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At least 1,027 records · Page 57Linked to original sources
PubMed1996

Associations of HLA-DRB and -DQB genes with two and five year outcome in rheumatoid arthritis.

OBJECTIVE: To evaluate the clinical usefulness of genomic HLA typing during the first five years of established rheumatoid arthritis (RA). METHODS: The HLA-DRB and -DQB alleles were determined by restriction length polymorphisms and polymerase chain reaction amplification with sequence specific primers in 99 Swedish patients with RA. Clinical features after two and five years disease duration were related to the genetic pattern. Seventy four patients were seropositive, 25 had nodules, 90 developed erosions, and 15 required joint replacements. Twelve patients were in remission after five years. Disability was assessed by health assessment questionnaire, and radiographic damage in hands and feet by the Larsen method. RESULTS: Eighty seven per cent of the patients carried the conserved third hypervariable region sequence (HVR3), 32% had DRB1*04 on one allele, and 26% had DRB1*04 on both alleles (all frequencies significantly greater than in controls). Frequencies of DRB1*04 associated DQB*0301 and *0302 were normal. Patients carrying DRB1*04 on both alleles tended to have more radiographic changes after two years, but this difference had diminished after five years. Disability did not vary with regard to the genotype. Homozygous HVR3 patients had about three times greater risk of undergoing joint replacement. Homozygosity for HVR3 and presence of DQB*0302 both tended to be associated with erosive disease. CONCLUSIONS: We confirmed a strong association of disease with the presence of the shared epitope on one or two alleles. However, genotype was not strongly associated with disease severity after two and five years disease duration, and thus the value of genomic typing to select patients for early aggressive therapy is questionable.

Adult↗
PubMed1995

Necrotic, ulcerative bronchitis, the presenting feature of lymphoproliferative disease following heart-lung transplantation.

Following heart-lung transplantation two of 21 patients who survived more than 100 days developed post-transplant lymphoproliferative disease. Both presented with localised ulcerative bronchitis documented at flexible bronchoscopy four months after transplantation. Histological examination showed necrosis with acute inflammation and ulceration. Case 2 demonstrated lymphoproliferative disease from biopsies subsequently taken at rigid bronchoscopy. Case 1 later developed lung nodules and a monoclonal high grade B cell non-Hodgkin's lymphoma was confirmed by an open lung biopsy. The bronchoscopic features described should alert clinicians to post-transplant lymphoproliferative disease as an underlying diagnosis and suggest that bronchus associated lymphoid tissue is the initial site for clonal proliferation in the disease.

Adult↗
PubMed2000

Ultrasound-guided percutaneous lung biopsy in sheep.

Lung biopsies were taken through the ninth intercostal space on the two sides of the thorax of 10 clinically healthy sheep, using a Tru-Cut needle on one side and the Bard Biopty-System on the other. Nine of the 10 sheep remained clinically healthy, but one coughed transiently and had a mild bloody discharge from the right nostril immediately after the biopsy. The sheep were slaughtered 10 days later and the lungs and pleura were examined macroscopically; there were either no lesions or only small scars visible at the sites of the biopsies. However, well-developed subpleural nodules due to parasites were observed in some of the lungs. There were no adhesions between the costal and pulmonary pleurae. Of the 20 biopsy specimens, 18 were ideal for histological examination, and none of them was histologically normal. Mild interstitial pneumonia was diagnosed in 15 specimens, chronic bronchiolitis in nine specimens, and hyperplasia of smooth muscle or connective tissue in 17.

Animals↗
PubMed1982

Pathways of tumor spread through the lung: radiologic correlations with anatomy and pathology.

The pathways of tumor spread through the lung are described and their significance for radiographic interpretation is illustrated. A key to understanding the spread of bronchogenic carcinoma is the realization that although the normal flow of lymph in the pulmonary lymphatics is centripetal, lymphatic obstruction can cause reversal of flow. As a result, tumor cells are commonly carried centrifugally to the periphery in lymphatics or the connective tissue around them, and remote pleural involvement, secondary parenchymal masses, or satellite nodules may develop. Failure to appreciate peripheral spread of tumor has negative consequences for tumor staging, surgery, and radiotherapy. In the absence of hilar node involvement causing obstruction, long line shadows more than 0.5 inch (1.25 cm) in length proximal to a peripheral mass very infrequently represent tumor.

Bronchi↗
PubMed2004

A randomized phase II feasibility trial of BMS-275291 in patients with early stage breast cancer.

