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Biomedical subjects

E S Andersen

Publications and source records attributed to E S Andersen.

At least 19 recordsLinked to original sources
PubMed1995

The reliability of preconization diagnostic evaluation in patients with cervical intraepithelial neoplasia and microinvasive carcinoma.

The accuracy of preconization cytology and histology was evaluated in 536 patients undergoing combination laser conization. Exact agreement between cytology and cone diagnosis was observed in 41.8% of the patients. The lowest agreement, 13.6% was demonstrated in cytologic cervical intraepithelial neoplasia (CIN) I, the highest in cytologic CIN III, 64.3%. Concerning microinvasive disease, the positive predictive value of cytology was only 27.3%; the negative predictive value 94.6%. When cytology showed CIN II or worse, the cone biopsy showed CIN or invasive disease in 92.8%. Exact agreement between preconization histology and the cone biopsy was found in 59.5%. Highest agreement was observed in CIN III lesions, 67.1%, and the lowest agreement in CIN II lesions, 42.7%. When preconization showed CIN II, a higher grade of lesion was found in the cone biopsy in 29.1%. Cone biopsy revealed invasive disease in 38 cases. In 24 cases, invasive disease was not demonstrated prior to conization, corresponding totally to 4.7% of patients not suspected to have invasive disease prior to conization. Regarding invasive disease, the sensitivity of preconization histology was 36.8%, the positive predictive value 58.3%, and the negative predictive value 95.3%. Kappa statistics demonstrated rather low agreement between cone diagnoses and preconization diagnoses. These results confirm the potential risk of overlooking invasive disease by conventional preconization evaluation and demonstrate the need for excisional methods in the management of cervical intraepithelial neoplasia to provide a sufficient specimen for diagnostic purposes. Combined with the therapeutic results, combination laser conization was a reliable diagnostic and therapeutic method in the management of patients with CIN and microinvasive cancer of the cervix.

Conization↗
PubMed1992

Cryosurgery for cervical intraepithelial neoplasia: 10-year follow-up.

Cryotherapy was performed for the treatment of CIN in 261 patients, who were followed for 5 to 10 years after treatment. The overall cure rate was 83.5%. Increasing grade of CIN and enocervical involvement significantly reduced the cure rate. In pure exocervical lesions, a 91% cure rate in patients with CIN II lesions and a 77.8% cure rate in CIN III patients were observed. In patients with endocervical involvement, the influence of grade of lesion was of no significance. Life-table calculations demonstrated an overall risk of persisting CIN during the first year of observation of 8.8%, compared to a risk of 0.8% during Years 6 to 10. Log-rank test showed a risk of recurrence in patients with CIN III lesions significantly higher than that in patients with CIN II lesions and also a higher risk in patients with endocervical involvement. There was no significant influence of age on cure rates. Endocervical involvement should be considered a contraindication to cryotherapy, and a careful follow-up schedule is mandatory if cryotherapy is to keep its position as a recommendable therapy in patients with CIN.

Adolescent↗
PubMed1991

[Acute fatty liver in pregnancy. Report of 2 cases].

We present the case histories of two patients showing the clinical and biochemical manifestations of acute fatty liver of pregnancy associated with disseminated intravascular coagulation. Both patients were young primiparae. One was admitted in the 39th week of pregnancy, the other immediately after spontaneous delivery at the 36th week. Both patients recovered. Laboratory investigations, treatment and differential diagnosis are discussed.

Acute Disease↗
PubMed1990

Lymphocyte subpopulations in patients with cervical intraepithelial neoplasia.

Quantitation of T-lymphocyte subsets and natural killer cells in peripheral blood of 16 patients with cervical intraepithelial neoplasia and 15 controls with normal cervical cytology was performed using specific monoclonal antibodies and flow cytometry. No differences were observed in T-helper lymphocytes, T-suppressor/cytotoxic lymphocytes, Th/Ts cell ratios, or natural killer cells. The results indicate that disturbances of the cell-mediated immune response, observed in patients with invasive cancer of the cervix, are secondary to the disease and of no significance in the initiation of cervical cancer.

Female↗
PubMed1990

Stage II endometrial carcinoma: prognostic factors and the results of treatment.

Results of treatment and potential prognostic factors in 54 patients with clinical stage II endometrial carcinoma were analyzed. During the period analyzed, three different treatment techniques were used. The highest cure rate (70.6%) was observed in patients treated with simple hysterectomy and bilateral salpingo-oophorectomy followed by external pelvic irradiation and vaginal irradiation. Radiation therapy alone cured 50%. High tumor grade, deep myometrial invasion (greater than 50%), and invasion of the cervical stroma reduced the cure rates, but the only factor significantly reducing cure rate was patient age. Patients 59 years of age or older fared significantly more poorly than younger patients. Significant complications was observed in 9.3% of patients. Prospective studies of standardized treatment techniques in patients with stage II endometrial carcinoma are necessary to achieve better results and acquire more information.

