Biomedical subjects

C Busch

Publications and source records attributed to C Busch.

At least 109 records · Page 6Linked to original sources

PubMed1994

[Localized fibrous pleural mesothelioma. Value of image-producing methods for the differentiation from supradiaphragmatic tumors of the liver].

A 38-year-old woman in good health suddenly developed pain in the right chest and mild dyspnoea. She reported two bronchial infections in the preceding year. Physical examination revealed cyanosis of the lips and finger clubbing, slightly dulled percussion sounds and decreased breath sounds at the basis of the right chest, but no other abnormalities. Activity of the tumour marker CA 125 was raised (60 kU/l). The chest radiography showed a shadow in the right lower segment, resembling a high diaphragm. Computed tomography failed to separate the abnormal structure from the liver substance. Needle puncture discovered a small haemorrhagic effusion with mesothelial cells. Magnetic resonance imaging and a scintigraphy of the liver provided evidence that the mass was separate from the liver. At thoracotomy a tumour, 20 x 15 x 10 cm in size and connected by a pedicle to the pleura, was identified and excised. Immunocytochemical tests showed it to be a fibrous pleural mesothelioma without signs of malignancy. The patient was discharged 10 days postoperatively in good general condition.

Adult↗

PubMed1994

Radical systematic mediastinal lymphadenectomy in non-small cell lung cancer: a randomized controlled trial.

The value of radical systematic lymphadenectomy in the treatment of bronchial carcinoma is controversial. In a randomized controlled clinical trial, radical lymphadenectomy was compared with conventional node dissection in 182 patients with non-small cell lung cancer. Comparison of short-term results revealed a significantly longer operating time in those undergoing systematic lymphadenectomy, but overall morbidity and mortality rates were comparable between groups. However, there were complications associated with radical lymphadenectomy such as prolonged air leakage and haemorrhage. Interim analysis of results at a median follow-up of 26.8 months showed no significant influence of radical lymphadenectomy on local recurrence-free interval, metastasis-free interval or cancer-related survival. In conclusion, radical systematic lymphadenectomy is a safe operation that leads to a better staging of non-small cell lung cancer, but its prognostic benefit is questionable.

Adult↗

PubMed1994

Complications of adjacent organs in chronic pancreatitis managed by duodenum-preserving resection of the head of the pancreas.

Chronic pancreatitis frequently generates complications through involvement of adjacent organs. Distal common bile duct stenosis and segmental duodenal stenosis, the most frequent complications, are usually treated by resection or bypass procedures. This study presents experience with duodenum-preserving resection of the head of the pancreas in the treatment of patients with chronic pancreatitis with predominant involvement of the pancreatic head and coexisting complications involving adjacent organs. This procedure preserves the structure and function of the bile duct and duodenum. Sixty-six patients with severe chronic pancreatitis underwent duodenum-preserving resection of the head of the pancreas. Thirty-eight had associated complications of neighbouring organs: 37 had distal common bile duct stenosis, seven had duodenal stenosis, ten had evidence of segmental portal hypertension and one suffered from a pancreatopleural fistula. Details of all patients were documented prospectively; mean follow-up was 4.2 years. The complications of adjacent organs were permanently eradicated in 36 of 38 patients. Two patients required endoscopic stenting for persisting bile duct obstruction. There was substantial or complete relief of all symptoms in 35 patients. Duodenum-preserving resection of the head of the pancreas is effective in the treatment of severe chronic pancreatitis with predominant involvement of the pancreatic head and provides definitive management of associated complications of adjacent organs.

Adult↗

PubMed1994

Elevated expression of estramustine binding protein (EMBP) in prostatic intraepithelial neoplasia (PIN) compared with malignant and benign prostatic epithelia.

