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Biomedical subjects

B Sandstedt

Publications and source records attributed to B Sandstedt.

At least 91 records · Page 5Linked to original sources

Placental villitis and intrauterine growth retardation in a Swedish population.

Villitis was studied in placentas from 445 singleton infants from an ethnically homogeneous population with a good socioeconomic standard. There were 161 infants small for gestational age (SGA) and 284 appropriate for gestational age (AGA). Villitis was found in 12 SGA-placentas (7.5 per cent) and 8 AGA placentas (2.8 per cent) (p less than 0.05). The degree of villitis was also related to growth retardation (p less than 0.05). Except for one placenta with villitis due to CMV infection, the cause of villitis could not be determined. No association was found with various studied factors such as hypertension, pre-eclampsia, smoking or maternal pyrexia during pregnancy.

Adult↗

Placental lesions and maternal hemoglobin levels. A comparative investigation.

A high maternal hemoglobin level during pregnancy has been correlated to a low birth weight and a low placental weight, but has not been investigated in relation to placental factors. In 330 consecutive deliveries, placental lesions, birth weight and placental weight were studied in a multiple regression analysis in relation to maternal hemoglobin concentration, taking into consideration possible confounding factors such as smoking, hypertensive disorders, weight gain, primiparity, gestational age and sex. A high maternal hemoglobin concentration (greater than 130 g/l) was correlated with a low birth weight, acute infarcts and syncytial knots. Intervillous thrombosis was more common in non-smokers and multiparous women, increasing in incidence as gestational age advanced. Infarcts and microscopic perivillous fibrin were correlated with hypertension. Microscopic perivillous fibrin was slightly associated with a high hemoglobin level (greater than 130 g/l) in a bivariate analysis. These findings may indicate that a high maternal hemoglobin level impairs the uteroplacental circulation.

Adult↗

Transthyretin immunoreactivity in human and porcine liver, choroid plexus, and pancreatic islets.

We examined transthyretin immunoreactivity (TTR-IR) in human and porcine liver, choroid plexus, and pancreatic islets with both polyclonal and monoclonal antibodies to TTR. The specificity of the immunoreactions and the effects of various fixatives were tested in immunohistochemical and dot-blot systems. B-5 fixative (mercuric chloride and sodium acetate in formalin) was the best immunopreservative. In both species, the TTR-IR in choroid plexus epithelial cells was strong and was much greater than that in hepatocytes. Glucagon cells in pancreatic islets were also strongly TTR immunoreactive. Insulin cells were slightly TTR immunoreactive in human but strongly so in porcine pancreas. The finding of TTR-IR in normal islets explains the presence of TTR-IR in human endocrine pancreatic tumors, notably glucagonomas and malignant insulinomas.

Animals↗

Relationship between placental shape, cord insertion, lobes and gestational outcome.

Singleton placentas from 330 consecutive births were examined for size, shape, cord insertion, allanto-chorial vascular pattern and lobes. These factors were considered regarding possible interactions and correlation to pregnancy and perinatal outcome. Marginal cord insertion was correlated to extrachorial and bilobate placenta and to magistral wr mixed allanto-chorial vascular pattern. A paucity of lobes (less than 15) was associated with extrachorial placenta, marginal cord insertion, pre-eclampsia, gestational age less than 38 weeks and small for gestational age infants. The common denominator for abnormal configuration and marginal cord insertion seemed to be the paucity of lobes.

Female↗

Histopathology and immunohistology of HTLV-III/LAV related lymphadenopathy and AIDS.