PURPOSE: This pilot trial was performed to evaluate the safety, pharmacokinetics and feasibility of incorporating BMS-275291, a matrix metalloproteinase inhibitor (MMPI), into adjuvant breast cancer therapy. EXPERIMENTAL DESIGN: Patients with stage I (T1c)-IIIA breast cancer were eligible if planned adjuvant therapy consisted of either tamoxifen alone, doxorubicin + cyclophosphamide every 21 days for four cycles (AC), or AC followed by paclitaxel every 21 days for 4 cycles (AC>T). Patients were stratified by planned adjuvant therapy and randomized (2:1 ratio) to BMS-275291 (1200 mg/day) or matched placebo for 1 year. RESULTS: Seventy-two patients were recruited from March 2001 to July 2002. Grade >or=2 musculoskeletal toxicity, generally reversible arthralgia, was reported by 36.2% of patients receiving BMS-275291 compared with 16.7% of patients receiving placebo; difference = 19.5% (95% confidence interval: -0.06, 0.44; P = NS). Two patients receiving BMS-275291 developed palpable nodules along tendons. Grade >or=3 rash was reported by 8.5% of patients receiving BMS-275291 compared with 4.2% of patients receiving placebo; difference = 4.3% (95% confidence interval: -0.18, 0.3; P = NS). Overall, 33% of BMS-275291 patients and 21% of placebo patients discontinued treatment due to adverse events. BMS-275291 trough levels tended to decrease over time; 9 of 47 (19%) had >or=50% of trough concentrations > 124 ng/ml (IC(90) for matrix metalloproteinase-9). CONCLUSIONS: The pattern of arthralgia in BMS-275291-treated patients was consistent with matrix metalloproteinase inhibitor toxicity. Although the differential incidence of arthralgia did not reach statistical significance, the trial was terminated. An adjuvant trial in this patient population is not feasible.

Aged↗
PubMed2001

Genetic abnormalities in a pre and post-chemotherapy hepatoblastoma.

Comparative genomic hybridization (CGH) analysis was performed on both a pre- and post-chemotherapy hepatoblastoma from a 24-month-old female patient. The diagnostic sample obtained from a tru-cut biopsy was a mixed epithelial-mesenchymal tumor with both fetal and embryonal patterns present. In contrast, the post-chemotherapy tumor exhibited a prominent anaplastic large cell population focally reminiscent of pleomorphic hepatocellular carcinoma (HCC). CGH analysis indicated that there were similarities as well as differences in the gains and losses of genetic material in each tumor. The diagnostic sample had gains of chromosome 1q, 2, 2(q31q33), 7, 8q, 12(q15q22), 17q and 20 material, while the post-chemotherapy tumor had gains of 1q, 2, 7, 8q, 10, 17q and 20 material. In addition, the pre- and post-chemotherapy samples may have incurred loss of chromosome 17p material. The main differences between the two samples involved localized gain of 2(q31q33) and 12(q15q22) in the pre-chemotherapy sample, and gain of chromosome 10 material in the post-chemotherapy tumor. The patient subsequently developed metastatic nodules in her lungs, the histology of which was identical in pattern to the diagnostic pattern, and appeared to have localized gain of 2(q31q33) and 12(q15q22). These results are consistent with published results that gain of chromosome 8q and 20 are associated with an unfavorable prognosis.

Child, Preschool↗
PubMedDate not supplied

Metastatic pulmonary artery sarcoma. Report of a case with diagnosis by fine needle aspiration.

BACKGROUND: Primary pulmonary artery sarcomas (PPASs) are uncommon neoplasms with a poor prognosis. They often present with symptoms of pulmonary thromboembolus. They may be locally aggressive and give rise to embolic pulmonary metastases. Extrathoracic metastases are uncommon. They are usually diagnosed late in the course of the disease or at autopsy. Radiographic studies alone are insufficient to definitively diagnose PPAS. CASE: A 68-year-old female presented with symptoms consistent with pulmonary thromboemboli. Computed tomography of the chest with intravenous contrast revealed an intraluminal filling defect involving the left main pulmonary artery. Despite anticoagulation therapy, the symptoms persisted. Four months after the initial presentation, the patient developed multiple nodules in the left lung. Fine needle aspiration (FNA) of one of the nodules showed loosely cohesive clusters of pleomorphic and spindle-shaped malignant cells and isolated ones. These cells were embedded in extracellular, metachromatic material. They were vimentin positive and keratin negative. There was no evidence of extrapulmonary disease. A diagnosis of metastatic pulmonary artery sarcoma was made and confirmed on histology. Three weeks following the pneumonectomy, the patient died of postoperative complications. CONCLUSION: Patients with PPAS often present with symptoms of atypical or nonresolving pulmonary thromboemboli. The interval between presentation and definitive diagnosis is usually delayed and probably affects the prognosis. The timely use of FNA techniques could result in an earlier diagnosis, possibly improving outcome.

Aged↗
PubMedDate not supplied

Fine needle aspiration biopsy of the thyroid gland in patients with prior Graves' disease treated with radioactive iodine. Morphologic findings and potential pitfalls.

