PubMed Health⌕ Search

Biomedical subjects

D Wiese

Publications and source records attributed to D Wiese.

9 recordsLinked to original sources
PubMed2001

Molecular staging of early colon cancer on the basis of sentinel node analysis: a multicenter phase II trial.

PURPOSE: Approximately 30% of patients with American Joint Committee on Cancer stage I or II colorectal cancer (CRC) develop systemic disease. We hypothesized that multimarker reverse transcriptase-polymerase chain reaction (RT-PCR) analysis of sentinel lymph nodes (SNs) draining a primary CRC could detect micrometastases not detected by conventional histopathologic analysis. PATIENTS AND METHODS: In a multi-institutional study, 40 patients with primary CRC underwent dye-directed lymphatic mapping at the time of colon resection. Each dye-stained SN was tagged, and the tumor and regional nodes were resected en bloc. All lymph nodes were examined by conventional hematoxylin and eosin (HE) staining. In addition, each SN was cut into multiple sections for cytokeratin immunohistochemical (CK-IHC) staining and for RT-PCR and electrochemiluminescent detection of three markers: beta-chain human chorionic gonadotropin, hepatocyte growth factor receptor, and universal melanoma-associated antigen. Whenever possible, RT-PCR assay was also performed on primary tumor tissue. The detection sensitivity of individual markers was 10(-3) to 10(-4) microg of RNA and one to five tumor cells in 10(7) lymphocytes of healthy donors. RESULTS: One to three SNs were identified in each patient. An average of 15 nodes were removed from each CRC specimen. No nonsentinel (untagged) node contained evidence of tumor if all tagged (sentinel) nodes in the same specimen were histopathology tumor-negative. HE staining of SNs identified tumor in 10 patients (25%), and CK-IHC of SNs identified occult micrometastases in four patients (10%) whose SNs were negative by HE. Of the remaining 26 patients with no evidence of SN involvement by HE or CK-IHC, 12 (46%) had positive RT-PCR results. The number of markers expressed in each SN correlated (P <.04) with the T stage of the primary tumor. There was 79% concordance in marker expression for the respective pairs (n = 38) of primary tumor and histopathologically positive SNs, and 86% (12 of 14) concordance between RT-PCR positive and histopathologically positive SNs. CONCLUSION: Identification and focused examination of the SN is a novel method of staging CRC. CK-IHC and RT-PCR identified occult micrometastases in 53% of patients whose SNs were negative by conventional staging techniques. These ultrasensitive assays of the SN can identify patients who may be at high risk for recurrence of CRC and therefore are more likely to benefit from systemic adjuvant therapy.

Antigens, Neoplasm↗
PubMed2001

Ultrastaging of colorectal cancer by sentinel lymph node mapping technique--a multicenter trial.

Sentinel lymph node (SLN) mapping accurately diagnoses the status of nodal basin with >95% accuracy in melanoma and breast cancer. A multicenter trial for SLN mapping was performed on 203 patients with colorectal cancer to determine accuracy, upstaging, skip metastasis, and aberrant drainage. Lymphazurin 1% was injected subserosally around the tumor and 1-4 blue staining nodes were marked as SLNs for detailed histological analysis. SLN mapping was successful in 98% of patients with an average of 1.7 SLNs per patient. SLNs were negative in 63% of the patients and positive in 37% of the patients. Skip metastasis was seen in 8 of the patients. Occult micrometastasis was found in 14% of patients. In 5% of the patients, unusual lymphatic drainage lead to an alteration of the extent of lymphadenectomy. This multicenter trial proved that SLN mapping in patients with colorectal cancer is simple, cost effective, and upstages at least 14% of patients from AJCC stage I/II to stage III. These patients may then benefit from adjuvant chemotherapy.

Adult↗
PubMed2000

Technical details of sentinel lymph node mapping in colorectal cancer and its impact on staging.

