Biomedical subjects

E S Andersen

Publications and source records attributed to E S Andersen.

At least 19 recordsLinked to original sources

PubMed1999

Why do Alzheimer patients have difficulty with pronouns? Working memory, semantics, and reference in comprehension and production in Alzheimer's disease.

Three experiments investigated the extent to which semantic and working-memory deficits contribute to Alzheimer patients' impairments in producing and comprehending referring expressions. In Experiment 1, the spontaneous speech of 11 patients with Alzheimer's disease (AD) contained a greater ratio of pronouns to full noun phrases than did the spontaneous speech produced by 9 healthy controls. Experiments 2 and 3 used a cross-modal naming methodology to compare reference comprehension in another group of 10 patients and 10 age-matched controls. In Experiment 2, patients were less sensitive than healthy controls to the grammatical information necessary for processing pronouns. In Experiment 3, patients were better able to remember referent information in short paragraphs when reference was maintained with full noun phrases rather than pronouns, but healthy controls showed the reverse pattern. Performance in all three experiments was linked to working memory performance but not to word finding difficulty. We discuss these findings in terms of a theory of reference processing, the Informational Load Hypothesis, which views referential impairments in AD as the consequence of normal discourse processing in the context of a working memory impairment.

Aged↗

PubMed1998

Sentence comprehension deficits in Alzheimer's disease: a comparison of off-line vs. on-line sentence processing.

Two studies explored whether sentence comprehension impairments in Alzheimer's disease (AD) are due to deficits in syntactic processing or memory. Study 1 used a picture-pointing sentence comprehension task to measure the final outcome of comprehension in an off-line fashion. It showed the comprehension of 30 patients with AD to be impaired, but suggested that the deficits could not be attributed solely to syntactic impairments. Study 2 investigated the effects of memory on sentence comprehension by comparing off-line (grammaticality judgment) with on-line (cross-modal naming) language processing in 11 AD and 9 control subjects. The results revealed impaired performance in the off-line task but normal performance in the on-line task using the same sentences. Performance on the off-line task correlated with independent measures of verbal working memory. These data are used to argue that sentence comprehension impairments are related to verbal working memory deficits in AD.

Aged↗

PubMed1998

Category-specific semantic deficits in focal and widespread brain damage: a computational account.

Category-specific semantic impairments have been explained in terms of preferential damage to different types of features (e.g., perceptual vs. functional). This account is compatible with cases in which the impairments were the result of relatively focal lesions, as in herpes encephalitis. Recently, however, there have been reports of category-specific impairments associated with Alzheimer's disease, in which there is more widespread, patchy damage. We present experiments with a connectionist model that show how "category-specific" impairments can arise in cases of both localized and widespread damage; in this model, types of features are topographically organized, but specific categories are not. These effects mainly depend on differences between categories in the distribution of correlated features. The model's predictions about degree of impairment on natural kinds and artifacts over the course of semantic deterioration are shown to be consistent with existing patient data. The model shows how the probabilistic nature of damage in Alzheimer's disease interacts with the structure of semantic memory to yield different patterns of impairment between patients and categories over time.

Alzheimer Disease↗

PubMed1998

Combination laser conization as treatment of microinvasive carcinoma of the uterine cervix.

During the period June 1985 to August 1992 combination laser conization was considered definite therapy in 41 patients with microinvasive carcinoma of the cervix. Selection criteria for conservative, fertility-saving therapy were: invasion 3 mm or less, no lymphovascular involvement and horizontal spread of 7 mm or less. After treatment patients were followed for 5 to 12 years, mean follow-up 81 months, and mean number of examination was 10. In one cases, adenocarcinoma in situ was diagnosed during follow-up. In all other cases persistent or recurrent disease was not diagnosed during follow-up. By thorough histopathologic evaluation and strict criteria for selection of patients, it was possible to perform conservative treatment with no observed risk of undertreatment. Combination laser conization was a useful treatment modality. A follow-up regimen based on colposcopy and cytology proved sufficient.

Adolescent↗

PubMed1997

Double dissociation of semantic categories in Alzheimer's disease.

