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Birgit Weynand

Publications and source records attributed to Birgit Weynand.

14 recordsLinked to original sources
PubMed2006

Prognostic factors for long-term survival in patients with thoracic metastatic disease: a 10-year experience.

OBJECTIVE: To compare survival results after resection in patients with thoracic parenchymal metastatic disease versus non-parenchymal metastatic disease and to identify prognostic factors for survival. METHODS: From 1990 to 2002, we retrospectively studied 134 procedures performed on 93 patients (3-84 years old). There were 73 patients with parenchymal resection and 20 patients with non-parenchymal resection. Tumor histology was epithelial in 62 patients, sarcoma in 21 patients, and teratomas and melanoma in 6 and 4 patients, respectively. Sixty-five patients underwent a metastasectomy once, whereas 28 had their metastatic disease repeatedly resected. RESULTS: Follow-up was 100% complete with a mean time of 43 months (range 1-169). In-hospital mortality was 2.2% (3/134 procedures) and major morbidity 5.5%. Median survival was 39 months (95% CI: 21-56 months). Overall, the actuarial survival at 1, 3, and 5 years were 84%, 55%, and 44%, respectively. For the entire group, by univariate analysis, among the 13 predictor variables selected, only the number of metastases (Hazard Ratio (HR)=3.4 [95% CI: 1.9-6.1]) and completeness of resection (HR=2.3 [95% CI: 1.3-4.2]) were found to be significant for death whereas repeated metastasectomy was found to be a significant predictor for survival (HR=0.25 [95% CI: 0.12-0.55]). In the group of parenchymal metastatic disease, a size greater than 3cm was a predictor for death (HR=2 [95% CI: 1.1-3.7]). In the subgroup of patients with colorectal metastasis, bilateral disease was also found to be a significant predictor for death (HR=3.6, [95% CI: 1.2-11.1]). CONCLUSION: This study supports our current aggressive approach to metastatic thoracic disease. Indeed, patient's survival is improved while a low mortality and morbidity is achieved. The most beneficial impact on long-term survival is correlated to the completeness of the surgery whereas the increasing number and size of the metastasis inversely correlate with survival.

Adolescent↗
PubMed2006

Pneumoproteins as markers of paraquat lung injury: a clinical case.

OBJECTIVE: To describe the changes in lung-specific secretory proteins in biological fluids in a fatal case of paraquat ingestion and to present immunostaining data obtained on postmortem lung tissue specimens. METHODS: A 20-year-old man committed suicide by ingesting 100ml of a 20% paraquat solution. Surfactant associated proteins A (SP-A), B (SP-B) and Clara cell 16kDa protein (CC16) were determined in the serum and on broncho-alveloar lavage performed 18h after admission. Renal failure progressed rapidly and the patient died from refractory hypoxia. Immunostaining studies using antibodies directed against CC16, SP-A and SP-B were performed on postmortem lung tissue specimens. RESULTS: Serum CC16 seemed to increase gradually with the progression of renal impairment. Serum SP-A and SP-B levels increased before any significant changes in pulmonary gas exchanges. The immunostaining study showed that the labeling for SP-A and SP-B was reduced or absent following paraquat toxicity, while Clara cells were relatively preserved. CONCLUSIONS: The elevation of serum CC16 with paraquat toxicity is probably mainly related to a reduced renal clearance. The increase of serum SP-A and SP-B could reflect an increased lung to blood leakage, independently of the alteration of the renal function.

Acute Kidney Injury↗
PubMed2006

Epithelial-myoepithelial carcinoma of the submandibular gland with symptomatic lung metastases treated with chemotherapy.

This report concerns a patient with symptomatic lung metastases from an epithelial-myoepithelial carcinoma of the submandibular gland. Although the efficacy of chemotherapy is unknown in this disease, our patient was treated with cisplatin combined with 5-fluorouracil and later with paclitaxel and cyclophosphamide. Chemotherapy allowed disease stabilization and relief of the pulmonary symptoms. This is the first report on the use of chemotherapy in this very rare salivary gland carcinoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2006

Breast tuberculosis imaging.

