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Biomedical subjects

E Campo

Publications and source records attributed to E Campo.

At least 199 records · Page 11Linked to original sources

Lectin binding patterns in normal and neoplastic colonic mucosa. A study of Dolichos biflorus agglutinin, peanut agglutinin, and wheat germ agglutinin.

The cellular distribution of the carbohydrates labeled by Dolichos bifluorus agglutinin (DBA), peanut agglutinin (PNA), and wheat germ agglutinin (WGA) were studied in 21 normal colonic mucosae, 17 transitional mucosae, 9 nonneoplastic polyps (NNP), 27 adenomas, and 25 colorectal carcinomas. In normal mucosa DBA bound selectively to mucin of the goblet cells in the upper colonic crypt and to apical cytoplasm of the superficial columnar cells with a strong linear pattern. PNA binding was present only in the supranuclear portion (Golgi area) of the cells. WGA showed a strong reactivity in the goblet-cell mucin and in the supranuclear portion and apical cytoplasm of columnar cells. Transitional mucosa (TM) showed a decrease in DBA binding to goblet-cell mucin, which was replaced by an increase in PNA reactivity. The DBA linear pattern in the apical cytoplasm of columnar cells was unmodified, however. Changes similar to those of TM were observed in juvenile and Peutz-Jeghers polyps. Adenomas showed a progressive loss of DBA reactivity and an increase in PNA positivity related to the degree of dysplasia. This change was more evident in the linear pattern of apical cytoplasm. Only 32% of the carcinomas reacted with DBA and those were mucinous and well-differentiated adenocarcinomas. WGA was positive in all carcinomas with a different pattern than in normal mucosa. These findings suggest that the different lectin-binding patterns in normal and neoplastic colonic mucosa are related to the degree of cellular differentiation. In the process of malignant transformation the carbohydrate distribution undergoes progressive changes through the adenoma-carcinoma sequence. These changes are related to the degree of dysplasia in adenomas and to the degree of differentiation in carcinomas.

Adenoma↗

Renal hemangioma and renal artery aneurysm in the Klippel-Trenaunay syndrome.

We describe a young woman with the Klippel-Trenaunay-Weber syndrome in whom gross unilateral hematuria developed. A renal arteriogram showed a left renal artery aneurysm. Artery reconstruction was impossible and left nephrectomy was performed. Pathological examination showed multiple renal pelvic hemangiomas as the cause of the gross hematuria.

Adult↗

Epithelioid hemangioendothelioma of the liver: report of two cases.

This report describes two patients with hepatic epithelioid hemangioendothelioma: a 33-year-old woman and a 28-year-old man. The first case presented with a palpable abdominal mass and has survived without treatment for 6 years since diagnosis, with ascites but a good general condition. The other patient presented with abdominal pain and cholestasis. He had a rapid course and death occurred 6 months after the onset of symptoms. Histologically the tumors consisted of a proliferation of neoplastic cells with an angiogenic tendency embedded in a myxohyaline stroma. Positivity for the factor VIII-related antigen, for UEA-I and for vimentin and negativity for keratin of the neoplastic cells in the immunohistochemical investigation permitted identification of their endothelial origin. In both cases, the initial diagnosis was erroneous.

Adult↗

Intestinal lymphoma in a patient with chronic lymphocytic leukemia of atypical phenotype: Richter's syndrome of unusual presentation.

A patient who developed an intestinal large-cell pleomorphic lymphoma during the course of untreated chronic lymphocytic leukemia (CLL) with an atypical phenotype (SIgG kappa) is reported. This is an unusual presentation of Richter's syndrome since RS with primary gastrointestinal involvement has only been described in two patients. In our case, immunological studies disclosed the same immunoglobulin (IgG kappa) in the large-cell pleomorphic lymphoma and on the surface of CLL cells, suggesting that both had arisen from the same clonal proliferation.

Aged↗

Human chorionic gonadotropin in colorectal carcinoma. An immunohistochemical study.

