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At least 1,045 records · Page 58Linked to original sources
PubMed1993

Tissue response to bioerodible, subcutaneous drug implants: a possible determinant of drug absorption kinetics.

The fibrous tissue compartments that develop in response to the subcutaneous implantation of bioerodible heat-fused rods of norethindrone and cholesterol (85 and 15%, respectively) were studied by light and electron microscopy at various intervals after implantation to determine whether the biological inflammatory response may play a role in drug absorption. Thirty-five regularly menstruating, sterilized (tubal ligation), healthy females each received four Annuelle rods. The microanatomy of seven of the largest implants (135 mg norethindrone) was studied. A dense fibrous biological compartment was found to surround each rod. By light microscopy no abnormal tissue response was revealed. Scanning and transmission electron microscopy showed that the surfaces of the rods were covered by a cellular matrix of mononuclear cells. The fibrous compartment was composed of a loose cellular bed immediately surrounding the norethindrone rod, a dense fibrous connective tissue envelope containing blood and lymphatic vessels, and an outer fatty connective tissue layer. Transmission electron microscopy confirmed that the cellular tissue immediately surrounding the rods was composed mainly of lipid laden macrophages. Norethindrone levels in tissue capsules at 3 and 10.5 months were 0.05 and 8.4% by weight, respectively. These observations suggest that the local inflammatory response plays a role in the active processing of this delivery system. This picture is qualitatively different from the general view of the fibrous capsule as a simple rate limiting membrane. The effects observed in this study suggest that a more complex, functional biological system develops in response to the subcutaneous introduction of a drug delivery device.

Absorption↗
PubMed1994

The swollen leg and primary lymphoedema.

Children who present with unilateral or bilateral swelling of the legs are often suspected of having a deep venous thrombosis. The incidence of deep venous thrombosis in children is low and lymphoedema may be a more appropriate diagnosis. Lymphoedema can be primary or secondary. In childhood, primary lymphoedema is more common and may be seen associated with other congenital abnormalities, such as cardiac anomalies or gonadal dysgenesis. Primary hypoplastic lymphoedema is the most often encountered type. It is more common in girls, especially around puberty, and is typically painless. Atypical presentations produce diagnostic confusion and may require imaging to confirm the presence, extent, and precise anatomical nature of the lymphatic dysplasia. This article describes four patients presenting with limb pain and reviews the clinical features and imaging options in children with suspected lymphoedema.

Adolescent↗
PubMed1970

Tropical splenomegaly syndrome: long-term proguanil therapy correlated with spleen size, serum IgM, and lymphocyte transformation.

Forty-three patients with an initial diagnosis of tropical splenomegaly syndrome were placed on long-term proguanil therapy. All patients who failed to respond to proguanil and who were adequately followed up developed identifiable disease, usually malignant lymphoma or chronic lymphatic leukaemia. In patients who responded to proguanil IgM values were always very high and phytohaemagglutinin (P.H.A.)-lymphocyte-transformation scores were always normal before treatment was started. In patients who failed to respond IgM values were within the normal range or below, while P.H.A.-lymphocyte-transformation scores were abnormally low. During proguanil treatment IgM values fell gradually, closely paralleling the decrease in spleen size.

Adult↗
PubMed1985

The carriage and delivery of substances to lymphatic tissues by recirculating lymphocytes. I. The concentration of ricin in lymphocyte traffic areas.

Thoracic duct lymphocytes (TDL) were loaded in vitro with ricin before intravenous injection into syngeneic rats. TDL that had been incubated at 10 micrograms of ricin/5 X 10(7) cells/ml migrated from the blood into the spleen and lymph nodes (LN) according to the physiological pattern, and TDL incubated at 10 times that concentration were only slightly impaired in their ability to enter LN. The transfer of cells to recipients with thoracic duct fistulae indicated that very few ricin-treated lymphocytes left the LN to recirculate back to lymph. Most of the ricin-loaded lymphocytes died within the lymphatic tissues, probably between 7 and 15 hr after injection. The ricin toxicity was transferred locally, causing selective damage to the cell population within the traffic areas of the lymphatic tissues without disrupting the tissue architecture. This pattern of intensive cell destruction was not seen after a lethal dose of free ricin, which caused more diffuse and less severe damage to the spleen and LN, proving that lymphocytes are effective carriers of ricin. The surviving host lymphocytes were distributed abnormally, presumably because of the obvious damage to small blood vessels in LN and elsewhere. Lymphocytes accumulated especially in the red pulp of the spleen. Although the method described has drawbacks, it might be developed in order to concentrate ricin in the vicinity of neoplastic cells in diffuse lymphomas and leukaemias.