We report unusual magnetic resonance images of breast tuberculosis before and after treatment. Magnetic resonance imaging may assess the efficiency of treatment of breast tuberculosis.

Adult↗
PubMed2006

Primary combined squamous and small cell carcinoma of the larynx: Report of two cases and discussion of treatment modalities.

Combined small cell carcinoma (SMCC) of the larynx consists of SMCC admixed with a component of squamous cell carcinoma or adenocarcinoma. These tumors are very rare and, to date, only a few cases have been fully described. This points out the lack of information available about the correct management of these patients. Here, we describe two additional cases of combined SMCC of the larynx that illustrate the difficulties that we can encounter to diagnose correctly these patients and, by consequence, to treat them adequately.

Adult↗
PubMed2006

Solid and pseudopapillary tumor of the pancreas--review and new insights into pathogenesis.

Solid pseudopapillary tumors (SPT) of the pancreas are rare neoplasms that occur mostly in young women. Despite of a low malignant potential, 10% to 15% of the cases have aggressive behavior with metastatic dissemination possibly leading to death. To date, no pathological factor can reliably predict the outcome of these tumours. Galectin-3, a major actor in the carcinogenesis of pancreatic ductal adenocarcinoma, has not been investigated in SPT. The presence of progesterone receptors is frequently reported in SPT, whereas that of estrogen receptor (ER) is unclear. We studied 5 cases of SPT consisting of 4 pancreatic tumors and 1 metastatic case. The morphological distinctive feature of metastatic nodules was the presence of polygonal or spindle cells with pleiomorphic nuclei and high mitotic count exhibiting a diffuse, infiltrative growth pattern. We found a strong expression of galectin-3 in all SPTs, whereas, interestingly, it was lower in metastatic nodules. Conversely, no galectin-3 expression was found in normal pancreatic endocrine cells or in neuroendocrine tumors. We suggest therefore that galectin-3 is a useful marker to distinguish SPT from neuroendocrine tumor, and also indicator of behavior because its low expression is associated with metastatic spreading. Moreover, the presence of galectin-3 in both SPT and pancreatic ducts rises the hypothesis of a posible ductal origin of these tumors. Specific antibodies for anti-ERalpha and anti-ERbeta demonstrated a strong expression of ERbeta whereas ERalpha was not detected. In conclusion, the present study brings the first evidence of the involvement of galectin-3 in SPT but also brought up clues which allowed to reconcile previously conflicting results on the presence of ER.

Adenocarcinoma, Papillary↗
PubMed2005

Accessory or sublingual salivary gland biopsy to assess systemic disease: a comparative retrospective study.

Minor salivary gland biopsies are commonly performed as part of the diagnosis of Sjögren's syndrome or other systemic diseases. Until now, a lip biopsy taken from inside the inferior lip has been the most often performed method to assess the accessory salivary glands. Because of the risk of damaging the inferior alveolar nerve and of harvesting non-contributive biopsies, for the past several years we have chosen the sublingual biopsy described by Adam. The aim of this study was to describe the indication and diagnosis and to evaluate work incapacity, pain and the complication rate among our salivary gland biopsies. In this retrospective study, we evaluated 79 biopsies (lip, n=24, and sublingual, n=55) taken at the Department of Oral and Maxillofacial Surgery of the University Hospital St-Luc, Brussels, by multiple junior trainees and senior surgeons (n=17). Data were collected from record study and from telephonic patient questionnaires. The three major indications were: sicca syndrome (24%), suspicion of Sjögren's syndrome (32%) or exclusion of other systemic diseases (44%). The histology results of the lip and sublingual biopsies, respectively, were: normal tissue (29%, 24%), chronic inflammation (29%, 41%), compatible, but not characteristic for Sjögren (8%, 7%), Sjögren's syndrome (13%, 24%), salivary gland atrophy (13%, 0%) or non-contributive (8%, 0%). The procedures were both almost painless (time during which painkillers had to be taken: 0.33 vs. 0.69 days, NS) and work incapacity was not encountered in any group. After one lip biopsy we had to deal with a permanent anesthesia of the lower lip (6.6%), and after one sublingual biopsy a swelling of the floor of the mouth had to be incised under local anesthesia (2.7%). Thus, sublingual biopsy is an easy procedure with low morbidity and excellent reliability in comparison to lip biopsy. No salivary gland atrophy and no non-contributive biopsies were encountered; no important bleeding or nerve lesion was recorded after sublingual biopsies.

