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J Sandbank

Publications and source records attributed to J Sandbank.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Atypical mycobacterial cervical lymphadenitis in children].

Scrofula (mycobacterial cervical lymphadenitis) has been well-known for thousands of years. Atypical mycobacteria were first categorized by Timpe and Runyon in 1954. Treatment has varied over the centuries, from exclusion therapy in ancient Greece, through digitalis, iodide, chemotherapy, and surgical excision. The varied differential diagnosis and consequent diagnostic and therapeutic challenges make reassessment of this almost forgotten disease necessary. 21 patients with typical mycobacterial cervical lymphadenitis seen in over the past 5 years were reviewed. Age distribution ranged from 1-14 years, with peak incidence at 4 years; 9 were boys and 12 girls. Most presented with nontender, palpable neck masses and minimal constitutional complaints. Adenopathy was unilateral in all cases but 2. Mycobacterium avium-intracellulare and M. fortuitum were the main causative organisms. All underwent excision of the affected nodes. Long-term follow-up has been uneventful, except for 1 case of local recurrence requiring re-excision. This study emphasizes the marked variability in the clinical presentation of scrofula in children, stressing the importance of the differential diagnosis between tuberculous and atypical mycobacterial cervical lymphadenitis. The treatment of choice for the latter is complete excision of the affected nodes. Other treatment is followed by recurrence and unnecessary complications and should be avoided.

Adolescent↗
PubMed1999

The chemokine SDF-1 stimulates integrin-mediated arrest of CD34(+) cells on vascular endothelium under shear flow.

The chemokine SDF-1 plays a central role in the repopulation of the bone marrow (BM) by circulating CD34(+) progenitors, but the mechanisms of its action remain obscure. To extravasate to target tissue, a blood-borne cell must arrest firmly on vascular endothelium. Murine hematopoietic progenitors were recently shown in vivo to roll along BM microvessels that display selectins and integrins. We now show that SDF-1 is constitutively expressed by human BM endothelium. In vitro, human CD34(+) cells establish efficient rolling on P-selectin, E-selectin, and the CD44 ligand hyaluronic acid under physiological shear flow. ICAM-1 alone did not tether CD34(+) cells under flow, but, in the presence of surface-bound SDF-1, CD34(+) progenitors rolling on endothelial selectin rapidly developed firm adhesion to the endothelial surface, mediated by an interaction between ICAM-1 and its integrin ligand, which coimmobilized with SDF-1. Human CD34(+) cells accumulated efficiently on TNF-activated human umbilical cord endothelial cells in the absence of SDF-1, but they required immobilized SDF-1 to develop firm integrin-mediated adhesion and spreading. In the absence of selectins, SDF-1 also promoted VLA-4-mediated, Gi protein-dependent tethering and firm adhesion to VCAM-1 under shear flow. To our knowledge, this is the first demonstration that SDF-1 expressed on vascular endothelium is crucial for translating rolling adhesion of CD34(+) progenitors into firm adhesion by increasing the adhesiveness of the integrins VLA-4 and LFA-1 to their respective endothelial ligands, VCAM-1 and ICAM-1.

Antigens, CD34↗
PubMed1999

Inflammatory reactions associated with a calcium sulfate bone substitute.

OBJECTIVES: Loss of bone substance is a major source of disability that often requires grafting. Recently developed synthetic bone grafts have generated a lot of enthusiasm due to the lack of immunological reactions and infectious disease transmission risk. The current work describes some peculiar complications related to the use of calcium sulfate granules. METHODS: 15 implantations of calcium sulfate pellets Osteoset (Wright Medical Technology) were performed following resection of bone tumors at our service during 1999. Clinical or computerized tomography scans were available in all patients. RESULTS: 3 cases were encountered in which a severe inflammatory reaction developed. In one case serous drainage and an allergic reaction obligated graft removal. In another case, inflammation resolved two months following implantation. In the last case, wound breakdown occurred. CONCLUSIONS: A sterile inflammatory response has previously hindered the use of absorbable poly-lactic and poly-glycolic acid rods. Apparently due to rapid graft resorption, the resulting calcium-rich fluid incites inflammation. The single case of an allergic reaction is interesting. An allergy to plaster of Paris is rare and related to minor additives. These were not present in the bone substitute used. Inflammatory complications should be considered when assessing the risk-benefit ratio of using different types of bone replacement materials, and comparing allogeneic grafts to synthetic ones.

Adult↗
PubMed1998

Technetium-99m-MIBI scintimammography in palpable and nonpalpable breast lesions.