The expression of estramustine-binding protein (EMBP) was studied immunohistochemically in whole-mount prostate sections. Specimens were taken from the prostates of 15 patients who had undergone total prostatectomy due to localized (TOd-T2 NO MO) prostatic cancer (PC). Almost all the examined whole-mount sections displayed areas with prostatic intraepithelial neoplasia (PIN). PIN is regarded as the main precursor of invasive PC. High- and low-grade PIN expressed EMBP. The average positively stained areas accounted for averages of 69.2% and 48.7%, respectively. High-grade PIN contained the highest EMBP levels of all the investigated (benign and malignant) epithelia, followed by moderately differentiated PC. With regard to areas with PC, the highest levels of EMBP expression (61.3%) were observed in moderately differentiated PC; poorly differentiated PC came second. Of all the examined epithelia, EMBP levels were lowest in well-differentiated PC (25.8%). Normal prostatic epithelia and hyperplasia were characterized by low EMBP expression, although somewhat higher than well-differentiated PC. A moderate expression (45%) was observed in the seminal vesicles. According to these results, EMBP was expressed mainly in the diseased peripheral zone (PZ), where PIN and prostatic cancer have their highest prevalence.

Aged↗

PubMed1994

Cloning and in vivo expression of functional triose phosphate/phosphate translocators from C3- and C4-plants: evidence for the putative participation of specific amino acid residues in the recognition of phosphoenolpyruvate.

The primary sequences of the chloroplast triose phosphate/phosphate translocator precursor proteins from C4-plants (maize mesophyll cells and Flaveria trinervia) and from the C3-type Flaveria pringlei were determined. The mature parts of these translocators possess 83-94% identical amino acid residues. The C4-translocator protein can be correctly targeted to C3-type chloroplasts and inserted into the envelope membrane. Expression of the mature parts of these chloroplast translocators (cTPT) in transformed yeast cells and subsequent reconstitution of the functional proteins reveals the difference between the recombinant translocator proteins from the two cell types with respect to the transport of phosphoenolpyruvate. Comparison of the cTPT sequences from F. pringlei and F. trinervia in combination with computer-aided molecular modelling of the substrate translocation pore leads to the suggestion, that only minor exchanges of amino acid residues between the C3- and C4-translocator proteins are sufficient to extend their substrate specificities to recognize also phosphoenolpyruvate.

Amino Acid Sequence↗

PubMed1994

Standardized in vitro mapping with multiple core biopsies of total prostatectomy specimens: localization and prediction of tumour volume and grade.

OBJECTIVE: To analyse the ability of systematic core biopsy mapping to provide prognostic information in patients with prostatic cancer. MATERIALS AND METHODS: The prostates of 60 men with prostatic cancer, stages T0d-T2, who had undergone total retropubic prostatectomy were studied. The average age of the patients was 63 years (range 49-72). Ten core biopsies (1.2 x 35 mm) were taken from the fresh specimens according to a standardized procedure. The total prostatectomy specimens were serially step-sectioned at 5 mm intervals and were assessed regarding tumour volume, grade and pT-stage. The World Health Organization (WHO) grade obtained in the mapping biopsies was compared with that in the operative specimens. Undergrading (WHO) decreased substantially by mapping biopsies, but was still present with the Gleason system. RESULTS: The volume of extracapsular tumours with extensively positive margins was significantly larger than that of intracapsular tumours (P < 0.01). In addition, the fraction of cancer obtained in the biopsies from tumours with grossly positive margins was significantly smaller than that observed in biopsies from pT2 tumours (P < 0.01). The cancer volume calculated from the result of the mapping correlated positively with the tumour volume determined by planimetry (R = 0.83). A weaker correlation was found when only the six dorsal mapping biopsies were taken into consideration (R = 0.68), but the correlation increased to R = 0.75 when the six most significant biopsies were selected with the help of a correlation matrix. Biopsies from the ventral part of the prostate were also important, to obtain an accurate assessment of the tumour fraction within the whole gland. CONCLUSION: Mapping of the prostate gland with multiple (six or more) core biopsies is necessary for preoperative assessment of tumour volume, grade and pT stage; these are all of importance when assigning patients with clinically localized prostatic cancer to prognostic classes.

Aged↗

PubMed1994

Preoperative histological and cytological diagnosis and DNA ploidy assessment of localized prostatic cancer. A comparison between findings in biopsies and total prostatectomy specimens.