Adult↗
PubMed2005

Prevalence of lymph nodes in the apex of level V: a plea against the necessity to dissect the apex of level V in mucosal head and neck cancer.

BACKGROUND: We assessed the prevalence of histologically proven normal or invaded lymph nodes in the apex of level V. METHODS: Seventy neck dissections were performed in 41 patients with mucosal head and neck squamous cell carcinoma (SCC). Fifty-one neck dissections were performed in 30 previously untreated patients (group 1); 19 neck dissections were carried out in 11 patients previously irradiated (group 2). RESULTS: Pathologic analysis was unable to identify any lymph node in 70% of the apex specimens. In group 1, no lymph nodes were detected in 63%, whereas one or more noninvaded lymph nodes were present in 37%; in group 2, no lymph nodes were identified in 89%, whereas one or more normal lymph nodes were found in 11% (p = .03). Metastatic lymph nodes were never identified. CONCLUSIONS: The prevalence of lymph nodes in the apex was 30%. No invaded lymph nodes were identified. In addition to anatomic evidence, these results suggest that dissection of the apex is not necessary in mucosal head and neck SCC.

Carcinoma, Squamous Cell↗
PubMed2004

Tumor volume in pharyngolaryngeal squamous cell carcinoma: comparison at CT, MR imaging, and FDG PET and validation with surgical specimen.

PURPOSE: To compare computed tomography (CT), magnetic resonance (MR) imaging, and fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) for delineation of gross tumor volume (GTV) in pharyngolaryngeal squamous cell carcinoma and to validate results with the macroscopic surgical specimen when available. MATERIALS AND METHODS: Twenty-nine patients with stages II-IV squamous cell carcinoma treated with radiation therapy or chemotherapy and radiation therapy (n = 20) or with total laryngectomy (n = 9) were enrolled. Ten patients had oropharyngeal, 13 had laryngeal, and six had hypopharyngeal tumors. CT, MR imaging, and PET were performed with patients immobilized in a customized thermoplastic mask, and images were coregistered. GTVs obtained with the three modalities were compared quantitatively and qualitatively. If patients underwent total laryngectomy, images were validated with the surgical specimen after three-dimensional coregistration. The effect of each modality was estimated with linear mixed-effects models. Adjustments for multiple comparisons were made with the Bonferonni or Sidak method. RESULTS: For oropharyngeal tumors and for laryngeal or hypopharyngeal tumors, no significant difference (P >.99) was observed between average GTVs delineated at CT (32.0 and 21.4 cm(3), respectively) or MR imaging (27.9 and 21.4 cm(3), respectively), whereas average GTVs at PET were smaller (20.3 [P </=.10] and 16.4 cm(3) [P </=.01], respectively). GTVs from surgical specimens were significantly smaller (12.6 cm(3), P </=.06). In nine patients for whom a surgical specimen was available, no modality adequately depicted superficial tumor extension; this was due to limitations in spatial resolution. In addition, false-positive results were seen for cartilage, extralaryngeal, and preepiglottic extensions. CONCLUSION: Compared with GTVs at CT and MR imaging, GTVs at FDG PET were smaller. In nine patients for whom a surgical specimen was available, PET was found to be the most accurate modality. However, no modality managed to depict superficial tumor extension.

Adult↗
PubMed2003

Predictive value of the fraction of cancer cells immunolabeled for proliferating cell nuclear antigen or Ki67 in biopsies of head and neck carcinomas to identify lymph node metastasis: comparison with clinical and radiologic examinations.

