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J A Goeken

Publications and source records attributed to J A Goeken.

At least 55 records · Page 3Linked to original sources
PubMed1988

Squamous metaplasia of the prostate. An immunohistochemical study.

Immunoperoxidase strains for prostate-specific antigen (PSA), prostatic acid phosphatase (PAcP), epithelial membrane antigen (EMA), and cytokeratins (MAK 6 and CK-KES) were performed on 1 case of squamous cell carcinoma of the prostate and on 13 cases of squamous metaplasia of prostatic epithelium in an effort to demonstrate prostatic origin of the neoplastic and metaplastic cells and to differentiate them from primary or metastatic well-differentiated squamous cell carcinoma. The authors found no specific staining of the metaplastic or neoplastic cells for PSA and only focal single cell PAcP positivity in three cases of squamous metaplasia. All cases showed strong staining of surrounding normal glandular epithelium for both antigens. In all but one case, both the metaplastic and glandular epithelium had positive results for MAK 6 and CK-KES. EMA was expressed strongly in ten cases, was weak or variable in two, and had negative results in two cases of squamous metaplasia. In only four cases did the glandular epithelium have positive results for EMA. The remaining cases showed no staining. PSA and PAcP marking, therefore, may not be useful for separating atypical squamous metaplasia from well-differentiated squamous cell carcinoma or even primary prostatic from metastatic squamous cell carcinoma. These findings suggest that although prostatic glandular epithelial cells retain their ability to express some prostate-associated antigens, this ability is greatly reduced, lost, or not developed in cells that undergo metaplasia into squamous cells or that develop into squamous cell carcinoma.

Aged↗
PubMed1988

Immunohistochemical characterization of chondroid syringomas.

This study was initiated because the histogenesis of chondroid syringomas (CSs), especially the role of the myoepithelial cells, is still controversial. Twelve cases of CS were analyzed by immunohistochemical methods with a broad panel of routinely used antibodies. The epithelial elements were classified as tubuloglandular components, stromal cells, and solid nests. The authors' results indicated the following: (1) The inner cell layers of tubuloglandular components have distinct epithelial features with cytokeratin (CK), carcinoembryonic antigen (CEA), and epithelial membrane antigen (EMA) positivity. (2) The outer cell layers had negative results for muscle-specific actin (MSA), desmin, CEA, EMA, and CK (if antibody AE1/3 was used) and had positive results for vimentin, S-100 protein, neuron-specific enolase (NSE), and in three cases for glial fibrillary acidic protein (GFAP). (3) The stromal cells and, to a lesser extent, the solid nests expressed immunophenotypes similar to those of the outer cell layers. These data suggest that the stromal components may derive from the outer cells of the tubuloglandular elements but derive from the outer cells of the tubuloglandular elements but do not confirm their exclusive myoepithelial origin.

Adenoma, Sweat Gland↗
PubMed1988

beta-amyloid protein of Alzheimer's disease is found in cerebral and spinal cord vascular malformations.

Congo/Red deposition with birefringence to polarized light was demonstrated focally in cerebrovascular malformations removed surgically from 4 older patients (ages 85, 74, 74, and 63), and in a spinal cord vascular malformation in a 76-year-old patient. Lesser degrees of Congophilic change were observed in cerebrovascular malformations screened from 4 of 10 patients between the ages of 30 and 59. No Congophilic change was seen in 10 cerebrovascular malformations removed from patients under 30 years of age. Congophilic areas in all cases decorated with W-2 and 85/45 polyclonal antibodies raised to peptide sequences of cerebrovascular beta-amyloid and beta-amyloid of senile plaques from patients with Alzheimer's disease. Thus, the amyloid in these vascular malformations is immunologically related to beta-amyloid protein. This finding provides another indication that vascular beta-amyloid deposition is not specific for Alzheimer's disease and suggests that an existing abnormality of vessels may be a predisposing factor.

Adolescent↗
PubMed1986

Acute myelocytic leukemia manifested by prominent generalized lymphadenopathy: report of two cases with immunological, ultrastructural, and cytochemical studies.