The preoperative biopsy specimens of 49 men who underwent radical prostatectomy were compared with serially step-sectioned operative specimens, in order to evaluate diagnostic accuracy as regards the presence of cancer, its grade and its DNA ploidy. Both the FNAB and TRUS-GCB undergraded the cancer by one WHO grade in about 35-40% of cases. In cases where both biopsy types were available, the degree of undergrading was the same. Determination of DNA ploidy by the single-cell technique from FNAB had a sensitivity for detecting non-diploid DNA patterns of 59% whereas flow cytometric measurement of core biopsies had a sensitivity of 44.4% as regards non-diploid DNA, when compared with operative specimens. A comparison of ploidy in core biopsies versus ploidy in fine-needle aspirates revealed that more non-diploid DNA patterns were diagnosed in the fine-needle aspirates. These aneuploid patterns were not all confirmed by flow cytometric evaluation of the operative specimens, in which, however, more aneuploid patterns were diagnosed compared with the single-cell technique from FNAB. We conclude that the standard technique with 1-3 fine-needle aspirates or 1-3 TRUS-GCB has a pronounced tendency by both biopsy methods to underestimate the tumour grade. DNA ploidy analysis by FNAB and the single-cell cytometric method reveals aneuploid cell lines not found in the flow cytometric evaluation. In order to determine whether this reflects a methodological problem or a true discrimination between the ability of the two methods to find non-diploid cell lines further studies are needed. However, for a more correct preoperative assessment of tumour grade and DNA ploidy, more extensive sampling is required.

Adult↗

PubMed1994

Enlargement of the right ventricular outflow tract and the pulmonary artery with a new biodegradable patch in transannular position.

Absorbable, nonwoven patches made from polyhydroxybutyrate (PHB) were implanted as transannular patches into the right ventricular outflow tract and pulmonary artery in 13 weanling sheep, the test group. Six sheep, in which a transannular Dacron patch was implanted, served as control group. The test and the control patches were harvested 3-24 months later. The results were documented macroscopically, by histological examination, and by scanning electron microscopy. The 6-keto-PGF1 alpha activity was measured in the regenerated tissue and compared with that in the native pulmonary artery. No aneurysms were noted. Regeneration of a neointima and a neomedia, comparable to native arterial tissue, was observed in the test group. In the control group, a neointimal layer was present but no neomedia comparable to native arterial tissue. Scanning electron microscopy disclosed differences in the endothelial structure between the test and control groups. 6-keto-PGF1 alpha activity was present in both the test and control groups. It is concluded that absorbable, nonwoven patches of PHB can be used as a scaffold for tissue regeneration in low-pressure systems. The regenerated vessel had structural and biochemical qualities in common with the native pulmonary artery.

6-Ketoprostaglandin F1 alpha↗

PubMed1994

Pre- and postoperative DNA ploidy patterns correlated to pT-stage, histological grade and tumour volume in total prostatectomy specimens.

Fifty-four consecutive patients with a preoperative diagnosis of localized prostatic cancer underwent total retropubic prostatectomy. The specimens were step-sectioned at 5 mm intervals. Volumes of invasive cancer (IC) and prostatic intraepithelial neoplasia (PIN) were calculated by computerized planimetry. From preoperative core and fine needle aspiration biopsies and from each prostatectomy specimen, multiple samples were taken from IC and PIN areas for DNA ploidy analysis. The study aimed to evaluate current biopsy sampling techniques as regards their suitability for DNA analysis and to assess the heterogeneity of DNA-ploidy and correlate the latter to postoperative pT-stage and tumour volume. When compared with the prostatectomy specimens, the preoperative assessment of non-diploid DNA patterns in biopsies had a sensitivity of 62% and a specificity of 86%. Samples from 24 surgical specimens contained non-diploid DNA in the main tumour and in one or several of the satellites. However, all these cases also contained diploid cell lines, both in the main tumour and in one or several of the satellites. Tumours with a volume exceeding 12 cc:s were non-diploid in 87.5% of cases (7/8). Tumours with volumes between 8 and 12 cc:s contained non-diploid foci in 50% of cases (2/4). Tumours smaller than 2 cc:s were non-diploid in 18% of cases (2/11). All non-diploid tumours were moderately or poorly differentiated. Of the non-diploid tumours, 96% (23/24) displayed capsular penetration versus 57% (17/30) of the diploid tumours (p < 0.0001). All PIN samples were made up of diploid cell lines.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1994

The efficacy of preoperative systemic chemotherapy in the local control of muscle-invasive transitional cell carcinoma of the urinary bladder.

