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At least 1,063 records · Page 59Linked to original sources
PubMed2001

[Siewert-Stein classification of adenocarcinoma of the esophagogastric junction].

Nowadays the terminology used for the definition of adenocarcinomas at the oesophagogastric junction is "cardiac carcinoma", which can be easily misunderstood. This definition of adenocarcinomas of the oesophagogastric junction does not allow correct comparison of diagnosis (endoscopic, radiological and pathologic), epidemiology and surgical therapy in national and international aspects, because different tumours can develope in the same area, and all called cardia tumors. Siewert and Stein recommended a classification to solve this problem. The classification of the tumours is morphological/topographical. Type I is adenocarcinoma of the distal part of the oesophagus. Type II is adenocarcinoma of the real cardia and type III is subcardial gastric adenocarcinoma. At classification, we always consider results of endoscopy (ortograde and retroflexed view of the oesophago-gastric junction), the x-rays of the oesophagus and stomach, findings at the operation and pathohistologic results. Between 1/1/1974 and 31/12/2000, a total number of 50,878 upper panendoscopic examinations were performed at the Endoscopic Laboratory of the Surgical Department. Adenocarcinoma of the cardia was diagnosed in 488 patients. According to the Siewert-Stein classification, type I tumour was found in 123 (25.2%), type II in 240 (49.18%), and type III was present in 125 (25.61%) patients. The importance of this classification is it enables unified pre-operative assessment and it can also help to decide the type of the surgical intervention. In our patients with type I cancer--depending of the size of the tumour--distal 2/3 oesophagectomy with the resection of the proximal lesser curve of the stomach or total gastrectomy were performed. In the first group oesophago-jejuno-gastrostomy, in case of total gastrectomy Roux-en-Y loop anastomosis was created. In patients with types II and III cancers total gastrectomy was performed. In every patient lymphadenectomy was performed. We suggest the use of this new classification in clinical, gastroenterology--with special regard to the endoscopy--and pathology.

Adenocarcinoma↗
PubMed2001

[Classification of mood disorders: from the viewpoint of clinical psychiatry].

Various classifications of depression have been developed up to this time. They are divided into three categories--etiological, phenomenological and multidimensional classification. The author discussed characteristics of three classifications from the viewpoint of clinical psychiatry. Etiological classifications include Kielholz's one and Pichot's one. They are useful to guide to clinical practice, but clinical features are not clearly described in them. Phenomenological classifications include ICD-10 and DSM-IV. They are practical to facilitate research and improve communication among clinicians and researchers all over the world. Although their reliability is on the increase, they leave something to be desired in regard to pursuit of etiology. The most famous multidimensional classification in Japan is Kasahara and Kimura's one. It introduces multiaxial system that includes premorbid character, precipitating factor, clinical features, response to treatment, and course. However, it is not fully grounded in empirical evidence.

Humans↗
PubMedDate not supplied

Universal spine fracture classification.

A prospective, multi-center study was done to establish and evaluate a system for classifying spine fractures. The classification was designed with three goals in mind: 1) that the classification be easy to use and understand, 2) that the classification allow physicians, regardless of specialty, to communicate about spine fracture, 3) and to provide spine surgeons with a standardized tool to track treatment methods vs. outcomes. The classification uses five criteria to classify an injury: 1) columns injured, 2) extent of translatory displacement, 3) extent of angulation, 4) canal compromise, and 5) percent loss of height. Using these five criteria, fractures are classified into categories A, B, or C. After five years of field testing, statistical analysis, and refining, the classification system has proven to be useful and to provide consistent, reliable classification of spine fractures.

Humans↗
PubMed1975

TNM classification of malignant tumours of the bladder, prostate, testis and kidney.

TNM classification is a short description of a cancer at a point in its natural history--the onset of definitive treatment--and should be considered in planning treatment, in assessing prognosis, in evaluating end results, in facilitating the exchange of information between treatment centres and thus in contributing to the continuing investigation of human cancer. For four cancers of urologic sites there are new TNM classifications. Although previous classifications of bladder cancer were satisfactory, the new classifications for kidney, prostate and testis are the first internationally accepted classifications for these three organs that are clinically practical. Widespread use of these classifications is recommended.

