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Biomedical subjects

T J Eide

Publications and source records attributed to T J Eide.

At least 37 records · Page 2Linked to original sources

Remote frozen section service in Norway.

Remote frozen section service has been in regular use in northern Norway since 1990. Two local hospitals are equipped with a motorized video microscope remote controlled from the workstation at the University Hospital. The video images are transmitted via a two ways audio and video telenetwork. This dynamic telepathology system utilizes a videocodec for image compression and a transfer rate of 384 Kbit/s. The video images of surgical specimens and frozen sections are displayed on monitors at both the sender and receiver site. From 1990 until 1. July 1994 tissue from 100 patients have been examined. Breasts and thyroid tissues accounts for 74 of cases. Correct benign versus-malignant diagnosis has been given obtained in 89 cases. One false positive, three false negative and seven deferred diagnosis regarding malignancy have occurred. The false positive diagnosis had no major consequences for the patient. Two of the deferred diagnosis turned out to be malignant. The average time taken for examination of each frozen section was 12 minutes (range, 3 to 45 min). Our concept of remote frozen section service can be recommended for hospitals without a local service in surgical pathology.

Breast Neoplasms↗

[Cystic lymphangioma of the mesentery].

Cystic lymphangioma of the mesentery is a rare congenital lesion with a relatively low growth potential. It is typically found in young adults, and thereby excluded from other, more aggressive lymphatic malformations seen in newborns. Symptoms of onset may be dramatic and sudden, but are often preceded by an interval of diffuse abdominal discomfort, possibly associated with loss of weight and a palpable abdominal mass. The multicystic architecture of the lesion is clearly visible on an abdominal CAT-scan and indicates the diagnosis. Percutaneous drainage of the cysts has neither diagnostic nor therapeutic effects. Radical excision of the expansion may include resection of the related intestinal segment. Lymphangioma of the mesentery is not malignant. We suggest an ultrasound follow-up six months after the intervention to establish whether the surgery has been successful.

Adult↗

Renal and hepatic toxicity after high-dose 7-hydroxymethotrexate in the rat.

To examine directly the hepatic and renal toxicity of 7-hydroxymethotrexate (7-OH-MTX) without interference of the parent compound methotrexate (MTX), we purified and gave 100 mg/kg 7-OH-MTX to rats, a dose resulting in serum levels of 7-OH-MTX comparable with those achieved in the clinic after the administration of high-dose MTX (HD-MTX). After only 5 h, the 7-OH-MTX-treated rats demonstrated 2.6-fold increases in serum creatinine values and 2-fold elevations in serum aspartate aminotransferase (ASAT) levels as compared with the controls. Morphologic evidence of toxicity, however, was apparent only in the kidneys. Intraluminal cellular debris containing membranous material and deteriorated organelles was seen, but no precipitate of the delivered drug. The peak serum concentration of 7-OH was up to 939 microM, and concentrations of 7-OH-MTX declined triphasically, showing a t1/2 alpha value of 2.45 min, a t1/2 beta value of 30.5 min, and a terminal half-life (t1/2 gamma) of 240 min. The total clearance value was 14.5 ml min-1 kg, and the postdistributional volume of distribution (V beta) was 5070 ml/kg. Our results may indicate a direct toxic effect of 7-OH-MTX on kidney and liver cells.

Animals↗

Current status of telepathology.

Telepathology is moving from the experimental stage to become a regular feature of pathology practice. This has been made possible by technical advances in telecommunications and image processing. Since 1990 the University Hospital of Tromsø has provided local hospitals in northern Norway with a remote frozen section service and with access to video conferences for the review of microscopic findings and for the discussion of major diagnostic issues. Several other hospitals in Norway are now participating in this development and practical relations among pathology laboratories for the purpose of consultation and education will be the next step in the procedure. Similar developments in telepathology have taken place in other countries. Standardization of network and telepathology workstations will be needed before extensive international collaboration can be achieved. Progress in high quality video devices, high capacity telecommunication lines and improved image compression techniques will increase the usage of telepathology services and make them cost-effective. Thus, telepathology will contribute to the development of pathology services in the next century.