Age Factors↗
PubMed1990

Laser conization: follow-up in patients with cervical intraepithelial neoplasia in the cone margin.

Combination laser conization was performed in 469 patients for the treatment of cervical intraepithelial neoplasia (CIN). In 58 cases (12.4%), CIN was located in the margins of the cone. Fifty-one patients with involvement of the margins were evaluated by cytologic examination, using the Ayre spatula and the Cytobrush, and by cervical biopsy and endocervical curettage (ECC). In six cases, the histologic evaluation was positive, and in three of these cases, the cytology was positive too. Hysterectomy was performed in five cases, but in only one case was a significant lesion demonstrated in the uterus. These results justify expectant, conservative management of patients treated with combination laser conization. Follow-up based on colposcopy and cytology seems sufficient.

Aged↗
PubMed1990

Naming consistency in Alzheimer's disease.

Although lexical semantic deficits are postulated to play a prominent role in the anomia of Alzheimer's disease, it is unclear whether the primary disturbance is one of lexical access or one of lexical semantic loss. Response consistency on a naming task is one means of evaluating the underlying source of naming impairment. Access dysfunction usually implies variable word-finding difficulty, while a theory of lexical loss predicts that many word names would be consistently unavailable. Nineteen Alzheimer's disease patients were administered a visual confrontation naming task (the Boston Naming Test) on two occasions 6 months apart. Eighty percent of errors occurred consistently at both times; only 20% of errors occurred on only one occasion. Response consistency occurred significantly more often than expected under the assumption of no response consistency. Findings support the hypothesis that anomia in Alzheimer's disease is in part due to a loss of lexical semantic information.

Aged↗
PubMed1989

Adenocarcinoma in situ of the uterine cervix: a clinico-pathologic study of 36 cases.

Thirty-six consecutive cases of adenocarcinoma in situ (ACIS) of the uterine cervix, including 8 cases of early stromal invasion to a depth not exceeding 5 mm, were revised with specific reference to detection rate and treatment. The final histologic diagnoses were based on 31 cone biopsies, 1 hysterectomy specimen, and 4 endocervical curettings/punch biopsies. ACIS was localized in the transformation zone of all cone biopsies/hysterectomy specimen, with a mostly superficial spread in the glands. The mucosal surface was involved in 34 cases. In 29 cone biopsies, ACIS was found unifocal. ACIS was associated with lesions of the squamous epithelium, mostly severe, in 25 cases. On review, all cervical smears were positive and ACIS could be specifically diagnosed in 24 cases. Pretreatment biopsies showed ACIS in 28 cases. Detection of early invasive adenocarcinoma required cone biopsy in most cases. Colposcopy showed no characteristics of ACIS. The detection of ACIS depended on the extension of the lesion. Conization with uninvolved margins was an adequate treatment. Residual ACIS was only found in cases with coexisting early invasive adenocarcinoma. No recurrences or frankly invasive adenocarcinomas have been observed during the observation period.

Adenocarcinoma↗
PubMed1989

Primary carcinoma of the vagina: a study of 29 cases.

Twenty-nine cases of primary carcinoma of the vagina were reviewed. Vaginal carcinoma produced symptoms in 26 cases and postmenopausal bleeding was the most frequently observed symptom. Squamous carcinoma was the dominating histologic type (83%). Twelve patients had previously been treated for invasive or preinvasive cervical disease. Six patients had previously received pelvic irradiation. The median time from cervical carcinoma to vaginal carcinoma was 20 years, and from pelvic irradiation to vaginal carcinoma, 25 years. Two factors significantly influenced the results of treatment: the mode of delivery of radiation therapy and the total tumor dose. Clinical staging did not significantly influence the results of treatment although stage I patients did better than stage II-IV patients. Combination of external pelvic irradiation and brachytherapy, with a total tumor dose of 7000 R or more, was necessary to prevent local recurrence.

Aged↗
PubMed1989

Autoimmune associated recurrent abortions.

