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Biomedical subjects

C S Papadimitriou

Publications and source records attributed to C S Papadimitriou.

At least 37 records · Page 2Linked to original sources
PubMed1990

Association of serum IgM kappa monoclonicity in patients with Sjögren's syndrome with an increased proportion of kappa positive plasma cells infiltrating the labial minor salivary glands.

Minor salivary gland biopsy specimens from 11 patients with primary Sjögren's syndrome with circulating monoclonal IgM kappa cryoglobulins, seven without cryoglobulins, and four patients with rheumatoid arthritis and Sjögren's syndrome (one with monoclonal and three with polyclonal cryoglobulins) were examined by the peroxidase antiperoxidase bridge technique, using antihuman kappa and lambda antibodies. In 6/11 patients with primary Sjögren's syndrome and in one patient with Sjögren's syndrome and rheumatoid arthritis with monoclonal cryoglobulins a predominance of plasma cells containing intracytoplasmic kappa light chains was found (kappa:lambda greater than 3:1). Two of those seven patients had immunohistological features of immunocytomas. In the other five patients with circulating monoclonal cryoglobulins the kappa:lambda ratio of positive cells did not exceed 3:1, while six out of seven patients without cryoglobulins and the patients with rheumatoid arthritis and Sjögren's syndrome with polyclonal cryoglobulins had almost equal numbers of kappa and lambda stained cells. One of seven patients with primary Sjögren's syndrome without cryoglobulins had an increased number of lambda light chain positive cells, indicating a non-secretory lambda monoclonal population. These findings suggest that the main area of B cell monoclonal expansion in primary Sjögren's syndrome may be the affected exocrine glands.

Adult↗
PubMed1989

The forgotten cause of sicca complex; sarcoidosis.

Sarcoidosis is a chronic systemic disease of unknown cause with prominent symptoms from the respiratory system. It can occasionally affect the exocrine glands presenting with xerophthalmia and xerostomia similar to Sjögren's syndrome. We present 5 such patients who visited our rheumatology clinic complaining of dry eyes and mouth. Investigation for xerophthalmia and xerostomia showed positive rose bengal tests in all patients, positive Schirmer's I tests in 4 and decreased parotid flow rate in 3. Minor salivary gland biopsy showed noncaseating granulomas compatible with sarcoidosis in 3. In the other 2 patients the diagnosis was obtained with transbronchial lung biopsy that revealed noncaseating granulomas. Transbronchial lung biopsy also showed granulomas in 2 patients with positive minor salivary gland biopsy. Our results suggest that sarcoidosis can present with initial symptoms of dry eyes and dry mouth. When this happens, transbronchial and minor salivary gland biopsy are very valuable in differentiating sarcoidosis from Sjögren's syndrome.

Biopsy↗
PubMed1988

Epithelial HLA-DR expression and lymphocyte subsets in gastric mucosa in type B chronic gastritis.

Lymphocyte subpopulations (B, T4, T8), monocytes/macrophages (LeuM5, KiM5) and HLA-DR antigen expression were studied immunohistochemically in frozen sections from 32 antral and 37 fundal biopsies of type-B chronic gastritis. Aberrant HLA-DR antigen expression in epithelial cells of gastric mucosa was found in all cases closely related to mononuclear infiltrates. Epithelial HLA-DR expression and mononuclear infiltrates were practically absent in foci of intestinal metaplasia. These findings suggest that an immunopathologic mechanism probably plays a role in initiation or perpetuation of type-B chronic gastritis.

Chronic Disease↗
PubMed1988

Prevalence of primary Sjögren's syndrome in an elderly population.