OBJECTIVE: To evaluate the morphologic findings and their potential pitfalls in fine needle aspiration biopsies (FNAB) of thyroid glands obtained following radioactive iodine (RaI) (131I) treatment for Graves' disease. STUDY DESIGN: Study of thyroid FNAB specimens from six patients with prior Graves' disease treated with RaI who developed palpable nodules and had subsequent thyroid resections. RESULTS: The cytologic changes attributed to radiation were quite variable among the six cases and were so pronounced in one case that a false positive diagnosis of papillary carcinoma was made even though a history of RaI had been provided. The FNAB specimen from the second case, submitted without a history of RaI treatment, was diagnosed as suspicious for papillary carcinoma. The smears from patient 3 were signed out descriptively because the pertinent clinical history had not been provided. The FNAB specimens from the last three patients were correctly interpreted because of the history of RaI therapy provided. All six thyroid surgical specimens showed changes consistent with radiation injury, and none contained evidence of malignancy. CONCLUSION: The study's findings demonstrate that the atypia produced by RaI may be severe, leading to an erroneous diagnosis of malignancy. Provision of the appropriate clinical history of Graves' disease treated with RaI may prevent this pitfall.

Adult↗
PubMedDate not supplied

[Experimental skin leishmaniasis: II--course of the infection in the Cebus apella primate (Cebidae) caused by Leishmania (V.) braziliensis and L. (L.) amazonensis].

As a means of assessing the usefulness of the monkey Cebus apella as an experimental model for the study of cutaneous leishmaniasis, 5 of these animals were inoculated intradermally at 8 sites along the tail with 3 X 10(6) promastigotes of L. (V.) braziliensis, while a further 5 monkeys received similar inoculations with 3 X 10(6) promastigotes of L. (L.) amazonensis. Following the inoculations, weekly examinations and monthly biopsies showed evolution of resulting skin lesions to be as follows: a) L. (V.) braziliensis: lesions were first visible 15-20 days post-inoculation (p.i), and at 30 days they were clearly of an erythematous-papular nature, which assumed a nodular form at 60 days; after 3 months a spontaneous ulceration of these lesions was noted and, at 4 months, the initiation of healing. In one animal total healing was apparent 5 months p.i; in two others at 6 months, in another monkey after 7 months, and in the last animal at 10 months p.i. Amastigotes were demonstrated in smears from the lesions of all monkeys up to 90 days p.i; up to 120 days in two animals, and at 180 days p.i. in the monkey which showed resolution of the lesions after 10 months. b) L. (L.) amazonensis lesions were first apparent after 20 days p.i; at 30 days they were of an erythematous-papular nature, developing into nodules at 60 days. From the third month of infection onwards, however, the lesions diminished rapidly and, at 90 days p.i. amastigotes were no longer detectable in the skin.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1999

Phaeohyphomycosis from Exphiala jeanselmei with concomitant Nocardia asteroides infection in a renal transplant recipient: case report and review of the literature.

A 59-year-old black man who received a cadaveric renal transplant 15 months earlier developed subcutaneous nodules on his right upper extremity that were identified as phaeohyphomycosis caused by Exophiala jeanselmei. The man was admitted 4 weeks later with a swollen left arm and had Nocardia asteroides in this area and in the apex of his left lung. He was treated with surgical excision, and itraconazole, imipenem-cilastatin, and trimethoprim-sulfamethoxazole. With the potential presence of more than one microorganism in an immunocompromised patient, it is important to identify and differentiate them correctly to direct appropriate therapy.

Arm↗
PubMed1980

Chronic toxicity and hepatocarcinogenicity of (+) rugulosin, an anthraquinoid mycotoxin from penicillium species: preliminary surveys in mice.

(+) Rugulosin (RUG) is bis-anthraquinoid pigment produced by fungi such as Penicillium rugulosum Thom, P. tardum and others, and its chemical structure is very close to (-) luteoskyrin, one of bis-anthraquinoid pigments of Penicillium islandicum Sopp and hepatocarcinogenic to mice and rats. This investigation was concerned with the subacute and chronic effects of RUG on hepatic injury and hepatocellular tumor induction in male mice fed purified diets for 22 days containing 1.5 mg/5 g diet/animal per day or whole feeding period containing 0.3 and 0.75 mg RUG/5 g diet/animal per day. A half of male DDD mice receiving 1.5 mg RUG for the initial 22 days of feeding died 1-3 weeks thereafter from the acute hepatic injury characterized by fatty degeneration and liver cell necrosis, and hepatocellular carcinoma developed in one out of 14 mice surviving the feeding of control diet for additional 400 days. Each one fourth of cases of male ddYS mice receiving 0.3 and 0.75 mg RUG for 500-700 days developed hyperplastic nodules of liver cells. These data suggest that RUG is possibly a weak hepatocarcinogen for male mice with a potency les than one tenth of (-) luteoskyrin.

