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Biomedical subjects

J Linder

Publications and source records attributed to J Linder.

At least 127 records · Page 7Linked to original sources
PubMed1988

The role of surveillance bronchoscopy and bronchoalveolar lavage prior to heart transplantation.

All patients had an elevated bronchitis score over that of normal controls. The cause of this bronchitis is likely multifactorial and was not uniformly predicted by bronchial neutrophil counts, current smoking history, or PFT abnormality. All patients had, in addition to high bronchitis score, evidence of increased bronchial neutrophils and/or PFT abnormality or cancer. These findings lead to a change in management prior to heart transplantation.

Adult↗
PubMed1987

Thromboangiitis obliterans (Buerger's disease) and smokeless tobacco.

Thromboangiitis obliterans, a distinct clinical and pathologic entity characterized by segmental inflammatory and proliferative lesions of the tunica media of small arteries and veins, has been reported frequently in men who have a history of heavy cigarette smoking. We report a case of thromboangiitis obliterans in a 38-year-old man that was clearly associated with the use of smokeless (chewing) tobacco. In addition to a physical history and examination and laboratory evaluation, a biopsy of the skin and deep subcutaneous tissue of the patient's left thigh was performed, and this revealed occlusion of 2 large dermal blood vessels by a highly organized thrombus. A regimen of nifedipine and antiplatelet therapy, plus complete abstinence from tobacco, resulted in resolution of the patient's symptoms and pain. Our findings may be of particular importance in view of the increasing popularity of smokeless tobacco and the complications which may result from its use.

Adult↗
PubMed1987

Cutaneous necrotizing granulomatous vasculitis with evolution to T cell lymphoma.

The evolution of unusual cutaneous vasculitis to a systemic T cell lymphoma was observed over a 12-year period. Precise classification of the skin biopsy specimens during the course of this patient's illness was difficult. Different observers suggested malignant hemangioendothelioma, malignant lymphoma, regressing atypical histiocytosis, and granulomatous vasculitis. In retrospect, the biopsy specimens likely represented the spectrum of cutaneous lymphomatoid granulomatosis. This condition is yet another example of a reactive lymphoid proliferation proceeding to a malignant lymphoma.

Diagnosis, Differential↗
PubMed1987

Hepatitis in fatal infectious mononucleosis.

A detailed clinicopathologic analysis of 30 patients with sporadic fatal infectious mononucleosis and 31 males with fatal infectious mononucleosis and the X-linked lymphoproliferative syndrome was performed to determine the extent of hepatic dysfunction in these cases. At death, the median age of patients with sporadic infectious mononucleosis was 10.7 yr vs. 2.4 yr for X-linked lymphoproliferative syndrome. The median survival time was 8 wk for sporadic infectious mononucleosis and only 4 wk for X-linked lymphoproliferative syndrome. The male to female ratio was 3:2 in sporadic infectious mononucleosis; all patients with X-linked lymphoproliferative syndrome were males. Fever, sore throat, lymphadenopathy, hepatomegaly, and splenomegaly were prominent findings. Hepatic dysfunction was uniformly present and caused death in 13 of 30 sporadic infectious mononucleosis cases and 18 of 31 X-linked lymphoproliferative syndrome cases. Diagnosis of infectious mononucleosis was confirmed by heterophile antibody titers or Monospot, Epstein-Barr virus antibody studies, viral culture, molecular hybridization studies, clinical and histologic findings, and pedigree analysis.

Child↗
PubMed1987

Thymic lesions in fatal infectious mononucleosis.

Thymic lesions were studied in 35 patients with fatal infectious mononucleosis (FIM) including 21 males with the X-linked lymphoproliferative syndrome (XLP) and 14 non-XLP patients. Six patterns based on the lymphocyte content and status of Hassall's bodies were observed: massive lymphoproliferation effaced the architecture and Hassall's bodies (HB) in 6 cases. Epstein-Barr virus (EBV)-laden B cells surrounded by cytotoxic T cells and natural killer cells were found in one of these cases. Only 5 of the 35 thymuses contained normal-appearing HB. Seven showed a moderate reduction in HB. Rarely, multinucleated giant cells and hyaline globules were seen where one might expect HB to reside. Plasma cells and macrophages were generally abundant. Eight displayed a marked depletion of HB. In 7, no HB were recognized. Massive necrosis was seen in one of these cases. Stress involution was encountered in only two patients, both of whom had sporadic fatal IM. Thymic lesions and alterations were similar but less extensive in sporadic FIM. These morphological studies, taken in context with clinical and experimental reports, suggest that destruction of thymic epithelium may contribute to the progression of immune defects seen in XLP following EBV infection. The destruction of HB that we observed was similar in appearance to lesions in several other immune deficiency disorders.