Transitional cell carcinoma of the urinary bladder has a poor prognosis, once the muscle layers of the bladder wall have been invaded, irrespective of whether operative or radiation therapy is chosen for local treatment. The main reason for this is probably the existence of disseminated micrometastases at the time of primary treatment. Thus, a combination of systemic and local treatment would seem logical. The present study reports the response to chemotherapy in 30 patients with muscle-invasive urinary bladder tumours and the findings at subsequent cystectomy. The chemotherapy comprised cisplatin, methotrexate and leucovorin rescue and was tolerated without any alarming side-effects or increase in perioperative morbidity or mortality. The complete response rate was 43% (13/30) and, in 27% (8/30), there was a partial response with conversion into a more superficial tumour stage. The total, beneficial response rate was thus 70%.

Adult↗

PubMed1994

Histopathology of localized prostate cancer. Consensus Conference on Diagnosis and Prognostic Parameters in Localized Prostate Cancer. Stockholm, Sweden, May 12-13, 1993.

Future handling of patients with localized prostate cancer will undoubtedly depend upon a more sophisticated prognostication than that available today. The basis will continue to be the histopathological evaluation of tumor size, grade, localization and distribution within the gland. The aim of this section is to summarize current concepts of the morphological characteristics of localized prostate cancer and their prognostic implications as well as to give guidelines for standardization of the methods involved in morphological evaluation. First, baseline recommendations for the tissue processing procedures are given: Needle core biopsies, taken in a systematic way, potentially contain the information necessary for estimation of grade, size, distribution and extension to seminal vesicles, and could yield material for DNA-measurements, cytogenetic and genetic information. For TUR specimens it is suggested that at least 10 grams should be embedded or 8 to 10 cassettes employed minimally. The prostatectomy specimens should be carefully examined. Material should be frozen both from tumor tissue and from other areas eg by taking 'mapping' biopsies in a standardized way. After fixation (in 10% buffered formalin for at least 24 hours) and appropriate inking of surgical margins, whole mount sections at 2.5-5 mm intervals should be cut. The extension of the tumor should be outlined and at least the two largest tumors should be graded. Capsule penetration and extension to surgical margins and seminal vesicles should be indicated. Grading of malignancy should always include the Gleason grade and where possible Gleason score (ie the sum of the dominant and the secondary grade or pattern). The WHO and the Boecking systems combine a grading of glandular architecture with a grading of the nuclear atypia. It is stressed that in core biopsies the amount of cancer is sometimes scanty, which limits the possibility to find dominant and secondary patterns. In such cases, a grading of glandular differentiation and of nuclear grade seems rational. Also, for comparison with cytological grading, the WHO system is suitable, since in both cases both tissue differentiation and nuclear atypia are judged. The future need for objective techniques is recognized. Prostatectomy pathology includes important features with high correlation to postoperative prognosis: eg capsular penetration. The extent of capsular penetration and the extent of involvement of the surgical margins is of importance. Only focal penetration or focal involvement of the margin carry a relatively low risk of of progression.(ABSTRACT TRUNCATED AT 400 WORDS)

Biomarkers, Tumor↗

PubMed1994

Grading of transitional cell bladder carcinoma by texture analysis of histological sections.

Conventional subjective visual grading of malignancy in bladder carcinoma suffers from poor standardization. In an attempt to improve this by image analysis we carried out a texture analysis of a total of 197 images from Feulgen-stained histological tissue sections. The textural features used were based on the spatial gray-tone co-occurrence probability matrices for step-lengths 3, 4 and 6 pixels. These features were compared to the subjective grading by multivariate statistical methods. Using a two-stage hierarchical classifier 84.3% agreement was obtained between the subjective and computer-based classification. This was verified through the jackknifed classification technique.

Carcinoma, Transitional Cell↗

PubMed1994

Transrectal ultrasound-guided core biopsies of the prostate. A comparison between the standard 1.2-mm needle and three thinner needles.