False Negative Reactions↗

Cell death initiated by 3-deazaadenosine in HL-60 cells is apoptosis and is partially inhibited by homocysteine.

Cell death initiated by the adenosine analog 3-deazaadenosine (c3 Ado) was studied in human promyelocytic leukemia HL-60 cells. A rapid decrease in cell number was seen after 4-hr exposure to 50-100 microM c3 Ado. The dominating mode of cell death was apoptosis as demonstrated by condensation and fragmentation of the nucleus, formation of apoptotic bodies and endonucleolytic degradation of DNA. Four hour treatment with 100 microM c3 Ado resulted in a reduction of early S-phase cells, and appearance of cells with a lower DNA and protein content than that of the G1 population. Whereas 25 and 50 microM c3 Ado only initiated apoptosis in S-phase cells, 75 and 100 microM c3 Ado also initiated apoptosis in G1- and G2 + M-phase cells, suggesting different mechanisms for cell death at different concentrations. Apoptosis initiated by 100 microM c3 Ado was completely inhibited by 1 mM ZnCl2. Addition of homocysteine thiolactone (Hcy) partly inhibited cell death by c3 Ado. Light microscopic examination of cultures treated with 100 microM c3 Ado and 1 mM Hcy showed nuclear condensation and fragmentation consistent with the first stage in apoptosis, however, only a minor formation of apoptotic bodies took place in these cultures compared to that observed in cultures treated with 100 microM c3 Ado alone. The modifying action of Hcy on c3 Ado initiated apoptosis in HL-60 cells and this suggests that c3 Ado and 3-deazaadenosylhomocysteine (c3 AdoHcy) interact with different targets during initiation and progression of cell death in this cell line.

Apoptosis↗

Trends in colorectal cancer incidence and histologic findings in Maori and Polynesian residents of New Zealand.

BACKGROUND: The aim of this study was to combine an epidemiologic survey of colorectal cancer among Maori, Polynesian, and white inhabitants of New Zealand with a detailed analysis of tumor subsite and histopathology. METHODS: Data were obtained from the New Zealand National Cancer Registry and included all registrants from 1970 to 1984. Sections of histologic specimens of colorectal cancer of Maori and non-Maori were retrieved from three Auckland hospitals. RESULTS: The annual age-adjusted incidence rates of large intestinal cancer among male and female Maoris and male and female Polynesians were 40%, 40%, 39%, and 29%, respectively, of the total population incidence. Time-trend analysis showed the incidence of large intestinal cancer to be increasing among all racial groups. The relative proportion of rectal cancers was higher in male and female Maoris and female Polynesians than in the general population, whereas male Polynesians had a relatively high proportion of right colonic cancers. High-grade carcinoma and mucinous carcinoma occurred more frequently in young individuals regardless of race. Carcinomas were diagnosed at a more advanced stage in Maoris. CONCLUSION: Given the similar environmental characteristics of the three racial groups, the findings indicate the presence of powerful protective factors in Maoris and Polynesians. These could be constitutional or mediated by unrecognized dietary constituents.

Adenocarcinoma↗

Immunolocalization of cystatin A in neoplastic, virus and inflammatory lesions of the uterine cervix.

Cystatin A was immunohistochemically demonstrated in the normal squamous epithelium of the uterine cervix, particularly in the parabasal and superficial cell layers whereas it was absent or scanty in the basal cells and in areas with parakeratosis. Cystatin A was also found in neoplastic lesions (dysplasia, carcinoma in situ and squamous cell carcinoma), but less abundant than in normal squamous epithelium. The immunoreaction in intraepithelial neoplasia was closely related to the degree of morphological maturation of the squamous cells with more abundant cystatin A in low grade dysplasia and less in high grade dysplasia and carcinoma in situ. In squamous cell carcinoma, cystatin A was often abundant in highly differentiated areas and almost absent in poorly differentiated ones. Cystatin A was found in the squamous epithelium in herpes and in condylomatous lesions. It was also found in the cytoplasm of neutrophils, but not in lymphocytes and plasma cells. In unspecific cervicitis, cystatin A was found extracytoplasmatically as small vesicles in the epithelial-stromal junction. The implications of cystatin A in neoplastic, virus, and inflammatory processes are discussed.