Age Factors↗
PubMed1987

Chromosomal abnormalities in indolent lymphoma.

Cytogenetic studies were performed on lymph node biopsies from 60 patients with indolent (low grade) non-Hodgkin's lymphoma. Thirty-two of the 39 successfully cultured biopsies had abnormal clones. The 32 abnormal clones represented the following histologies: seven small lymphocytic lymphoma (SL), eight follicular small cleaved cell lymphoma (FSC), 14 follicular mixed, small cleaved, and large cell lymphoma (FM), and three composite lymphomas. One of the composite lymphomas had FSC/DSC (diffuse small cleaved cell) and the other two FM/DM (diffuse mixed, small cleaved and large cell). Twenty-seven of the 32 biopsies were immunologically typed, and all were B cell. The clones all exhibited more structural than numerical abnormalities, and there was no difference in the modal chromosome number of the abnormal clones found in each histology. Biopsies with no normal cells were more frequently found in the SL histology (71%) than in the two follicular lymphoma groups (54%-55%). A translocation of the 14q32 segment was the most common abnormality found in all three histologies. In the follicular lymphomas a t(14;18)(q32;q21) was seen in 52% (13 of 25) of these patients, this translocation was not observed in the SL patients. Overall 84% (21 of 25) of the follicular lymphoma patients had abnormalities of 14q32 and/or 18q21. Other specific abnormalities included anomalies of chromosome #3 in FM, an abnormal 10q in FSC and FM lymphoma, and a high incidence of +18 and chromosome #1 abnormalities in patients with t(14;18). The presence of specific chromosome abnormalities in the indolent lymphoma patients suggests a relationship between certain karyotypic features and histology.

Adult↗
PubMed1987

Intermediate lymphocytic lymphoma: an immunohistologic study with comparison to other lymphocytic lymphomas.

In an immunohistologic analysis of 13 cases of intermediate lymphocytic lymphoma (ILL), the immunophenotype of ILL was compared to the immunophenotypes of other B-lymphocytic lymphomas and the normal lymphoid follicle to determine the normal cell in the scheme of B-cell differentiation that corresponds to ILL. The characteristic immunophenotype of ILL was surface IgM +/- D+, cytoplasmic immunoglobulin -, B1+, BA1+, B2-, BA2-, B4+, Leu 14+, HLA-DR+, Leu 1+, and common acute lymphoblastic leukemia associated (CALLA) antigen -. The immunophenotype of ILL was similar to that of lymphocytes in normal primary follicles and the mantle zones of secondary follicles. The "immature" phenotype of ILL was identical to that of small lymphocytic lymphoma, which strongly supports their close lineage relationship. In contrast, the "mature" phenotypes of the follicular center cell and lymphoplasmacytoid lymphomas suggest that they correspond to normal cells at later stages of differentiation. Our findings indicate that B-lymphocytic lymphomas recapitulate the normal stages of B-cell differentiation. The cell of ILL appears to be an immature B cell that homes to, and resides in, primary follicles and the mantle zones of secondary follicles. The cytologic, architectural, immunologic, and clinical features of ILL indicate that it should be included as a separate category in the International Working Formulation.

Antigens, Neoplasm↗
PubMed1987

Polypoid tumor of the esophagus.

