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Biomedical subjects

J Koudstaal

Publications and source records attributed to J Koudstaal.

At least 55 records · Page 3Linked to original sources
PubMed1992

Sources of interobserver variation in histopathological grading of cervical dysplasia.

The present study aimed to assess where the interobserver variation in grading cervical dysplasia stems from. Four experienced pathologists examined 93 histological slides, after they agreed on which morphological characteristics should be considered relevant for grading. They scored 6 morphological characteristics for each slide and assigned it to a degree of dysplasia. Compared to a previous study, the interobserver variation showed a statistically significant improvement: the weighted group kappa value increased from 0.55 to 0.69. For the scores of the individual characteristics considerable interobserver variation was observed: weighted group kappa values ranged from 0.28 to 0.49. The pathologists slightly differed in which characteristics they considered most important for their grading. The agreement on the degree of dysplasia turned out to be better than the agreement on the morphological characteristics on which this diagnosis is based. In the discussion, a few explanations for this paradoxical finding are put forward.

Confidence Intervals↗
PubMed1992

Immunocytochemical analysis of oestrogen receptors and progesterone receptors in the human uterus throughout the menstrual cycle and after the menopause.

To obtain more insight into the relationship between cyclic and regional changes in steroid receptor expression and function-related changes in the various types of cell of the normal human uterus, we performed an immunocytochemical study on paraffin-embedded sections. The distribution and intensity of immunostaining for the oestrogen receptor and the progesterone receptor in the various types of cell were semiquantitatively scored. The data were statistically compared for the different phases of the menstrual cycle and after the menopause, and for the different regions of the corpus and (endo)cervix uteri. During the menstrual cycle, significant changes in oestrogen receptor score were observed in glandular and stromal cells of endometrium basalis and functionalis and in smooth muscle cells of the myometrium. In all types of cell, oestrogen receptor expression reached a maximum in the late proliferative phase. During the early secretory phase, oestrogen receptor staining declined sharply in stromal and smooth muscle cells, whereas, in glandular epithelium, oestrogen receptor expression decreased more gradually. During mid- and late-secretory phases, an increase in oestrogen receptor staining was also observed in predecidualizing stromal cells and smooth muscle cells. Progesterone receptor numbers changed significantly in glandular epithelium but not in stromal and smooth muscle cells. Glandular progesterone receptor expression reached a maximum in the early secretory phase and was then drastically reduced. During mid- and late-secretory phases stromal cells were moderately stained for progesterone receptor in contrast to epithelial gland cells which showed no or very weak staining. No regional variations in steroid receptor distribution in endometrium and myometrium were found.(ABSTRACT TRUNCATED AT 250 WORDS)

Endometrium↗
PubMed1992

The three-group metaphase as a morphologic indicator of high-ploidy cells in cervical intraepithelial neoplasia.

There is a need for additional morphologic criteria to improve the value of histologic classification for the prediction of the biologic behavior of cervical intraepithelial neoplasia (CIN). Representative slides from 72 cone specimens containing CIN were examined to study the correlation between the presence of three group metaphases (TGMs), a morphologically well defined and light microscopically readily recognizable atypical mitotic figure, and the incidence of aneuploid cells with a nuclear DNA content greater than 5C. The numbers of cells greater than 5C (minus the polyploid cells 8C +/- 1C) were counted, using LEYTAS image cytometry on Cytospin preparations from the 72 blocks corresponding to the slides searched for TGMs and used for histologic classification of the lesions in classes CIN 1-3. It appeared that large numbers of aneuploid cells greater than 5C were more closely related to the presence of TGM than to a higher CIN class per se, particularly in women older than 35. Since aneuploid CIN has a higher progression rate than euploid CIN, the presence of TGMs will indicate a biologically unfavorable lesion. Thus, TGM deserves further investigation as an additional morphologic parameter for predicting the biologic behavior of CIN.

Adult↗
PubMed1991

Clinical and pathological aspects of benign and malignant squamous epithelium of the corpus uteri; a report of two cases.

Two patients with primary squamous cell carcinoma of the uterus are described. In both patients, the disease was at an advanced stage when the diagnosis was made. Although endometrial malignancies with squamous elements account for 10-30% of endometrial carcinomas, primary squamous cell carcinoma of the uterus is extremely rare. Up to now fewer than 30 cases have been reported. The pathogenesis, morphogenesis and aetiology of squamous epithelium in the corpus uteri is discussed. Finally, some clinical aspects of the primary squamous cell carcinoma of the corpus uteri are reviewed.