Sixty-two elderly apparently healthy volunteers, inmates of a public nursing home, were examined for evidence of primary Sjögren's syndrome (pSS). Evaluation included a specific questionnaire for subjective xerophthalmia and xerostomia, slit-lamp eye examination after rose Bengal staining. Schirmer's I test, stimulated parotid flow measurement, testing of sera for autoantibodies and labial minor salivary gland biopsy. A greater than or equal to 2+ lip biopsy score on Tarpley's scale was a sine qua non for the diagnosis of Sjögren's syndrome. Labial salivary gland (LSG) biopsy revealed fibrosis and/or fatty infiltration in the majority of the individuals, related to ageing. However, four people had a lip biopsy score of greater than or equal to 2+, which, supplemented by other objective criteria, classified three of them as having pSS. Another four had an LSG biopsy score of 1+, and although they fulfilled other objective criteria, they could not be characterized as pSS. All these individuals were completely asymptomatic, and none of them had anti-Ro(SSA) or anti-La(SSB) autoantibodies. The present study suggests that pSS in elderly people in elderly people is subclinical, benign and relatively common.

Aged↗
PubMed1988

Common acute lymphoplastic leukemia antigen (CALLA) and intestinal metaplasia.

Intestinal metaplasia (IM) foci in 19 antral and 14 fundal gastric biopsies from patients with chronic atrophic gastritis were studied immunohistochemically for the presence of CALLA antigen. In only 2 cases were metaplastic glands completely negative, in 14 cases they were all positive, and in 17 cases variable proportions of CALLA positive and negative metaplastic glands were present. Complete IM seems to be less frequent than the incomplete type when the presence of CALLA is taken in consideration. CALLA is obviously a much better marker for complete or incomplete small IM. The possible importance of the presence of CALLA in IM foci for the future development of gastric cancer is discussed.

Antigens, Differentiation↗
PubMed1988

Sjögren's syndrome in progressive systemic sclerosis.

Forty-four sequential, unselected patients with progressive systemic sclerosis (PSS) were prospectively evaluated for evidence of coexistent Sjögren's syndrome (SS). This diagnosis was established when a patient with focal lymphocytic infiltration in the labial salivary gland (LSG) biopsy, scoring greater than or equal to 2+ in Tarpley's scale, had keratoconjunctivitis sicca (KCS) (positive rose bengal test) and/or xerostomia (subjective xerostomia and decreased parotid flow rate). Ten patients had an LSG biopsy score of greater than or equal to 2+, 3 a 1+ score, 17 had mild to moderate fibrosis only and 14 had normal tissue. Nine of the 10 patients with a greater than or equal to 2+ score had SS, according to applied criteria, suggesting a 20.5% prevalence of SS in our population with PSS. On the other hand, pure fibrosis in the biopsy was felt to be secondary to PSS. Parotid gland enlargement was present in 44.4% of the patients with SS, but was extremely uncommon in the fibrosis and normal tissue groups. Subjective xerophthalmia and xerostomia, although elicited by specific questionnaire in the majority of the patients with SS, did not constitute major complaints. Serious internal manifestations, with the exception of esophageal and pulmonary involvement, were unusual in all groups. Anti-Ro (SSA) antibodies were detected in 33.3% of the patients with SS and 11.8% of those with fibrosis. Our study suggests that SS in scleroderma is relatively common and, although lacking prominent exocrine gland symptomatology, resembles primary SS in some clinical and serologic respects.

Autoantibodies↗
PubMed1987

High incidence of malignant pleural mesothelioma in neighbouring villages of Northwestern Greece.

Between 1981 and 1985 seven patients from three villages of the Metsovo area in Northwestern Greece (population 5000) developed malignant pleural mesothelioma (MPM). The diagnosis was made with pleural biopsy and pleural fluid cytology. Six of these patients have died 18-24 months after the first symptoms (usually dyspnea on exertion) and 1 is still alive after 24 months. Seven MPMs in 5,000 in five years is about 280 times the expected incidence of 1/1,000,000/year. In the same area, endemic pleural calcifications linked to nonoccupational asbestos exposure have recently been reported, but none of our patients with MPM had pleural calcifications. The combination of MPM and pleural plaques in such a high frequency in the same area strongly suggests asbestos fiber as a common etiologic agent. On the other hand, the fact that the combination of MPM and pleural plaques did not occur in the same individuals, suggests a different response to this common offending agent.

