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PubMed1975

Radiological evaluation of the aortic-pulmonic window.

Knowledge of the roentgen anatomy of the aortic-pulmonic window will minimize confusion of pathologic and normal radiographic appearances. When deep intrusion of lung into the window is seen or when the window is outlined by far within it, gross enlargement of ductus nodes or masses in this area can be excluded with a reasonable degree of certainty. If masses or lymph nodes are present in the window, the mediastinal pleura "closing" on its lateral side will show on abnormal configuration with convexity directed laterally. Medial extension of masses or enlarged lymph nodes may cause impression on the left lateral wall of the esophagus and may compromise the left recurrent laryngeal nerve.

Adipose Tissue↗
PubMed1986

Percutaneous bone biopsy in the patient with known or suspected osseous metastases.

One hundred fifty-three percutaneous bone biopsies were performed on 70 patients with and 83 patients without a known extraosseous primary tumor who had either scintigraphic evidence or plain radiographic evidence suggesting bony metastases. Biopsy results were shown to be true-negative, true-positive, or false-negative based on results of the needle biopsy, open biopsy, or radiographic follow-up. The overall accuracy of biopsy was 95.4%. In the group with positive scans only, the accuracy was 85.7%. Twenty-nine percent of the patients with known cancer and 33.7% of patients without cancer proved to have benign causes for their radiographic abnormality. The rate of significant complications was 0.7%. Biopsy of suspect osseous lesions can be performed safely and may significantly alter treatment. Biopsy of scan-positive, radiograph-negative lesions is a highly accurate procedure.

Biopsy↗
PubMed1995

Thoracic nodal staging with PET imaging with 18FDG in patients with bronchogenic carcinoma.

PURPOSE: To assess the role of positron emission tomographic (PET) imaging with 18-fluoro-2-deoxyglucose (18FDG) in detecting thoracic lymph node metastases in patients with bronchogenic carcinoma. MATERIALS AND METHODS: Over a 2-year period, any patient presenting to our institution with newly diagnosed bronchogenic carcinoma who was to have thoracic nodes sampled was considered eligible. All PET studies were performed prior to nodal sampling and areas of increased uptake were mapped according to the American Thoracic Society classification. Studies were correlated with CT and pathology. Sensitivity and specificity for predicting nodal metastases was calculated. RESULTS: Forty-two patients had 62 nodal stations (40 hilar/lobar, 22 mediastinal) sampled. The sensitivity and specificity for hilar/lobar lymph node station metastases using PET imaging was 73% and 76%, respectively. With CT, the sensitivity and specificity were 27% and 86%. The sensitivity and specificity using PET imaging for mediastinal node station metastases was 92% and 100%, respectively, while with CT the figures were 58% and 80%. The sensitivity and specificity for combined thoracic nodal station metastases using PET imaging was 83% and 82%, respectively, while with CT it was 43% and 85%. There was a strong statistical relationship between positive PET imaging and lymph node abnormalities. CONCLUSIONS: 18FDG-PET imaging is accurate in detecting thoracic lymph node metastases in patients with bronchogenic carcinoma. Normal results of PET studies virtually preclude the need for mediastinal nodal sampling prior to surgery, whereas abnormal results of studies most likely represent mediastinal metastases. Treatment can be based on the extent of disease suggested by PET imaging.

Adult↗
PubMed2000

CT and MR imaging of generalized cystic lymphangiomatosis in pediatric patients.

OBJECTIVE: The aim of this study was to describe the spectrum of abnormalities seen in generalized cystic lymphangiomatosis as shown by CT and MR imaging and to correlate these findings to gross pathology. CONCLUSION: MR imaging and CT may substantially broaden visualization of the spectrum of abnormalities seen in generalized cystic lymphangiomatosis by revealing the complete extent of disease and, thus, may contribute to clinical management of the disease by preventing initial misdiagnosis.

Child↗
PubMed1986

Long-term seropositivity for human T-lymphotropic virus type III in homosexual men without the acquired immunodeficiency syndrome: development of immunologic and clinical abnormalities. A longitudinal study.