Although it is well recognized that granulocytic sarcoma can cause localized lymphadenopathy, widespread nodal involvement by acute myelocytic leukemia (AML), clinically mimicking non-Hodgkin's lymphoma, has only been previously described twice. We report the clinicopathological, immunological, and cytochemical features of two patients who had widespread, prominent lymphadenopathy secondary to AML as well as concurrent marrow leukemia (M1 and M2). For one patient the lymphadenopathy was the predominant abnormality prompting him to seek medical attention, while the second patient had symptoms of infection following a 9-month history of myelodysplasia. The disease in both patients was aggressive; one patient survived only 1 week and the other survived only 5 weeks after diagnosis. In both cases the granulocytic sarcoma was confirmed by cytochemistry studies (naphthol ASD-chloroacetate esterase on tissue sections and myeloperoxidase on imprint smears), and electron microscopy, including morphology (both cases) or ultrastructural localization of myeloperoxidase (case 2). Non-specific esterase activity was not detected in either patient's blasts, although serum lysozyme was elevated in both cases. Immunological studies revealed reactivity of both patients' cells with panleukocyte, MY4, MY7, OKM-1, and Leu-M1 monoclonal antibodies and with alpha-1-antitrypsin and muramidase antibodies. The cells of one of these patients also reacted with anti-S-100 protein. Although the cytochemical studies indicated that both cases exhibited only myeloid differentiation, the immunological markers suggested that the tumor cells possessed some features of monocytes, perhaps explaining their propensity for widespread tumor formation. Morphological, immunological, cytochemical, and ultrastructural methods of diagnosing granulocytic sarcoma are presented.

Aged↗
PubMed1986

Neoplastic angioendotheliomatosis: immunopathologic and morphologic evidence for intravascular malignant lymphomatosis.

Neoplastic angioendotheliomatosis (NAE) is a rare entity characterized by multifocal, intravascular proliferation of large pleomorphic cells within small vessels of most organs, with a particular affinity for the central nervous system. Clinically, patients with NAE present with focal neurologic signs and a progressive decline in mental status, followed by death in a few months. The histogenesis of NAE is controversial but has been previously thought to represent a malignant proliferation of endothelial cells. Three autopsy cases with clinical and histologic features of NAE were investigated by electron microscopic, standard histochemical, and immunohistochemical technics that included the use of three panleukocyte monoclonal antibodies (PLA), the endothelial-cell-specific reagents, FVIII-RAG anti-sera and Ulex europaeus agglutinin (UEA), and muramidase. The NAE cells in all three cases were stained positively by the PLA, whereas the adjacent endothelial cells and not the NAE cells were stained by FVIII-RAG and UEA. Muramidase by immunoperoxidase technic and nonspecific esterase (chloracetate) were not present in NAE cells. These results indicate that NAE is a leukocyte-derived neoplasm and not a malignant endothelial cell neoplasm. Based on these findings and on a review of the literature, it is proposed that NAE represents intravascular malignant lymphomatosis (IML). IML appears to be a primary manifestation and/or a major secondary form of disseminated malignant lymphoma. This would explain the spectrum of findings in previously reported cases.

Adult↗
PubMed1986

Primitive neuroectodermal tumor in the skin with features of neuroblastoma in an adult patient.

A case of primitive neuroectodermal tumor of an 81-year-old man is presented, which was located in the cutis. The occurrence in this age and this superficial location is unusual and raises wide differential diagnostic possibilities. The tumor demonstrated Homer Wright rosettes, was positive for neuron-specific enolase and ultrastructurally revealed neurosecretory granules. These features support the diagnosis of a peripheral neuroblastoma. We discuss the controversy about the terminology of peripheral neuroblastoma vs. neuroepithelioma, as well as the differential diagnosis of these tumors.

Aged↗
PubMed1985

Nonendemic adult T-cell leukemia/lymphoma in the United States: report of two cases and review of the literature.

Adult T-cell leukemia/lymphoma (ATLL) is a recently described distinct clinicopathologic entity characterized by a leukemic or lymphomatous proliferation of hyperlobulated peripheral T-cells, which is usually widespread at presentation and is associated with infection by a type C retrovirus. ATLL rarely is described outside of endemic regions, which include southwestern Japan, the Caribbean region, and the southeastern United States. The authors report the clinical, pathologic, and immunologic features of two cases of nonendemic ATLL that occurred in patients from the midwest United States. One patient was a 16-year-old white girl from rural Iowa, and the other was a 46-year-old white man from rural Minnesota. The features of 13 other probable nonendemic ATLL cases from the United States were compiled and reviewed. In the United States, nonendemic ATLL occurred in widespread geographic locations, affected mostly white people, and was characterized by an aggressive course with generalized adenopathy, blood and bone marrow involvement, and hepatosplenomegaly at presentation. Skin involvement was present in one-fourth of the patients. Hypercalcemia was rare. Although antibodies to type C retrovirus were detected in three of the five patients tested, the available data is not sufficient to establish a conclusive association between nonendemic ATLL and type C retrovirus infection.

