients (15.4%); Hunt-Lawrence-Rodino anastomosis-34(65%). During procedures staplers and VALTRAC rings were used, as well as ultrasound selector and argon coagulator for hepatic and pancreatic resections. Quality of life after gastrectomy was determined on the basis of interviews taken from patients, in whom GIT continuity was reconstructed with or without intestinal pouch creation. We also evaluated incidence and type of complications after such procedures. Perioperative mortality in our material was 7.7%. We concluded that the best results was achieved when continuity of gastrointestinal tract after total gastrectomy was reconstructed with intestinal (first loop of jejunum) pouch creation (Hunt-Lawrence procedure). This method warranted high quality of life and low incidence of complications. Staplers enables us to shorten time of procedure and to decrease the number of anastomosis leaks, so that our results of surgical treatment of patients with gastric cancer were better.

Adult↗
PubMed1996

[Cancer metastasis].

Despite increasing insight into the biology of tumour development, the number of cancer deaths has not been subsequently reduced. This may be because approximately half of the cancers have metastasized already at the time of initial diagnosis. It seems important therefore, to learn more about the complex metastatic process. This process includes several linked sequential steps, and depends on an intimate interaction between the metastatic cells and the environment. In this review, we discuss these steps with emphasis on recent studies of the various cellular interactions that take place. Understanding these factors should result in diagnostic improvements and more effective treatment of cancer metastasis.

Cell Adhesion Molecules↗
PubMed1996

Evaluation of digitally guided fine needle aspiration cytology versus fine needle core biopsy for the diagnosis of recurrent rectal cancer.

The clinical value of transrectally digitally guided fine needle aspiration cytology (FNAC) was compared with fine needle core biopsy (FNCB), FNAC was performed with a 21G and FNCB with a 18G needle. No prophylactic antibiotic was given. In the first part of the study 100 patients (20 primary/80 recurrences, 17 benign/83 cancers) were studied by both techniques. In 93% a definite diagnoses was given in FNAC specimen versus 96% of the FNCB cases. There were no false positive cancer diagnoses. The sensitivity of the FNAC was 88% versus 68% of the FNCB specimens. This difference was statistically significant. In a second part of the study 142 specimens of recurrent cases were examined by FNAC including 78 of the patients of the first part. The negative predictive value was around 60% for FNAC versus around 40% for FNCB. Both techniques were without any major complications. For the diagnosis of a palpable recurrent pelvic tumour a digitally guided puncture may be tried before proceeding to CT or US guided examination. In our hands FNAC seems preferable to FNCB.

Aged↗
PubMed1996

Follow-up of prostatic intraepithelial neoplasia.

Biopsy or fine-needle aspiration cytology are the only appropriate methods for detection of prostatic intraepithelial neoplasia (PIN). PIN has been suggested to be a principal precursor of invasive carcinoma of the prostate. Most reports on an association of PIN and invasive prostatic cancer have a follow-up of less than 1 year, indicating that the successively diagnosed cancer most probably was present at the time of diagnosis of PIN. The natural history of PIN is unknown and detection of PIN should therefore not influence therapeutic decisions. If coexistent carcinoma is not found, close surveillance is recommended to identify a possible subsequent cancer at an early stage. Follow-up examinations should be performed at 6-month intervals for 2 years and thereafter annually.

Biopsy, Needle↗
PubMed1996

Ki-67 index in fine needle aspiration cytology specimens from primary and recurrent rectal cancer.

A Ki-67 index was determined in 63 fine needle aspiration cytology (FNAC) specimens from patients with rectal cancer, 21 with primary cancers and 42 with local recurrences. Seventeen of the patients had received external irradiation before the examination. In primary cancers, in recurrences as well as in the post-irradiation cases, the mean percentage of Ki-67 positive cells was about 55% with a wide variation. The percentage of Ki-67 positive cells was independent of the length of the recurrence-free period. In conclusion, the Ki-67 antigen may well be studied in FNAC specimens. The presence of antigen did not correlate with development of recurrence, length of recurrence-free period or irradiation prior to the analysis.