The long-term effects of seropositivity for human T-lymphotropic virus type III (HTLV-III) on T-lymphocyte subsets and health status were evaluated in longitudinal studies of 250 initially healthy homosexual men. The relative risk of having an inverted T-lymphocyte helper-to-suppressor ratio rose from 14.3-fold among short-term seropositive subjects (less than 19 months) to 46.9-fold among long-term seropositive subjects (greater than 29 months) in comparison with the risk among seronegative subjects. Overall, 91.7% of long-term seropositive men had inverted ratios, compared with 12.9% of seronegative men. None of the seropositive men who developed an inverted ratio later reestablished a normal ratio. Both decreased T-helper cell number and percentage (p = 0.003) and increased T-suppressor cell number and percentage (p = 0.03) were significantly correlated with duration of seropositivity. Among seropositive persons, lymphadenopathy was a highly significant short-term as well as long-term consequence, whereas diarrhea, oral thrush, and herpes zoster were correlated with long-term seropositivity. Overall, 50% of long-term seropositive men compared with 16% of seronegative men developed at least one of five clinical symptoms (p less than 0.003). We conclude that a high proportion of persons infected with HTLV-III will develop measurable immunologic and clinical abnormalities.

Antibodies, Viral↗
PubMed1986

Abnormal B-cell response to T-cell-independent polyclonal B-cell activators in homosexuals presenting persistent generalized lymph node enlargement and HTLV-III antibodies.

B-cell functions were investigated in a well-defined high-risk group for the development of AIDS/AIDS-related complex (ARC). Stimulation of mononuclear cells (MNC) with T-cell-independent polyclonal B-cell activators failed to increase high spontaneous IgG levels observed in vivo and in vitro. The secretion of IgM following stimulation with Klebsiella M (Klebs M) or Salmonella (Salm) membrane preparation increased by a factor of 4 to 6 and thus ranged between the results of the control group and those of AIDS/ARC patients; the response to a T-cell-independent B-cell mitogen, Staphylococcus aureus Cowan I (SAC), showed profound abnormalities as well in this group. This indicates that functional B-cell abnormalities can be seen in addition to T-cell dysfunctions in patients at increased risk for the development of AIDS/ARC.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Thymic dysfunction in the mutant diabetic (db/db) mouse.

Thymic function has been explored in genetically diabetic homozygous C57BL/KsJ (db/db) mice by evaluating their serum thymic factor (FTS) levels with a rosette assay. As previously reported for other autoimmune mice (NZB or MRL/I mice), the age-dependent decline of FTS levels was significantly accelerated in diabetic mice when compared to heterozygous littermates. Furthermore, FTS inhibitory molecules were detected in db/db mouse sera (as early as 10 wk of age) as evaluated by their ability to absorb in vitro the activity of synthetic FTS in the rosette assay, and in vivo for their capacity to induce the disappearance of endogenous FTS when injected into normal mice. These inhibitors were shown to be immunoglobulins. Histologically, the thymus presented an accelerated involution starting with a cortical lymphocytic depletion and an increased number of Hassall's corpuscles. Ultrastructural studies showed alterations in thymic epithelial cells, mainly represented by an increasing number of cytoplasmic vacuoles. By means of indirect immunofluorescence with anti-FTS monoclonal antibodies, it was shown that the number of FTS+ cells was reduced in db/db mouse thymuses: at the age of 22 wk, diabetic mice had 10 times fewer FTS+ cells than heterozygotes of the same age. Taken together, these results indicate important abnormalities in the thymus of diabetic mice. It is possible that the associated lymphocyte dysfunction plays a role in the pathogenesis of the autoimmune disease presented by db/db mice.

Aging↗
PubMed1993

Constitutive expression of tenascin in T-dependent zones of human lymphoid tissues.

Tenascin is a major extracellular matrix glycoprotein that can interfere with the action of fibronectin by inhibiting cell adhesion and spreading. Although tenascin is able to exert important immunomodulatory activities on T and B cells and macrophages, little is known about its distribution in different lymphohemopoietic tissues. In this study we have analyzed tenascin immunoreactivity on cryostat and paraffin sections of normal and pathological lymphoid tissues using two different monoclonal antibodies. We demonstrated strong tenascin expression in all peripheral lymphoid tissues, whereas it was barely detectable in the thymus and in bone marrow. In reactive lymph nodes, tenascin was mainly found in T-dependent zones, forming a variably close-woven reticular network corresponding to fibroblastic reticulum cells and blood vessels basal laminae, showing a partial co-localization with fibronectin. In B-dependent zones, tenascin was restricted to blood vessels. Using double-marker analysis, we performed a thorough study comparing tenascin expression in different compartments of lymphoid microenvironments. Tenascin network appeared much thicker in chronically stimulated tissues, where CD4+ lymphocytes with "memory" phenotype (CD45RO+/CD45RA-) were predominant, and at sites of ongoing inflammation. In particular, a striking increase of tenascin was observed in sarcoid lymph node, as well as in myasthenic hyperplastic thymuses. In addition, tenascin can be abnormally synthesized in tissue involved by various types of lymphomas, including Hodgkin's disease and hairy cell leukemia.

