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Biomedical subjects

E Siim

Publications and source records attributed to E Siim.

At least 19 recordsLinked to original sources
PubMed2000

Tumor infiltrating lymphocytes in melanoma comprise high numbers of T-cell clonotypes that are lost during in vitro culture.

Melanoma is generally accepted as being an antigenic tumor capable of eliciting T-cell responses that, however, in most cases are inadequate to control tumor growth. Tumor-infiltrating lymphocytes (TIL) in melanoma lesions comprise clonotypic T cells, indicating the in situ recognition of melanoma-associated peptide epitopes. Cultured TIL have been studied in order to unveil characteristics of TIL and the interactions of TIL and melanoma cells. Whether in vitro cultured TIL mirrors the in situ situation has, however, been questioned. In the present study we have taken advantage of T-cell receptor clonotype mapping methodology to conduct a full and detailed analysis of the T-cell clonotypes in melanoma lesions and in corresponding lines of TIL established in vitro. All melanoma lesions and the corresponding TIL cultures comprised high numbers of T-cell clonotypes, typically in the range of 40 to more than 60. The subsequent comparison of T-cell clonotypes present in the original lesions and in the corresponding T-cell lines established in vitro demonstrated that a very limited number of the T-cell clonotypes established in vitro are identical to the T-cell clonotypes expanded in situ. These results demonstrate that in situ T-cell clonotypes in melanoma are not readily expanded in vitro and that the majority of T-cell clonotypes present in cultured TIL are not present in situ.

Cell Count↗
PubMed1996

Breast reconstruction and tissue expansion in irradiated versus not irradiated women after mastectomy.

Thirty-five women whose breast cancer had been treated by radiation and 111 in whom it had not underwent unilateral breast reconstruction with the tissue expansion technique after modified radical mastectomy. Their records were reviewed and in a questionnaire the patients reported their own opinion on the results. The two groups differed significantly, because those patients who had been irradiated had a more painful course of expansion and a less over-expansion. Their reconstructed breasts were harder, had more deformities, and they required significantly more capsulotomies. The irradiated group also reported less satisfaction with the cosmetic results and more unfulfilled expectations. Tissue expansion cannot therefore be recommended as a routine procedure for breast reconstruction in patients after irradiation. However, our results do not show whether other methods are better for these patients.

Adult↗
PubMed1995

Capsular contracture after breast reconstruction with the tissue expansion technique. A comparison of smooth and textured silicone breast prostheses.

Twenty consecutive breast reconstructions were done by the expansion technique. Either textured or smooth expander prostheses were used followed by silicone implants. Histological samples were taken from the capsule when the expander was removed and the implant inserted. The results show no difference in capsular formation between the groups, although the microscopic evaluations from the group with textured prostheses showed considerable numbers of silicone droplets. The patients were generally pleased with the results even though some reconstructed breasts were slightly firm when evaluated postoperatively.

Adult↗
PubMed1994

Analysis of T cell receptor alpha beta variability in lymphocytes infiltrating melanoma primary tumours and metastatic lesions.

The T cell receptor (TCR) alpha beta variable (V) gene family usage of tumour-infiltrating lymphocytes (TIL) in four different primary human malignant melanomas and their corresponding metastatic lesions was characterized using a recently developed method based on the reverse-transcription-coupled polymerase chain reaction (RT-PCR). All patients were typed for HLA-A1 and -A2, either serologically or by a newly developed RT-PCR method. Two of these patients expressed HLA-A2, one the HLA-A1 haplotype and one further patient was heterozygous HLA-A1/-A2. The prognostic parameters for all four patients indicated that rapid progression of the disease was to be expected. However, only two of the patients showed rapid progression, while the remaining two patients are still alive after more than 3 years. In TIL in primary melanomas, a possible correlation was suggested between HLA-A2 and the preferential usage of the TCR V gene families V alpha 4, V alpha 5, V alpha 22 and V beta 8, whereas the V beta 3 gene family appeared to be expressed together with HLA-A1. Other highly expressed V gene families, apparently not restricted to either HLA-A1 or -A2, were V alpha 1 (expressed in three of four primary tumours) and V alpha 21 (expressed in two of four tumours). We found no evidence suggesting any correlations between the haplotypes HLA-A1 and -A2 and preferential V gene family expression in the metastatic lesions, and the only common feature was V alpha 8, which was found to be highly expressed in two out of three subcutaneous metastases. The V gene families, which were highly expressed in the primary tumour were generally not, or only very weakly, expressed in metastases and vice versa, possibly reflecting a change in the phenotype of the metastatic melanoma target cells. With regards to patient 0368, it was possible to obtain and study material from two subcutaneous metastases. The first metastasis was excised more than a year after the primary tumour, showing a completely different V region repertoire. The second metastasis was excised at surgery 2 years after primary surgery and likewise showed a dramatic shift in comparison to the first subcutaneous metastasis. Although the present study only included a small number of patients, it suggests that the estimation of V gene expression, if applied to a larger amount of patient material, might make it possible to substantiate further the suggested correlations between the T cell response against the tumour, HLA and antigen expression.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1992

Treatment of donor sites--calcium alginate versus paraffin gauze.

