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Biomedical subjects

I T Yeh

Publications and source records attributed to I T Yeh.

31 records · Page 2Linked to original sources
PubMed1991

Endocervical carcinoma.

The past two decades have seen an increase in the incidence of endocervical carcinoma. Numerous studies have increased understanding of these tumors; hormonal therapy, human papilloma virus, and other cofactors have been implicated in the etiology of endocervical carcinoma. Early diagnosis is difficult: precursor lesions to adenocarcinoma in situ are still poorly defined and understood, and there may be a rapid transit time from in situ to invasive carcinoma. The definition of microinvasive adenocarcinoma is not uniformly agreed upon, and at this time the recommendation is not to use the term. Histologic typing and grading of adenocarcinoma may be useful in the prediction of prognosis for patients. Therapy is based upon stage of disease, the most beneficial results being obtained from either radical surgery or combination surgery and radiation therapy.

Adenocarcinoma↗
PubMed1991

High-signal-intensity rim surrounding uterine leiomyomas on MR images: pathologic correlation.

A high-intensity rim surrounding uterine leiomyomas was identified on T2-weighted magnetic resonance (MR) images in five of 13 patients with histopathologically confirmed leiomyomas. These peripheral high-intensity rims were not associated with subject age or with size, location, or degeneration of the leiomyomas. Histologic examination revealed markedly dilated lymphatic vessels, dilated veins, edema, or a combination of these features to correspond to the location of the high-intensity rims. These benign causes of high intensity in the myometrium should not be confused with clinically important processes such as adenomyosis or invasion by endometrial carcinoma.

Adult↗
PubMed1990

Definitive irradiation for intraductal carcinoma of the breast.

During the period from 1978 to 1985, 51 women with intraductal carcinoma of the breast were treated with definitive irradiation following breast-conserving surgery. Surgical treatment of the primary tumor in all patients consisted of excisional biopsy or wide resection. In general, definitive irradiation consisted of conventional breast tangents to 4500-5000 cGy followed by a breast boost to a total dose of 6000-6600 cGy (median = 6000 cGy; range = 4200-6600 cGy). No patient was treated with radiation to a supraclavicular or axillary field. For the 51 patients, the median follow-up was 68 months (range = 25-126 months). The 5-year actuarial rate of local failure was 6%. A total of five patients failed in the breast at 19, 35, 40, 79, and 119 months following definitive irradiation. Salvage treatment in these five patients consisted of mastectomy in all five patients plus adjuvant tamoxifen in one patient. All five of the patients with breast failures are alive and NED (no evidence of disease), although with limited follow-up (median = 12 months; range = 6-68 months). These results suggest that definitive irradiation is an acceptable alternative to conventional mastectomy for appropriately selected and staged patients with intraductal carcinoma of the breast. In view of the long natural history of this disease, prolonged and careful follow-up of these patients is required.

Adult↗
PubMed1990

Intermediate trophoblast: further immunocytochemical characterization.

Intermediate trophoblast has been recently described as a distinctive subpopulation of trophoblast. Previous immunocytochemical studies demonstrated that these cells react with antibodies against human placental lactogen (hPL) but fail to react with antibodies against beta-human chorionic gonadotropin (beta-hCG). To further characterize the immunocytochemical features of intermediate trophoblast and to possibly identify a more sensitive marker, we studied 88 placentas and implantation sites ranging from 4 to 40 wk gestation with a panel of antibodies that included keratin, epithelial membrane antigen (EMA), placental alkaline phosphatase (PLAP), alpha-hCG, and prolactin. Keratin was found in all intermediate trophoblast cells throughout gestation, and EMA was present in intermediate trophoblast in the second and third trimesters but was less consistently expressed than keratin. Comparison with the distribution of hPL revealed that keratin and EMA were present in intermediate trophoblast cells that were hPL-positive as well as many that were hPL-negative. alpha-hCG showed reactivity in intermediate trophoblast in the first and second trimester. PLAP and prolactin showed little or no reactivity in intermediate trophoblast. Decidual cells, which may be difficult to distinguish from intermediate trophoblast at the implantation site, failed to react with any of the antibodies tested. Cytotrophoblast and syncytiotrophoblast were positive for keratin throughout gestation, but EMA was negative in cytotrophoblast and inconsistently expressed in syncytiotrophoblast. Thus, antibodies against keratin and EMA are more sensitive than those directed against hPL in identifying intermediate trophoblast and are therefore useful in distinguishing intermediate trophoblast from decidua.