Bone Marrow↗
PubMed1985

The role of receptors in 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) toxicity.

There is good evidence that the Ah-(TCDD-) receptor plays a role in the toxicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and its congeners. TCDD and other chlorinated aromatic hydrocarbons with chlorine atoms in lateral positions (2,3,7,8-tetrachlorodibenzofuran, 3,3',4,4'-tetrachloroazoxybenzene, 3,3',4,4'(5,5')-tetra(hexa)chlorobiphenyl), all bind to the receptor and show a similar pattern of toxicity, although there is a wide range in potency. The Ah-receptor is viewed as the major product of the regulatory gene of the Ah-locus in the mouse. Several of the toxicities of TCDD and congeners (teratogenesis, thymic involution and hepatic porphyria) have been shown to segregate with the Ah-locus. In vitro studies using keratinizing cells or fetal thymus organ culture have shown a good correlation between activity as ligands of the receptor and toxicity for the compounds discussed. The great differences in toxic potency of these compounds in vivo may therefore be a result of variation in rate of metabolism and excretion rather than differences in affinity for the Ah-receptor. The physiological role of the Ah-receptor is discussed, whether it has developed as a response to exposure to toxic substances in the environment, as a means of induction of P-450-dependent polysubstrate mono-oxygenase activities in order to make those substances more liable for excretion--or is there a physiological ligand? TCDD has a long half-life in the body, and a sustained competition for binding to the receptor between TCDD and a ligand of importance for normal cell functions may result in toxicities such as the wasting syndrome. This tentative ligand could be of varying importance in different species, which might explain the great variation in sensitivity between species, the hamster being about 5000 times less sensitive than the guinea pig.

Abnormalities, Drug-Induced↗
PubMed2004

New paradigms in neuroendocrinology: relationships between obesity, systemic inflammation and the neuroendocrine system.

Obesity may be an independent risk factor for coronary artery disease and contribute to a chronic state of systemic inflammation leading to atherosclerosis and metabolic abnormalities, such as diabetes, insulin resistance, dyslipidemia and hypertension. Visceral fat, in fact, may act as an endocrine organ, synthesizing and releasing atherogenic inflammatory cytokines, whose circulating levels depend on the individual's nutritional state, and the extent and anatomical location of fat stores. Unsuspected viral infections might also be involved in enhancing autocrine/paracrine mechanisms of cytokine release from omental fat. Elevated levels of blood cytokines may interact with the neuroendocrine system, autonomic nerves and peripheral lymphatic organs. This may lead to local inflammatory reactions in many body compartments, in particular in the heart tissue, possibly affecting the process of circulatory recovery in obese subjects, and predisposing these patients to a greater risk of myocardial inflammatory disease than individuals with normal body mass index. Circulating levels of inflammatory cytokines might be considered to determine risk categories for development of cardiovascular complications in obese subjects. In addition, their reduction with pharmacological antagonists might prevent and/or control acute cardiovascular events and increase energy expenditure in obese patients, especially after surgical treatment, through reduction of cytokine inhibition of the hypothalamic-pituitary-thyroid axis.

Adipocytes↗
PubMedDate not supplied

Postoperative chylous ascites: a rare complication of laparoscopic Nissen fundoplication.

The accumulation of chylous fluid in the abdominal cavity is an infrequent, yet alarming, complication in abdominal surgery. Laparoscopic fundoplication has assumed a central role in the surgical treatment of gastroesophageal reflux disease and is significantly altering the balance of therapy toward more common and earlier surgical intervention. We report the case of a 67-year-old woman with gastroesophageal reflux disease and intense esophagitis who underwent a laparoscopic Nissen fundoplication in February 2000. The procedure was performed without apparent complications. Twenty days later, the patient complained of abdominal pain and distension. Ultrasonography showed ascites, whereas endoscopic and radiological exploration of the fundoplication demonstrated no abnormalities. A paracentesis was performed, which showed a milky fluid with high concentrations of triglycerides (1024 ng/dL) and cholesterol (241 ng/dL). The patient was treated successfully with total parenteral nutrition for 3 weeks, followed by a low-fat diet. To our knowledge, this is the third reported case of chylous ascites after a Nissen fundoplication and the second case after laparoscopic fundoplication. The development of chylous ascites seems to be related to the injury of lymphatic vessels, including the thoracic duct, during the retroesophageal window dissection. The careful dissection and judicious use of diathermy is proposed to prevent this rare complication.