Animals↗
PubMedDate not supplied

Lymphatic system changes in diabetes mellitus: role of insulin and hyperglycemia.

BACKGROUND: Diabetic alterations of blood vessels have been well studied, but much less is known about the lymphatic system, which plays an important role in the transport of particles and defensive responses. Accordingly, we investigated lymphatic changes in diabetic rats. METHODS: Ten, 30 or 60 days after alloxan-induced diabetes (40 mg/kg; i.v.), we studied thoracic duct lymph flow and lymphocyte output, thoracic duct lymph transport of radiotracer particles ((99m)Tc-dextran 500), lymph node uptake and scintigraphic visualization of subcutaneously injected radiotracer particles, as well as the effect of insulin administration and food deprivation. RESULTS: Diabetes significantly increased thoracic duct lymph flow and the transport of dextran from the footpad subcutaneous tissue. Abnormal lymphocyte output from the thoracic duct occurred in the first 10 days. Uptake of dextran into regional lymph nodes was decreased in diabetes. Insulin per se, although not normalizing blood sugar levels, appeared to recover thoracic duct lymphocyte output and lymph node uptake of (99m)Tc-dextran 500 without affecting the thoracic duct lymph flow or the amount of radiotracer recovered therein. Normalization of glycemia (by food deprivation) restored the lymph flow to control levels without modifying the lymphocyte output. On the other hand, under insulin-restored normoglycemic conditions, both the thoracic duct lymph flow and the lymphocyte output were normalized. CONCLUSIONS: These findings suggest that variables related to defensive mechanisms, such as lymphocyte recirculation and particles uptake into the lymph nodes can benefit from insulin treatment, whereas glycemic control can benefit transport mechanisms in the lymphatic system, such as lymph flow and lymphatic transport of particles.

Animals↗
PubMed1979

Computerized body tomography in breast cancer. I. Internal mammary nodes and radiation treatment planning.

The internal mammary area has been reviewed on CBT scans from 46 postmastectomy patients, and chest wall thicknesses computed there from the scan. Thicknesses ranged from 10 to 43 mm and 16 to 70 mm on the operated and nonoperated sides, and were weight-related in 38 modified mastectomy patients. Direct Cobalt and 15 MeV electron portals delivered 97-98% of the dose prescribed at 3 cm to a depth of 35 mm, the maximum average thickness on the operated side, while 12 and 10 MeV electrons gave 10 and 20% less at that depth. At 70 mm, underdosage with Cobalt and 15 MeV was 22% and 72%; insignificant doses were delivered with 10 and 12 MeV electrons. Routine determination of chest wall thickness is recommended in patients planned for electron beam treatment, in obese patients, and in patients treated with tangential photon techniques, to avoid underdosage to the internal mammary area. Internal mammary nodes were not routinely visualized, but abnormalities consistent with enlarged nodes were seen in six patients and gross recurrence in another.

Adult↗
PubMed1983

Malignant histiocytosis. Clinical and cytogenetic studies in a newborn and a child.