Carcinoma in Situ↗

The validity of frozen section diagnosis based on video-microscopy.

To investigate the accuracy of video-microscopy of frozen sections, two pathologists reexamined 80 cases of archival material, on which frozen sections had previously been performed. Diagnoses based on the two trials (Observer 1 and 2) and diagnoses obtained in the original frozen section situation were compared with the final diagnoses based on paraffin embedded material. Observer 1 had two false negative diagnoses, but no false positive, whereas Observer 2 had one false positive, but no false negative diagnosis when compared with the final diagnoses. No false positive or false negative diagnoses were made in the original frozen sections situation and the number of inconclusive diagnoses were 5, as compared with 6 and 8 in the two trials based on video-microscopy. More experience with video-microscopy will probably achieve a quality of frozen section diagnoses similar to that of direct light-microscopy.

Diagnosis, Differential↗

Frozen section service via the telenetwork in northern Norway.

We present preliminary results of remote frozen section service for two local hospitals in Northern Norway. The service is arranged by remote controlling microscopes with motorized X, Y and Z stage movements, magnification and illumination located at Kirkenes and Harstad Hospitals at a distance up to 400 km apart from the workstation at the University Hospital in Tromsø. The video-images of the frozen section are transmitted via a two-ways phone and video telenetwork with 2 Mbit/s capacity. The images are displayed on a monitor as both still and live images and diagnosed by pathologists in Tromsø. To data, 50 patients are examined by remote frozen section service. Correct benign versus malignant diagnoses are given in all cases compared with final diagnoses based on formalin fixed and paraffin embedded material except for two false negative malignant cases and two deferred diagnoses. The average time taken for examining each case of frozen section was 13 minutes. For hospitals with limited requirement of local pathology service and for hospitals with deficiency of specialists, remote frozen section service may be a worthwhile substitute.

Diagnosis, Differential↗

The risk of cancer at all sites following gastric operation for benign disease. A cohort study of 4,224 patients.

This report represents the results of a historical cohort analysis of 3,360 males and 864 females who had a gastric resection or gastroenterostomy for benign disease between 1990 and 1969. Within the period 1970 to 1988 the cohort was cross-checked with the data files at the Cancer Registry of Norway to identify the patients in whom cancer had been diagnosed. When analyzed according to cancer sites, increased risk was recorded for the oropharynx, stomach, colon, pancreas, liver, biliary tract, larynx, lungs, urinary bladder and non--melanomatous cancers of the skin in males. In females, increased risk was only observed for the oropharynx, but was close to a statistically significant level also for cancer of the stomach. A lower number of tumors of the central nervous system than expected was observed in both males and females. The increased risk of cancer of the lungs, larynx and urinary bladder in males can be regarded as evidence of the high prevalence of smokers in the cohort. We suggest that the increased risk of cancer of digestive organs is mainly related to life-style factors, particularly tobacco-specific nitrosamines whose effect is enhanced by surgical sequelae.

Cohort Studies↗

[Occurrence of recurrence after regression of low-grade dysplasia in vaginal cytological smears].

329 females with regress of low-grade dysplasia were followed up by annual vaginal smears for a maximum of 14 years. 53 developed recurrence of dysplasia. The average annual risk of recurrence was greatest 2-4 years after regress, being 4.3%. The average annual risk of recurrence for those followed up for more than ten years was 0.5%. None of the females developed cervical cancer. It is concluded that annual controls may prevent females with regress of previous low-grade dysplasia from developing cancer. After ten years with no further dysplasia, the females are recommended to follow the general practice for persons without previous dysplasia or cancer.

Adult↗

[Use of telecommunications in pathology and anatomy services].

Telepathology comprises the transmission of microscopic images via the telecommunications network. This paper describes the first experiences from this new technology in Norway. These include teleconferences based on showing histologic slides from the Department of Pathology at the University Hospital in Tromsø to clinicians at local hospitals. A frozen section service to Kirkenes Hospital, based on remote control of a robotic microscope and transmission of high quality video images of the slide, has also been successfully established.