Alkaline Phosphatase↗
PubMed1990

Tuberculosis, AIDS, and i.v. drug abuse.

The number of tuberculosis cases reported has begun to rise. This rise in the number of cases may be due to HIV infection, particularly among intravenous drug abusers.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Lactational and clear cell changes of the breast in nonlactating, nonpregnant women.

Secretory changes that occurred in the breasts of 32 women who were not pregnant or lactating were reviewed. These changes took two forms, with partial or complete involvement of one or more lobules. The more frequently occurring focal lactating effect was observed in 23 patients. The second form, a marked clearing of the cytoplasm within acinar cells, occurred in nine patients. Both patterns were present simultaneously in 2 of the 32 patients. Hormonal, anti-psychotic, and anti-hypertensive medications appear to correlate with the lactational change.

Adenocarcinoma↗
PubMed1985

Ultrastructure of cystosarcoma phyllodes and fibroadenoma. A comparative study.

Electron microscopic studies were conducted on 11 cases of cystosarcoma phyllodes (6 benign, 3 malignant, 2 recurrent), 1 stromal sarcoma, and 15 cases of fibroadenomas. Particular emphasis was placed on examination of the epithelial-stromal junction. The epithelial cells were basically similar in all cases. The basal lamina of fibroadenomas tended to be reduplicated, whereas in cystosarcoma phyllodes the basal lamina was less reduplicated and even focally absent. A continuous layer of delimiting fibroblasts was not present in either type of tumor. Stromal cells were generally fibroblasts, with 2 of 15 being fibroadenomas and 2 of 11 cystosarcoma phyllodes showing myofibroblastic differentiation. The stromal sarcoma also showed smooth muscle differentiation. The authors conclude that the epithelial-stromal junction is abnormal in both fibroadenomas and cystosarcomas, but the abnormality is different in these two tumors. Increasing prominence of stromal cell junctions and of lysosomes also correlated with the diagnosis of cystosarcoma, particularly the malignant variant.

Adenofibroma↗
PubMedDate not supplied

Vacuolated cytotrophoblast: a subpopulation of trophoblast in the chorion laeve.

In summary, immunocytochemical analysis of the placenta and fetal membranes discloses two subpopulations of trophoblastic cells in the chorion laeve with distinct morphologic and immunocytochemical features. Both subpopulations are composed of mononucleate cells but one contains clear vacuolated cytoplasm whereas the other contains non-vacuolated eosinophilic cytoplasm. The vacuolated cells are placental alkaline phosphatase (PLAP) positive and human placental lactogen (hPL) negative, whereas the eosinophilic cells are PLAP negative and hPL positive. Both cell types contained immunoreactive keratin and epithelial membrane antigen, but are negative for human chorionic gonadotropin(beta), pregnancy specific beta I-glycoprotein, and prolactin. Electron microscopic studies of the vacuolated cells show that these cells contain numerous lucent non-membrane bound lipid droplets and pinocytotic vesicles. In addition they contain numerous intracellular filaments and desmosomes corresponding to the immuno-cytochemical localization of keratin. Their precise function is not clear, but the abundance of PLAP, an enzyme associated with absorption, suggests that these cells may be involved with maternal fetal transport. The vacuolated cells appear to be limited to the chorion. Their characteristic morphologic and immunocytochemical features and unique anatomic distribution suggests that they represent a distinctive subpopulation of trophoblastic cells for which we propose the term 'vacuolated cytotrophoblast'.

Alkaline Phosphatase↗
PubMedDate not supplied

Evaluation of dialyzers used in shortened dialysis.