Malignant histiocytosis (MH) was diagnosed on the cytologic and cytochemical features of the malignant cells present in bone marrow smears from an infant and a child. The diagnosis of MH was confirmed by light and electron microscopic studies on bone marrow and skin biopsy specimens, and bone marrow and liver biopsy specimens, respectively. Both patients showed a deterioration while receiving prednisone monotherapy, but they responded well to a combination of vincristine and cyclophosphamide. The infant has remained disease-free for 52+ months now, but the child died of a relapse 11 months after diagnosis. Cytogenetic studies of blood and/or bone marrow cells were performed before treatment. In the infant, a pathologic cell line with a translocation t(8;16)(p11;p13) was found; this abnormality was no longer present after remission was obtained. In the second patient, a hyperdiploid cell line with major karyotypic anomalies was found. When studied in relapse and shortly before death, additional chromosomal abnormalities were seen. The data from this study show that prednisone should be used with caution in MH, and that it should be omitted from combination chemotherapy when adverse effects are noted during short-term monotherapy. Also, cytogenetic studies should be performed more often in MH to determine the significance and possible nonrandomness of chromosomal abnormalities in this disease.

Antineoplastic Agents↗
PubMed2006

Current approaches to medullary thyroid carcinoma, sporadic and familial.

Medullary thyroid carcinoma (MTC) is a rare malignancy of the thyroid C cells. It occurs in hereditary (25% of cases) and sporadic forms, and aggressiveness is related to the clinical presentation (hereditary vs. sporadic) and the type of RET mutation present. In hereditary cases, early diagnosis makes preventative surgery possible. In established cases, thorough surgical extirpation of the primary tumor and nodal metastases has been the mainstay of treatment. Radioactive iodine, external beam radiation therapy (EBRT), and conventional chemotherapy have not been effective. Newer systemic treatments, with agents that target abnormal RET proteins, hold promise and are being tested in clinical trials for patients with metastatic disease.

Carcinoma, Medullary↗
PubMed2004

Abnormal development of thymic dendritic and epithelial cells in human X-linked severe combined immunodeficiency.

The X-linked form of severe combined immunodeficiency (X-SCID) is caused by mutations in the common cytokine receptor gamma chain and results in lack of T and NK cells and defective B cells. Without immune reconstitution, X-SCID patients typically die from infection during infancy. This report describes thymic epithelial (TE), lymphocyte, and dendritic cell (DC) differentiation in the thymic microenvironment of seven X-SCID patients who died before or after treatment for their immunodeficiency. X-SCID thymus consisted predominately of TE cells without grossly evident corticomedullary distinction. CD3+ and CD1a+ developing T cells and CD83+ thymic DC were reduced >50-fold when compared to age- and gender-matched control thymus (P < 0.001). TE expression of epithelial differentiation markers CK14, involucrin, and high molecular weight cytokeratins also differed in X-SCID versus normal thymus. These histopathologic findings indicate that in addition to T cells, thymic DC development and differentiation of TE cells are also abnormal in X-SCID.

Bone Marrow Transplantation↗
PubMedDate not supplied

CT demonstration of prominent right hilar soft tissue collections.

Three cases of normal soft tissue collections of the right hilum which could be confused with thrombus of the right pulmonary artery or adenopathy are demonstrated. These abnormalities are due to normal accumulations of hilar fat and lymph nodes. Their typical appearance allows easy recognition.

Aged↗
PubMedDate not supplied

Breast reconstruction with a transverse rectus abdominis myocutaneous flap: spectrum of normal and abnormal MR imaging findings.

The authors retrospectively reviewed their clinical database for cases of breast magnetic resonance (MR) imaging performed in women who had undergone breast reconstruction with a transverse rectus abdominis myocutaneous (TRAM) flap. Patient histories, MR imaging results, and, when available, biopsy results were reviewed. During a 4-year period, 24 neobreasts were imaged in 22 women who had undergone TRAM flap reconstruction after mastectomy. In most of the cases (64%), the indication for MR imaging was a palpable abnormality or pain. In four of 24 cases (17%), recurrent breast cancer was detected. These cases consisted of a local chest wall tumor (n = 2), an infiltrating chest wall tumor (n = 1), and axillary nodal recurrence (n = 1). In all four cases, MR imaging demonstrated a suspicious lesion or abnormality. In 11 of 24 cases (46%), benign findings only were demonstrated. These consisted of localized or diffuse skin thickening, fibrosis, fat necrosis, and seroma. In nine of 24 cases (38%), no pathologic abnormality was identified. MR imaging is useful in detection of locally recurrent tumor in patients who have undergone breast reconstruction with a TRAM flap. MR imaging allows differentiation between benign and malignant findings in patients with palpable abnormalities or pain after TRAM flap reconstruction.