Biopsy, Needle↗
PubMed1995

Up-regulation of the oligosaccharide sialyl LewisX: a new prognostic parameter in metastatic prostate cancer.

Metastatic prostate cancer has an unpredictable long-term prognosis. At present, there are few specific predictors to indicate the outcome for the individual patient. We have studied immunoreactivity for type-2 carbohydrate structures, known to be involved in various cell adhesion processes, in patients with metastatic prostate cancer. One group of patients (n = 26) did not progress within 3 years after orchiectomy, while another group of patients (n = 33) progressed within 1 year following castration and survived less than 2 years. Among the parameters studied, sialyl LewisX carbohydrate up-regulation was the only variable showing significant association with poor prognosis (P < 0.01). Sialyl LewisX discriminated between these two outcome groups with 71% predictability and 96% specificity. Our results indicate that up-regulation of sialyl LewisX is associated with hormonal-resistant, aggressive disease. This prognostic marker may, therefore, have an important role in selecting proper treatment for patients with metastatic prostate cancer.

Adenocarcinoma↗
PubMed1995

TP53 mutations in prostatic cancer. Analysis of pre- and post-treatment archival formalin-fixed tumour tissue.

The TP53 gene mutation pattern in prostatic cancer was examined in relation to progression and survival, using archival formalin-fixed pre- and post-treatment tumour specimens from 84 prostatic cancer patients. Thirty-four had hormone-sensitive tumours and 50 were hormone-resistant. Six of the 34 (18 per cent) therapy-responding tumours and 19 of the 50 (38 per cent) hormone-resistant tumours showed p53 protein accumulation in the post-treatment specimen. Both pre- and post-treatment specimens from these 25 patients were analysed for mutation of the conserved regions of the TP53 gene (exons 5-8), using constant denaturant gel electrophoresis (CDGE) followed by DNA sequencing. In the post-treatment samples, mutations were detected in three of the six patients with hormone-responsive tumours and in 11 of the 19 patients with hormone-resistant tumours. The three (100 per cent) patients with therapy-responsive tumours with mutations and nine of the 11 (82 per cent) patients with therapy-resistant tumours with mutations died of the disease. Thirteen of the 14 mutations in the post-treatment specimens were transitions, 11 occurring at CpG dinucleotides in which codon 273 was involved in ten. A significantly higher proportion of tumours with mutations were poorly differentiated compared with tumours without mutation (P < 0.04). Our findings indicate that TP53 mutation is a late event in tumour development of the prostate gland and that codon 273 might be a 'hotspot' for mutation in the progression of the disease.

Aged↗
PubMed1995

High incidence of human papillomavirus in 146 cervical carcinomas. A study using three different pairs of consensus primers, and detecting viral genomes with putative deletions.

Polymerase chain reaction (PCR) primer sets and probe-cocktails were used for human papillomavirus (HPV) detection and typing of 146 fresh frozen biopsies of cervical carcinoma. We obtained a high detection rate (96%) by using three sets of consensus primer pairs directed at the L1 and E1 regions of HPV and by probing with a cocktail of random-labelled consensus and type-specific PCR products derived from HPV plasmids. In addition, we performed type-specific PCR amplification with E6-E7 primers. The procedure was designed to detect all HPV-positive cases in a rapid, sensitive and specific way. In addition, by using different regions for amplification, we detected cases with putative genomic deletions in HPV. All the negative PCR and DNA isolation controls were negative. The six negative samples were negative with all probe-cocktails and type-specific primers and three of these negative samples were clear cell carcinomas. The detection rate was similar in squamous carcinomas and in adenocarcinomas and type 16 was most common (65%) in both types of carcinoma. There were no double infections of human papillomavirus 16 and 18.

Adenocarcinoma↗
PubMed1995

Squamous cell carcinomas of the lower lip.