Female↗
PubMed1975

An improved classification of ballistocardiographic changes.

On the basis of a critical analysis of the most frequently used classifications of ballistocardiographic changes, an improved classification is proposed, which simultaneously respects the degree of pathological changes appraised according to Brown; the configurations and amplitudes of waves and segments, as well as their dependences on time. The proposed classification essentially accepts the symbols used in the classifications used up to the present, thus obviating errors and mistakes which the new classification might involve. The improved classification facilitates a better differentiation of first-degree pathological changes into those caused by disturbances of cardiovascular dynamics and those due to extracardial factors.

Ballistocardiography↗
PubMed2002

[Goseki classification in adenocarcinoma of the cardia].

BACKGROUND: To assess an additional prognostic value of Goseki histological classification to TNM staging system in adenocarcinoma of the cardia. METHODS: Sixty-one patients curatively resected for advanced (T2, T3 and T4) cardia cancer at the I Division of General Surgery, University of Verona were classified in four different grades according to Goseki. Survival curves were estimated with Kaplan-Meier method and compared by the log-rank test. Multivariate analysis was performed by Cox regression model. c2 test was used to compare Goseki to Lauren classification and grading. After discharge from hospital all patients were followed with a mean follow-up of 39.5 months. RESULTS: Lauren classification and grading were significantly related to tubular differentiation (p<0.01). Kaplan-Meier estimates of survival showed a better 5-year outcome for tumors with good tubular differentiation (19%), even though the difference with poor tubular differentiated tumors was not statistically significant (p'0.06). Diffuse type carcinomas and tumors with poor cytological differentiation showed a worse prognosis at univariate analysis (p<0.01). Multivariate analysis showed no additional prognostic significance of any of the histological classification analyzed. Only T (p<0.02; RR 2.2; IC 1.2-4) and N (p<0.01; RR 5; IC 2.4-11) were independent prognostic factors. CONCLUSIONS: In adenocarcinoma of the cardia, Goseki classification did not add any information to Lauren classification and to TNM staging system.

Adenocarcinoma↗
PubMed1975

World Health Organization classification and nomenclature of ovarian cancer.

A World Health Organization (WHO) committee of representatives from seven nations published a histologic typing of ovarian tumors in 1973. Their typing of common epithelial tumor was based largely on the classification by the International Federation of Gynaecology and Obstetrics (FIGO), and the single most important concept to emerge from the FIGO and WHO classifications was the distinction among common epithelial tumors between tumors of borderline malignancy and carcinomas. A second general category of ovarian tumors, some of which are clinically malignant, was designated by the WHO committee as sex cord-stromal tumors (neoplasms containing granulosa, theca, collagen-producing stromal, Sertoli, and/or Leydig cells). The WHO classification of germ cell tumors emphasized the necessity of careful examination of the gross specimen with jucicious sampling for microscopic evaluation. The classification and nomenclature used within an institution should be the one most conductive to mutual understanding and optimal patient care; however, when that nomenclature has to be translated into one with more widespread acceptance, the WHO classification, based on the earlier and widely adopted classification of FIGO, is presently the most deserving of universal usage.

Female↗
PubMed2002

Classification of childhood arthritis.

The classification of the juvenile arthritides is an evolving process which has yet to achieve its ultimate goal of delineating biologically distinct disease groups with predictable outcomes and responses to treatment. There have been considerable advances, however, since the first attempts at classification over 100 years ago, as the clinical heterogeneity of juvenile arthritis has become understood. The aim of this chapter is to highlight the historical milestones in classification, the most recent proposals for developing a unified, international classification, and the published literature aimed at evaluating the classification process. In conclusion, it is recommended that all clinicians involved in paediatric rheumatology take part in the ongoing process of juvenile arthritis classification by the prospective collection of standardized clinical data.

Arthritis, Juvenile↗
PubMed1976

The clinical significance of classifications of cirrhosis. A comparison between conventional criteria and numerical taxonomy.