Fifty-nine lymph node biopsies from homosexual men with serum antibodies to HTLV-III/LAV were the subject of a detailed histopathological and immunohistochemical study. The histological findings were correlated to the patients clinical status, and the T4/T8 ratios in blood and lymph nodes. Four histological patterns predominated and were defined as follicular hyperplasia (FH), follicular fragmentation (FF), follicular atrophy (FA), and follicular depletion (FD). Immunocytochemical studies indicated that destruction of follicular dendritic cells is related to the initiation of follicular involution from FH to FF, but the possible role of follicular infiltrating T-cells cannot be excluded. Marked individual variations in lymph node angiogenesis increasing during involution were observed, which suggests that the degree of angiogenic host response may predispose for evolution of Kaposi's sarcoma. The majority of the patients with the clinical diagnosis of persistent generalized lymphadenopathy (PGL) were morphologically staged as FH or FF (89%), whereas most of the AIDS patients showed lymph node changes compatible with FA and FD (89%). Patients with AIDS-related complex (ARC) had a wider spectrum of morphological lymph node changes but a majority of cases (62%) were also classified as FA or FD. Clinical follow-up showed progression from PGL to ARC in seven of 21 cases with the FF pattern and only in three of 19 cases with FH, indicating a possible prognostic value in differentiating between FH and FF. Three cases with FD and one with FA progressed to AIDS during the time of observation. T4/T8 ratios in blood and lymph nodes were significantly lower in patients with FD histology compared to patients of the other histological groups. At autopsy, all AIDS cases showed the FD pattern of lymphadenopathy. Autopsy findings in seven patients emphasized the importance of post-mortem studies in clarifying the spectrum of opportunistic diseases, including tumors which afflict the AIDS patients.

AIDS-Related Complex↗

Hepatotoxicity associated with low-dose, long-term methotrexate treatment of rheumatoid arthritis.

Liver biopsies were performed in 17 patients with therapy-refractory rheumatoid arthritis who were treated successfully with 5-15 mg/week methotrexate (mtx). The average duration of exposure to mtx therapy for each patient was 2.8 years (range 1.5-5 years). Total cumulative mtx doses ranged between 633 and 1,655 mg (mean 1,060 mg). The biopsies revealed 16 cases of normal histology, of which 3 showed nuclear variability in the hepatocytes; 4 with mild fatty infiltration, 2 with mild fatty infiltration and portal round cell infiltration. Portal fibrosis was found in one patient who had psoriasis in addition to clinical RA.

Adult↗

An EBV genome carrying pre-B cell leukemia in a homosexual man with characteristic karyotype and impaired EBV-specific immunity.

A Burkitt-like lymphoma/leukemia confined to bone marrow was detected in a human T cell leukemia virus (HTLV)-III/LAV- and Epstein-Barr virus (EBV)-seropositive homosexual man. The tumor cells were EBNA-positive and contained at least 22 EBV genomes per cell. They were totally immunoglobin negative, but showed other markers for B cells detected with monoclonal antibodies. The patient had an impaired cellular immunity to EBV antigens and EBV-infected cells at diagnosis, but these reactions normalized during treatment. Cell clones derived from the bone marrow tumor in vitro also carried EBV and had six different marker chromosomes, including the typical 14q+ chromosome and a t(8 - ;8), which resulted in trisomy for the largest part of 8q. Partial trisomy for 12q was also observed. The patient completed six courses of combination chemotherapy and remains in excellent health after 34 months of follow-up.

Adult↗

The advantages of preoperative therapy in Wilms' tumour. A summarised report on clinical trials conducted by the International Society of Paediatric Oncology (SIOP).

During 1971-1980, three consecutive clinical studies on nephroblastoma were conducted by the International Society of Paediatric Oncology (SIOP). Besides several questions on different postoperative treatment modalities, the emphasis of these trials was to determine the role of preoperative therapy. In SIOP-1 (1971-1974) we compared preoperative radiotherapy to immediate surgery. There is no difference in survival or recurrence-free survival between both groups. Tumour ruptures, however, did occur significantly less in the pretreated group, and the recurrence-free survival is clearly lower in patients with intraoperative tumour rupture. These results were confirmed by SIOP-2, a non-randomised study conducted between 1974 and 1976. The question tackled by SIOP-5 (1977-1980) was whether preoperative chemotherapy could be a substitute for preoperative radiotherapy. The two preoperative therapies produced equally satisfactory results in terms of recurrence-free survival and 4-year survival rates, and the reduction in the number of operative ruptures. In addition, it was shown that with preoperative chemotherapy about 45% of an unselected population of patients with Wilms' tumour can be treated and cured without any irradiation and its well-known sequelae. The actual need for radiotherapy in stage II tumours with negative lymph node involvement (about 30% of the patients after pretreatment) is under investigation in SIOP-6. Cytohistological grading is equally possible after chemotherapy, and also without pretreatment. If antitumour treatment is begun before histopathological diagnosis, then the risk of overtreating patients with benign conditions, or of administering an inappropriate treatment to patients with malignant tumours of other types, is about 6%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Mesoblastic nephromas: a study of 29 tumours from the SIOP nephroblastoma file.

