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Biomedical subjects

K R Geisinger

Publications and source records attributed to K R Geisinger.

At least 127 records · Page 7Linked to original sources
PubMed1986

Endometrial adenocarcinoma. A multiparameter clinicopathologic analysis including the DNA profile and the sex steroid hormone receptors.

With endometrial adenocarcinoma, several factors, such as stage and histologic grade, are well recognized as having prognostic significance. Other variables, e.g., nuclear grade, probably are also important clinically. A preliminary investigation of the prognostic value of the ploidy, cell cycle kinetics, and sex steroid receptor contents of these tumors has been conducted and compared with more conventional prognostic factors such as stage, grades, and depth of invasion. As analyzed by flow cytometry, the proliferative activities of the carcinomas were significantly associated with prognosis. Tumors with lower levels of proliferative activity were related to improved survivals. Two thirds of the carcinomas were diploid; ploidy did not carry prognostic weight in the series. Both the estrogen and progesterone receptor status were related to survival. Patients whose tumors were positive for these receptors had a better prognosis than did those in which the receptors were not present in significant quantities.

Adenocarcinoma↗
PubMed1986

Reye's syndrome in adults. A case report and review of the literature.

Adult Reye's syndrome (ARS) is an infrequently diagnosed condition that typically affects patients younger than age 35 years. We describe a 61-year-old man with ARS occurring after influenza B-USSR infection and aspirin use. The diagnosis of ARS was confirmed by oil-red-O stain of liver biopsy tissue and subsequent electron microscopy. We review the literature on ARS and compare the clinical features and management of ARS with pediatric Rye's syndrome. This case is of interest to practitioners treating adult patients because it demonstrates that the patient population at risk for Reye's syndrome is broader than generally believed.

Aspirin↗
PubMed1986

Ticlopidine versus aspirin and dipyridamole: influence on platelet deposition and three-month patency of polytetrafluoroethylene grafts.

In an attempt to establish a specific drug regimen that would retard neointimal fibrous thickening (NFT) and promote patency of small arterial grafts, we studied acute platelet accumulation and 3-month patency of 4 mm polytetrafluoroethylene (PTFE) grafts in dogs treated with oral aspirin (2 mg/kg/day) in combination with dipyridamole (5 mg/kg/day) (ASA/D) or ticlopidine (25 mg/kg/day) (T). After 3 days of treatment, 15 dogs were given indium 111-labeled autologous platelets and then had bilateral femoral artery grafts placed (control, 10 grafts; each drug group, 10 grafts). The calculated graft radioactivity expressed as average counts per 10 minutes +/- standard error of the mean (SEM) was as follows: control = 542,003 +/- 63,991; ASA/D = 135,163 +/- 14,443 (p less than 0.001, Student's t test); T = 104,650 +/- 14,004 (p less than 0.001). Bilateral femoral artery and carotid artery grafts were placed in 15 other dogs (control, 20 grafts; each drug group, 20 grafts). Three months later the 60 grafts were excised and their patency recorded: control = 20% (4 of 20 grafts); ASA/D = 70% (12 of 17 grafts) (p less than 0.01, chi-square analysis); T = 30% (6 of 20 grafts) (p greater than 0.05). Mean anastomotic NFT +/- SEM of each graft was measured with an ocular micrometer: control = 1.6 +/- 0.2 mm; ASA/D = 0.7 +/- 0.2 mm (p less than 0.001, Student's t test); T = 1.3 +/- 0.2 mm (p greater than 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Benign lymphoepithelial cysts of the parotid gland. A histologic, cytologic, and ultrastructural study.

Five cases of benign lymphoepithelial cysts (BLCs) of the parotid gland are reported, and the histologic, aspiration cytologic, and ultrastructural findings are described in detail. These uncommon parotid lesions contain epithelium-lined cystic spaces encased by abundant lymphoid tissue with germinal centers. The epithelium was "mucoepidermoid" in three of our cases and squamous in two. Familiarity with the morphologic features of BLCs should make it possible to distinguish them from similar-appearing cystic lesions, especially low-grade cystic mucoepidermoid carcinoma and cystic types of benign lymphoepithelial lesion (so-called Mikulicz's disease). These distinctions, however, are difficult on aspiration cytology specimens.