Classification of patients with cirrhosis serves the clinical purpose of selecting patients for adequate therapy. A material of 441 patients from a randomized clinical trial of prednisone treatment were classified according to different criteria, and the effect of this therapy was assessed by comparing the survival curves of controls and treated patients in the groups. Six classifications based on single criteria were studied, viz. females vs. males, alcoholics vs. non-alcoholics, compensated vs. decompensated cases, active vs. inactive cases, manifest vs. latent cases, and non-primary biliary vs. primary biliary cirrhosis. The latter group was too small for further analysis. Furthermore, the material was classified by numerical taxonomy, based on 56 clinical symptoms and signs and histological and serological changes. The taxonomical classification showed interdependence with all the clinical classifications, except that of primary biliary cirrhosis. Three clinical classifications, viz. those based on sex, alcoholism, and compensation, and one taxonomic class showed a significant therapeutic relevance. Combination of these criteria revealed that female patients with compensated non-alcoholic cirrhosis, previously demonstrated to benefit from prednisone treatment, showed a markedly greater prednisone effect if they belonged to the taxonomic group than if they did not. According to clinical, histologic, and laboratory data, the latter group was characterized as less severe cases than the former one. Whereas this discrepancy between clinical severity and therapeutic effect cannot be fully explained, the data do suggest that clinical criteria may not be ideal for selection of patients with cirrhosis for steroid therapy, and that numerical taxonomy may provide clues for more clinically significant classifications.

Alcoholism↗
PubMedDate not supplied

Rewriting the histological classification of lupus nephritis.

The World Health Organization (WHO) classification of lupus (SLE) nephritis was published almost 20 years ago, and there is world-wide recognition of its utility in the diagnosis and treatment of SLE glomerulonephritis (GN). However, a number of problems have been recognized: The classification of severe segmental (WHO class III > or = 50%) and membranous glomerulonephritis (MGN) complicated by the lesions of severe segmental or diffuse GN (WHO classes Vc > or = 50% or Vd) is ambiguous; The implications of non-immune complex pathogenic mechanisms are not acknowledged and SLE interstitial nephritis and vasculitis are not included in the current classification. We propose a revision that retains the classes of the current WHO classification. Informed by investigations utilizing the WHO classification, it places severe segmental GN in class III (segmental GN) and mixed MGN and segmental and diffuse GN in class V (MGN). It optimizes the use of electron and fluorescence microscopy in defining controversial and ambiguous lesions. It develops subclasses based upon pathogenic insights gained since the advent of the WHO classification. Finally, it recognizes the need to include the disease specific lesions of SLE tubulointerstial nephritis and vasculitis.

Humans↗
PubMed2002

[New WHO classification of urothelial carcinoma of the urinary bladder].

The WHO classification of urothelial carcinomas of the urinary bladder (1999) presents the papillary urothelial neoplasia of low malignant potential (PUNLMP) as a new entity in between the papillomas and the papillary urothelial carcinomas. This neoplasia shows a typical basal palisading, a low mitotic rate, and a low MIB-1-proliferation index. The PUNLMP is said to have an increased risk of development of recurrent papillary lesions with the possibility of malignant transformation. At present, there is an intensive discussion on this new entity. The participants of a meeting on the consensus classification on urothelial tumors held in Ancona in 2000 have meanwhile split in two discussion groups. One favors the new WHO classification with the papillary urothelial carcinomas G I, G II, and G III, but without PUNLMP, whereas the other group favors the consensus classification of 1998 with papillomas, papillary urothelial neoplasia of low malignant potential, and non invasive as well as invasive low-grade and high grade papillary urothelial carcinomas. Future long term prospective studies will show the significance of PUNLMP compared to well differentiated non invasive papillary urothelial urinary bladder carcinoma G I (G Ia). Otherwise, there is no significant difference in the classification of carcinomas and non epithelial lesions compared with the previous classification of 1973. The new WHO does however discriminate the minimally invasive papillary urothelial carcinomas in those with infiltration of the lamina propria above the muscularis mucosae (pT1a), the infiltration of the lamina muscularis mucosae (pT1b), and the extension beyond the muscularis mucosae (pT1c). The recurrence rate increases from stage pT1b. This substaging may be of therapeutical relevance.

Adenocarcinoma, Papillary↗
PubMed2003

Molecular classification of cancer: unsupervised self-organizing map analysis of gene expression microarray data.