BACKGROUND: Neck metastasis is a major prognostic factor of head and neck carcinoma, but its preoperative detection is currently unreliable. Molecular markers of the metastatic potential of a carcinoma would help to avoid unnecessary neck dissection in patients with nonmetastatic cancer. METHODS: The fractions of cancer cells immunostained for proliferating cell nuclear antigen (PCNA) and Ki67 were determined in 80 preoperative biopsy specimens of head and neck carcinomas. The value of both indexes to detect metastasis in the subsequent neck dissection was compared with that of the clinical and radiologic examinations. RESULTS: PCNA and Ki67 indexes correlated with neck metastasis. Cutoff points were determined for both indexes to discriminate metastatic from nonmetastatic carcinomas. By multivariate logistic regression, these indexes were significant predictors of metastases, together with clinical T stage and neck palpation. CONCLUSION: The fraction of cancer cells immunolabeled for PCNA or Ki67 in preoperative biopsy specimens is helpful to predict neck metastasis.

Adult↗
PubMed2002

TNF-mediated toxicity after massive induction of specific CD8+ T cells following immunization of mice with a tumor-specific peptide.

We immunized mice with antigenic peptide P815E, which is presented by H-2K(d) and recognized by tumor-specific CTL raised against P815 tumor cells. This peptide is encoded by the ubiquitously expressed gene MsrA and carries a mutated residue conferring tumor specificity. Unexpectedly, we observed a severe toxicity occurring in the early hours after the third injection, resulting in the death of most mice within 24 h. The toxic syndrome was reminiscent of TNF-induced shock, and the sera of ill mice contained high levels of TNF. Toxicity was prevented by injection of neutralizing anti-TNF Abs, confirming the involvement of TNF. Depletion of CD8+ T cells could also prevent toxicity, and ex vivo experiments confirmed that CD8+ lymphocytes were the major cellular source of TNF in immunized mice. Tetramer analysis of the lymphocytes of immunized mice indicated a massive expansion of P815E-specific T cells, up to >60% of circulating CD8+ lymphocytes. A similar toxicity was observed after massive expansion of specific CD8+ T cells following immunization with another P815 peptide, which is encoded by gene P1A and was injected in a form covalently linked to an immunostimulatory peptide derived from IL-1. We conclude that the toxicity is caused by specific CD8+ lymphocytes, which are extensively amplified by peptide immunization in a QS21-based adjuvant and produce toxic levels of TNF upon further stimulation with the peptide. Our results suggest that immunotherapy trials involving new peptides should be pursued with caution and should include a careful monitoring of the T cell response.

Amino Acid Sequence↗
PubMedDate not supplied

A new, liquid-based cytology technique.

OBJECTIVE: To evaluate a new liquid-based cytology technique, Papspin (Thermo Shandon, Pittsburgh, Pennsylvania, U.S.A.). STUDY DESIGN: Three thousand cervical samples were examined. Each cervix was sampled with a Cervex Brush (Roche, Oss, the Netherlands), used first for a Pap smear and afterwards for a Papspin. One cytospin was prepared from each vial. RESULTS: An identical rate of epithelial cell abnormalities (3.8%) was detected with the two methods. Diagnostic concordance was observed in 86% of the 114 cases. Differences in diagnoses occurred in 168 of 3,000 cases (5.6%) concerning fungal infection (22 cases), epithelial cell abnormalities (24 cases) and minimal differences within the nonneoplastic Bethesda category (122 cases). Endocervical cells were absent from 158 Papspins (5.3%) and 66 Pap smears (2.2%), while they were present in the respective Pap smear or Papspin. Seven Papspins were considered "satisfactory, but limited by ..." (SBLB) as compared to 33 Pap smears given the absence of endocervical cells. CONCLUSION: Discordances concerning epithelial cell abnormalities were observed in 24 of 3,000 cases (0.8%). Fungal infections were more easily diagnosed on Papspin. The absence of endocervical cells in 5.3% of Papspins is due to a bias of methodology. Quality improvement was evident on Papspin for SBLB specimens. HPV testing could be performed with good results.

Adolescent↗