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Biomedical subjects

E L Wiley

Publications and source records attributed to E L Wiley.

34 records · Page 2Linked to original sources

Monoclonal antibody to Pneumocystis carinii. Comparison with silver stain in bronchial lavage specimens.

Monoclonal 3F6 anti-Pneumocystis carinii antibody (MAB-3F6) was used to stain cell blocks from 164 bronchial lavage specimens from patients with the acquired immune deficiency syndrome (AIDS) and AIDS-related complex and compared with slides stained with Grocott's modification of the Gomori methenamine silver stain. Pneumocystis organisms were present in 83 of 164 cases using MAB-3F6 stain, whereas Grocott's modified silver stain demonstrated Pneumocystis organisms in 48. MAB-3F6 demonstrated Pneumocystis organisms in 38 cases with negative silver stains, whereas silver stain identified Pneumocystis organisms in only three MAB-3F6-negative cases. Of 70 patients with clinical Pneumocystis pneumonia at the time of the specimen was obtained, 59 had MAB-3F6-positive specimens, whereas 39 had organisms detected using Grocott's modified silver stain. Of 37 patients without clinically apparent Pneumocystis pneumonia any time in their course, 4 had abundant organisms and 33 had negative stains with MAB-3F6. MAB-3F6 detected Pneumocystis organisms in 22 of 31 cases of Pneumocystis pneumonia that had no organisms identified using Grocott's silver stain (X2 = 5.76, P = 0.016). MAB-3F6 immunochemical staining is a more sensitive method than Grocott's modified silver stain to detect Pneumocystis organisms.

Antibodies, Monoclonal↗

Adrenal carcinoma presenting as a lesion resembling cutaneous angiosarcoma.

A case is reported of adrenal carcinoma presenting as an angiosarcoma-like metastasis in the scalp. Adrenal carcinoma is a rare tumor, and it metastasizes to skin rarely. The authors discuss the features of this tumor that led to a diagnosis of angiosarcoma and the means by which such a metastasis may be distinguished from vascular tumors.

Adrenal Cortex Neoplasms↗

Reactivity of fungal organisms in tissue sections using anti-mycobacteria antibodies.

Sixty-four cases of deep fungal infections diagnosed using PAS or silver stains and 18 control cases of sarcoidosis, M. tuberculosis and M. leprae infection were stained using commercial polyclonal antibody raised against M. paratuberculosis (MP), M. Duvalii (MD), and Bacillus Calmette-Guerin (BCG). Nine of 13 cases of sporotrichosis stained positively using anti-MP antibody only; 13 of 14 cases of histoplasmosis stained with anti-BCG, anti-MD, and anti-MP; seven cases of cryptococcosis had only focal staining of rare individual organisms within masses of negative organisms; seven of eight cases of coccidioidomycosis stained predominantly with anti-BCG and anti-MP; eight cases of aspergillus had focal (1 to 5% of organisms) staining of hyphae with anti-BCG and anti-MD; and four of 12 cases of Candida infection showed focal nonspecific staining with both antibodies and nonimmune serum. Control cases of sarcoidosis exhibited no staining with any of the three antibodies, whereas cases of mycobacterial infection showed staining of bacilli and intracellular debris with all three antibodies.

Antibodies, Bacterial↗

Cutaneous phaeohyphomycosis caused by a rare fungal pathogen, Hormonema dematioides: successful treatment with ketoconazole.

Annular, fungating, ulcerated lesions developed on both hands of a 64-year-old immunocompetent man 2 months after he was cut with barbed wire. A dematiaceous mold, Hormonema dematioides, heretofore not definitively associated with human disease, was grown from two separate tissue specimens during a period of 9 days. Histopathologic examination demonstrated rare small, periodic acid-Schiff-positive, hyaline, yeastlike organisms in tissue. Twelve weeks of empiric therapy with ketoconazole, 400 mg/day, was curative.

Dermatomycoses↗

Bilateral synchronous testis tumors of different histology in a patient with the acquired immunodeficiency syndrome related complex.