During a 10-year period, 30 patients with lesions of the lower lip, suspected to be cancerous, were operated on by primary resection without a prior biopsy. The patients have been continuously followed to evaluate if the treatment strategy, with avoidance of an incisional biopsy, might influence local recurrence and metastatic rate. One patient developed a second primary lesion, and none of the patients had local recurrences. Local lymph node metastases were detected in two patients. There was full agreement between the initial clinical and histopathological diagnosis among 26 patients with squamous cell carcinomas. In another two patients, the histopathological examination revealed severe epithelial dysplasia, and finally one case was diagnosed histopathologically as a keratoacanthoma. In 29 out of the 30 cases, a pre-treatment biopsy would not have influenced the extent of the surgical procedure.

Adult↗
PubMed1995

Histopathological grading and DNA ploidy as prognostic markers in metastatic prostatic cancer.

The present study compares the prognostic potential of tumour grade and DNA ploidy status in patients with advanced-stage prostatic cancer. Two outcome groups were selected on the basis of time to progression and survival after orchiectomy. A poor-outcome group consisted of 32 therapy-resistant patients who experienced disease progression during the first year after orchiectomy and subsequently death due to prostatic cancer during the following year. A good-outcome group consisted of 27 therapy-responsive patients who showed disease regression and no signs of progression during a 3 year follow-up. The primary tumours were graded twice according to WHO and Gleason classification systems by two pathologists. Final agreement between the pathologists was obtained after a consensus meeting. The analysis revealed no prognostic importance of the two histological classification systems (P = 0.62 and P = 0.70) and disclosed weak inter- and intra-observer reproducibility (kappa < 0.70). DNA ploidy analyses were performed by image cytometry on formalin-fixed, paraffin-embedded samples of the primary tumours. Overall, 48% of the tumours were diploid, 20% tetraploid and 32% anueploid. DNA ploidy status did not discriminate between the two outcome groups (P = 0.46). Histological grade and DNA ploidy showed no prognostic importance in patients with prostatic cancer and skeletal metastases.

Adult↗
PubMed1995

DNA ploidy, serum prostate specific antigen, histological grade and immunohistochemistry as predictive parameters of lymph node metastases in T1-T3/M0 prostatic adenocarcinoma.

OBJECTIVE: To evaluate whether DNA ploidy and immunohistochemistry performed in primary prostatic carcinoma specimens give predictive information on regional lymph node metastasis in addition to T category, histological grade and serum prostate specific antigen (PSA). PATIENTS AND METHODS: Pre-treatment TURP specimens from 80 patients with prostatic carcinoma T0-T3/M0 disease were retrospectively evaluated by means of DNA ploidy and histological grade, and immunostaining for PSA, prostatic acid phosphatase (PAP), neuron-specific enolase (NSE) and p53 protein. Pelvic lymph node dissection was performed in all patients. Serum PSA was determined in 76 of the 80 patients before pelvic staging lymphadenectomy. Thirty-two (40%) of the 80 patients had pN+ disease. RESULTS: Thirty-six patients (46%) had serum PSA values below the upper reference limit (< or = 10 micrograms/L). By univariate analysis the pN category correlated with the serum PSA level (P < 0.001), histological grade (P < 0.001), tissue PSA (P < 0.001), tissue PAP (P < 0.04), T category (P < 0.005) and DNA ploidy (P < 0.02). Multivariate analysis revealed that the serum PSA level was the most powerful independent prognosticator, followed by the T category, tissue PAP and tissue PSA. Histological grade and DNA ploidy did not reach the level of significance in the multivariate analysis. CONCLUSION: These data suggest that tissue PAP and tissue PSA predict the pN status in patients with T0-T3/M0 prostate carcinoma, in addition to serum PSA and T category. Neuroendocrine differentiation and p53 protein seem to have no predictive ability.

Adenocarcinoma↗
PubMed1994

Prostatic carcinoma: a multivariate analysis of prognostic factors.