Adolescent↗
PubMed1983

Second lymphoid malignant neoplasms occurring in patients treated for Hodgkin's disease.

Patients who have been treated for Hodgkin's disease are at increased risk for second malignant neoplasms, particularly acute nonlymphoblastic leukemia and non-Hodgkin's lymphoid malignant neoplasms (NHLMs). We diagnosed five cases of NHLM in 242 patients initially treated for Hodgkin's disease between 1973 and 1980, giving a minimum incidence for this occurrence of 2.1%. The initial therapy for Hodgkin's disease, irradiation in three patients and chemotherapy in two patients, resulted in a complete remission in each case. The NHLM appeared 12, 13, 26, 30, and 54 months after the diagnosis of Hodgkin's disease. The cell type of NHLM and immunologic phenotype were as follows: large cell, immunoblastic T; large cell, immunoblastic null; large cell, cleaved and noncleaved B; large cell, cleaved and noncleaved (not studied); and lymphoblastic T. A review of 24 other cases of NHLMs, occurring in patients treated for Hodgkin's disease, reported in the literature, confirm the morphologic and immunologic heterogeneity. The poor response to therapy in our patients and those previously described demonstrate the seriousness of this phenomenon.

Adolescent↗
PubMed1982

Complications of plasma exchange in neurological patients.

Complications occurred during 154 plasma exchanges performed in 17 patients for a variety of neurological disorders. Mild, self-limited, toxic reaction to citrate was the most frequent complication (7.8%), followed by transient hypotension (2.6%) and visual scotomata (1.3%). More serious complications, occurring on one occasion each, were cardiac arrhythmia, myocardial infarction, and gross hemolysis. There were no infections. The spectrum and frequency of complications in these plasma exchanges were compared with those in other series dealing with both neurological and nonneurological patients. Several risk factors for development of complications were identified, one of the most important being the nature of the illness being treated. The incidence of two of the most serious complications, severe infection and bleeding diathesis, appeared to be higher in patients with renal insufficiency or hematologic disorders, respectively, than in neurological patients.

Adolescent↗
PubMed1982

Systemic lupus erythematosus complicated by disseminated sarcoidosis. Report of a case associated with circulating immune complexes.

The association of SLE with sarcoidosis has been reported infrequently. The case of a 47-year-old white woman who had the diagnosis of SLE made at our institution in October of 1979 is presented. In February 1980, the onset of bilateral hilar adenopathy prompted an investigation leading to the diagnosis of sarcoidosis. Circulating immune complexes were markedly elevated. The association of these two diseases has only recently been recognized and may be more widespread than previously suspected. Some animal and clinical data, in concert with our observations, suggest that humoral autoimmunity may give rise to both processes in the same patient.

Antigen-Antibody Complex↗
PubMed1982

Peripheral neuropathy associated with monoclonal gammopathy. Studies of intraneural injections of monoclonal immunoglobulin sera.

A causal relationship between paraproteinemia and neuropathies has been suggested. We studied three patients with chronic sensorimotor polyneuropathy associated with plasma cell dyscrasia and monoclonal gammopathies (IgGK, IgMK, IgA lambda). Sural nerve biopsies showed mild (2 cases) to moderate loss of myelinated fibers (1 case). Teased single fiber studies showed segmental demyelination-remyelination in two patients. Direct immunofluorescence demonstrated immune deposits of the myelin sheath of the same specificity as the serum paraprotein, IgGK (1 of 3 cases). Treatment with prednisone, melphalan or chlorambucil, and plasmapheresis resulted in remission (1 case), partial improvement (1 case), or had no effect (1 case), although reduction of monoclonal immunoglobulin occurred in all. To investigate the role the paraproteins might play in the pathogenesis of the neuropathy, patients' serum was injected intraneurally into rat sciatic nerves. None of the animals developed weakness, slowing of in vitro conduction of sciatic nerve, or significant evidence of demyelination by light- or electron-microscopy or teased single fiber studies 48 hours postinjection. Similar injections of rabbit serum with experimental allergic neuritis (EAN) produced focal segmental demyelination. Our studies employing an in vivo bioassay technique failed to establish antimyelin activity of monoclonal immunoglobulin sera.

Aged↗
PubMed1981

An immunopathologic study of giant papillary conjunctivitis associated with an ocular prosthesis.