The incidence of bilateral testis tumors is approximately 1.5%. Of these cases the majority have the same histological status and few occur synchronously. Recently, an increased number of nonseminomatous germ cell tumors have been reported in the acquired immunodeficiency syndrome population. We describe a rare case of bilateral synchronous testis tumors of different histological status (seminoma and embryonal cell carcinoma) in a patient with the acquired immunodeficiency syndrome related complex. The patient was managed with bilateral orchiectomy and retroperitoneal lymph node dissection. Pathological stage was B1. The treatment was complicated by the fact that the patient is on azidothymidine, a drug that causes bone marrow suppression as a side effect. Because of persistent neutropenia no chemotherapy was given. The patient had no evidence of disease almost 1 year after retroperitoneal lymph node dissection.

AIDS-Related Complex↗

Immunohistochemical demonstration of H antigen, peanut agglutinin receptor, and Saphora japonica receptor expression in infant thymuses and thymic neoplasias.

Ten infant thymuses and 13 primary thymic tumors obtained from archived paraffin-embedded tissue were examined for the presence of tissue blood group O antigen (H), peanut agglutinin receptor antigen (PNA-r), Saphora japonica agglutinin receptor antigen (SJA-r), carcinoembryonic antigen (CEA), cytokeratin (CK), and epithelial membrane antigen (EMA). In the thymuses studied, Hassall's corpuscles contained abundant immunoreactive CK, PNA-r, and H antigens, whereas CEA, SJA-r, and EMA were present focally in Hassall's corpuscles. Immunoreactive CK, PNA-r, and CEA were demonstrated focally in the subcapsular region, cortical nurse cells, and subcapsular-perivascular monocytic cells, respectively. PNA-r was present in all 12 epithelial type tumors, including all eight thymomas. CEA was present in nine tumors, including six thymomas. Six thymomas contained H antigen and SJA-r; five continued CK and EMA. SJA-r and EMA were also present in one carcinoid tumor of thymic origin. In epithelial thymomas, the antigens stained nests of epithelial cells resembling the pattern of staining in Hassall's corpuscles. Membrane staining of spindle cells of both spindle cell and epithelial thymomas was less intense than staining of epithelial type cells.

ABO Blood-Group System↗

Polyclonal antibodies raised against Bacillus Calmette-Guerin, Mycobacterium duvalii, and Mycobacterium paratuberculosis used to detect mycobacteria in tissue with the use of immunohistochemical techniques.

Commercially available polyclonal antibodies raised against strains of mycobacteria were used to detect organisms in tissue sections from 34 cases of tuberculosis, leprosy, and atypical mycobacteria. Thirty-two cases of fungal infections, granulomatous inflammation, and sarcoidosis were used as negative controls. Sections stained with the use of antibodies raised against Bacillus Calmette-Guerin (BCG), Mycobacterium duvalii (MD), and Mycobacterium paratuberculosis (MP) were compared with Kinyoun and Fite-stained tissue sections. In caseating granulomata, clumps of mycobacterial debris, cells, and cell fragments stained. In histiocytic granulomata of mycobacterial infections, histiocyte cytoplasm contained both organisms and debris. The three antibodies showed cross-reactivity against the four groups of mycobacteria tested. Mycobacterial staining using immunoperoxidase was apparent in most cases at low-power (scanning) magnification. Thirty-two of 34 cases of mycobacterial infection, including all 24 Kinyoun-Fite-positive cases, were positive for immunoreactive organisms and debris using anti-MD, anti-BCG, and/or anti-MP. Eight of ten cases of culture-proven mycobacterial infection, in which Kinyoun and Fite stains were negative, had immunoreactive organisms or antigen with anti-BCG, MD, or MP. The antibodies also stained organisms in five cases of sporotrichosis in which the organisms were identified as yeast forms in tissue sections.

Antibodies, Bacterial↗

H, peanut lectin receptor, and carcinoembryonic antigen distribution in keratoacanthomas, squamous dysplasias, and carcinomas of skin.