The clearance of urea and beta 2-microglobulin are important considerations along with biocompatibility in selecting membranes for use in shortened dialysis. During 3 hr of dialysis we have measured the in vivo urea clearances, pre- and post-beta 2-M levels, plasma clearance and simultaneous dialysance of beta 2-M. Leucopenia was compared after 15 min of dialysis on a cellulose acetate (CA) dialyzer and a polyacrylonitrile dialyzer (PAN). Clearance of urea was similar in both dialyzers. In contrast to CA, PAN removed beta 2-M and exhibited minimal leucopenia. The dialysance of beta 2-M was significantly less than the simultaneous blood side clearance. The disparity between blood clearance and dialysance by PAN membranes suggests removal of beta 2-M by adsorption and diffusion. We conclude that in comparison with CA dialyzers, PAN membranes remove beta 2-M, have equivalent urea clearances, and are more biocompatible.

Acrylic Resins↗
PubMedDate not supplied

Residual trophoblastic tissue as a source of highly atypical cells in the postpartum cervicovaginal smear.

A cervicovaginal smear containing atypical cells, which were interpreted as dysplastic cells, was obtained from a women one-year postpartum. These cells were seen singly, in small groups and in clusters embedded in an amorphous pink matrix. They had amphophilic cytoplasm and increased nuclear/cytoplasmic ratios, as well as hyperchromatic nuclei with variably prominent nucleoli, features that are characteristic of trophoblastic cells. No evidence of dysplasia was seen on subsequent colposcopic examination or cervical biopsy. Endocervical curettage yielded fragments of exfoliated endometrium and residual trophoblastic tissue associated with a placental implantation site. Although involution of the placental site is generally complete by six to seven weeks postpartum, maternal-fetal tissue may in fact continue to be exfoliated for several months or longer after delivery. If seen on a cervicovaginal smear, these cells can be highly atypical and may be mistaken as dysplastic or malignant. The cytologic features that characterize trophoblasts and their persistence in postpartum cervicovaginal smears are discussed.

Adult↗
PubMedDate not supplied

Mammographically detected, clinically occult ductal carcinoma in situ treated with breast-conserving surgery and definitive breast irradiation.

PURPOSE: Ductal carcinoma in situ (DCIS) is increasingly detected as a nonpalpable lesion on mammographic screening performed for the early detection of breast cancer. Because of the growing incidence of mammographically detected DCIS, the present study was undertaken to determine the outcome of treatment of nonpalpable, mammographically detected intraductal carcinoma of the breast using breast-conserving surgery and definitive breast irradiation. MATERIALS AND METHODS: An analysis was performed of 110 women who presented with unilateral, nonpalpable, mammographically detected intraductal carcinoma of the breast and who were treated with breast-conserving surgery and definitive breast irradiation at 10 institutions in Europe and the United States. In all patients, complete gross excision of the primary tumor was performed, and breast irradiation was delivered with definitive intent. When performed, pathologic axillary lymph node staging was node negative (n=29). The median follow-up time was 9.3 years. RESULTS: The 10-year actuarial overall survival rate was 93%, and the 10-year actuarial cause-specific survival rate was 96%. The 10-year actuarial rate of freedom from distant metastases was 96%. There were 15 local recurrences in the treated breast. The actuarial rate of local failure was 7% at 5 years and 14% at 10 years. The histology of the local recurrence was intraductal carcinoma in 9 cases and invasive ductal carcinoma (with or without associated intraductal carcinoma) in 6 cases. The median time to local recurrence was 5.0 years (mean, 5.4; range, 2.1-15.2). With a median follow-up time of 4.4 years after salvage treatment, 14 of the 15 patients with local recurrence were alive without evidence of disease at the time of last follow-up examination. The crude incidence of local recurrence was 7% (3/42) when the final pathology margin of tumor excision was negative, 29% (5/17) when the margin was close or positive, and 14% (7/51) when the margin was unknown. There was no difference in the rate of local recurrence based on pathologic characteristics of the primary tumor. DISCUSSION: Results from the present study demonstrate high rates of overall survival, cause-specific survival, and freedom from distant metastases at 10 years following the treatment of nonpalpable, mammographically detected DCIS of the breast using breast-conserving surgery and definitive breast irradiation. Local recurrences within the treated breast were detected early and were treated with salvage for cure. These results support the initial treatment of nonpalpable, mammographically detected DCIS of the breast using breast-conserving surgery and definitive breast irradiation. Improvements in patient selection have the potential to reduce the risk of local recurrence.

Adult↗