Adult↗
PubMed1997

[131I SPECT-imaging with body outline using convenient lightweight source].

In order to make the body outline clearly in SPECT images, we devised a simple line source holder with the objectives to have a lightweight line source, to reduce the radiation exposure to the staff and to make the system readily available. This technique was applied to evaluate the localizing lesions in patients with radioiodine treatment of thyroid cancer. 131I-SPECT imaging with body outline was found to be effective in 86.7 percent (13/15) of the cases compared with planar imaging. Clinically, the results significantly helped in the discrimination between cervical lymph node metastasis and thyroid bed, and between mediastinal lymph node metastasis and bone metastasis. In the case of multiple lung metastasis demonstrating diffuse accumulation in the lung fields, 131I-SPECT imaging with body outline did not provide an increase in sensitivity compared with planar imaging. This method is easy to perform and it is considered to be useful for localization of abnormal accumulation, relative to the body outline.

Aged↗
PubMed1998

p53 gene alternation in squamous cell carcinoma of the esophagus detected by PCR-cold SSCP analysis.

Mutations of the p53 tumor suppressor gene play an important role in the development of common human malignancies. Previous reports revealed that the frequencies of p53 alternations in esophageal carcinoma varied from 26% to 87%. The clinical significance of p53 alternations is still disputed. In the present study, we used polymerase chain reaction--"cold" single-strand conformation polymorphism (PCR-"cold" SSCP)--to investigate p53 genetic alternations in 63 surgical specimens of esophageal squamous cell carcinoma (ESC). Our experiments showed that the optimum buffer temperature for "cold" SSCP analysis was 14 degrees C while the PCR products were around 200-300 bp in size. Among 63 tumorous samples, p53 alternations was detected in 47 tumors, or an incidence rate of 74.6%. For nontumorous mucosal samples, the incidence of p53 alternations was 55.5% (35/63 samples). Additionally, p53 alternations occurred most frequently at exon 6 (50.8%), followed by exon 7 (33.3%), exon 8 (17.5%) and exon 5 (12.7%). Multiple genetic alternations (> or = 2 exons) between p53 exons 5-8 in the same examined samples were found in 21 (33.3%) of 63 tumors, and in 8 (12.7%) of 63 nontumorous mucosal specimens. Our results further showed that p53 alternations did not correlate with age, depth of tumor invasion, lymph node metastasis, tumor stage, cell differentiation or lymphovascular invasion in ESC (P > 0.05). Moreover, the survival rate in patients with p53 alternations was similar to that in patients without p53 alternations (P > 0.05). In conclusion, PCR-"cold" SSCP is a rapid and sensitive method for identifying p53 genetic alternations. p53 genetic alternations occur with a relatively high incidence for ESC, but p53 abnormality has no impact on prognosis.

Age Factors↗
PubMed1986

Pathological study of sequelae of Kawasaki disease (MCLS). With special reference to the heart and coronary arterial lesions.

Unexpected sudden cardiac death among children with a history of Kawasaki disease has come to be reported in Japan. Death occurred between 2 months and 8 years after complete recovery from Kawasaki disease according to our study material. To study the lesions of Kawasaki disease sequelae we examined 61 cases of Kawasaki disease which came to autopsy. In 17 of these the deaths apparently to be due to sequelae of this disease, were characterized by cardiac insufficiency caused by ancient coronary aneurysm with organized thrombotic occlusion and superimposed acute ischemic myocardial degeneration and/or necrosis. The age of the lesions appears to correlate with the interval period between complete recovery from this disease and death. Six cases succumbed incidentally of other causes: one traffic accident, one hemophilus meningitis, one chronic myeloid leukemia, one neuroblastoma, one meningeal hemorrhage due to rupture of basilar arterial aneurysm, and one acute lymphatic leukemia. Even in these cases, definite sequelae of arteritis were detected. A surgically resected coronary aneurysm and a ventricular aneurysm were also examined. It was disclosed by mass physical check-up of school children that 0.1% had a history of Kawasaki disease, among which 5-6% showed cardiac and/or coronary abnormality including aneurysms. The high incidence of cardiac involvement in Kawasaki disease has been proved in this study and this kind of lesion has the possibility of resulting in unexpected cardiac death of children.