Data that demonstrate distinct patterns of semantic impairment in Alzheimer's disease (AD) are presented. Findings suggest that while groups of mild-moderate patients may not display category specific impairments, some individual patients do show selective impairment of either natural kinds or artifacts. We present a model of semantic organization in which category specific impairments arise from damage to distributed features underlying different types of categories. We incorporate the crucial notions of intercorrelations and distinguishing features, allowing us to demonstrate (1) how category specific impairments can result from widespread damage and (2) how selective deficits in AD reflect different points in the progression of impairment. The different patterns of impairment arise from an interaction between the nature of the semantic categories and the progression of damage.

Aged↗

PubMed1995

The reliability of preconization diagnostic evaluation in patients with cervical intraepithelial neoplasia and microinvasive carcinoma.

The accuracy of preconization cytology and histology was evaluated in 536 patients undergoing combination laser conization. Exact agreement between cytology and cone diagnosis was observed in 41.8% of the patients. The lowest agreement, 13.6% was demonstrated in cytologic cervical intraepithelial neoplasia (CIN) I, the highest in cytologic CIN III, 64.3%. Concerning microinvasive disease, the positive predictive value of cytology was only 27.3%; the negative predictive value 94.6%. When cytology showed CIN II or worse, the cone biopsy showed CIN or invasive disease in 92.8%. Exact agreement between preconization histology and the cone biopsy was found in 59.5%. Highest agreement was observed in CIN III lesions, 67.1%, and the lowest agreement in CIN II lesions, 42.7%. When preconization showed CIN II, a higher grade of lesion was found in the cone biopsy in 29.1%. Cone biopsy revealed invasive disease in 38 cases. In 24 cases, invasive disease was not demonstrated prior to conization, corresponding totally to 4.7% of patients not suspected to have invasive disease prior to conization. Regarding invasive disease, the sensitivity of preconization histology was 36.8%, the positive predictive value 58.3%, and the negative predictive value 95.3%. Kappa statistics demonstrated rather low agreement between cone diagnoses and preconization diagnoses. These results confirm the potential risk of overlooking invasive disease by conventional preconization evaluation and demonstrate the need for excisional methods in the management of cervical intraepithelial neoplasia to provide a sufficient specimen for diagnostic purposes. Combined with the therapeutic results, combination laser conization was a reliable diagnostic and therapeutic method in the management of patients with CIN and microinvasive cancer of the cervix.

Conization↗

PubMed1994

Laser conization: the results of treatment of cervical intraepithelial neoplasia.

Combination laser conization was performed for the treatment of cervical intraepithelial neoplasia (CIN) in 473 patients, who were followed for a mean period of 70 months. In 16 cases (3.4%) CIN was demonstrated during follow up, and in 10 cases (2.1%) within the first year after treatment. The grade of CIN in the cone specimen was of no predictive value to recurrence. When excisional margins were involved recurrence was observed in 8.7% of cases, compared to 2.3% when margins were uninvolved. The risk of recurrence was significantly higher in patients with involvement of the endocervical cone margin. The only case of invasive disease during follow-up was observed more than 2 years after conization; cone biopsy was without involved margins. The results clearly demonstrate the method to be effective and justify an expectant management of all patients after conization by this method.

Adult↗

PubMed1993

[Cryotherapy of cervical intraepithelial neoplasia. Long-term prognosis].

Cryotherapy for the treatment of cervical intraepithelial neoplasia (CIN) was performed in 261 patients and the patients were followed for five to 10 years. Cure rate fed significantly with inoeasing grade of CIN and with endocervical involvement. In pure exocervical lesions, 91% and 77.8% of patients with respectively CIN II and CIN III were cured. In patients with endocervical involvement, the grade of lesion was not significant. Life-table calculations showed an over-all risk of persisting CIN during the first year of observation of 8.8%, and a risk of 0.8% during years 6 to 10. Patients age was of no significance. Endocervical involvement should be a contraindication to cryotherapy, and a careful follow-up schedule is mandatory. A careful colposcopic examination especially concerning the lesion area might help to increase the cure rate in patients with exocervical CIN III lesions.

Adult↗

PubMed1992

Cryosurgery for cervical intraepithelial neoplasia: 10-year follow-up.