Aged↗
PubMed1991

The fate of meniscus cartilage after transplantation of cryopreserved nontissue-antigen-matched allograft. A case report.

A cryopreserved nontissue-antigen-matched meniscus was transplanted in the knee of a 48-year-old man with lateral compartment osteoarthrosis. After six months, diagnostic arthroscopy was performed. Clinical, histologic, and histochemical studies showed that meniscal chondrocytes survived cryopreservation and transplantation. One year after surgery, the outline of the donor meniscus on an arthrogram appeared normal.

CD4-Positive T-Lymphocytes↗
PubMed1991

Pain in scar as an early symptom of acquired thoracic lung hernia.

Hernia of the lung manifests itself as an elastic, usually replaceable, swelling in the chest wall, which changes in size during inspiration and expiration. It does not generally cause any symptoms. We describe the case history of a 49 yr old man with an acquired thoracic lung hernia, which had first presented three years previously as pain in an operation scar during coughing and lifting. Histopathology of the excised lung tissue showed abnormalities suggestive of previous episodes of strangulation.

Cicatrix↗
PubMed1991

Neuroendocrine cells in anthracosilicotic lungs.

In normal human lungs, neuroendocrine (NE) cells can be found as solitary NE cells and in corpuscular aggregates, the neuroepithelial bodies. By means of a quantitative morphometric method, we compared the number and distribution of chromogranin-reactive NE cells in anthracosilicotic and control lungs. After death, 14 pairs of control and 12 pairs of anthracosilicotic lungs were sampled. The extents of anthracosilicosis and emphysema were described for the right lung. The left upper lobe was used for quantitative determination of the number and distribution of NE cells, visualized by immunohistochemical staining for chromogranin. In contrast to expectations, we found no statistical difference in the numbers of chromogranin-reactive NE cells per 10 cm of epithelium between control (11.0) and anthracosilicotic (2.4) lungs. In both groups, there was a much greater number of chromogranin-reactive cells in the more peripheral compared to the central airways. Most peripheral NE cells were arranged in neuroepithelial bodies, which were not found in the central airways.

Aged↗
PubMed1991

Malignant lymphoma of the testis.

Five patients with primary non-Hodgkin's lymphoma of the testis were studied. The lymphomas had an intermediate grade of malignancy according to the Working Formulation. One patient was in clinical stage IEA, 3 in clinical stage IIEA and one in clinical stage IVB. Central nervous system (CNS) infiltration occurred in 3 patients. The survival was very poor and ranged from 9 days to 5 1/2 years after diagnosis, median 7 1/2 months. In order to improve prognosis aggressive (3 or more cytostatics) chemotherapy is recommended to follow orchidectomy and staging. As for other lymphomas of intermediate- and high-grade malignancy, a more effective systemic therapy is needed for the younger patients, but in the elderly (greater than 70 years) the regimen and the dose intensity have to be adapted to their tolerance. Prophylactic radiation of the opposite uninvolved testis is not recommended, but frequent scrotal ultrasonography during the first 2 years after diagnosis appears essential. Prophylactic intrathecal chemotherapy means an overtreatment for patients in clinical stages I and II, but is indicated in relapsing patients and in clinical stages III and IV.

Aged↗
PubMed1990

[Indications for an increased risk of neural tube defects in pregnancies following ovulation induction and (or) in-vitro fertilization].

Several authors have reported a possible association between IVF or induction of ovulation on the one hand and the occurrence of neural tube defects on the other hand. Here a review is given of recent literature on this subject, including data available from The Netherlands. Collaborative epidemiologic studies are needed to evaluate the potential risks. In individual pregnancies prenatal examination is advised. In spontaneous abortions fetal pathological evaluation is desirable.

Abortion, Spontaneous↗
PubMed1990

Infection of mice with lactate dehydrogenase-elevating virus destroys the subpopulation of Kupffer cells involved in receptor-mediated endocytosis of lactate dehydrogenase and other enzymes.