Aged↗
PubMed1998

Cervical lymphadenopathy: sonographic differentiation between tuberculous nodes and nodal metastases from non-head and neck carcinomas.

PURPOSE: Clinical examination alone cannot differentiate between cervical tuberculous lymphadenitis and cervical nodal metastases from non-head and neck (NHN) carcinomas because the distributions of involved lymph nodes are similar. We evaluated the sonographic features of cervical lymph nodes that could be used to differentiate between the 2 categories of nodes. METHODS: We retrospectively reviewed sonograms of abnormal cervical lymph nodes in 47 patients with proven cervical tuberculous lymphadenitis and in 22 patients with proven nodal metastases from NHN carcinomas. RESULTS: Abnormal nodes in tuberculous lymphadenitis and nodal metastases from NHN carcinomas were commonly found in the supraclavicular fossa (15% and 38%, respectively) and the posterior triangle (70% and 41%, respectively). Statistically significant (p < 0.05) features for differential diagnosis were lymph nodes' longest diameter, echogenicity, short-to-long axis ratio, appearance of surrounding soft tissues, and presence of intranodal cystic necrosis, matting, and posterior enhancement. Nodal size, echogenicity, presence of an echogenic hilum, calcification, coagulation necrosis, and sharpness of borders helped in identifying the abnormal lymph nodes. CONCLUSIONS: Sonographic features that helped to differentiate between the 2 categories of nodes were shape, edema of surrounding soft tissue, homogeneity, intranodal cystic necrosis, matting, and posterior enhancement.

Adult↗
PubMed1978

Angioimmunoblastic lymphadenopathy: an ultrastructural and immunologic study with review of the literature.

Six cases of angioimmunoblastic lymphadenopathy (AIBL) are presented, detailed ultrastructural and immunohistologic studies of several involved organs are described, and the literature is reviewed. The features of the lesion are of normal immune reactive cells containing polyclonal cytoplasmic immunoglobulin. Large numbers of dying and degenerating cells result in accumulations of cell debris, corresponding to the characteristic interstitial material seen by light microscopy. Our studies confirm that the vascular changes are unique to lymph nodes, appear confined to postcapillary venules, and consist of endothelial cell hypertrophy and expansion of the vessel wall by basement membrane-like material, cellular debris and collagen fibers. No deposits of amyloid or antigen-antibody complexes were noted by ultrastructural or immunologic techniques. Our data reveal morphologic and laboratory features of a hyperimmune state but with paradoxical cutaneous anergy and decrease in blood (T) lymphocytes. We postulate that AIBL is an abnormal, but non-neoplastic immune reaction related to the autoimmune disorders, resulting from a loss of suppressor T cells with hyperfunction of the B lymphocyte system.

Adult↗
PubMed1976

Sézary's syndrome: a cytogenetic, cytophotometric and autoradiographic study.

Cytophotometric, cytogenetic, and autoradiographic studies were performed in cells of three patients suffering from clinically diagnosed Sézary's syndrome with erythroderma and the presence of abnormal lymphoid cells in the peripheral blood, skin, bone marrow and lymph-nodes. Feulgen DNA cytophotometry of cells in the peripheral blood and skin lesions showed marked aneuploidy and tetraploidy. Multiple translocations were identified with a G-banding technique. The chromosomal abnormalities varied widely between the patients, but C and D group chromosomes were more frequently involved than others. All breakpoints of the translocations were localised in the centromeric region. Autoradiography of blood and skin samples revealed many labelled cells in the skin and a lower number in the blood, indicating cell proliferation in the skin. It is concluded that the pathological cells occurring in the Sézary syndrome are abnormal lymphoid cells with a tendency to proliferate in the dermis. The variability observed between and in the patients is in all probability due to a difference in the degree of dedifferentiation.

Aged↗
PubMed1998

In vivo lactate editing with simultaneous detection of choline, creatine, NAA, and lipid singlets at 1.5 T using PRESS excitation with applications to the study of brain and head and neck tumors.