An unsupervised self-organizing map-based clustering strategy has been developed to classify tissue samples from an oligonucleotide microarray patient database. Our method is based on the likelihood that a test data vector may have a gene expression fingerprint that is shared by more than one tumor class and as such can identify datasets that cannot be unequivocally assigned to a single tumor class. Our self-organizing map analysis completely separated the tumor from the normal expression datasets. Within the 14 different tumor types, classification accuracies on the order of approximately 80% correct were achieved. Nearly perfect classifications were found for leukemia, central nervous system, melanoma, uterine, and lymphoma tumor types, with very poor classifications found for colorectal, ovarian, breast, and lung tumors. Classification results were further analyzed to identify sets of differentially expressed genes between tumor and normal gene expressions and among each tumor class. Within the total pool of 1139 genes most differentially expressed in this dataset, subsets were found that could be vetted according to previously published literature sources to be specific tumor markers. Attempts to classify gene expression datasets from other sources found a wide range of classification accuracies. Discussions about the utility of this method and the quality of data needed for accurate tumor classifications are provided.

Algorithms↗
PubMedDate not supplied

[Wernicke's classification and others concepts of classifying mental disorders].

The authors of this article on the basis "Uber die Klassifikation der Psychosen" analysis present the method of mental disorders' classification proposed by Carl Wernicke in 1899. Wernicke's classification was an alternative for other classification concepts existing in the 19th century. Carl Wernicke as one of the first noticed the impossibility of creating a classification based on etiology. Basing his classification concept on mental disorders localisation, he created an alternative opposed to classifications based on two main approaches: descriptive and etiological.

Germany↗
PubMed2003

Interrater reliability of the International Association for the Study of Pain and Tunks' spinal cord injury pain classification schemes.

OBJECTIVE: To determine the interrater reliability of the International Association for the Study of Pain and Tunks' spinal cord injury pain classification schemes. METHODS: A total of 64 pain sites reported by 29 individuals were classified using International Association for the Study of Pain and Tunks' classification schemes. Three raters independently categorized each pain site. RESULTS: In general, disagreement in pain classification between the three raters was found for about 50-70% of the pain sites. Disagreement between rater pairs (two raters at a time) was somewhat better, ranging from about 20% to 50%. The kappa statistic for interrater agreement was in the marginally acceptable range (i.e., 0.3 to 0.65). Although disagreement tended to be somewhat higher using the Tunks scheme, both classification schemes showed low interrater agreement. CONCLUSIONS: Consistent with our previous research using the Donovan spinal cord injury pain classification scheme, considerable variability between raters was demonstrated using the International Association for the Study of Pain and Tunks' spinal cord injury pain classification schemes.

Female↗
PubMed1992

[Principles for the classification of anti-arrhythmia agents in cardiac arrhythmias].

Clinically useful antiarrhythmic drugs are a group of heterogenous compounds, both with respect to chemical structure and to cellular mechanism of action. The classification of antiarrhythmic agents according to Vaughan Williams is based on electrophysiological findings in isolated heart muscle and defines four classes of drug actions. The criteria for classification include blockade of ion channels (classes I and IV), interaction with receptors (class II), and alteration of electrophysiological parameters, e.g., prolongation in action potential duration (class III). Several antiarrhythmic drugs possess actions in more than one class. The classification does not include all established antiarrhythmics, e.g., digitalis. Class-I action is further subdivided on the basis of extent of Na+ channel block and additional change in action potential duration. The kinetics of the onset and offset of Na+ channel block can be explained by models in which association and dissociation from the receptor are functions of channel state, i.e., activated, inactivated or resting. Detailed analysis has led to the concept of saturation block (24). Recently, the European Society of Cardiology has presented a classification of antiarrhythmics based on a more comprehensive compilation of drug action (18). Any useful classification of antiarrhythmic agents should offer guidance for their clinical use. This goal has not yet been reached. The criteria of classification are physicochemical properties or cellular mechanism of action as detected with sophisticated electrophysiological techniques. However, in spite of this fact, successful therapeutic use of antiarrhythmic drugs remains, to a large extent, still empirical.