A 21-year-old woman, whose left eye had been enucleated when she was 2 years old, developed giant papillary conjunctivitis and experienced ocular discomfort and increased tearing when she wore her prosthesis. Cultures grew normal flora, and topical antibiotics failed to relieve her symptoms. Immunopathologic studies of a conjunctival biopsy specimen disclosed plasma cells of all five classes of immunoglobulins in the substantia propria and many IgE-containing cells. Russell bodies found in some of the plasma cells were of the IgM and IgG types. The patient was treated with a 2% solution of cromolyn sodium, applied four times a day. Within one month, her symptoms had resolved, there was less conjunctival congestion, and the papillae were much less prominent. Our findings suggested that there may be a heterogenous humoral response in giant papillary conjunctivitis along with a strong immediate (Type I) hypersensitivity component.

Adult↗
PubMed1980

C-reactive protein in giant cell (cranial, temporal) arteritis.

A controlled study of C-reactive protein in patients with and without temporal arteritis was performed. C-reactive protein was elevated in 10 of 11 patients with biopsy-proven temporal arteritis before treatment. It was positive in 14 of 32 control patients with negative temporal artery biopsies. This difference is statistically significant. C-reactive protein was elevated in 6 to 9 (depending on the adequacy of therapy) of 34 patients with temporal arteritis after corticosteroids were started. C-reactive protein and erythrocyte sedimentation rate are positively correlated in untreated arteritis. Clinical correlation showed C-reactive protein was more sensitive than the erythrocyte sedimentation rate in following the adequacy of corticosteroid dosages in temporal arteritis probably because many more noninflammatory factors influence erythrocyte sedimentation than influence C-reactive protein.

Adrenal Cortex Hormones↗
PubMed1980

Cell-mediated immunity in patients with basal and squamous cell skin cancer.

T and B lymphocyte levels were normal in fifty patients with basal and squamous cell skin cancer. Patients with basal cell carcinomas and small squamous cell carcinomas reacted normally to intradermal antigens and to dinitrochlorobenzene (DNCB). However, patients with large (greater than 3 cm) squamous cell carcinomas appeared to have defective systemic cell-mediated immunity because only 33% of them reacted to at least one intradermal antigen, and only 67% could be sensitized to DNCB. Presently, it is unknown whether this defect is related to the occurrence or behavior of squamous cell carcinoma.

Adult↗
PubMed1979

In vivo comparison of replamineform, Silastic, and bioelectric polyurethane arterial grafts.

The replamineform process allows fabrication of microporous prostheses with control of both pore diameter and structural geometry by means of a variety for biomaterials. Tubular prostheses 3 cm long, 6 mm inside diameter, and 1 mm wall thickness were made of Silastic or Bioelectric Polyurethane (BEP) with use of a template of the echinoderm Heterocentrotus mammillatus. Pore diameter of the prosthesis wall was 18 to 25 mu. Light and scanning-electron microscopy of grafts removed between 1 and 32 weeks demonstrated that organization and endothelialization of neointima were similar for both polymers, being complete by 4 to 8 weeks. However, the character of prosthesis wall ingrowth was strikingly different: the microporous lattice of BEP was completely ingrown early, but was apparently fragmented by continued granulomatous inflammation by 32 weeks, while Silastic generated minimal inflammatory response and slower fibrous tissue and capillary ingrowth. Thus, with Silastic and BEP, similarities in neointima organization appeared independent of distinct differences in wall ingrowth. The replamineform process is a unique means of studying surface healing and wall ingrowth of different biomaterials as microporous vascular prostheses in a controlled fashion.

Arteries↗
PubMed1979

Aggressive biologic behavior of basal- and squamous-cell cancers in patients with chronic lymphocytic leukemia or chronic lymphocytic lymphoma.

Three basal- and four squamous-cell carcinomas in seven patients with chronic lymphocytic leukemia or chronic lymphocytic lymphoma recurred repeatedly after conventional treatment, and grew to large sizes. The squamous-cell carcinomas metastasized in all four of the patients so afflicted. Absolute numbers of circulating T lymphocytes were normal in the seven patients, but they had cutaneous anergy to intradermal tests with common antigens and to dinitrochlorobenzene. The following recommendations for management of cutaneous carcinomas in patients with malignant lymphomatoses are made: 1) closer surveillance than for patients with cutaneous cancers but without malignant lymphomatoses, 2) early treatment of actinic keratoses to prevent possible transformation to malignancy, and 3) microscopically controlled excision of basal- or squamous-cell carcinomas larger than 1 cm in diameter.

Aged↗
PubMed1978

Mycobacterium gordonae infection of a prosthetic aortic valve.

A patient prviously suspected of having a mycobacterial infection was found to have a Mycobacterium gordonae infection of his prosthetic aortic valve. Following replacement of his infected prosthesis and systemic therapy for two years, the patient has apparently been cured.

Aortic Valve↗