UNLABELLED: The aim of this study was to determine the diagnostic accuracy of 99mTc-MIBI scintimammography in patients with palpable and nonpalpable breast cancer. METHODS: One hundred and forty patients with a clinically palpable breast mass and/or suspicious mammographic finding had prone scintimammography after the intravenous injection of 740 MBq 99Tc-MIBI within 5 days before open biopsy or surgery. All patients had mammography within 2 mo before the scintimammography. The mammography was read as probably benign, probably malignant or indeterminate. The scintimammography was read as positive or negative for breast cancer. The scintigraphic studies were correlated with mammographic findings and with histopathology. RESULTS: Histopathological studies showed that the mean tumor size for 61 palpable tumors was 2.57 cm with a range of 1-6 cm, and for 24 nonpalpable tumors the mean size was 1.34 cm with a range of 0.5-3 cm. Mammography had an overall sensitivity of 91.58% and a specificity of 42.87%; the sensitivity was 90.16% and 95.45% and specificity was 57.14% and 32.14% for palpable and nonpalpable tumors, respectively. Eight cases were considered indeterminate. Scintimammography was true-positive for 71 breast cancers, true-negative for 47, false-positive for 8 and false-negative for 14. The overall sensitivity was 83.5% and the specificity 85.4%. In the patients with palpable masses, sensitivity was 95.1% and specificity 75%; in those with nonpalpable lesions, sensitivity was only 54.2% and specificity, 93.5%. Among 18 cases of palpable abnormalities with probably benign mammography, six had true-positive scintimammography. Of eight patients with indeterminate mammography, one was true-positive on scintimammography. CONCLUSION: Scintimammography is an accurate and clinically useful tool for evaluating patients with palpable breast abnormalities when mammography is negative and in the cases of indeterminate mammography. A significant improvement in lesion detectability is necessary in nonpalpable breast abnormalities.

Breast Neoplasms↗
PubMed1997

Fiberoptic-guided CO2 laser for harvesting of the internal mammary artery.

OBJECTIVE: The internal mammary artery is the preferred conduit in coronary artery bypass grafting. Although most centers use electrocautery to dissect the internal mammary artery, it has several disadvantages. The purpose of this study in a canine model was to evaluate and compare a fiberoptic CO2 laser device versus electrocautery for harvesting the internal mammary artery. MATERIAL AND METHODS: In ten mongrel dogs, both internal mammary arteries with their surrounding pedicles, were dissected from the thoracic wall, using a low-current electrocautery for one artery and a continuous wave, fiberoptic-guided CO2 laser (13 watts) for the contralateral vessel. Blood flow through the vessels was measured immediately after dissection. RESULTS: Mean flow through the laser dissected arteries was 71.3 +/- 23.7 ml/min versus 52.9 +/- 16.5 ml/min in those dissected using electrocautery. Histological examination of the chest wall specimens dissected with electrocautery showed the presence of necrosis, edema and hemorrhage surrounding the muscle, while the specimens dissected with the laser revealed only a narrow area of burn on the surgical margins of the muscle. The laser-assisted dissection was more accurate, as easy, and almost as fast as with the use of electrocautery. CONCLUSIONS: Stripping of the internal mammary artery with the fiberoptic CO2 laser offers a promising alternative to electrocautery. Owing to its greater accuracy, the laser technique may reduce the likelihood of damaging the endothelial lining of the dissected vessel. By reducing the degree of soft tissue damage, the CO2 laser may also lower the incidence of sternal wound infection and reduce postoperative chest wall pain and dysesthesia.

Animals↗
PubMed1996

Cirrhotic glomerulonephritis: an underdiagnosed condition.

Glomerular pathology in liver cirrhosis is common in autopsies but is underdiagnosed antemortem. The most common pathologic findings are mesangial disease with immunoglobulin A deposits, and membranoproliferative glomerulonephritis. The latter is associated, most frequently, with hepatitis C infection and cryoglobulinemia. We describe a patient with longstanding liver cirrhosis who presented with a nephritic and nephrotic syndrome. Membranoproliferative glomerulonephritis was diagnosed on kidney biopsy. There was no clinical, laboratory or histologic evidence of hepatitis C infection or cryoglobulinemia. The different aspects of "cirrhotic glomerulonephritis" are discussed and the need for searching for this underdiagnosed condition in patients with chronic liver disease is emphasized.

Biopsy↗
PubMed1996

Effect of green argon (514 nm) laser exposure on rose bengal-stained guinea pig cornea.