Animals↗
PubMed2003

Alterations in molecular pathways of diffusely infiltrating glial neoplasms: application to tumor classification and anti-tumor therapy (Review).

Recent advances in our understanding of the molecular genetic mechanisms underlying diffusely infiltrating brain neoplasms have important implications for the classification and therapy of these tumors. Traditionally, primary brain tumors have been classified histologically; however, it is now clear that tumors within a single histologically defined category are heterogeneous from a molecular genetic perspective. Furthermore, many new experimental therapeutic strategies directed against these almost invariably fatal tumors are aimed at molecular rather than histologic abnormalities. Consequently, the classification of these tumors is in the process of being re-evaluated as underlying molecular genetic mechanisms continue to be elucidated. This review covers traditional histologic based classification of infiltrating glial neoplasms together with molecular abnormalities of these tumors involving p53, epidermal growth factor receptor, the retinoblastoma pathway, platelet derived growth factor receptor, genetic losses on chromosome 10, and loss of heterozygosity on chromosomes 1p and 19q. The contribution of these molecular genetic abnormalities to the classification and therapy of these tumors is discussed. Although at the present no molecular system for the classification of brain tumors has been generally accepted, microarray technologies offer the exciting prospect of practical molecular classification in the future.

Antineoplastic Agents↗
PubMed1992

[Present views on classification of cerebrovascular diseases].

In conjunction with the declaration of the "brain decade" which was called for by the unfavourable position as regards early diagnosis and by inadequate treatment of cerebral diseases, the author reflects on the importance of classification of cerebrovascular diseases. He submits a historical review of different classifications of cerebrovascular diseases starting with the international classification of diseases introduced into practice as early in 1893, the clinical and research classification elaborated by Millikan in 1975--both are still used by WHO--to the most recent suggestions of Hachinski of 1990 and the Classification of spontaneous intracerebral haematoma by Mizukami elaborated in 1985. The paper contains also the author's own modification of the clinical and research classification.

Cerebrovascular Disorders↗
PubMed2003

[Symptomatic intracranial artery stenosis: angiographic classifications and stent-assisted angioplasty].

OBJECTIVE: To assess the safety and efficacy of stent-assisted angioplasty (SAA) for symptomatic intracranial artery stenosis, and to evaluate preliminarily the significance of classification of location, morphology and access (LMA classification) of intracranial artery stenosis in SAA. METHODS: Forty-two patients with symptomatic intracranial artery stenosis (diameter reduction: 50% - 74%, n = 15; >or= 75%, n = 27), located in middle cerebral artery (n = 27), intracranial internal carotid artery (n = 4), intracranial vertebral artery (n = 7) and basilar artery (n = 4) respectively, refractory to medical therapy were enrolled in this study. RESULTS: LMA classification: 23 of the forty-two lesions (54.8%) located at the site of bifurcation, which were classified according to the location into type A (n = 8), B (n = 11), C (n = 2), D (n = 1) and F (n = 1) respectively. Type A, B and C lesions were 19, 19 and 4 respectively in the light of morphologic classification. Type I, II and III accesses were 15, 23 and 4 respectively in the light of access classification. TECHNIQUE: The technical successful rate of SAA was 95.2% (40/42) for the group overall, and 100% (15/15), 94.7% (22/23), and 75% (3/4) for type I, II, III accesses, respectively. The rate of periprocedural complication and death was 9.5% (4/42), including acute occlusion (n = 1) and high perfusion syndrome (n = 3). After emergency measures, 3 patients were cured completely, and the remaining one with severe MCA trunk stenosis of type C lesion died of subarachnoid hemorrhage (2.4%). During a clinical follow-up period ranging from 1 to 18 months (median 8 months), 39 patients receiving SAA have been still free from ischemic events. There was no restenosisfound angiographically 6 months (n = 7) and 12 months (n = 4) after SAA. CONCLUSIONS: Our results suggest that under rigorous control of procedural and periprocedural measures, SAA appears to be a safe and effective therapy for symptomatic intracranial stenoses of type A and B lesions, but it is not risk-free for type C lesions. The LMA classification is helpful for predicting the results of SAA and to design the procedure. However, further study is needed.

Adolescent↗