Five cases of an uncommon esophageal tumor consisting of a mucosal squamous cell carcinoma that surrounds a polypoid mass of spindle cells were examined. The spindle cell component was composed of elongated cells with blunt nuclei, admixed with multinucleated giant cells. Reticulin fibers enveloped individual cells, and abundant collagen was present. Thirteen to 69 mitotic figures occurred per 10 high-power fields. Electron microscopy showed dilated cisternae of rough endoplasmic reticulum and peripheral intermediate filaments within the cytoplasm. Intermediate-type junctions (zonulae adherens) and subplasmalemmal linear densities connected some cells. No tonofibrillar bundles or desmosomes (maculae adherens) were present. Immunoperoxidase stains detected no keratin in the spindle cells. Alpha-1-antichymotrypsin and alpha-1-antitrypsin were in the spindle cells in five of five and three of five cases, respectively. The absence of desmosomes, tonofibrillar bundles, and keratin and the presence of alpha-1-antitrypsin and alpha-1-antichymotrypsin favor fibrohistiocytic differentiation of the spindle cell component.

Carcinoma, Squamous Cell↗
PubMed1987

Cytopathology of opportunistic infection in bronchoalveolar lavage.

Bronchoalveolar lavage is an important tool for the cytologic and microbiologic examination of the lung. Silver- or Papanicolaou-stained slides from 604 lavage specimens from 344 patients were evaluated for the presence of fungal, parasitic, and viral organisms. Yeast, pseudohyphae, or hyphae occurred in 155 specimens (25.7%). Candida was the most frequent opportunistic fungus in immunosuppressed hosts. Patients with clinically significant Candida infection had many budding yeasts and pseudohyphae on cytologic preparations of their lavage fluid. Aspergillus, which occurred in five patients, was readily identified by cytologic examination and by fungal culture. Pneumocystis carinii was found in 14 patients (4%). Cytopathologic characteristics of Herpes simplex or cytomegalovirus were present in four patients (1.2%). In 414 specimens no pathogens were identified by either microbial culture or cytologic examination; usually, these patients had pulmonary hemorrhage, recurrent neoplasia, or therapy-induced lung disease to account for their abnormal chest x-rays. Cytologic and microbiologic examination of lavage fluid readily identified opportunistic pathogens. The ease and low morbidity of bronchoalveolar lavage support its use in the assessment of pulmonary infiltrates in immunocompromised hosts.

Adult↗
PubMed1987

The thymus gland in secondary immunodeficiency.

The microenvironment within the thymus gland and various thymic hormones facilitates the maturation of prothymocytes to functional T lymphocytes. Abnormal thymic morphology is a hallmark feature of several primary and secondary immunodeficiencies. Thymus glands from patients with the acquired immunodeficiency syndrome or graft-vs-host disease and from patients receiving cyclosporine A therapy are depleted of thymocytes, have a striking reduction in thymic epithelial cell mass, and are virtually devoid of Hassall's corpuscles. In malnourished individuals, similar thymic atrophy is present, although the Hassall's corpuscles are present and cystically dilated. Absence of differentiation antigens or anomalous expression of major histocompatibility antigens occurs on thymic epithelial cells in these conditions, and resembles immunologic abnormalities of the thymus in severe combined immunodeficiency. In acquired immunodeficiency syndrome, graft-vs-host disease, and cyclosporine therapy, there is an expansion of cytotoxic/suppressor (CD8) lymphocytes. Experimental evidence suggests that in many situations, such cells may cause damage to the thymic epithelium. The damage to the thymic epithelium may alter the thymic microenvironment and contribute to the immune dysfunction observed in these patients. In addition, a damaged microenvironment may hinder therapeutic efforts to reconstitute immunity.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Monoclonal antibodies marking T lymphocytes in paraffin-embedded tissue.

The authors investigated the ability of 70 monoclonal antibodies obtained from the Third International Workshop on Human Leukocyte Antigens (Oxford, 1986) to mark T lymphocytes in B5-fixed paraffin-embedded tissue. No staining occurred with 65 of the antibodies; however, 5 antibodies marked small lymphocytes in the T-cell areas of human tonsil. Two antibodies which strongly labeled lymphocytes, UCHL1 and T2/48, were used to examine 106 cases of non-Hodgkin's lymphoma, 29 cases of Hodgkin's disease, and a variety of normal and neoplastic tissues. UCHL1 and T2/48 each marked 86% (37/43) of B5-fixed T-cell lymphomas. Only 50% of formalin-fixed T-cell lymphomas were marked with these antibodies. UCHL1 marked 1.8% (1/56) of the B-cell lymphomas, compared with T2/48, which marked 19.6% (11/56) of the B-cell lymphomas. T2/48 had the interesting attribute of marking cells of the follicular mantle-zone and intermediate lymphocytic lymphoma, suggesting that the antibody recognizes a B-cell differentiation antigen. No Reed-Sternberg cells, epithelial neoplasms, sarcomas, neurogenic tumors, or normal nonlymphoid tissue were marked by either antibody. These antibodies successfully mark T cells in paraffin tissue sections and should aid in the investigation and characterization of abnormal lymphoid proliferations, "undifferentiated" malignant neoplasms, and immunologically mediated disorders.

