Mandibular joint involvement in a case of Fanconi's syndrome with renal failure.
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Bicarbonates↗
Biomedical subjects
S Meijer
Publications and source records attributed to S Meijer.
Proximal symphalangism of fingers associated with fusion of os naviculare and talus and occurrence of two accessory bones in the feet (os paranaviculare and os tibiale externum) in an European--Indonesian--Chinese family.
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Abnormalities, Multiple↗
Pathologic analysis of sentinel lymph nodes.
The sentinel lymph node (SLN) procedure enables selective targeting of the first draining lymph node, where the initial metastases will form. A negative SLN predicts the absence of tumor metastases in the other regional lymph nodes with a high degree of accuracy. This means that in case of a negative SLN, regional lymph node dissection is no longer necessary. Besides saving patients the significant morbidity associated with lymph node dissection, it will also save costs. Crucial for the success of the SLN procedure is the screening of the SLN for metastases by the pathologist. To this end, several techniques are available such as standard histo- and cytopathological techniques, immunohistochemistry, flow cytometry, and molecular biological techniques. In this paper, the value of these methods for detecting SLN metastases is discussed. Some of these techniques have also appeared to be quite useful for intraoperative evaluation of SLNs. The standard protocol for detection of SLN metastases consists of extensive histopathological investigation including stepped sections stained with hematoxylin and eosin (HE) and immunohistochemistry. Intraoperative frozen section analysis and imprint cytology of SLNs have been shown to be reasonably reliable for detecting breast cancer metastases in SLNs. Further studies are necessary to establish the role of multiparameter flow cytometry and sophisticated molecular biological techniques such as reverse transcription polymerase chain reaction (RT-PCR) in detecting SLN metastases.
Biopsy, Needle↗
Are locoregional cutaneous metastases in melanoma predictable?
BACKGROUND: In-transit metastases and satellite lesions are manifestations of locoregional cutaneous recurrence that are characteristic of malignant melanoma. They are the result of tumor cell emboli entrapped in the dermal lymphatics between the primary tumor and the regional lymph node basin. Histopathological features of lymphatic invasion were investigated to determine the possibility of predicting locoregional cutaneous metastases in melanoma patients. METHODS: In a prospective study, 258 patients with clinical stage I melanoma underwent wide local excision and sentinel node biopsy. Nodal metastases were found in 53 (21%) patients. Of 29 patients (11.2%) who had developed recurrences to date, 17 (6.6%) had locoregional cutaneous metastases. All surgical specimens were examined with particular attention to histopathological signs of lymphatic vascular invasion or microscopic satellites. RESULTS: Unequivocal signs of lymphatic invasion were observed in 14 of 258 patients (5.4%), and 13 (93%) of these patients subsequently developed in-transit metastases, after a median interval of 10 months. The primary melanoma was located on the extremities in seven patients. The median Breslow thickness was 2.5 mm, and 5 showed ulceration. In 244 of 258 patients (94.6%), there were no signs of lymphatic invasion. To date, only four patients (1.6%) have had a locoregional cutaneous recurrence, occurring after a median interval of 29 months. All four of these patients had ulcerative melanomas on an extremity, with a median thickness of 4.0 mm. The presence of lymphatic invasion was significantly related to early locoregional cutaneous relapse (P < .0001). CONCLUSIONS: Locoregional cutaneous recurrence appears to be highly predictable in the presence of histopathological signs of lymphatic invasion. Lymphatic invasion is an important prognostic parameter and should be included as a stratification criterion when selecting patients for adjuvant (locoregional) therapy.
Adult↗
Intra-operative ultrasound in detection of liver metastases.
Intra-operative ultrasonography (IOUS) combined with palpation of the liver is significantly more accurate than either computer tomography (CT) or percutaneous ultrasonography employed pre-operatively. Accurate staging of colorectal cancer is essential for appropriate treatment strategy. There is a large impact of IOUS on tumour staging and treatment especially in patients with suspected liver lesions at pre-operative imaging.
Colorectal Neoplasms↗
Aortic aneurysm repair is associated with a lower inflammatory response compared with surgery for inflammatory bowel disease.
BACKGROUND: Since the plasma cytokine profile reflects the body's inflammatory response to injury, this study was designed to prospectively observe the plasma cytokine levels in response to the degree of different sorts of abdominal surgical trauma. METHODS: Plasma levels of TNF-alpha, type I TNF receptor (p55), type II TNF receptor (p75), IL-6, IL-8, IL-10, phospholipase A(2) (PLA(2)), and haptoglobin were measured peri-operatively in patients undergoing bowel resection for inflammatory bowel disease or diverticulitis (IBD) (n = 9), elective repair of abdominal aortic aneurysm (AAA) (n = 9), or laparoscopic cholecystectomy (lap chole) (n = 9). RESULTS: The IBD patients showed a significant (p < 0.05) post-operative elevation in plasma IL-6, p55, p75, and PLA(2) levels, but no significant change in TNF-alpha, IL-8, IL-10 or haptoglobin levels. The AAA patients had a significant post-operative rise in IL-10 levels and a significant decrease in plasma haptoglobin levels, but no significant change of TNF-alpha, IL-6, IL-8, p55, p75, or PLA(2) concentrations. The lap chole patients demonstrated no significant change in any of these parameters. CONCLUSION: These data show that IL-6, IL-10, p55, and p75 are markers to measure the degree of inflammatory stress associated with abdominal operative procedures and demonstrate the relative lack of a cytokine response to laparoscopic cholecystectomy.
Adult↗
The sentinel node concept in melanoma and breast cancer: relevancy and therapeutic consequences.
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Breast Neoplasms↗
Immunological response in laparoscopic surgery.
Immunological response to surgical trauma may be protected during laparoscopic surgery. A less surgical trauma, in comparison with conventional surgery, may explained these important advantages. Plasma and macrophages studies have demonstrated that laparoscopic cholecystectomy causes less depression of cell mediated immunity than open cholecystectomy. What will be the impact of this immunological protection in laparoscopic advanced and oncological surgery? Experimental studies have showed that laparoscopic techniques in advanced and oncological surgery may have important advantages concerning the "preservation of the immune status" of the patient. That will imply in the future a lower percentage of infections, local recurrence and even a lower percentage of distant metastases. On the other hand, the appearance of tumor implants in the port sites after laparoscopic resection for cancer is a significant drawback of this procedure. Proper investigations have to be carried out in order to find the cause and the solution of this dilemma.
Acute-Phase Reaction↗