Adult↗
PubMed1986

Analysis of the relationships of the ploidy and cell cycle kinetics to differentiation and the female sex steroid hormone receptors in adenocarcinoma of the endometrium.

Flow cytometry was used to evaluate proliferative activity and ploidy status in 21 endometrial adenocarcinomas. These data were compared with their histologic and nuclear grades and their estrogen and progesterone receptor contents. Proliferative activity was significantly related to histologic and nuclear grades and the progesterone receptor status but not to the estrogen receptor status. Unlike the majority of solid human malignant neoplasms, only seven tumors were aneuploid, the remainder being diploid. Ploidy was not significantly associated with either grading system, receptor status, or the proliferative index.

Adenocarcinoma↗
PubMed1986

Intermediate filaments in endometrial and endocervical carcinomas. The diagnostic utility of vimentin patterns.

We examined the distribution of high- and low-molecular-weight cytokeratins, vimentin, and carcinoembryonic antigen (CEA) in normal endometrial glands and endocervical glands (20 cases each) and in endometrial and endocervical adenocarcinomas (29 cases and 15 cases respectively). Low- and high-molecular-weight cytokeratin staining was present in normal endometrial and endocervical epithelium and in carcinomas. Coexpression of vimentin and cytokeratin was universally present in normal proliferative endometrial glands, with marked decrease or absence of vimentin staining in secretory phase patterns. Vimentin staining had a perinuclear distribution within the cells, in contrast to the cytokeratins, which stained diffusely. Vimentin was found in only 65% of endometrial adenocarcinomas. Staining was typically focal as well as regional in portions of the tumors. Vimentin was never observed in normal or neoplastic endocervical epithelium. Ultrastructural studies corroborate the perinuclear vimentin immunostaining pattern we observed in endometrial adenocarcinomas. CEA staining results were similar to those previously reported. These data indicate that the presence of vimentin may readily distinguish endometrial from endocervical carcinoma and is diagnostically useful in the study of metastatic adenocarcinomas.

Adenocarcinoma↗
PubMed1986

Use of monoclonal antiestrogen receptor antibody to evaluate estrogen receptor content in fine needle aspiration breast biopsies.

A monoclonal antibody prepared against estrogen receptor has been shown to be highly specific and sensitive for the detection and quantification of estrogen receptor in human breast lesions using immunohistochemical methods. A semiquantitative relationship has been shown between the intensity of staining and biochemical receptor analysis. To evaluate the usefulness of this technique in fine needle aspiration biopsies, 41 cases of breast cancer were studied. Nuclear localization of receptor antibody PAP complex was observed. Comparison of the immunocytochemical analysis of the aspiration cytologic specimens to the biochemical analysis of the excised tumor mass revealed a sensitivity and specificity of 80% and 89%, respectively. There was a significant semiquantitative correlation between the methods. These results extend the observation that antireceptor monoclonal antibody in immunohistochemical analysis is an effective tool in the evaluation of estrogen receptor content in human breast lesions and with careful specimen handling and proper controls may be extended to the evaluation of fine needle aspiration biopsies.

Antibodies, Monoclonal↗
PubMed1986

Atypical carcinoid of the lung: radiographic features.

Atypical carcinoid of the lung is a neuroendocrine neoplasm with cellular and clinical features intermediate between those of typical carcinoid and small cell undifferentiated carcinoma of the lung. These neoplasms exhibit a wide range of histologic appearances and are misdiagnosed in up to 50% of cases. The clinical records and radiographs of 32 patients with this diagnosis from the University of Virginia Medical Center and Wake Forest University Medical Center were reviewed. Sixteen of these cases had been misdiagnosed pathologically. While the most frequent radiographic finding was a round or avoid lobulated peripheral mass, other appearances included thin-walled cavities, poorly defined nonsegmental infiltrates, and mediastinal masses. Fifty percent of the patients in this study have died from their tumor, with a mean survival of 15.5 months. This contrasts with both typical carcinoid and small cell undifferentiated carcinoma, in which patients develop fatal metastatic disease in 5% and nearly 100%, respectively. Proper categorization of typical carcinoid, atypical carcinoid, and small cell undifferentiated carcinoma is necessary to determine appropriate therapy, prognosis, and reporting of end results.