Arteritis↗
PubMed1996

Lung carcinoma surgical pathology report adequacy: a College of American Pathologists Q-Probes study of over 8300 cases from 464 institutions.

OBJECTIVE: To assess the adequacy of reporting gross and microscopic pathologic findings of resected lung carcinoma. DESIGN: Q-Probes study following the College of American Pathologists format. SETTING: Pathology laboratories, 1991. PARTICIPANTS: Four hundred sixty-four institutions. MAIN OUTCOME MEASURES: Rate of reporting gross and microscopic features. RESULTS: Information provided in over 8300 surgical pathology reports of resected primary lung carcinomas from 464 institutions was reviewed. Descriptors included gross and microscopic findings. The rate of reporting the descriptors from the aggregate sample is listed as follows (the corrected rate for those descriptors in which evaluation was not applicable are listed in parentheses for each descriptor where appropriate): general findings, standard report or checklist used 20.8%, type of procedure stated 89.6%, and lobe or lung of origin stated 99.1% (99.5%); gross findings, distance of neoplasm from nearest visceral pleura 61.1%, involvement or lack of involvement of bronchus 68.7%, presence or absence of involvement of veins 18.3%, parenchyma not involved by neoplasm described 80.1% (81.4%), visceral pleural surface described 83.0%, tumor size stated 97.2%, and description of regional lymph nodes attached to specimen 74.7% (82.7%); and microscopic findings, microscopic description 77.6%, histologic type of tumor stated 99.3%, grade of carcinoma stated 80.9% (88.7%), presence or absence of lymphatic vascular invasion 24.3%, status of lymph nodes stated 89.0% (95.9%), presence or absence of venous invasion 22.6%, presence or absence of neoplasm at bronchial margin 90.8%, presence or absence of neoplasm at vascular margin 30.9%, presence or absence of carcinoma in the visceral pleura 64.6% (66.9%), and presence or absence of abnormality in nonneoplastic parenchyma 72.8% (74.1%). CONCLUSION: The rate of reporting gross and microscopic features varies; recommendations for reporting are made and include the use of a standard report form or checklist.

Humans↗
PubMed1977

Thyroid disease following irradiation for benign conditions.

One hundred twenty-five patients with a history of prior irradiation to the head and neck region for benign disease underwent thyroidectomies between 1967 and 1976 at Evanston Hospital. One hundred twenty-four had a palpable abnormality. Forty-two had carcinoma, and nine of these had nodal metastases. Palpation was found to be more accurate than thyroid isotope scan in finding carcinoma within an abnormal gland. Some form of irradiation thyroiditis was found in one half of the resected specimens.

Adolescent↗
PubMed1984

Sinus histiocytosis with massive lymphadenopathy. An analysis of 14 deaths occurring in a patient registry.

Sinus histiocytosis with massive lymphadenopathy (SHML) is generally regarded as a benign disorder in spite of its propensity to form large masses and to disseminate to both nodal and extranodal sites. Although in most patients the extent of SHML does not appear to determine disease outcome, recent reports have documented that infiltrates of SHML can cause death. To gain perspective on the role of SHML in patient deaths in this population, the authors analyzed the 14 known fatalities in an SHML registry comprising 215 patients. The average age at death was 33 years. Autopsy was performed on eight patients. SHML infiltrates were clearly the cause of death in only two patients (previously reported). In another four cases persistent SHML was prominent at death. The other deaths were the result of complications of defined immunologic abnormalities (five), or of unusual infections (three). The authors have not seen an example of cytologic malignant transformation of SHML.

Adolescent↗