To assess the biological significance of human chorionic gonadotropin (HCG) detection in large bowel carcinomas, we have studied immunohistochemically 50 colorectal carcinomas, 20 adenomas, 8 ulcerative colitis, and 10 normal colonic mucosae. The HCG-immunoreactive cells were found in 26 carcinomas (52%). Positivity was not detected in any normal mucosa or benign lesions. Cells containing HCG predominated in mucinous (80%) and poorly differentiated carcinomas (92%). No trophoblastic differentiation could be demonstrated in any tumor. Human chorionic gonadotropin was detected more frequently in carcinomas invading the entire bowel wall (67%) than in those confined to the submucosa or muscularis propria (30%). Fifteen of 19 cases (79%) with lymph node and/or hepatic metastases had HCG in the primary tumor, whereas only 9 of 23 cases (32%) without metastases showed HCG immunoreactivity. The eight patients with hepatic metastases had HCG in the primary tumor. Thus, the immunohistochemical detection of HCG in colorectal carcinomas may be a biological marker of prognostic significance.

Carcinoma↗

Improved sex-specific criteria of left ventricular hypertrophy for clinical and computer interpretation of electrocardiograms: validation with autopsy findings.

In a previous study of 543 patients we developed, using echocardiographic left ventricular mass as the reference standard, two new sets of criteria that improve the electrocardiographic diagnosis of left ventricular hypertrophy (LVH). One set of criteria, which is suitable for routine clinical use, detects LVH when the sum of voltage in RaVL + SV3 (Cornell voltage) exceeds 2.8 mV in men and 2.0 mV in women. The second set of criteria, suitable for use in interpretation of the computerized electrocardiogram, uses logistic regression models based on electrocardiographic and demographic variables with independent predictive value for LVH, with separate equations for patients in sinus rhythm and atrial fibrillation. To test these criteria prospectively with use of a different reference standard, antemortem electrocardiograms were compared with left ventricular muscle mass measured at autopsy in 135 patients. Sensitivity of standard Sokolow-Lyon voltage (SLV) criteria (SV1 + RV5 or RV6 greater than 3.5 mV) for LVH was only 22%, but specificity was 100%. The Cornell voltage criteria improved sensitivity to 42%, while maintaining high specificity at 96%. Higher sensitivity (62%) was achieved by use of the new regression criteria, with a specificity of 92%. Overall test accuracy was 60% for SLV criteria, 68% for the Cornell voltage criteria, and 77% for the new regression criteria (p less than .005 vs SLV). We conclude that the Cornell voltage criteria improve the sensitivity of the electrocardiogram for detection of LVH and are easily applicable in clinical practice.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiomegaly↗

Cost-effectiveness of echocardiography and electrocardiography for detection of left ventricular hypertrophy in patients with systemic hypertension.

Although echocardiography is more accurate than electrocardiography for detection of left ventricular hypertrophy, it is also more expensive, making it uncertain whether echocardiography is cost-effective for detection of this abnormality in hypertensive patients. Accordingly, the sensitivity of M-mode echocardiographic and electrocardiographic criteria for left ventricular hypertrophy was determined in necropsied patients with anatomic hypertrophy of mild (n = 26), moderate (n = 21) or severe (n = 46) degree, and the prevalence of each degree of hypertrophy was determined in 561 hypertensive adults drawn from clinical and employed population samples. The sensitivity of echocardiographic left ventricular mass index criteria was 57% in necropsied patients with mild hypertrophy and 98% in patients with moderate or severe hypertrophy. All electrocardiographic criteria exhibited lower sensitivity: 15 to 42% for mild, 10 to 38% for moderate, and 30 to 57% for severe hypertrophy. Cost estimates from three sources were $160 for M-mode echocardiography and $48 to $64 for 12-lead electrocardiography. In populations with a 12 to 40% prevalence of hypertrophy, echocardiography was calculated to cost less than electrocardiography per instance of hypertrophy detected ($390-$1013 vs $800-$1829), yielded better separation in predicted incidence of morbid events between hypertensive patients with or without hypertrophy (3.4-4.7 vs 1.5-2.1 per 100 patient-years as opposed to 3.0-4.4 vs 1.9-2.9 per 100 patient-years), and required smaller case and control samples for hypothetical research studies (n = 254-309 vs 397-3478).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiomegaly↗

Echocardiographic detection of pressure-overload left ventricular hypertrophy: effect of criteria and patient population.

To evaluate the performance of M-mode echocardiography for detection of pressure-overload left ventricular hypertrophy (LVH), we tested the sensitivity of previously defined sex-specific upper limits of normal echo LV measurements in 31 patients with necropsy-proven pressure-overload LVH and determined the prevalence of LVH detected by each echo criterion in 316 employed patients with uncomplicated hypertension, 100 patients with hypertension evaluated in a referral center, and 38 hospital patients with moderate to severe (WHO class 2) hypertension. Echo measurements were LV mass (LVM), LVM index (LVMI), cross-sectional area (CSA), septal and posterior wall thickness (IVST and PWT), LV internal dimension (LVID), and relative wall thickness (RWT). Prevalences of echo LVH were as follows. (Table: see text). Thus, echo criteria based on LVM are more sensitive than other measurements for detection of necropsy-proven pressure-overload LVH and reveal the highest prevalence of LVH in clinical hypertension populations, and the prevalence of LVH in hypertension is highly dependent on the population studied.