In the surgery of burns a good healing of donor areas is essential. A controlled trial of 17 cases is presented. Mirror-image donor areas in the same patient were treated on one leg with a traditional dressing of paraffin gauze, Jelonet, on the other leg with Kaltostat, a calcium sodium alginate wound dressing. Healing time, haemostasis, ease and comfort with removal, dressings, infection and quality of the regenerated skin, were estimated. The Kaltostat dressing seemed to be superior due to the quality of the re-epithelialized donor site, the haemostatic quality and the ease and comfort with removal. There was a marginal profit in healing time.

Adult↗
PubMed1991

Duoderm application on scalp donor sites in children.

In a search for an invisible skin donor site and a comfortable dressing for the donor site, a study was designed in which the scalp was used as the donor site and Duoderm was applied as the dressing. The study contained 18 children with minor burns. A Duoderm dressing on scalp donor sites showed a normal healing time. In using the scalp as a donor site the patient can be mobilized very quickly after the operation and the scar is hidden and invisible 1 month postoperation.

Bandages, Hydrocolloid↗
PubMed1991

Soft-tissue procedures for the exposed knee arthroplasty. 18 cases followed for 7 (1-17) years.

Reconstructive surgery was performed in 18 knee arthroplasties because of wound-healing problems or skin necrosis. The procedure, after debridement, included myocutaneous, muscle flap, and split-skin grafts. Revision was necessary in 6 cases. After 1-17 years, 6 patients had died, 2 had had a low femur amputation, and 5 had had an arthrodesis. Five patients had retained the prosthesis, although 3 of them had considerable pain and poor mobility; only 2 patients were tolerably painfree and had acceptable mobility. Patients with an exposed knee endoprosthesis should be referred to centers with special competence in plastic reconstructive surgery.

Adult↗
PubMed1989

Omiderm treatment of scalds in children.

As a temporary dressing on scald wounds in children Omiderm was tried in 10 consecutive patients. Omiderm is a thin, transparent, hydrophilic polyurethane membrane, permeable to water and oxygen. It was applied on the wound when exudation was declining, about 4-10 hours postburn. The dressing formed a crust with the wound exudate and was removed when the wound had reepithelialized or at day 14 postburn before split skin grafting of the wound if the wound had not yet healed. The dressing had no advantages nor disadvantages compared to conventional exposure treatment with regard to healing time, rate of bacterial contamination, need for split skin grafting, quality of scars on spontaneously healed areas nor comfort to the patients.

Burns↗
PubMed1989

Treatment of donor sites--Duoderm or Omiderm?

In the search for a good temporary donor site dressing two synthetic products were compared in a randomized controlled clinical trial: Duoderm, a double layer dressing with an inner hydrocolloid polymer complex layer and an outer layer of polyurethane foam, impermeable to water and oxygen, and Omiderm, a hydrophilic polyurethane transparent membrane, permeable to water and oxygen. Sequence analysis showed that the trial could finish when eight patients had been treated. The Duoderm dressing resulted in solid re-epithelialization almost 3 days earlier than Omiderm, and it was more comfortable for the patients. Neither the Duoderm-treated nor the Omiderm-treated donor sites showed any signs of clinical infection. Due to fluid accumulation beneath the dressing during the first postoperative days the Duoderm dressing had to be changed more often than the Omiderm.

Adolescent↗
PubMed1988

Antacid in the prevention of upper gastrointestinal bleeding in burns.

In a retrospective survey the efficacy of a prophylactic antacid regime with aluminiumhydroxyde/magnesiumcarbonate (LINK, A.L. pharma) was investigated in 157 patients with major burns. Only 14% developed any sign of upper gastrointestinal stress ulceration, and only 5% revealed clinically significant bleeding indicating blood transfusion. No case developed haemodynamic instability, nor need for acute surgery, and no one died from haemorrhage. We found the regime economically attractive, and with few and reversible side effects. We conclude that our prophylactic regime is highly effective.

Adult↗