Cryotherapy was performed for the treatment of CIN in 261 patients, who were followed for 5 to 10 years after treatment. The overall cure rate was 83.5%. Increasing grade of CIN and enocervical involvement significantly reduced the cure rate. In pure exocervical lesions, a 91% cure rate in patients with CIN II lesions and a 77.8% cure rate in CIN III patients were observed. In patients with endocervical involvement, the influence of grade of lesion was of no significance. Life-table calculations demonstrated an overall risk of persisting CIN during the first year of observation of 8.8%, compared to a risk of 0.8% during Years 6 to 10. Log-rank test showed a risk of recurrence in patients with CIN III lesions significantly higher than that in patients with CIN II lesions and also a higher risk in patients with endocervical involvement. There was no significant influence of age on cure rates. Endocervical involvement should be considered a contraindication to cryotherapy, and a careful follow-up schedule is mandatory if cryotherapy is to keep its position as a recommendable therapy in patients with CIN.

Adolescent↗

PubMed1991

[Acute fatty liver in pregnancy. Report of 2 cases].

We present the case histories of two patients showing the clinical and biochemical manifestations of acute fatty liver of pregnancy associated with disseminated intravascular coagulation. Both patients were young primiparae. One was admitted in the 39th week of pregnancy, the other immediately after spontaneous delivery at the 36th week. Both patients recovered. Laboratory investigations, treatment and differential diagnosis are discussed.

Acute Disease↗

PubMed1990

Lymphocyte subpopulations in patients with cervical intraepithelial neoplasia.

Quantitation of T-lymphocyte subsets and natural killer cells in peripheral blood of 16 patients with cervical intraepithelial neoplasia and 15 controls with normal cervical cytology was performed using specific monoclonal antibodies and flow cytometry. No differences were observed in T-helper lymphocytes, T-suppressor/cytotoxic lymphocytes, Th/Ts cell ratios, or natural killer cells. The results indicate that disturbances of the cell-mediated immune response, observed in patients with invasive cancer of the cervix, are secondary to the disease and of no significance in the initiation of cervical cancer.

Female↗

PubMed1990

Stage II endometrial carcinoma: prognostic factors and the results of treatment.

Results of treatment and potential prognostic factors in 54 patients with clinical stage II endometrial carcinoma were analyzed. During the period analyzed, three different treatment techniques were used. The highest cure rate (70.6%) was observed in patients treated with simple hysterectomy and bilateral salpingo-oophorectomy followed by external pelvic irradiation and vaginal irradiation. Radiation therapy alone cured 50%. High tumor grade, deep myometrial invasion (greater than 50%), and invasion of the cervical stroma reduced the cure rates, but the only factor significantly reducing cure rate was patient age. Patients 59 years of age or older fared significantly more poorly than younger patients. Significant complications was observed in 9.3% of patients. Prospective studies of standardized treatment techniques in patients with stage II endometrial carcinoma are necessary to achieve better results and acquire more information.

Age Factors↗

PubMed1990

Laser conization: follow-up in patients with cervical intraepithelial neoplasia in the cone margin.

Combination laser conization was performed in 469 patients for the treatment of cervical intraepithelial neoplasia (CIN). In 58 cases (12.4%), CIN was located in the margins of the cone. Fifty-one patients with involvement of the margins were evaluated by cytologic examination, using the Ayre spatula and the Cytobrush, and by cervical biopsy and endocervical curettage (ECC). In six cases, the histologic evaluation was positive, and in three of these cases, the cytology was positive too. Hysterectomy was performed in five cases, but in only one case was a significant lesion demonstrated in the uterus. These results justify expectant, conservative management of patients treated with combination laser conization. Follow-up based on colposcopy and cytology seems sufficient.

Aged↗

PubMed1990

Naming consistency in Alzheimer's disease.

Although lexical semantic deficits are postulated to play a prominent role in the anomia of Alzheimer's disease, it is unclear whether the primary disturbance is one of lexical access or one of lexical semantic loss. Response consistency on a naming task is one means of evaluating the underlying source of naming impairment. Access dysfunction usually implies variable word-finding difficulty, while a theory of lexical loss predicts that many word names would be consistently unavailable. Nineteen Alzheimer's disease patients were administered a visual confrontation naming task (the Boston Naming Test) on two occasions 6 months apart. Eighty percent of errors occurred consistently at both times; only 20% of errors occurred on only one occasion. Response consistency occurred significantly more often than expected under the assumption of no response consistency. Findings support the hypothesis that anomia in Alzheimer's disease is in part due to a loss of lexical semantic information.

Aged↗

PubMed1989

Adenocarcinoma in situ of the uterine cervix: a clinico-pathologic study of 36 cases.