Our purpose was to study the effect of continuous wave (CW) green argon laser (514 nm) exposure on rose bengal-stained cornea. Following staining with rose bengal (1%), the corneas of 48 albino guinea pigs were exposed to different power levels of argon laser, ranging between 0.04 and 0.8 W. The beam diameter ranged between 50 and 200 microns, and exposure time was 0.1 sec. Histology revealed minimal tissue coagulation at 0.05 W and 50 microns. Moderate coagulation of the anterior stromal lamellae was found at power levels of 0.07-0.6 W and a beam diameter of 100-200 microns. At power levels of 0.7 and 0.8 W, lamellar disruption was also noted. Our data indicate that 1% rose bengal is a good photosensitizer for superficial corneal stromal photocoagulation.

Animals↗
PubMed1995

Parenchymal leiomyoma of the breast. Report of a case and clinicopathological review.

We describe a 42-year-old woman with a solid breast mass of smooth muscle cell origin. Breast leiomyoma is an extremely rare benign tumour, with only 11 cases reported thus far. Various explanations have been offered with regard to its origin, such as hamartoma, embryonal migration from the nipple tissue, multipotent mesenchymal cells or the presence of myoepithelial cells originating from the breast ducts. The differential diagnosis for breast leiomyoma usually includes benign fibrous breast lesions, but leiomyosarcoma should definitely be ruled out. Surgical treatment consists of tumour excision with free margins. We discuss the tumour's clinical, pathological and immunohistochemical features, and review the current literature.

Adult↗
PubMed1995

Malignant fibrous histiocytoma of the breast.

Primary malignant fibrous histiocytoma of the female breast (MFH) occurs very rarely, and only 22 cases have been reported so far. We describe a 42-year-old female in whom MFH of the breast was diagnosed, and review the available literature. In accordance with knowledge concerning the biological and clinical behaviour of breast MFH, either wide local excision or mastectomy combined with axillary lymph nodes dissection is recommended, due to the high rate of recurrence and metastatic potential of this tumour.

Adult↗
PubMed1995

Intracranial gangliocytoma in a dog.

The clinical, pathologic, immunohistochemical, and electron microscopic characteristics of a pure intracranial gangliocytoma in a 6-year-old spayed female dog are presented. The tumor is very rare in humans, and has not been previously reported in the dog. The most remarkable feature of this tumor was that it was composed of a single neuronal cell type without the presence of glial elements, as demonstrated by the negative immunohistochemical reaction to glial fibrillary acidic protein.

Animals↗
PubMed1994

Microcephaly and congenital nephrotic syndrome owing to diffuse mesangial sclerosis: an autosomal recessive syndrome.

Three sibs born to consanguineous parents had congenital nephrotic syndrome, microcephaly, and psychomotor retardation. Pathology of the kidneys showed diffuse mesangial sclerosis with deposits of IgG and C3 in the mesangium and glomerular basement membranes. All three children died before the age of 3 years. Of 19 published cases of children with the association of congenital nephrotic syndrome and microcephaly, only four had histological evidence of diffuse mesangial sclerosis, and two of their sibs probably had the same disease. The association of nephrotic syndrome owing to congenital diffuse mesangial sclerosis, microcephaly, and mental retardation appears to be a distinct syndrome with an autosomal recessive mode of inheritance.

Abnormalities, Multiple↗
PubMed1994

Oncogenic osteomalacia induced by schwannoma in a patient with neurofibromatosis.

A 62-year-old woman known to be suffering from Von Recklinghausen disease and osteomalacia was operated on for a pelvic mass. Pathological examination of the excised tumor showed it to be a schwannoma and this tumor was considered to be responsible for the osteomalacia. The return of previously abnormal laboratory data to normal values and the impressive clinical and subjective improvement further support the assumption that the excised schwannoma was responsible for the pathology observed in this patient.

Female↗
PubMed1993

[Malignant peritoneal mesothelioma].

Public attention has recently been devoted worldwide to malignant mesotheliomas and their relation to exposure to industrial materials, especially asbestos and its products. The more common form of the disease is the pleural type, while the peritoneal variant is rare, with an estimated incidence of less than 1:1,000,000 new cases per year. In contrast to the pleural type, the relationship of malignant peritoneal mesothelioma to exposure to asbestos is unclear. The differential diagnosis, based on clinical appearance and imaging techniques, is broad and the diagnosis is inconclusive, so that the diagnosis must be confirmed by histologic examination. Treatment is a combination of surgery, chemotherapy and irradiation. Contrary to occasional reports, the malignancy is fatal, death occurring within a few months of diagnosis. We present a 65-year-old man in whom malignant peritoneal mesothelioma was diagnosed. The presenting symptoms were a large abdominal mass involving the colon, and ascites. He died 5 months after the diagnosis was made.

Aged↗