Transrectal ultrasound (TRUS) examination is a well established method for the diagnosis of prostate cancer. The examination technique has, however, certain limitations, and biopsies are needed to differentiate between malignant and benign lesions. In order to determine the influence of the thickness of the needle on the histopathological evaluation of specimens, core biopsies were taken from 36 patients with hypoechoic lesions suggestive of cancer detected by TRUS, using a 1.2-mm cutting needle followed by a thinner needle (0.9-, 0.8- or 0.7-mm). A total of 164 biopsies from 41 hypoechoic lesions were obtained. The specimens were coded and examined by a pathologist. They were judged according to amount of tissue obtained, quality, length, malignancy and grade. The best results were obtained with the 1.2- and 0.9-mm needles. The results were comparable and reliable for both needle types which can be recommended for clinical practice. The 0.8- and 0.7-mm needles were found to give more or less unsatisfactory results.

Adenocarcinoma↗

PubMed1994

Selective uptake of high-density lipoprotein-associated cholesteryl esters by human hepatocytes in primary culture.

High-density lipoprotein cholesteryl esters are taken up by many cells without simultaneous uptake of high-density lipoprotein apolipoproteins. This selective uptake was investigated in human hepatocytes in primary culture. Human high-density lipoprotein-3 (density, 1.125 to 1.21 gm/ml) was radiolabeled in both its apolipoprotein and in its cholesteryl ester moiety; uptake of these high-density lipoprotein3 tracers by hepatocytes was investigated. Apparent high-density lipoprotein3 particle uptake as measured with the cholesteryl ester tracer was in excess of that from the apolipoprotein tracer, indicating selective uptake of high-density lipoprotein3 cholesteryl esters by hepatocytes. This selective uptake is a regulated pathway in hepatocytes, as demonstrated by an inverse relationship between cell cholesterol and the rate of selective uptake. Studies on the mechanism of selective uptake have used inhibitors such as monensin, chloroquine, heparin, and a monoclonal antibody directed against low-density lipoprotein receptors. These experiments provide no evidence for a role of cell-secreted apolipoprotein E, endocytosis or retroendocytosis in selective uptake. The intracellular fate of high-density lipoprotein3-associated cholesteryl esters was investigated with [3H]cholesteryl oleate-labeled high-density lipoprotein3. Hepatocytes hydrolyzed [3H]cholesteryl oleate internalized from labeled high-density lipoprotein3; this catabolism was not inhibited by the presence of chloroquine. In parallel hepatocytes were incubated with [3H]cholesteryl oleate-labeled low-density lipoprotein. Cells hydrolyzed [3H]cholesteryl oleate taken up with low-density lipoprotein; however, this hydrolysis was inhibited by chloroquine, indicating lysosomal low-density lipoprotein cholesteryl ester catabolism. These experiments show that high-density lipoprotein3 cholesteryl esters selectively taken up by hepatocytes are hydrolyzed independently from the classical lysosomal catabolic pathway. The question was addressed if selective uptake mediates a net mass uptake of cholesterol rather than an isotope exchange phenomenon. Incubation of hepatocytes with high-density lipoprotein-3 suppressed endogenous sterol synthesis from sodium [14C]acetate. Hepatocytes were incubated in the presence of high-density lipoprotein3; medium cholesteryl esters decreased as a result of incubation with hepatocytes. These results show a net mass delivery of high-density lipoprotein cholesteryl esters to hepatocytes. In conclusion, the pathway for selective uptake of high-density lipoprotein cholesteryl esters could be demonstrated in human hepatocytes in primary culture. A role for selective uptake in high-density lipoprotein-mediated cholesterol delivery to the liver in human beings in vivo is proposed.

Animals↗

PubMed1993

Prostatic intraepithelial neoplasia and invasive carcinoma in total prostatectomy specimens: distribution, volumes and DNA ploidy.