Thirty-six consecutive cases of adenocarcinoma in situ (ACIS) of the uterine cervix, including 8 cases of early stromal invasion to a depth not exceeding 5 mm, were revised with specific reference to detection rate and treatment. The final histologic diagnoses were based on 31 cone biopsies, 1 hysterectomy specimen, and 4 endocervical curettings/punch biopsies. ACIS was localized in the transformation zone of all cone biopsies/hysterectomy specimen, with a mostly superficial spread in the glands. The mucosal surface was involved in 34 cases. In 29 cone biopsies, ACIS was found unifocal. ACIS was associated with lesions of the squamous epithelium, mostly severe, in 25 cases. On review, all cervical smears were positive and ACIS could be specifically diagnosed in 24 cases. Pretreatment biopsies showed ACIS in 28 cases. Detection of early invasive adenocarcinoma required cone biopsy in most cases. Colposcopy showed no characteristics of ACIS. The detection of ACIS depended on the extension of the lesion. Conization with uninvolved margins was an adequate treatment. Residual ACIS was only found in cases with coexisting early invasive adenocarcinoma. No recurrences or frankly invasive adenocarcinomas have been observed during the observation period.

Adenocarcinoma↗

PubMed1989

Primary carcinoma of the vagina: a study of 29 cases.

Twenty-nine cases of primary carcinoma of the vagina were reviewed. Vaginal carcinoma produced symptoms in 26 cases and postmenopausal bleeding was the most frequently observed symptom. Squamous carcinoma was the dominating histologic type (83%). Twelve patients had previously been treated for invasive or preinvasive cervical disease. Six patients had previously received pelvic irradiation. The median time from cervical carcinoma to vaginal carcinoma was 20 years, and from pelvic irradiation to vaginal carcinoma, 25 years. Two factors significantly influenced the results of treatment: the mode of delivery of radiation therapy and the total tumor dose. Clinical staging did not significantly influence the results of treatment although stage I patients did better than stage II-IV patients. Combination of external pelvic irradiation and brachytherapy, with a total tumor dose of 7000 R or more, was necessary to prevent local recurrence.

Aged↗

PubMed1989

Autoimmune associated recurrent abortions.

A possible relationship between recurrent spontaneous abortions and autoimmune abnormalities was studied. Eight serological autoimmune or autoimmune-correlated parameters were investigated in 91 women with unexplained recurrent abortions (greater than or equal to 3 consecutive, spontaneous abortions) and 89 fertile control women. Five parameters were seen significantly more frequently in 19 women with at least one second trimester miscarriage which had been associated with severe intrauterine growth regardation (IUGR), than in controls. Seventeen of these 19 patients (89%) had at least one positive autoimmune parameter, compared to 15 of 72 patients (21%) with no second trimester abortions with IUGR (P less than 0.0001) and 14 (16%) of the controls (P less than 0.0001). No single autoantibody characterized patients who exhibited a significant accumulation of autoimmune parameters. These findings may suggest that women with recurrent abortions, in whom autoimmunity is thought to play a role, cannot be identified merely by one laboratory assay, such as that for cardiolipin antibodies, but must be defined by positivity of several criteria. Using our own test panel, preliminary clinical and serological criteria have been set up for the definition of an autoimmune-associated recurrent abortion condition. Twenty-three per cent of the patients in our material fulfilled these criteria, and seven out of nine of these women (78%) have to date been treated successfully with heparin/aspirin during pregnancy.

Abortion, Habitual↗

PubMed1988

The results of cryosurgery for cervical intraepithelial neoplasia.

During 4 years, 1980-1984, 197 patients were treated for CIN II and CIN III by cryosurgery. Included were 62 patients with endocervical involvement (positive ECC). The cure rates of a single cryosurgical treatment were lowered significantly by increasing grade of CIN and by endocervical involvement. The factors influencing the cure rates of cryosurgery are discussed in relation to the results obtained in the present study. The most important step in treatment of patients with CIN by conservative methods seems to be the pretreatment evaluation and not the method of treatment. Despite the fact that we achieved good results in treating patients with CIN II and endocervical involvement (cure rate: 88.9%) it is our opinion that endocervical involvement should contraindicate conservative procedures. The potential risk of overlooking invasive disease among these patients should always be kept in mind. Careful pretreatment evaluation in patients undergoing cryosurgery is mandatory, or else this excellent method would be brought into discredit.

Adult↗