Adult↗
PubMed1986

Aspiration cytology of salivary glands.

Although mass lesions of the salivary glands are readily accessible to examination by fine-needle aspiration, the use of this modality has been limited. In part, this may be related to the difficulty differentiating between benign and malignant neoplasms in some cytologic specimens. Marked atypia in reactive non-neoplastic epithelium also could result in a false-positive diagnosis. In addition, aspiration of hypocellular material from cystic neoplasms, eg, well-differentiated mucoepidermoid carcinoma, may lead to false-negative cytologic reports. However, the diagnostic specificities claimed by a number of authors for this method are excellent. Furthermore, aspirates of certain specific neoplasms may yield highly distinctive cellular samples, such as the uniform tumor cells and extracellular hyaline spheres in many adenoid cystic carcinomas. Another example is the characteristic transition between the epithelial and myoepithelial cells of pleomorphic adenomas, which may contain prominent myxoid matrical material. With the increasing recognition of such features, the reported levels of diagnostic accuracy are improving.

Adenoma, Pleomorphic↗
PubMed1985

Pure nongestational choriocarcinoma of the ovary. Report of a case.

The authors report a case of pure nongestational choriocarcinoma of the ovary (NGCO) in a prepubertal female patient and emphasize the electron microscopic and immunohistochemical findings. Pure NGCO accounts for 0.6% or less of all ovarian neoplasms. Distinction from gestational choriocarcinoma of the ovary (GCO) is important because of the worse prognosis of NGCO. No distinctive ultrastructural or immunohistochemical differences were found between NGCO and GCO. Cytogenetic studies may be indicated in future cases to investigate potential reasons for the difference in prognosis.

Child↗
PubMed1985

Enhanced functional recovery with venting during cardioplegic arrest in chronically damaged hearts.

Thirty dogs with experimental myocardial infarction underwent cardiopulmonary bypass, hypothermic asanguineous K+ cardioplegia (1 hour), and reperfusion (30 minutes). Ten hearts were vented throughout, 5 only during arrest, and 5 only during reperfusion; 10 were not vented. Left ventricular (LV) performance and compliance were assessed by isovolumic (LV balloon) indexes before bypass and after reperfusion. Vented hearts recovered 116 +/- 8.3% of prearrest developed LV systolic pressure (DLVSP) and 131 +/- 13.6% of prearrest rate of rise of LV pressure (dP/dt). Nonvented hearts allowed to develop pressure during arrest (11.6 +/- 1.6 mm Hg) and reperfusion (65 +/- 4 mm Hg) recovered 50 +/- 3.9% of prearrest DLVSP and 55 +/- 5% of prearrest dP/dt (p less than 0.05). Reduction in LV compliance was comparable in both groups. Mitochondrial architecture (electron microscopy) was preserved in vented hearts, but was modestly disrupted in nonvented hearts, thus suggesting slight metabolic impairment. Functional recovery was nearly complete in hearts vented only during reperfusion (DLVSP, 94 +/- 10.4%; dP/dt, 89 +/- 12.6%), but venting only during arrest led to functional depression (DLVSP, 50 +/- 6.6%; dP/dt, 51 +/- 8%; p = 0.01). We conclude that venting chronically infarcted hearts during cardiac operations affords better myocardial protection by avoiding the damage that occurs during nonvented reperfusion.

Animals↗
PubMed1985

Granulomatous pneumocystosis presenting as a solitary pulmonary nodule.

A case of pneumocytosis presented radiologically as a solitary pulmonary nodule. Of cases presenting in this unusual fashion, this may be the first in which the histology was that of a fibrous and granulomatous nodule. The only pathogen identified was Pneumocystis carinii. The expected histologic pattern in pneumocystosis (interstitial pneumonitis with foamy alveolar exudate) was completely absent. Outside the major pulmonary nodule, scattered microscopic noncaseating granulomas of sarcoid type were observed. Treatment in this case consisted only of segmental pulmonary resection, but no recurrence of pneumocytosis was observed.