Adult↗

Tuberculosis-associated hemophagocytic syndrome. A systemic process.

Virus-associated hemophagocytic syndrome has been recently identified as a benign, reactive histiocytic proliferation distinct from Rappaport's malignant hystiocytosis. Other etiologic agents, including different bacteria, have also been identified. Three autopsy cases of hemophagocytic syndrome associated to acute tuberculous sepsis are presented. Benign histiocytic proliferation with striking hemophagocytosis was present in a disseminated, multisystemic pattern in all three cases. A relationship between systemic histiocytic proliferation and an anergic status in these patients is suggested.

Aged↗

Performance of primary and derived M-mode echocardiographic measurements for detection of left ventricular hypertrophy in necropsied subjects and in patients with systemic hypertension, mitral regurgitation and dilated cardiomyopathy.

To determine which M-mode echocardiographic (echo) measurement best detects left ventricular (LV) hypertrophy, the sensitivity and specificity of upper normal limits of echo LV anatomic measurements (previously shown to have 97% specificity in living normal subjects) were tested in 60 necropsied patients with anatomic hypertrophy and in 28 necropsied patients with normal left ventricles. The prevalence of hypertrophy by each echo criterion was determined in 165 living patients with systemic hypertension, mitral regurgitation or dilated cardiomyopathy. The best separation between patients with normal vs increased necropsy LV mass was obtained using sex-specific echo LV mass index criteria (overall accuracy = 73 of 88 patients, 83%). Lower overall accuracies for separation of patients with and without hypertrophy were observed for echo cross-sectional area (59 of 88 patients, 67%; p less than 0.05 vs LV mass index) and indexes of LV wall thickness (39 to 51%, p less than 0.001). Among 113 living patients with moderate or severe hypertension, mitral regurgitation or dilated cardiomyopathy, LV mass index was increased in 73%, cross-sectional area index in 58% (p less than 0.02 vs LV mass index), and posterior wall thickness, septal thickness and relative wall thickness in only 11 to 32% (all p less than 0.001 vs LV mass index). Thus, an M-mode echo LV mass index of more than 134 g/m2 in men and more than 110 g/m2 in women detects concentric and eccentric LV hypertrophy accurately by comparison with necropsy and clinical reference standards; cross-sectional area is slightly less useful; and other M-mode echo criteria of LV hypertrophy perform too poorly to be clinically applicable.

Adult↗

Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings.

To determine the accuracy of echocardiographic left ventricular (LV) dimension and mass measurements for detection and quantification of LV hypertrophy, results of blindly read antemortem echocardiograms were compared with LV mass measurements made at necropsy in 55 patients. LV mass was calculated using M-mode LV measurements by Penn and American Society of Echocardiography (ASE) conventions and cube function and volume correction formulas in 52 patients. Penn-cube LV mass correlated closely with necropsy LV mass (r = 0.92, p less than 0.001) and overestimated it by only 6%; sensitivity in 18 patients with LV hypertrophy (necropsy LV mass more than 215 g) was 100% (18 of 18 patients) and specificity was 86% (29 of 34 patients). ASE-cube LV mass correlated similarly to necropsy LV mass (r = 0.90, p less than 0.001), but systematically overestimated it (by a mean of 25%); the overestimation could be corrected by the equation: LV mass = 0.80 (ASE-cube LV mass) + 0.6 g. Use of ASE measurements in the volume correction formula systematically underestimated necropsy LV mass (by a mean of 30%). In a subset of 9 patients, 3 of whom had technically inadequate M-mode echocardiograms, 2-dimensional echocardiographic (echo) LV mass by 2 methods was also significantly related to necropsy LV mass (r = 0.68, p less than 0.05 and r = 0.82, p less than 0.01). Among other indexes of LV anatomy, only measurement of myocardial cross-sectional area was acceptably accurate for quantitation of LV mass (r = 0.80, p less than 0.001) or diagnosis of LV hypertrophy (sensitivity = 72%, specificity = 94%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