Antibodies, Monoclonal↗
PubMed1987

[Effect of ozone on physical performance capacity].

Twelve healthy women and twelve healthy men were tested on an exercise bicycle until exhaustion in a climate chamber at ozone levels of 0, 0.06 and 0.12 ppm. Under high ozone, a clear decrease of performance was seen at maximal efforts as well as a shift of the anaerobic threshold to somewhat lower performance values. These changes are probably caused by increasingly difficult breathing due to a reflex bronchial constriction. At high ozone concentrations, further symptoms were recognized: itching in throat and neck region, thirst, fatigue and itching eyes.

Adult↗
PubMed1986

Lymphoplasmacytic lymphoma. Report of a case with three monoclonal proteins derived from a single neoplastic clone.

The unique case of a 60-year-old patient with a non-Hodgkin's B-cell lymphoma of the lymphoplasmacytic type and three associated monoclonal proteins, is described. The patient also exhibited various autoimmune phenomena that were consistent with the diagnoses of Sjögren's syndrome and autoimmune thyroiditis. The evolution from production of a single monoclonal protein (IgM-kappa) to three monoclonal proteins (IgG-kappa, IgA-kappa, and IgM-kappa) suggested that the lymphoplasmacytic cells were at different stages of terminal differentiation within a single neoplastic clone. The chronic antigenic stress imposed on the immune system by the autoimmune disorder may have played a role in the development of lymphoma and in the heavy chain immunoglobulin switching that occurred during the patients' clinical course.

Blood Protein Electrophoresis↗
PubMed1986

Fine-needle aspiration biopsy of the mediastinum.

Fine-needle aspiration is a useful technique to identify neoplasms of many sites, such as breast, thyroid, and lung. Thirty-two mediastinum aspirates from 29 patients were reviewed. Five aspirates yielded insufficient material. Five aspirates were of benign lesions. Four aspirates were suggestive of but not diagnostic of malignancy. Eighteen aspirates contained malignant cells; in 13 of these, a definite cell type was identified, which usually was metastatic lung carcinoma; in five instances, the cell type could not be unequivocally identified. Complications were minimal, two instances of pneumothorax (6.3 percent) and two of hemoptysis (6.3 percent). No deaths or hemorrhage occurred. In 16 of the 29 patients (55 percent), thoracotomy was avoided because of fine-needle aspiration biopsy. It is concluded that fine-needle aspiration biopsy of the mediastinum is a safe, useful diagnostic tool. This procedure may obviate the need for thoracotomy in persons with inoperable cancer, thus lowering medical costs and length of hospital stay.

Adolescent↗
PubMed1986

Complete response of granulosa cell tumor metastatic to liver after hepatic irradiation: a case report.

A case of granulosa cell tumor of the ovary with extensive metastases to the liver was treated by a course of fractionated hepatic irradiation consisting of 30.00 Gray delivered to the whole liver, followed by boost to gross disease for a total dose of 50.00 Gray given in six weeks. This was followed by complete tumor response with normal liver function tests, and computed tomography demonstrated a normal liver two years after radiotherapy. Liver metastases from granulosa cell tumor of the ovary are unusual, and little information has been published regarding management of this problem.

Aged↗
PubMed1986

Acquired immune deficiency syndrome (AIDS).

The epidemiology, clinical and pathologic manifestations, identification of groups at high risk, results of laboratory analyses, and description of the modes of transmission of the putative etiologic agent HTLV-III/LAV have been summarized. Mechanisms of induction of T-cellular immunodeficiency have been described, including the role of HTLV-III/LAV, and possible roles of CMV and EBV as cofactors have been presented. Prospects for preventing and treating AIDS have been succinctly summarized.

Acquired Immunodeficiency Syndrome↗