A possible relationship between recurrent spontaneous abortions and autoimmune abnormalities was studied. Eight serological autoimmune or autoimmune-correlated parameters were investigated in 91 women with unexplained recurrent abortions (greater than or equal to 3 consecutive, spontaneous abortions) and 89 fertile control women. Five parameters were seen significantly more frequently in 19 women with at least one second trimester miscarriage which had been associated with severe intrauterine growth regardation (IUGR), than in controls. Seventeen of these 19 patients (89%) had at least one positive autoimmune parameter, compared to 15 of 72 patients (21%) with no second trimester abortions with IUGR (P less than 0.0001) and 14 (16%) of the controls (P less than 0.0001). No single autoantibody characterized patients who exhibited a significant accumulation of autoimmune parameters. These findings may suggest that women with recurrent abortions, in whom autoimmunity is thought to play a role, cannot be identified merely by one laboratory assay, such as that for cardiolipin antibodies, but must be defined by positivity of several criteria. Using our own test panel, preliminary clinical and serological criteria have been set up for the definition of an autoimmune-associated recurrent abortion condition. Twenty-three per cent of the patients in our material fulfilled these criteria, and seven out of nine of these women (78%) have to date been treated successfully with heparin/aspirin during pregnancy.

Abortion, Habitual↗
PubMed1988

The results of cryosurgery for cervical intraepithelial neoplasia.

During 4 years, 1980-1984, 197 patients were treated for CIN II and CIN III by cryosurgery. Included were 62 patients with endocervical involvement (positive ECC). The cure rates of a single cryosurgical treatment were lowered significantly by increasing grade of CIN and by endocervical involvement. The factors influencing the cure rates of cryosurgery are discussed in relation to the results obtained in the present study. The most important step in treatment of patients with CIN by conservative methods seems to be the pretreatment evaluation and not the method of treatment. Despite the fact that we achieved good results in treating patients with CIN II and endocervical involvement (cure rate: 88.9%) it is our opinion that endocervical involvement should contraindicate conservative procedures. The potential risk of overlooking invasive disease among these patients should always be kept in mind. Careful pretreatment evaluation in patients undergoing cryosurgery is mandatory, or else this excellent method would be brought into discredit.

Adult↗
PubMed1988

Verrucous carcinoma of the female genital tract: report of a case and review of the literature.

Verrucous carcinoma (VC) of the female genital tract is a rare lesion, primarily affecting postmenopausal women. A case of VC of the vulva is reported, bringing the total number of VC of the female genital tract to 89. VC is a slowly growing, locally "pushing" tumor with a rather benign histologic appearance, and the clinical and histologic characteristics are described on the basis of the present report and a review of the literature. The treatment of VC is still a matter of discussion. It seems logical to treat the tumor by wide local excision, taking the lack of proof of spontaneous metastasis into consideration. Radiation therapy should be contraindicated, and local application of podophyllin, bleomycin therapy, and cryosurgery are ineffective methods in the treatment of VC.

Aged↗
PubMed1988

Meningismus as main symptom in toxic shock syndrome.

A case of toxic shock syndrome (TSS) with meningismus as main symptom is presented. The case illustrates that, in cases of rigidity of the neck and back, not directly explainable, TSS should be considered as a possible diagnosis. Toxic syndrome (TSS) is a severe, acute infectious disease with great variations in symptomatology (1,2). Its lethality is approximately 5% (3). The prognosis depends on early diagnosis and treatment.

Adolescent↗
PubMed1988

Treatment of habitual abortions associated with autoimmune abnormalities. A report of two cases.

In a study of the etiology of idiopathic habitual abortion, we have found 2 patients with a history of 5 and 4 spontaneous abortions respectively, possibly caused by autoimmune abnormalities. In the plasma of one of the patients we had found the presence of lupus anticoagulans and other lupus antibodies, whereas the other suffered from a latent autoimmune hepatitis. We describe the successful treatment of the 2 womens' subsequent pregnancies with subcutaneous heparin supplemented with acetylsalicylic acid.

Abortion, Habitual↗
PubMed1988

Adenocarcinoma of Bartholin's gland associated with extramammary Paget's disease of the vulva.

A case of adenocarcinoma of Bartholin's gland in association with Paget's disease of the vulva, in a 61-year-old woman is presented. Only 3 cases of this combination have previously been presented. Carcinoma of Bartholin's gland is a diagnostic problem in most cases, as in the present. Radical vulvectomy and bilateral inguinal-femoral lymph node dissection is the recommended mode of treatment.

Adenocarcinoma↗
PubMed1988

The clinical significance of asymptomatic mid-trimester low placentation diagnosed by ultrasound.

A prospective investigation of the problem of low placentation in mid-trimester, in uncomplicated pregnancies was performed. 773 pregnant women were included and 70 (9.1%) had a low-positioned placenta, defined as a placenta reaching or partially covering the cervical os, diagnosed by ultrasound between the 19th and 21st week of pregnancy. In no case did the placenta completely cover the cervical os. By repeat ultrasound examination in the 36th week of pregnancy, all low placentations had converted to normal position. Low placentation in mid-trimester was not associated with pregnancy complications or neonatal complications. A placenta reaching or partially covering the cervical os, in early pregnancy, seems to be normal, not influencing the subsequent course of pregnancy.

Adult↗