Tissue specimens from 150 patients with localised prostatic carcinomas and 116 patients with prostatic carcinomas with distant metastases were analysed for histological grade (WHO and Gleason) and immunoreactivity for prostate acid phosphatase (PAP), prostate-specific antigen (PSA), neurone-specific enolase (NSE), p53 protein, c-erbB-2 protein, cytokeratins (AE1/AE3) and vimentin. After stratification for the presence or absence of distant metastases, multivariate regression analysis revealed that WHO grading was the most powerful independent prognosticator, followed by age and prostate acid phosphatase expression. There was a trend towards reduced survival with decreasing prostate-specific antigen reactivity. The Gleason system showed poor prognostic ability. The analysis predicted reduced survival in the presence of extensive neurone-specific enolase reactivity, mostly because of one case of small-cell carcinoma.

Acid Phosphatase↗
PubMed1993

[Lung damage in amiodarone therapy].

Amiodarone pulmonary toxicity is the most serious side effect of amiodarone therapy. We describe a patient who died of this adverse effect. The clinical presentation is most often that of an indolent illness, with cough and/or fever. The diagnosis is made by careful exclusion of other causes of the observed illness and the finding of clinical, radiographic, physiologic, and pathologic abnormalities compatible with amiodarone toxicity. Examination prior to drug therapy, including lung function tests, is recommended for later controls. Of the therapeutic options, discontinuation of amiodarone is most frequent. However, for some patients with life-threatening ventricular arrhythmias this is the only effective therapy.

Aged↗
PubMed1993

Effect of exercise on valvular resistance in patients with mitral stenosis.

OBJECTIVES: This exercise study assessed the relation between valvular resistance and flow in patients with mitral stenosis. BACKGROUND: Valvular resistance has been proposed as an alternative measure of stenotic valvular lesions, which is speculated to remain stable under changing hemodynamic conditions. METHODS: In 35 of 40 patients with pure or predominant mitral stenosis, continuous wave Doppler measurements of the mitral stenotic jet were possible at rest and during supine bicycle ergometry. Simultaneously, transvalvular flow was assessed by thermodilution technique. For calculation of valvular resistance, the mean mitral valve pressure gradient was determined according to the simplified Bernoulli equation and divided by transvalvular flow. Additionally, effective mitral valve area was calculated according to the continuity equation method, dividing flow by the mean diastolic flow velocity. RESULTS: Valvular resistance was 65 +/- 32 dynes.s.cm-5 at rest and increased to 82 +/- 43 dynes.s.cm-5 at 25 W (p < 0.001). The most prominent increase in valvular resistance (rest to 25 W 63 +/- 28 to 95 +/- 48 dynes.s.cm-5, p < 0.001) was found in those patients who had no or only a moderate (< 20%) change in effective mitral valve area. In contrast, valvular resistance remained constant (67 +/- 36 vs. 70 +/- 32 dynes.s.cm-5) in patients with a significant (> or = 20%) increase in mitral valve area with exercise. CONCLUSIONS: In patients with mitral stenosis, the exercise-induced changes in valvular resistance are heterogeneous. This is the result of the variable response of mitral valve area to an increase in flow. In the individual patient, mitral valve area can significantly increase, a factor that has to be taken into account when interpreting the hemodynamic relevance of the obstruction. Calculated valvular resistance is flow dependent and has no advantage over valve area calculations for quantifying mitral stenosis.

Adult↗
PubMed1993

Hormone resistant prostatic adenocarcinoma. An evaluation of prognostic factors in pre- and post-treatment specimens.

Pre- and post-treatment specimens from 47 patients with hormone resistant prostatic carcinoma were compared with each other regarding histological grade and immunoreactivity for p53 protein, neuron specific enolase and c-erbB-2 protein. Significantly more specimens expressed a high malignancy grade when the tumour had become hormone resistant than at the time of initial diagnosis (Gleason P: < 0.0001, WHO P:0.0003). p53 protein immunoreactivity increased significantly with disease progression (P:0.006), while tissue PSA immunoreactivity was reduced in post-treatment specimens (P:0.011). p53 protein expression did not correlate with histological grade or PSA expression and seems to be an independent parameter which participates late in the neoplastic transformation. Thirty-two percent of the tumours were neuron specific enolase positive, but this parameter did not correlate with development of hormone resistance. c-erbB-2 protein reactivity was not recognised.

Adenocarcinoma↗