Animals↗
PubMed2006

Sonography of Budd-Chiari syndrome.

OBJECTIVE: The purpose of this pictorial essay is to review the color Doppler sonographic features of Budd-Chari syndrome. CONCLUSION: Combining color and spectral data, sonography provides hemodynamic and anatomic information about vessel patency and collateral vessel formation. The diagnosis of Budd-Chari syndrome is based on the involvement of hepatic veins although intrahepatic collateral circulation and dilated caudate veins are also important and frequent signs. Half of the patients will develop regenerative nodules that can simulate hepatocellular carcinoma.

Adult↗
PubMed2005

Artecoll: the Arizona experience and lessons learned.

BACKGROUND: Artefill is one of several new materials being introduced to the U.S. market as a soft tissue augmenting agent. OBJECTIVE: The objectives were to evaluate the safety and efficacy of injecting Artecoll (Rofil Medical International Breda, the Netherlands) in facial wrinkles compared with injecting Zyderm or Zyplast (INAMED, Santa Barbara, CA, USA) and discuss the practical lessons learned. METHODS: Thirty-eight patients were randomly selected to receive Artecoll or Zyderm/Zyplast into facial defects. Wrinkles were evaluated by the treating physician, the subject, and masked physician evaluators. Similar evaluations were performed on several collagen patients crossing over to Artecoll. Adverse reactions were recorded. RESULTS. All evaluators felt Artecoll to be superior to collagen in all treated areas except for the glabella and upper lip lines. In these areas, differentiation by photographs between the two products became more difficult for the masked evaluators. The adverse side effects of Artecoll were almost equal with those of collagen, but most were of minimal consequence. Three patients developed persistent nodules (all in perioral sites), which were treatable with intralesional steroids. CONCLUSION. Artecoll treatment of wrinkles and folds was found to be effective, long lasting, safe, and associated with a high percentage of patient acceptance. There is a learning curve in injecting this thicker, more permanent product.

Adult↗
PubMed1995

Corynebacterium CDC group JK (Corynebacterium jeikeium) sepsis in haematological patients: a report of three cases and a systematic literature review.

We describe 3 patients with Corynebacterium jeikeium sepsis in neutropenic phase during treatment for acute myeloid leukaemia. Fever was the first symptom. All had a central venous catheter which was removed. Two patients developed subcutaneous nodules containing pus when the neutrophil count recovered; 1 had intracutaneous and pulmonary lesions. They were treated with vancomycin and recovered when the neutrophil count started to rise. A review of 80 neutropenic patients with C. jeikeium sepsis reported in the literature, together with our 3 cases indicates that risk factors for infection are the presence of a central venous catheter, being an adult male or postmenopausal female, profound and prolonged neutropenia and exposure to multiple antibiotics. Skin lesions are reported in 48% and pulmonary lesions in 36% of the patients. The overall mortality is 34% but in patients with recovery of the bone marrow only 5%. Therefore haematopoietic growth factors should be considered in neutropenic patients with C. jeikeium infection.

Adult↗
PubMed1990

Genetic diversity of spontaneously developed primary and metastatic mammary tumor cells in mice.

Metastatic cells are often considered to be clonal derivatives of one of the primary tumor cell subpopulations. To determine if the cells of spontaneously developed lung nodules in a mammary tumor-bearing mouse represent the major or minor population of the cells in the primary tumor, comparisons were made of the pattern of their mouse mammary tumor virus (MMTV) proviral integrations, and their insertional mutations of the mouse mammary tumor proto-oncogenes, int-1 and int-2. Of the 78 tumor-bearing C3H/He mice sacrificed, seven mice showed metastatic lung nodules, but only four mice had nodule tissues adequate for the present analysis. Examination of the primary tumors and the corresponding lung nodules of these four mice revealed that the number of newly integrated MMTV proviruses and their sites of integration in the genomic DNAs of primary tumors and tumor nodules were variable, and that the int-1 gene was disrupted in three of the primary tumors but not in any of the metastasized tumor tissue. These results support the notion that, at least in some mice, the majority of cells constituting the primary mammary tumors and the corresponding metastases are of different genotypes and raise the possibility that the activation of different int-proto-oncogenes may be involved in the genesis of different cell subpopulations including metastatic cells in the same mouse.

Animals↗
PubMed1987

Cyst rupture as a pathogenic mechanism of toxoplasmic encephalitis.

Seemingly intact cysts and sequential stages of disintegrating cysts of Toxoplasma were identified immunohistologically within developing microglial nodules in a Panamanian night monkey (Aotus lemurinus). This monkey had been successfully immunized and challenged 5 months earlier. This supports the hypothesis that glial nodules unassociated with Toxoplasma tachyzoites may represent the tombstone of a Toxoplasma cyst. Disintegration of cysts may give rise to clinical encephalitis in the presence of apparently adequate immunity.

Animals↗