In a series of 889 Wilms' tumours we found 29 pure mesoblastic nephromas. The age of the patients varied from newborn to 22 months, but only five were older than four months. Two histologic types were recognized--leiomyomatous (9) and cellular (20) with a fibrohistiocytic appearance. The leiomyomatous type was almost invariably in stage I, smaller and present in younger infants. At operation half of the cellular type has ruptured or infiltrated the renal pelvis or perirenal tissue. Two patients died of postoperative complications. All others are alive after four years and free from disease.

Female↗

Long-term toxicity of a hydrogelic occlusive device in the isthmus of the human oviduct. A light microscopic study.

Ten women applying for sterilization volunteered for a tubal blocking procedure. An occlusive device of gamma polymerized hydrogel, a P-block, was applied in the isthmic part of the oviduct by trans-cervical hysteroscopy. Bilateral expulsion occurred in three and unilateral in six subjects. Six patients became pregnant. The P-block was in position from one week to 32 months. Histologically, the reaction to the P-block was first erosion and acute unspecific inflammation. Later there was a histiocytic and foreign-body reaction due to dissolution of the hydrogel. When the P-block was expelled no changes were present in the material.

Animals↗

Nephroblastoma with fibroadenomatous-like structures.

Review of the histological sections of the tumours of 889 patients from the files of the SIOP Nephroblastoma trials and studies has revealed 23 cases with a distinctive growth pattern. Due to the similarity of the histological structures with the architecture of adenofibroma (fibroadenoma) of the ovary we have called this type: nephroblastoma with fibroadenomatous-like structures (NFS). We have studied the clinical and histopathological factors and correlated them with recurrence-free survival and actuarial survival and compared them with the whole series of SIOP Nephroblastomas. This subtype appears to be a distinctive clinicopathological entity with favourable prognosis.

Child↗

Bile reflux to the stomach and gastritis before and after cholecystectomy.

Thirty-four patients with gallstone disease were examined with cholescintigraphy and gastroscopy before and after cholecystectomy. Sixteen patients had a functioning and 23 a non-functioning gallbladder at cholescintigraphy. At scintigraphy 99Tcm-activity was found over the gastric fundus in 28% before and in 22% after cholecystectomy and there was no difference between the groups with and without a functioning gallbladder regarding bile reflux. Before cholecystectomy bile-stained contents in the stomach was significantly more often found among those with a non-functioning gallbladder (87%) than in those with a functioning gallbladder (44%). After cholecystectomy the number of patients with bile-stained contents in the stomach was high in both groups (92% and 82% respectively). No correlation could be found between the two methods to detect bile in the stomach. Before cholecystectomy patients with a functioning gallbladder had inflammatory changes in the antral as well as the fundic mucosa in 31%. Patients with a nonfunctioning gallbladder had inflammatory changes in the antral mucosa in 47% and in the fundic mucosa in 56%. These differences were however not statistically significant. No correlation could be found between bile-stained contents in the stomach and chronic gastritis or scintigraphically detected bile in the stomach and chronic gastritis. The degree and distribution of chronic gastritis was virtually unchanged one year after cholecystectomy.

Adult↗

Spontaneous regression of stage IV neuroblastoma.

Neuroblastoma presenting with wide spread osseous metastases (stage IV) is generally considered incurable. However, rare cases of spontaneous regression and cure are on record. This report deals with such a case in which an infant received steroids as sole treatment for developing skeletal pain. Established metastases to the brain, scalp and skeleton disappeared. Today 4 1/2 years later the patient is free from symptoms and signs of tumour.

Bone Neoplasms↗