Prostatic intraepithelial neoplasia (PIN) has been postulated to be the main precursor of invasive carcinoma of the prostate (IC). The occurrence, distribution and volumes of PIN and IC in addition to grade were studied in 54 patients who underwent total prostatectomy because of localised IC (T0d-T2 NO MO). PIN always occurred multifocally, localised generally in the peripheral zone (PZ) and was found in all cases. PIN 1 was the most common grade, PIN 3 the least. PIN 3 occurred exclusively in the PZ, in the vicinity of or intermingled with high grade IC. PIN and IC grades were usually concordant. The relative volumes of IC and PIN showed an inverse relationship, i.e. at small IC + PIN volumes PIN dominated, whereas at large IC + PIN volumes both relative and absolute PIN volumes were lower. Furthermore, with increasing PIN grade a tendency towards an increase in tumour volume, Gleason score and frequency of disruption of the basal cell layer was observed. These findings indicate progression from PIN to IC. DNA ploidy of PIN areas was determined by means of flow cytometry. Areas containing PIN 1, 2 or 3 were sampled (1 plug/ml of PIN). All foci displayed only diploid DNA profiles regardless of PIN volume and grade, even with coexistent IC displaying heterogeneous DNA patterns. Our results support the claim that low and medium grade prostatic carcinoma arises from near-diploid PIN stemlines and may progress into heterogeneous tumours containing non-diploid stemlines.

Aged↗

PubMed1993

Neoadjuvant GnRH-agonist treatment (triptorelin and cyproterone acetate for flare protection) and total prostatectomy.

The effects of 3 months treatment with the GnRH agonist triptorelin as a neoadjuvant to total prostatectomy in 40 men with localized prostatic cancer have been evaluated. The study included 1 patient with a stage T1b tumour, 25 patients with stage T2 tumours and 14 with stage T3 tumours. The patients were examined by digital rectal examination, transrectal ultrasound before and after treatment. Serum testosterone and prostate-specific antigen (PSA) levels were followed. The totally removed prostate gland was step-sectioned at 5-mm intervals and the whole-mount sections were assessed for tumour pathology stage (pT stage). Triptorelin treatment resulted in a significant decrease in total gland and tumour volume and in a reduction in the serum levels of PSA and testosterone. In comparison with the findings from a previous study, in which neoadjuvant treatment was not used, it appears that the proportion of tumours invading the margins of the surgical specimen decreased.

Adenocarcinoma↗

PubMed1993

Histopathological changes in androgen-deprived localized prostatic cancer. A study in total prostatectomy specimens.

Androgen deprivation with triptorelin treatment prior to total prostatectomy gave the opportunity of studying consequent morphological changes in the surgical specimens from 38 men with localized prostatic cancer. Multiple core-needle biopsies were taken prior to treatment and compared to the step-sectioned surgical specimens. The histological changes in the prostate following androgen deprivation include glandular atrophy, nuclear pyknosis, cytoplasmic vacuolation, squamous metaplasia and an increase in the relative amount of stroma. None of these changes could be correlated to pretreatment tumour grade, nor to the volume of the residual tumour. A positive correlation was found between tumour grade prior to therapy and volume of residual tumour after treatment. The treatment was not associated with downgrading of the malignancy. On the contrary, in 16% of the cases, foci of a higher grade were found in the surgical specimens compared to the pretreatment core-needle biopsies.

Biopsy, Needle↗

PubMed1993

Characterization of localized prostatic cancer: distribution, grading and pT-staging in radical prostatectomy specimens.

Ninety-one patients underwent radical retropubic prostatectomy. Forty-three specimens were examined after limited sectioning (series 1) and 48 underwent whole organ serial step-sectioning at 5 mm intervals (series 2) of the removed prostate gland. The latter allowed a more extensive assessment of tumour localization, multicentricity, extension, pT-stage and grade. Eighty-eight percent of specimens in series 1 had free surgical margins compared with only 41% in series 2 (p = 0.00001). Preoperative tumour grading by fine-needle aspiration biopsy, TUR-chips or 1.2 mm core biopsies was in agreement with postoperative grading in the prostatectomy specimens in 48% of the cases in series 1 and 67% in series 2, respectively. In series 2, preoperative localization of the tumours by palpation was accurately assessed in 75% of cases when compared to the findings at step-sectioning. Sixty-eight percent of 40 eligible glands in series 2 contained multiple tumours. 12/13 cases of unifocal tumours (92%) were classified as large single tumours. The sections were divided into four peripheral and four central parts/octants, and the tumour localization was marked within these octants. The apical and middle third of the prostate contained tumour in all cases, whereas the basal (cranial part) was engaged in 35%. Small tumours were localized mainly in the periphery of the gland, with no significant difference between dorsal and ventral octants. However, large tumours were situated mainly in the dorsal peripheral octants, concomitant with an increased involvement of the ventral and central octants.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