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Biomedical subjects

J Weyler

Publications and source records attributed to J Weyler.

47 records · Page 3Linked to original sources

Stereological evaluation of malignant mesothelioma versus benign pleural hyperplasia.

The differential diagnosis between malignant mesothelioma and benign pleural hyperplasia constitutes a well-known problem. In the present study we examined unbiased stereological techniques to assess the mean nuclear volume (MNV) using the point-sampled intercepts (PSI) in 37 cases of malignant mesothelioma and in 28 cases of benign pleural hyperplasia. Neither the use of different fixatives nor the histological type of malignant mesothelioma produced any significant difference on the measured nuclear volume. The differences observed between the MNV data obtained from benign pleural hyperplasia and those from any of the three types of malignant mesothelioma were found to be highly significant. All lesions with an MNV larger than 250 microns3 were found in our study to correspond to the malignant mesothelioma type, while an MNV that was smaller than 200 microns3 could only be detected in benign specimens. These observations lead us to propose the MNV measurement using PSI as an additional tool to enhance the differential diagnosis of malignant mesothelioma versus benign pleural hyperplasia.

Cell Nucleus↗

Detection of numerical chromosomal aberrations in paraffin-embedded malignant pleural mesothelioma by non-isotopic in situ hybridization.

An in situ hybridization (ISH) study on paraffin sections of 13 malignant mesotheliomas was performed to detect numerical chromosomal aberrations with biotin-labelled DNA probes specific for the centromeric regions of chromosomes 1, 3, 6, 7, 11, and 17. All chromosomes contributed to numerical changes, which can be summarized as follows: first, a monosomy for chromosome 6 was found in one case; second, in five cases a trisomy for at least one chromosome was detected; and third, in seven cases a pentasomy or a higher polysomy was found for at least one chromosome. Although these data have to be confirmed on a larger group of patients, survival analysis of this group showed no significant difference between the first and second groups taken together and the third group. In this study no specific numerical chromosomal aberrations were identified. Nevertheless, numerical gains appear to be more frequent than has previously been shown by karyotype analysis.

Chromosome Aberrations↗

Prognostic value of bcl-2 expression in invasive breast cancer.

Expression of the bcl-2 proto-oncogene was studied immunohistochemically in 251 invasive ductal breast carcinomas (median follow-up time 91 months, range 24-186 months) and the results were correlated with clinicopathological data and prognostic variables. Sixty-three (25%) tumours were scored bcl-2 negative and 188 (75%) tumours were bcl-2 positive. No relationship could be observed between bcl-2 status and tumour grade, pTNM staging or menopausal status. A strong positive relationship was demonstrated between bcl-2 immunoreactivity and oestrogen receptor status (P < 0.001) and progesterone receptor status (P < 0.001). No prognostic value was demonstrated for bcl-2 expression on disease-free survival and overall survival in axillary node-negative breast cancer patients. However, in axillary node-positive breast cancer patients multivariate analysis demonstrated absence of bcl-2 expression to be independently related to shortened disease-free survival (P = 0.003) and shortened overall survival (P < 0.001). Our results suggest a potential important role for bcl-2 expression as a modulator of response to adjuvant therapy in breast cancer.

Adult↗

Proliferation in malignant mesothelioma as determined by mitosis counts and immunoreactivity for proliferating cell nuclear antigen (PCNA).

In order to assess its discriminating and prognostic value, we studied immunoreactivity for proliferating nuclear cell antigen (PCNA) in human malignant mesothelioma (31 cases) and in human non-neoplastic mesothelium (33 cases with reactive mesothelium and 20 cases of normal mesothelium) using the murine monoclonal antibody PC10. We also compared it with mitosis counts expressed as the mitotic volume index (MV index). There were differences between malignant mesothelioma, reactive mesothelium, and normal mesothelium for percentage of PCNA immunoreactive cells (mean +/- SD; 27 +/- 9, 9.5 +/- 5.1, and 3.6 +/- 1.6, respectively) and for their MV index (20.3 +/- 4.5, 9.4 +/- 2.1, and 3.6 +/- 0.6, respectively). The median actuarial survival was 10.1 months for patients with less than 25 per cent PCNA immunoreactive cells, 9.4 months for patients with less than 20 mitoses per mm2 of tumoural tissue, 5.9 months for patients with more than 25 per cent PCNA immunoreactive cells, and 5.3 months for patients with more than 20 mitoses per mm2 of tumoural tissue. Our results suggest that PCNA immunoreactivity is useful in discriminating between neoplastic and non-neoplastic mesothelium and that it may have prognostic value in malignant mesothelioma.

Adult↗

Immunoreactivity for bcl-2 protein in malignant mesothelioma and non-neoplastic mesothelium.