Two T2-independent J-difference lactate editing schemes for the PRESS magnetic resonance spectroscopy localization sequence are introduced. The techniques, which allow for simultaneous acquisition of the lactate doublet (1.3 ppm) and edited singlets upfield of and including choline (3.2 ppm), exploit the dependence of the in-phase intensity of the methyl doublet upon the time interval separating two inversion (BASING) pulses applied to its coupling partner after initial excitation. Editing method 1, which allows for echo times TE = n/J (n = 1, 2, 3, . . . . ), alters the BASING carrier frequency for each of two cycles so that, for one cycle, the quartet is inverted, whereas, for the other cycle, the quartet is unaffected. Method 2, which also provides water suppression, allows for editing for TE > 1/J by alternating, between cycles, the time interval separating the inversion pulses. Experimental results were obtained at 1.5 T using a Shinnar Le-Roux-designed maximum phase inversion pulse with a filter transition bandwidth of 55 Hz. Spectra were acquired from phantoms and in vivo from the human brain and neck. In a neck muscle study, the lipid suppression factor, achieved partly through the use of a novel phase regularization algorithm, was measured to be over 10(3). Spectra acquired from a primary brain and a metastatic neck tumor demonstrated the presence of lactate and choline signals consistent with abnormal spectral patterns. The advantages and limitations of the methods are analyzed theoretically and experimentally, and significance of the results is discussed.

Aspartic Acid↗
PubMed1989

Rate of chromosomal aberrations in prenatally detected hydrops fetalis and hygroma colli.

Chromosome analyses were carried out in a series of 775 fetuses with morphological abnormalities diagnosed by ultrasound. Among these cases, 57 demonstrated non-immune hydrops fetalis with hygroma colli (group 1) and a further 116 non-immune hydrops fetalis without hygroma colli (group 2). Different chromosome abnormalities were found in 54.5% of cases of group 1 where chromosome analyses could be performed, and in 27.6% of cases of group 2. The most common aberrations were monosomy X and trisomy 21.

Chromosome Aberrations↗
PubMed2006

Accuracy of surveillance computed tomography in detecting recurrent or new primary lung cancer in patients with completely resected lung cancer.

BACKGROUND: To determine the eventual outcome of abnormalities detected on surveillance computed tomography (CT) in patients with previously resected nonsmall-cell lung cancer (NSCLC), and to assess the accuracy of CT when used by the thoracic surgeon, and to determine the characteristics of abnormalities on CT that correlate with the development of recurrent NSCLC. METHODS: A cohort of patients who had abnormal postoperative CT scans of the chest and upper abdomen in 2002 were followed up into 2005. Abnormalities consisted of pulmonary nodules, pleural effusions, or adenopathy. Data collected included recurrence patterns, the availability of previous scans for comparison, the interval between initial resection and the abnormal CT, nodule size, growth, and multiplicity, as well as progression of pleural effusions or adenopathy. RESULTS: In all, 105 scans in 92 patients were read as abnormal in 2002 by the radiologist. After further investigation or follow-up, or both, for a mean of 3.2 years, 78% of patients who had recurrent NSCLC had their site of first recurrence inside the chest. The negative predictive value of CT when used by the thoracic surgeon was 99%; however, the positive predictive value was only 53%. Abnormalities that correlated with the diagnosis of recurrent cancer included pulmonary nodules that either grew or were larger than 1 cm and pleural effusions that developed after the first postoperative year. CONCLUSIONS: Intrathoracic recurrent NSCLC was rarely missed by the surgeon utilizing surveillance CT, but a significant number of negative investigations were generated by its use. Characteristics of abnormal surveillance CT findings exist that correlate with the presence of malignancy.

Calcinosis↗
PubMed2002

Identification and validation of metastasis-associated proteins in head and neck cancer cell lines by two-dimensional electrophoresis and mass spectrometry.

Despite improvements in treatment of patients with head and neck squamous cell carcinoma (HNSCC) over the last two decades, the survival rate of these patients has not increased significantly. One of the major factors in the poor outcome of the disease is regional metastasis. To better understand the mechanisms of this process at the protein level, we performed two-dimensional electrophoresis (2-DE) and mass spectrometry using SELDI ProteinChip technology to identify proteins differentially expressed in two HNSCC cell lines, UMSCC10A and UMSCC10B, from the same patient. UMSCC10A was derived from the primary tumor and UMSCC10B from a metastatic lymph node. The differentially expressed proteins were excised from the gels. Following in-gel digestion by trypsin, mass profiles of the peptides were generated. Proteins were identified by submitting the peptide mass profiles to a public available NCBInr databases (www.proteometrics.com). Two membrane-associated proteins, annexin I and annexin II and glycolytic protein enolase-alpha were found to be upregulated, and calumenin precursor down-regulated, in metastatic cell line UMSCC10B. The identity of these proteins was confirmed by analyzing additional peptide mass fingerprints obtained by endoproteinase lysine-C digestion. The results were also validated by Western blotting analysis. Our results showed that enolase-alpha, annexin-I and annexin-II might be important molecules in head and neck cancer invasion and metastasis. The results also suggest an important complementary role for proteomics in identification of molecular abnormalities important in cancer development and progression.

Amino Acid Sequence↗