Diagnosis, Differential↗
PubMed1983

Pathologic alterations in the brain and liver in hyperpipecolic acidemia.

Pipecolic acid is a cyclic secondary imino acid produced in the metabolism of lysine. The metabolic role and fate of pipecolic acid in the human central nervous system are largely unknown. The biochemical defect in two brothers, both less than two years of age, with minor dysmorphic features, progressive neurological dysfunction, and hepatomegaly was identified as hyperpipecolatemia. At autopsy, the older brother's brain weight was increased, with bilateral pallor of the putamen. Distinctive changes included accumulation of 1-1.5 micrometer periodic acid-Schiff (PAS) positive, diastase-resistant, Alcian blue-negative, non-lipid, non-fluorescent granules in astrocytes, satellite cells, and perivascular foot processes. Both light and electron microscopy showed total absence of these granules in neurons. In the older sibling, the liver showed micronodular cirrhosis with distinctive intrahepatocytic accumulation of 0.2-1 micrometer membrane-bound material of low electron density. Pericellular fibrosis and similar cytoplasmic inclusions were present in the liver biopsy from his brother. The distinctive astrocytic storage phenomenon and the liver changes are compared to the findings in Zellweger's syndrome and lysinuric protein intolerance, which are also associated with altered pipecolate metabolism.

Brain↗
PubMed1982

Papillary adenoma of the lung with lamellar and electron dense granules. An ultrastructural study.

An unusual papillary adenoma in the periphery of the lung was resected in a 25-year-old woman. Examination of the tumor showed a noninfiltrating cellular neoplasms consisting of cuboidal to columnar epithelial cells with eosinophilic granular cytoplasm and without nuclear atypia. Ultrastructurally the tumor cells had microvilli, infrequent cell junctions, and cytoplasmic dense granules and whorled lamellar membrane membrane inclusions. These findings suggest that this benign pulmonary neoplasm has morphologic characteristics consistent with a Clara Cell and alveolar type II pneumocyte differentiation. Although tumors of similar types can be experimentally induced in mice, and the light microscopic features of similar human neoplasms have been described, this is the first report of the ultrastructural characteristics of a benign human lung tumor with morphologic features resembling Clara cell and alveolar type II pneumocytes.

Adult↗
PubMed1982

Collateral channels and histopathology in hepatic vein occlusion.

Hepatic arteriography, venography, and histopathology were reviewed in 20 patients with hepatic venous occlusion. The hepatic histologic materials (14 patients) were carefully examined in retrospect and correlated with the angiographic findings. Hepatic arteriographic findings were usually nonspecific but revealed neoplasms in all six patients studied and collaterals in four. Collateral channels that were recognized angiographically in 15 patients were extrahepatic, intrahepatic-interlobar, and indeterminate. The intrahepatic type was found in the partial Budd-Chiari syndrome, whereas other patterns were present in both diffuse and localized forms of hepatic venous occlusive disease. Histologically, the centrilobular sinusoids were congested and distorted in association with parenchymal destruction and compression. Hepatic venography correlated poorly with histopathologic findings.

Adolescent↗
PubMed1980

Pulmonary artery constriction by mediastinal lymphoma simulating pulmonary embolus.

Two cases of constriction of the pulmonary artery secondary to mediastinal lymphoma are reported. Both patients had clinical symptoms of pulmonary embolism. Radionuclide lung scans showed no perfusion of the right lung in one patient, and diminished perfusion of the right lung in the other. Pulmonary angiography revealed diffuse concentric narrowing of right main pulmonary arteries in both patients and of lobar branches in one, in whom severe encasement of the right pulmonary artery by a lymphomatous mass confirmed at autopsy. The decisive role of pulmonary angiography in determining the underlying pathology in patients with abnormal perfusion scans is illustrated.

Adult↗