The distribution of blood group antigen H(O), peanut lectin receptor (PNL-R) (a precursor to the MN blood group antigens), and carcinoembryonic antigen (CEA) was examined in 15 squamous cell carcinomas, 10 keratoacanthomas, 17 squamous dysplasias, and 5 normal controls using immunoperoxidase techniques. All controls and 8 carcinomas, 10 keratoacanthomas, 14 dysplasias expressed H antigen. All controls and 9 carcinomas, 10 keratoacanthomas, 16 dysplasias expressed PNL-R antigen. CEA was present in 15 carcinomas, in trace amounts in 3 keratoacanthomas, in 6 dysplasias, and in 0 controls. The staining for H antigen and PNL-R in the carcinomas and dysplasias was disorganized, patchy, and less than that of normal epithelium, while staining in keratoacanthomas was uniform, with normal to increased intensity as compared to controls in 9 cases. CEA showed weak focal staining in 5 carcinomas, 8 dysplasias and 3 keratoacanthomas, and more intense and extensive cytoplasmic and membrane staining in 10 carcinomas and 5 dysplasias, and no cellular staining in 4 dysplasias and 7 keratoacanthomas. CEA was present in greatest amounts in the well-differentiated carcinomas and focal in the less-differentiated tumors. The well-differentiated carcinomas had a greater percentage of cells staining for H antigen and PNL-R. The pattern of staining for H, PNL-R, and CEA appears to distinguish keratoacanthomas from carcinomas and squamous dysplasias, and may be a useful adjunct to diagnosis.

ABO Blood-Group System↗

Malignant cell detection and cervical cancer screening.

A study was conducted to determine the isolated, single-cell detection characteristics of human observers as this information relates to cervical cancer screening. Two interrelated experiments were performed. First, the receiver operating characteristic (ROC) was obtained for slide screening. In this experiment, approximately 1,200 slides were examined. Second, ROCs were obtained for human observer cell discrimination, using a rating method. An individual's curves were computed, assuming a multiple decision criterion. In this experiment, 6,375 cells from the same specimens used in the slide screening experiment were studied. In both experiments, results were analyzed using a Gaussian signal-detection model. This approach provided analytical detection criteria and rigorous definition of ROCs. These experiments addressed the problem of where the screening information lies: (1) in individual cells alone or (2) with additional components in global or other a priori information. We quantified the detection requirements of (1) the Papanicolaou smear screening process, Az = 0.99, and (2) the capabilities of trained cytotechnologists on isolated single cells, Az = 0.87. System modeling using intermediate cell detection instead of "rare event" detection resulted in a reduction of the predicted number of cells required for analysis from approximately 60,000 to 750.

Female↗

Immunoperoxidase detection of carcinoembryonic antigen and blood group substances in papillary transitional cell carcinoma of the bladder.

Immunoperoxidase localization of A and B blood group substances and carcinoembryonic antigen in papillary transitional cell carcinoma of the bladder demonstrated blood group substances in 22 of 48 carcinomas and trace amounts of carcinoembryonic antigen in 26. All 22 cases of transitional cell carcinoma positive for blood group substances were stage O (noninvasive) and 21 were grade I or II (well differentiated). Of 26 tumors negative for blood group substances 14 were grade III (poorly differentiated). Of 17 patients who had tumors positive for blood group substances at any time no positive tumor was followed by invasive carcinoma. In contrast, of 17 patients who had tumors negative for blood group substances 15 either had invasive carcinoma at the time of diagnosis or later. Carcinoembryonic antigen positivity did not correlate with pathologic stage, histologic grade or clinical course.

ABO Blood-Group System↗

Distribution of blood group substances in normal human colon. Use of the unlabeled antibody (PAP) immunoperoxidase technic to identify A and B blood group substances.

A modification of the unlabeled antibody immunoperoxidase technic, using human antisera to identify blood group substances A and B in normal human colon is described. Overall, staining for the blood group substances is strongest in the cecum and proximal colon; there is a progressive reduction of staining for the blood group substances in the distal colon with almost complete loss in the recto-sigmoid area. The blood group substances are present in epithelial cells and in epithelial mucin, the most intense positive staining often being located in the supranuclear, Golgi region of the cells.

ABO Blood-Group System↗

Distribution of carcinoembryonic antigens and blood group substances in adenocarcinoma of the colon.