Immunohistochemical study of bcl-2 protein immunoreactivity in human non-neoplastic mesothelium (44 cases) and in malignant mesothelioma (62 cases) using a murine monoclonal antibody (clone 124) showed cytoplasmic immunoreactivity for bcl-2 protein in five cases of malignant mesothelioma. Non-neoplastic mesothelium was not immunoreactive. Immunoreactivity for bcl-2 protein does not add useful prognostic information in malignant mesothelioma since survival times of bcl-2 positive and bcl-2 negative cases did not differ. Nevertheless, the detection of bcl-2 protein in malignant mesothelioma might be useful for the differentiation from reactive mesothelium.

Epithelium↗

[The use of the cervix brush for early diagnosis of cervix uteri cancer: quality of the smear].

From may 1988 till may 1989, a cervix-brush has been used to take smears by a group of general practitioners involved in a cervical cancer screening program. These smears are compared--retrospectively--with a selection of smears from previous cervical cancer screening programs. The collection devices previously used were an Ayre spatula and an Ayre spatula combined with a cotton tipped swab. All smears have been cytologically examined by the Center for Cancer Prevention of the UIA and have been described using the standardized KOPA-method. 3 Groups of smears have been included in the study: --group 1 (n = 299): use of a cervix-brush --group 2 (n = 1315): use of an Ayre spatula --group 3 (n = 1450): use of an Ayre spatula + cotton tipped swab. Concerning their previous experience in taking smears, all the participating GP's are considered to be comparable. There was a slight difference in the age distribution of the women examined, between group 1 and the other 2 groups. From this study, we concluded: --a larger number of smears from the group using the cervix-brush (group 1) has been described as having "good quality". This result was confirmed after matching for age group. --the number of abnormal smears detected was comparable for all groups.

Female↗

Comparison of MRI features of different grades of DCIS and invasive carcinoma of the breast.

The purpose of the study is to compare mammography and magnetic resonance (MR) mammography in detection and assessment of extent, of histologically proven ductal carcinoma in situ (DCIS) and to compare MR features of DCIS, with features of invasive carcinoma. Forty histopathologically proven and MR detected pure DCIS lesions were described and compared with 213 enhancing invasive carcinomas. Histopathological examination revealed 49 pure DCIS, MR detected 40 of them (81.6%). There was a good correlation between diameter measured on mammography, MR and histopathology. MR was able to detect additional foci. Ductal enhancement, a focal area or a mass were perceived in respectively 8 (20%), 8 (20%) and 24 (60%) DCIS and in 0, 6 (2.8%) and 207 (97.2%) invasive lesions. Maximal contrast enhancement after 3 minutes was seen in 60.9% of DCIS and before 3 minutes in 61% of invasive masses. Signal intensity increase of more than 100% was seen in 76.9% of DCIS and in 91.1% of invasive carcinomas. DCIS had a wash out in 53.8% and invasive carcinomas in 65.3%. MR was able to detect 81.6% of DCIS. Diameter prediction was good on mammography and MR mammography. The only MR feature exclusively seen in DCIS was ductal enhancement.

Aged↗

The Diabetic Foot Project of Flanders, the northern part of Belgium: implementation of the St Vincent consensus. Sensibilisation and registration in diabetes centres.

As a result of the St Vincent declaration, a Belgian "task force" was installed in 1992 and consequently 16 working groups were formed. They presented their objectives in 1995. The working group "prevention and treatment of diabetic foot lesions" started the implementation of a screening program to obtain an overview of the presentation of diabetic foot lesions, the amputation rate and the prevalence of patients with a foot at risk. This study reports the results from 43 out of 73 Flemish diabetes centres. 1653 patients were enrolled in this study (53% women, 47% men, median age 61). 34.6% were type 1 and, 65.4% type 2. One or more arterial pedal pulses were absent in 28%, 30.5% had an abnormal monofilament test, 35% skin lesions and 28% malformations. Still 19% smoked, 15.8% had visual problems and 11% had already developed an ulcer previously. Ulcers were reported in 8.7% of which almost 2/3 belonged to Wagner class I. 69 (3.87%) of the patients had had amputations. According to the four-risk categories-scale 46.3% of the patients belonged to the highest one; peripheral vascular disease, previous amputations, previous ulcers, and Charcot joints. In our region we didn't have previous data on the prevalence and morbidity of the amputation rate with diabetes patients. We observed 3.87% amputations, which is rather high in comparison with international data (0.44% - 2.4%). The general follow-up of diabetic foot problems can be organised in co-operation with other care providers. A national program therefore is going to start in the next months. We all have to be aware of the size of the problem to offer the best possible prevention. As we have seen, the use of inlay soles and podiatrist-made ortheses for example is very low. We hope that all care providers will participate in this important project, so that they will acquire a specific attitude towards these patients. In daily clinical practice there are some key-roles to be respected by all health care providers. In our opinion the next are of the utmost importance: take off your diabetic patient's shoes when they visit you; give specific education if your patient has a foot at risk; if an ulcer is present, carefully follow-up is mandatory and if no good evolution of the ulcer is seen, an early referral to a diabetic foot clinic is obvious. Together we can lower down the amputation rate of diabetic foot lesions. And that would be a marvelous implementation of the St Vincent declaration in Belgium.

Aged↗