In previous experiments in rats, we have shown that the rapid plasma clearance of a number of clinically important enzymes is due to receptor-mediated endocytosis by Kupffer cells and other resident macrophages. Others have shown that infection of mice with lactate dehydrogenase-elevating virus, a virus that proliferates in macrophages, leads to reduced plasma elimination of these enzymes. This paper integrates these two sets of experiments. Plasma elimination of intravenously injected, radioactively labeled lactate dehydrogenase M4 and mitochondrial malate dehydrogenase in mice was shown to be caused in part by uptake in liver, spleen and bone. Uptake of lactate dehydrogenase M4 by these tissues was, to a large extent, saturable and the two dehydrogenases competitively inhibited each other's clearance. These results suggest that, also in mice, these enzymes are partly cleared from plasma by endocytosis by way of a common receptor on cells (probably macrophages) from liver, spleen and bone marrow. Morphometrical data showed that normal mouse liver contains 23 x 10(6) Kupffer cells/cm3. This number was reduced to about 30% of that of controls 24 hr after infection of mice with lactate dehydrogenase-elevating virus but returned to normal within the next 9 days. The saturable component of uptake of lactate dehydrogenase M4 by liver, spleen and bone had disappeared 24 hr after infection with the virus, and did not return after the Kupffer cell population had recovered. Our findings suggest that lactate dehydrogenase M4 is, to a large extent, removed from the circulation by way of a receptor on a subpopulation of macrophages that is permissive for replication of lactate dehydrogenase-elevating virus.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Is immunohistochemical analysis of oestrogen and progesterone receptors in endometrial carcinoma superior to the radioligand binding assay?

The aim of this study was to evaluate tissue and steroid receptor heterogeneity in endometrial carcinoma specimens as a possible source of discordance between biochemically assayed receptor status and response to endocrine treatment. For this purpose the oestrogen receptor (OR) and progesterone receptor (PR) levels in specimens from 16 endometrial carcinoma patients were analysed on adjacent tissue sections using both a radiochemical and an immunohistochemical assay. With immunohistochemical receptor analysis extensive tissue and tumour cell receptor heterogeneity was observed. Many tumour samples revealed up to 75 per cent contamination with benign tissue. In the majority of cases, evaluation of immunoreactivity in normal tissue elements of the specimen could explain the apparent discordance between semiquantitative immunohistochemical receptor scoring of tumour cells and radiochemical receptor assay. Immunohistochemical analysis of OR and PR in endometrial carcinoma specimens allows a more specific determination of tumour cell receptor content and hence may yield a more accurate prediction of response to endocrine therapy than the biochemical assay.

Adult↗
PubMed1990

Interobserver variation in histopathological grading of cervical dysplasia.

In order to assess the variability among histopathologists in grading cervical dysplasia, four experienced histopathologists examined the same set of 106 biopsy specimens and assigned them to one of five diagnostic categories. These were: no dysplasia, mild dysplasia, moderate dysplasia, severe dysplasia and carcinoma in situ. The histopathologists did not discuss the grading criteria beforehand. There was considerable disagreement among the pathologists: unweighted group kappa 0.28, weighted group kappa 0.56. It appeared that all grades of dysplasia were equally difficult to distinguish from adjacent categories. Various explanations for this interobserver variation are put forward.

Biopsy↗
PubMed1990

Intraglomerular platelet aggregation and experimental glomerulonephritis.

Oxygen free radical production inhibits ADPase-mediated antithrombotic action. Different forms of experimental glomerulonephritis (GN) are characterized by early glomerular influx of inflammatory cells and thrombus formation. The causal relationship of these inflammatory events is obscure. Previous studies have shown that glomerular ADPase in the rat kidney may function as a potent antithrombotic principle, whereas this enzyme is highly sensitive for oxygen free radicals. To study whether O2- producing inflammatory cells are able to induce intraglomerular thrombosis via impairment of ADPase, we investigated influx of inflammatory cells in relation to glomerular ADPase activity and platelet aggregation in three models of GN. In two of these models (anti-Thy1 and anti-GBM GN) influx of neutrophils and thrombus formation occurs, whereas in anti-FX1A nephritis this aspect of the inflammatory phase is not present. The results show a relationship between influx of oxygen free radical-producing cells, reduction of glomerular ADPase activity and increased platelet aggregation. Moreover, it is shown that impairment of glomerular ADPase and increased platelet aggregation in anti-Thy1 and anti-GBM GN could be reduced by treatment with superoxide dismutase and catalase. The demonstration that activated neutrophils perfused ex vivo in the rat kidney can directly affect glomerular ADPase and antithrombotic potential in an O2- dependent manner, further supports the proposed sequence of events; oxygen free radicals produced by activated neutrophils reduce glomerular ADPase activity, leading to facilitation of thrombus formation.

Animals↗
PubMed1990

Proliferation rate of colonic mucosa in normal subjects and patients with colonic neoplasms: a refined immunohistochemical method.