Immunoperoxidase techniques were used to localize carcinoembryonic antigens (CEA) and human blood group substances (BGS) in 41 adenocarcinomas of the colon and 15 metastases or recurrences of these tumors. Ten primary tumors (24 per cent) were strongly positive for both antigens, 12 (29 per cent) were positive for BGS only, 11 (27 per cent) were positive for CEA only, and eight (20 per cent) contained only microscopic amounts of either. With few exceptions, individual tumor cells contained either CEA, BGS, or neither, but not both. Cancers of the left colon which were positive for BGS were associated with a lower frequency of metastases than were those without BGS (p less than 0.01); tumors lacking both CEA and BGS metastasized more frequently than those tumors containing either or both antigens (p less than 0.01). In tumors of the right colon, there was no significant correlation between antigen content and frequency of metastases. In three cases, the development of recurrent or metastatic tumor was associated with a loss of BGS positivity. The data suggest that immunohistochemical studies of BGS and CEA may be of value in estimating the clinical behavior of certain colon carcinomas.

Adenocarcinoma↗

Expression of epithelial mucins Muc1, Muc2, and Muc3 in ductal carcinoma in situ of the breast.

Epithelial mucins are glycoproteins secreted by epithelial cells and their carcinomas. At least nine mucin genes have been identified, and their products (MUC1-MUC9) are expressed in various epithelia. MUC1 is a mucin expressed in breast epithelial cells, whereas MUC2 and MUC3 are primarily intestinal mucins. Although MUC1 and MUC2 expression has been documented in invasive ductal carcinoma of the breast, mucin expression in pure ductal carcinoma in situ (DCIS) has not been investigated. Sixty-one of 105 cases of DCIS without coexisting infiltrating carcinoma diagnosed during a 30-month period were selected as having sufficient tissue for study. Paraffin-embedded tissue sections were stained using immunohistochemical techniques with mouse monoclonal anti-MUC1, anti-MUC2, and rabbit-specific polyclonal anti-MUC3 antibodies. Immunoreactive epitopes of MUC1, MUC2, and MUC3 were expressed in DCIS in 61, 19, and 16 of 61 cases, respectively. MUC2 and MUC3 staining intensity in DCIS was markedly less than that observed for MUC1. Luminal and/or cytoplasmic patterns of staining were observed for MUC1. MUC2 and MUC3 showed only cytoplasmic staining. Cytoplasmic-only staining of MUC1 was associated with a higher grade of DCIS. Any MUC2 staining was also associated with a higher grade of DCIS. Coexpression of MUC2 and MUC3 was present in only 6 of 61 cases, and MUC3 staining was unrelated to the grade of DCIS. Cytoplasmic expression of MUC1 and MUC2 appears to be associated with a higher grade of DCIS. MUC3 expression appears to be independent of grade and expression of MUC1 and MUC2. The relationship of mucin expression and grade warrants further study.

Biomarkers, Tumor↗

Metastatic breast carcinoma in pleural fluid. Correlation of morphology with estrogen receptor activity and morphology of the primary carcinoma.

Sixty-nine breast carcinoma patients with malignant pleural effusions were studied (1) to compare the morphology of the carcinoma cells in the effusions with the morphology in the primary carcinomas and (2) to correlate the morphologic findings with the estrogen receptor (ER) activity of the carcinomas and with the survival of the patients. Twenty-six patients had effusions containing carcinoma cells forming hollow spheres (morula-positive cases) while 43 had pleomorphic tissue fragments or tumor giant cells or both (morula-negative cases). Twenty-nine of 44 primary carcinomas with hormone receptor determination were ER positive. The median survival of patients with ER-positive tumors was 77 months while the median survival of ER-negative patients was 46 months. Thirteen patients with morula-positive effusions and 16 patients with morula-negative effusions had ER-positive primary carcinomas (P less than .001). Thirteen of 17 patients with morula-positive effusions and 4 of 23 patients with morula-negative effusions had duct or tubule formation in their primary carcinomas (P less than .001). The median survival of 26 patients with morula-positive effusions was 92 months, compared with 49 months for 43 patients with morula-negative effusions (P less than .001). Patients with ER-positive/morula-negative carcinomas had a significantly better survival rate than did patients with ER-negative/morula-negative carcinomas, but a significantly poorer survival rate than did patients with morula-positive carcinomas.

Breast Neoplasms↗