Adult↗
PubMed1986

Cyclosporin A (CyA) in primary Sjögren's syndrome: a double blind study.

The efficacy and toxicity of cyclosporin A (CyA) were studied in a blind fashion in 20 patients with primary Sjögren's syndrome (pSS). The dose of CyA or placebo was 5 mg/kg of body weight daily. Among the 20 patients, 10 received CyA and 10 placebo. The two groups were matched for age, sex, and disease duration. Patients treated with CyA improved in subjective xerostomia in comparison with patients treated with placebo. Subjective xerophthalmia and recurrent parotid gland enlargement did not differ in the two groups. No change in Schirmer's test and stimulated parotid flow rate was observed in either group. In contrast, the histopathological lesion of patients treated with CyA remained unchanged in most of the patients, while in the placebo treated group the lesion deteriorated. Laboratory parameters did not change before or after treatment in either group. The only clinical side effect observed in the CyA treated group was hypertrichosis.

Clinical Trials as Topic↗
PubMed1986

Labial minor salivary gland biopsy: a highly discriminatory diagnostic method between sarcoidosis and Sjögren's syndrome.

Sixty labial minor salivary gland biopsies (lip biopsies) from 32 patients with sarcoidosis and 28 patients with primary Sjögren's syndrome were evaluated retrospectively and blindly. Six biopsies revealed typical sarcoid granulomata. All six belonged to patients with previously diagnosed sarcoidosis. Twelve lip biopsies, all from sarcoidosis patients, were classified as presenting 1+ or less lymphoid infiltrates according to Tarpley's classification. The biopsies of the remaining 14 patients with sarcoidosis showed normal tissues. Finally, 28 biopsies were classified as having 2+ or 3+ lymphoid infiltrates and/or fibrosis. All belonged to patients with Sjögren's syndrome. Our results indicate that lip biopsy has a rather low diagnostic yield in sarcoidosis (19%) but, more importantly, it can discriminate very well between sarcoidosis and Sjögren's syndrome.

Adult↗
PubMed1985

Primary gastrointestinal malignant lymphomas. A morphologic and immunohistochemical study.

Thirty-nine primary gastric and 22 intestinal malignant lymphomas collected from 1969 to 1980 have been studied morphologically and immunohistochemically. Eighteen of the 61 gastrointestinal lymphomas were of low-grade malignancy (9 lymphoplasmacytoid/cytic, 3 centrocytic, 6 centroblastic/centrocytic) and 43 were of high-grade malignancy (14 centroblastic, 7 lymphoblastic, 22 immunoblastic malignant lymphomas) according to the Kiel classification. The peroxidase-antiperoxidase (PAP) method was used in 53 of the 61 cases. Twenty-seven of them revealed a monoclonal positivity for intracytoplasmic IgS: kappa light chains in 18 and lambda light chains in 7 cases. Two cases represented alpha chain disease, revealing only a heavy chain positivity. The most frequent staining pattern of the lymphoma cells was that of kappa/mu. Cells with a mixed centrocytic and plasma cell configuration (centrocytoid plasma cells) proved to be positive for intracytoplasmic IgS. Lymphoma cells of all tested cases proved to be negative for all histiocytic markers. Histologically and immunohistochemically, the Greek cases of primary gastrointestinal malignant lymphomas seem to resemble "western" type lymphomas.

Adolescent↗
PubMed1985

Sialochemistry of patients with autoimmune rheumatic disease with and without histological manifestations of Sjögren's syndrome.

Fifty-one patients with autoimmune rheumatic diseases underwent biopsy of the labial minor salivary glands. These patients were divided according to histopathology of lip biopsies into three groups (negative lip biopsy, 1+ and 2+). From all the patients stimulated parotid salivary flow was measured. In the saliva sodium, potassium, magnesium, alpha-amylase, and immunoglobulin levels (IgA, IgG, IgM) were measured. It is shown that patients with advanced chronic inflammatory disease of the minor salivary glands have decreased stimulated salivary flow. However, no statistically significant differences were observed in the biochemical markers tested between the histopathological groups examined.