Computer Communication Networks↗

Remote frozen section service: a telepathology project in northern Norway.

We discuss the organization of a remote frozen section service in northern Norway. The service is operated by remote control of a motorized video-microscope located at Kirkenes Hospital, at a distance of more than 400 km from the workstation at the University Hospital in Tromsø. The video images of the frozen section are transmitted via a two-way telephone and video telenetwork with a 2 Mbit/s capacity. The images are displayed on monitors and diagnosed by pathologists in Tromsø. To date, 17 patients have been examined by remote frozen section. Correct benign versus malignant diagnoses have been given in all 17 cases compared with final diagnoses based on formalin-fixed and paraffin-embedded material. The average time taken for examining each frozen section was 15 minutes (range, 5 to 30 minutes). In none of the cases was the interpretation of the slides difficult due to deficient quality of the video images. For small hospitals with limited availability of local pathology services and for hospitals with a deficiency of specialists, telepathology may be a worthwhile substitute.

Equipment and Supplies, Hospital↗

Acute hepatotoxicity after high-dose methotrexate administration to rats.

Acute hepatotoxicity after administration of 10-1000 mg/kg methotrexate (MTX) to rats was studied by monitoring serum transaminases, liver morphology, and disposition kinetics of MTX and 7-hydroxy-methotrexate (7-OH-MTX). Half the control rats and rats administered 1000 mg/kg MTX, had their bile duct cannulated. One to 2 hr after administration of 1000 mg/kg MTX, 50% of MTX treated bile-drained rats (Ebc) developed cholestasis despite similar or larger initial bile flow rates than those which did not develop cholestasis (Ebn, controls). In Ebc animals, peak serum ASAT and ALAT levels were 6- and 4-fold higher than that of the control rats, and morphologically, prominent hepatocytic changes and grossly dilated bile canaliculi were found. Immediately prior to cholestasis, the Ebc animals reached biliary 7-OH-MTX levels (8.3 +/- 1.3 mM, mean +/- S.E.M.) which were equivalent to the threshold level for precipitation of 7-OH-MTX in rat bile in vitro, and 3-fold higher than the corresponding levels of 7-OH-MTX in the bile of Ebn rats. Ninety-five % of the drug in the precipitated material was 7-OH-MTX. Hence, 7-OH-MTX may play a role in acute MTX hepatotoxicity, a dose-limiting toxicity that may not be counteracted by leukovorin rescue.

Animals↗

[Breast tumor--a diagnostic challenge].

The study includes all patients referred for surgical examination with suspected breast cancer (n = 439) during a single year. All women were examined clinically. Mammography was performed in 372 cases (88%), and 195 (46%) women underwent biopsy. 37 (8.7%) of the admitted women had breast cancer, which was verified by histological examination. This corresponds to an incidence rate of 0.8 per 1,000 women, and an incidence rate of 2.0 per 1,000 in women above 40 years. In four patients who were not suspected as having breast cancer after clinical examination, breast cancer was revealed by mammography. However, mammography alone is insufficient, since three mammograms were false negative, in cases where cancers were diagnosed clinically. Therefore, both mammography and clinical investigation are necessary in the examination of women with breast tumors. When breast cancer cannot be ruled out by physical and mammographic examination, a representative specimen of the tumor should be removed for histological or cytological examination.

Adult↗

Organ changes in pigs after longterm parenteral nutrition.

When nutritional substrates used in clinical parenteral nutrition are given to rats a number of organ changes have been reported. These could be a species-related effect without significance outside the experimental laboratory. The reproduction of such organ changes in a large unrelated species would increase their importance. Longterm complete parenteral nutrition (CPN) was given to piglets. Nutritional substrates accepted in human parenteral nutrition were used, and the animals were parenterally fed for 6 and 12 weeks. Autopsy demonstrated an increased splenic weight. Epithelioid cell infiltration was found in the liver, spleen and lung. Osmiophilic fat droplets and vascular inflammation were seen in the pulmonary arteries. No signs of infections were found.

Journal Article↗