BACKGROUND: Sentinel lymph node (SLN) mapping for melanoma and breast cancer has greatly enhanced the identification of micrometastases in many patients, thereby upstaging a subset of these patients. The purpose of this study was to see if SLN mapping technique could be used to identify SLNs in colorectal cancer and to assess its impact on pathological staging and treatment. METHODS: At the time of surgery, 1 ml of Lymphazurin 1% was injected subserosally around the tumor without injecting into the lumen. The first to fourth blue nodes identified were considered the SLNs, which have the highest probability to contain metastases. A standard oncological resection of the bowel was then performed. Multilevel microsections of the SLNs, including a detailed pathological examination of the entire specimen, was performed. RESULTS: SLN was successfully identified in 85 (98.8%) of 86 patients. In 85 patients, there were 1,367 (16 per patient) lymph nodes examined, of which 140 (1.6 per patient) were identified as SLNs. In 53 (95%) of 56, of whom the SLNs were without metastases (negative), all other non-SLNs also were negative. In 29 (34% of 85) patients, SLNs were positive for metastases; in 14 of the 29 patients, other non-SLNs also were positive in addition to the SLNs. In the other 15 of the 29 patients (18% of 85 patients), SLNs were the only site of metastases, and all other non-SLNs were negative. In 7 patients (8.2% of 85 patients), micrometastases were identified only in 1 or 2 of the 10 sections of a single SLN. In five of seven patients, such micrometastases were detected by hematoxylin and eosin staining and immunohistochemistry; in the other two patients, it was detected only by immunohistochemistry. In patients with negative SLNs, the rate of occurrence of micrometastases in non-SLNs was 5 (0.4%) of 1,184 lymph nodes. CONCLUSIONS: SLN mapping can be performed easily in colorectal cancer patients, with an accuracy of more than 95%. The identification of submicroscopic lymph node metastases by this technique may have upstaged these patients (18%) from stage I/II to stage III disease, who may then benefit from further adjuvant chemotherapy.

Chemotherapy, Adjuvant↗
PubMed2000

Self-other agreement in personality and affectivity: the role of acquaintanceship, trait visibility, and assumed similarity.

Self- and other-ratings on the Big Five and a comprehensive inventory of trait affect were obtained from 74 married couples, 136 dating couples, and 279 friendship dyads. With the exception of Surprise, all scales showed significant self-other agreement in all 3 samples, thereby establishing their convergent validity. Consistent with the trait visibility effect, however, the Big Five consistently yielded higher agreement correlations than did the affectivity scales. Conversely, the affective traits consistently showed stronger evidence of assumed similarity (i.e., the tendency for judges to rate others as similar to themselves) than did the Big Five. Cross-sample comparisons indicated that agreement was significantly higher in the married sample than in the other 2 groups; however, analyses of 3 potential moderators in the dating and friendship samples failed to identify the source of this acquaintanceship effect.

Adult↗
PubMed2000

General traits of personality and affectivity as predictors of satisfaction in intimate relationships: evidence from self- and partner-ratings.

Self- and partner-ratings on trait affect and the Big Five were obtained from 74 married and 136 dating couples. The relationship satisfaction of each person (the "target") was correlated with four sets of ratings: (a) target's self-rated personality, (b) target's partner-rated personality, (c) partner's self-rated personality, and (d) partner's target-rated personality. Self- and partner-ratings of the target's personality yielded very similar results. Negative and positive affectivity were consistent predictors of satisfaction in both samples. Conscientiousness and agreeableness were reliably related to satisfaction in the dating couples, whereas extraversion consistently correlated with satisfaction in the married couples. These traits jointly predicted as much as 34% (self-ratings) and 26% (partner-ratings) of the variance in satisfaction. In contrast, the partner's personality played a lesser role in satisfaction.

Adult↗
PubMed2000

Low-dose methotrexate treatment for interstitial pregnancy. A case report.

BACKGROUND: Only a small number of case reports have described medical treatment of interstitial ectopic pregnancies. Almost all of the reported patients were treated with repeated high doses (1 mg/kg) of methotrexate. CASE: At 6 weeks of gestation, a 31-year-old woman, gravida 5, para 4, was diagnosed with a 0.96 x 1.36-cm right cornual pregnancy. As the patient desired future fertility, she received 100 mg of intramuscular methotrexate (50 mg/m2). She was then followed on an outpatient basis, with serum human chorionic gonadotropin values appropriately declining. Serial ultrasound also showed decreasing size of the gestational sac. Twenty-one days after the methotrexate dose, the patient experienced rupture of the right posterior cornu, necessitating exploratory laparotomy. CONCLUSION: Extreme caution should be used when treating interstitial gestations with single-dose methotrexate. All patients should be extensively counseled regarding the significantly increased risk of failure, possibility of rupture and need for emergency surgery.

Abortifacient Agents, Nonsteroidal↗
PubMed1995

Appendiceal endometriosis presenting as massive lower intestinal hemorrhage.

Appendiceal endometriosis is a very uncommon clinical entity. We describe a 33-yr-old white female who presented with painless profuse rectal bleeding. Emergency colonoscopy revealed bleeding from the appendiceal opening. An emergency appendectomy was performed which controlled her bleeding. The histopathological examination demonstrated appendiceal endometriosis. Painless bleeding from appendiceal endometriosis is extremely rare; however, it should be considered when evaluating young women of reproductive age who present with rectal bleeding.

Adult↗
PubMed1988

Orientation of small, flat, frozen-section specimens.

A method for orienting small, flat, frozen-section specimens perpendicular to the plane of sectioning can be performed by double-embedding and freezing. The technique is fast, simple, and reliable; it requires no special equipment.

Biopsy↗