Arthritis, Rheumatoid↗
PubMed1985

Respiratory manifestations in primary Sjögren's syndrome. A clinical, functional, and histologic study.

Thirty-six patients with primary Sjögren's syndrome were evaluated for respiratory manifestations using clinical, roentgenologic, functional, and in five cases, histologic criteria. Twenty seven patients (75 percent) had evidence of respiratory involvement, usually occurring early in the course of the disease. Diffuse interstitial lung disease was most common (25 percent) followed by small airways disease (22 percent), desiccation of upper respiratory tract (17 percent) and large airways obstruction (8 percent). There was no patient with pleural effusion. Transbronchial lung biopsy of five patients studied revealed interstitial pathology ranging from dense lymphocytic infiltrates to interstitial fibrosis. Roentgenologic evaluation was often suggestive of interstitial lung disease but did not correlate with functional or histologic findings.

Adult↗
PubMed1984

An immunocytochemical study of the distribution of lysozyme, a1-antitrypsin and a1-antichymotrypsin in the normal and pathological gall bladder.

We have studied the distribution of lysozyme (Ly), a1-antitrypsin (a1AT) and a1-antichymotrypsin ( a1AChy ) in the normal, chronically inflamed and neoplastic gall bladder mucosa using the peroxidase-anti-peroxidase (PAP) method. Ly was absent from the normal mucosa but it was found only in areas of glandular metaplasia of true antral type and in crypts of possible early metaplastic nature in cases of chronic cholecystitis. a1AT and a1AChy were also found in such metaplastic areas, but their presence was also observed immunohistochemically in areas of essentially normal and in non-metaplastic, chronically inflamed gall bladder mucosa. The possible local production of these substances by gall bladder epithelial cells is discussed. Ly, a1AT and a1AChy were also found in various histological types of adenocarcinoma of the gall bladder in varying degrees of frequency and intensity, unrelated to the histological type and invasiveness of the tumour.

Adenocarcinoma↗
PubMed1984

[A case of secondary ghost cell glaucoma with pseudohypopyon after cataract extraction].

A 75 year woman with chronic vitreous hemorrhage underwent extraction of a senile cataract. Surgery was complicated by the flow of brown fluid from the vitreous to the anterior chamber, which was not entirely removed. Post-operatively there was pain, 2 mm of brown hypopyon and intraocular pressure elevation to 60 mm Hg with the preoperative diagnosis of endophthalmitis, a pars plana vitreous tap and instillation of intravitreal antibiotics was performed. Bacterial cultures were negative and the presence of erythrocyte "ghost cells" established the diagnosis of hemolytic glaucoma. As medical management proved ineffective, a pars plana vitrectomy was performed. One year post-operatively the patient had a visual acuity of 0.4-0.5, normal intraocular pressure without medication and evidence of an old branch retinal vein occlusion. The mechanism of hemolytic "ghost-cell" glaucoma in this case is discussed.

Aged↗
PubMed1983

Comparative immunostaining of T-associated plasma cells and other lymph-node cells in paraffin sections.

The immunoperoxidase technique after trypsinization was used on paraffin sections of 24 lymph nodes with reactive lymphadenitis and abundant nests of T-associated plasma cells. These cells were negative for all the markers investigated, which were: intracytoplasmic immunoglobulins (CIg), a1-antichymotrypsin(a1-ACT), a1-antitrypsin(a1-AT), lysozyme(Lz) and fibronectin. Other categories of cells were positive or negative depending on their type. The best markers for polymorphs proved to be a1-AT and Lz, and for monocytes and histiocytes a1-ACT and Lz. Sinus histiocytes in particular were much more constantly and strongly positive for a1-ACT than for Lz. Endothelial cells appeared almost always positive for a1-ACT and were also occasionally positive for a1-AT. Fibronectin was consistently positive in mast cells and sometimes positive in other cells, especially those of monohistiocytic origin. Our present findings are against a B-cell or monohistiocytic origin for T-associated plasma cells.

Chymotrypsin↗