An increased colonic epithelial proliferation rate and an increase of the cryptal proliferative zone are probable markers of increased susceptibility to colonic cancer. In this study an immunohistochemical method using 5-bromo-deoxyuridine (BrdUrd) to measure the proliferation rate of colonic mucosa in vitro was used. Fresh endoscopic colonic biopsy specimens were incubated with BrdUrd and then processed for immunohistochemistry using a monoclonal antibody. Essential procedures with respect to the equal distribution of nuclei stained with BrdUrd in the biopsy specimens proved to be the cutting of the specimens before incubation and the use of a microwave oven at the beginning of incubation. The use of the procedure of the running average showed that 12 length cut crypts are sufficient to determine reliably the proliferation rate, expressed as the labelling index (LI). This was determined in the biopsy specimens of 10 subjects without organic colonic disease, eight patients with adenomatous colonic polyps, and in six patients with (recent) colonic carcinoma. Mean LI in the controls was significantly lower than in patients with colonic polyps and in those with colon cancer. It is concluded that this method is promising for screening persons at risk for colon cancer and will be of great potential in performing dietary intervention studies in these subjects.

Adolescent↗
PubMed1990

Minimum extension and appropriate topographic position of tissue destruction for treatment of cervical intraepithelial neoplasia.

Minimum extension and topographic position of tissue destruction for treatment of cervical intraepithelial neoplasia (CIN) is determined by the extension and the localization of the pathologic epithelium. In 65 cone specimens, we studied the depth of CIN II crypt involvement and the linear extent and topographic position of the CIN III lesions. The topographic position of the CIN III lesion was related to a reference point R, the most caudal point of the ectocervix. The mean maximum depth of CIN III crypt involvement appeared to be 1.6 +/- 1.0 mm, and the mean linear extent of the CIN III lesion was 7.4 +/- 3.7 mm. The distal border of the CIN III lesion was located at a mean distance of 8.2 +/- 4.4 mm from the reference point R, and the proximal border at a mean distance of 13.3 +/- 3.7 mm. Taking the mean + 2 SD values as directives (97.7% of the population) suggests that in almost all patients, the depth of crypt involvement did not exceed 3.6 mm; the linear extent of the CIN III did not exceed 14.8 mm. Furthermore, this implies that in almost all patients, the CIN III lesion was located between 0.6 mm distally (mean - 2 SD) and 20.7 mm proximally (mean + 2 SD) from the reference point R. Based on these results, we conclude that minimum local tissue destruction for treatment of CIN should have a depth of 4 mm over a distance of 15 mm, and should be localized at least between 1 mm distally and 21 mm proximally from the most caudal point of the ectocervix.

Adult↗
PubMed1990

Analysis of cryolesions in the uterine cervix: application techniques, extension, and failures.

Although cryosurgery is regularly used for treatment of cervical intraepithelial neoplasia (CIN), there are few data concerning freeze technique and attendant extension of the cryolesion. This study evaluated how to create cryolesions extensive enough to eradicate the CIN lesion completely. The way the extension of the cryolesion was influenced by type of probe, anatomical position in the cervix, shape of the external os, and freeze time was analyzed. Furthermore, we examined whether localization of the cryolesions corresponded with the CIN III location. Cryosurgery was applied to the cervix of 64 women the day before hysterectomy was performed for benign disease. Four types of probes were tested and freezing was done with a double freeze cycle. After extirpation of the uterus, slides were cut at the 3-, 6-, 9-, and 12-o'clock positions. With a computerized graphic tablet, the depth and linear extension of the cryolesion were measured morphometrically. After short freeze times, it appeared that an adequate lesion was present in only 67.4% of the slides. The large cone probe gave the best results; the small flat cervix probe the worst. At the 3- and 9-o'clock positions, a significantly higher percentage of inadequate lesions was found (60.8 and 65.3%, respectively). This proved to be due primarily to the extensive vascular supply at those positions. Longer freeze times gave an excellent result within all slides, even at the 3- and 9-o'clock positions. The topographic position of the cryolesion corresponded completely in all cases with that of the CIN III lesion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

A rare tumor at the elbow: a glomangioma. Differential diagnosis and therapy.

Referring to a case of a glomangioma at the elbow, several aspects of this tumor are illustrated. Since the related hemangiopericytoma can be distinguished from the glomangioma by its biological behavior, the morphological differential diagnosis of both tumors is discussed in detail. Therapeutic consequences of one or the other diagnosis are also indicated.

Aged↗