Biomedical subjects

F J Vera-Sempere

Publications and source records attributed to F J Vera-Sempere.

At least 19 recordsLinked to original sources

PubMed2002

Expression of p53 protein and tumor angiogenesis as prognostic factors in nasopharyngeal carcinoma patients.

The objective of this study was to evaluate the possible prognostic significance of p53 protein overexpression and tumor angiogenesis (TA) in nasopharyngeal carcinoma (NPC) patients, together with other clinicopathological variables. Forty-two NPC patients were evaluated in relation to survival. Nuclear p53 overexpression in neoplastic and endothelial cells was detected by immunohistochemistry (IHC) with the monoclonal antibody DO-7 and the polyclonal antibody against factor VIII-related antigen, respectively. Thereafter, we evaluated p53 cases in order to determine their nuclear immunoreactivity from negative (-) to positive (+, ++, +++). In addition, microvessels were counted in the most active areas of tumor neovascularization or hotspots using an image computer analyzer (MicroImage). A Cox multiple regression survival analysis was used to determine the best prognostic indicators in NPC patients. As a result, tumor microvessel count, considered as a continuous variable, was the most important independent prognostic indicator in relation to survival (p = 0.0273), with a relative risk of death of 2,4399 [95% confidence interval = 1.1051 ; 5.3871] associated with the highest microvessel counts. Moreover, the only clinicopathological variable that demonstrated prognostic value in a Cox multiple regression survival analysis was histological type (p = 0.05). In addition, we did not observe any statistical association between intratumoral microvessel density (IMD), clinicopathological variables and p53 protein expression.

Biomarkers, Tumor↗

PubMed2002

[Foam cell nephropathy in heterozygous female with Fabry's disease].

We describe the clinical and pathological characteristics of a 49 year-old heterozygous female carrier of Anderson-Fabry's disease. Light microscopy and ultrastructural study of a renal biopsy showed the presence of foam cell nephropathy and galactosylceramide deposits affecting podocytes, the parietal epithelium of Bowman's capsule and the distal tubular cells, endothelial cells and medullary interstitial elements. Retrospectively, the presence of storage disease was confirmed in a hysterectomy specimen obtained two years previously. Our observation shows that heterozygotes for this disorder can not only carry and transmit the disease but may also develop pathological deposits in various organs. A renal biopsy from these carriers allows precise identification of the disease, facilitates adequate genetic counseling and gives the option of enzyme replacement therapy in patients who have pathological deposits.

Fabry Disease↗

PubMed2001

Counts and areas of S-100-positive epidermal dendritic cells in atypical molluscum contagiosum affecting HIV+ patients.

Molluscum contagiosum is a common and self-limiting viral infection, that in HIV+ patients courses as an opportunist affection with atypical clinical features. Impaired cell-mediated immune response could be involved in such atypical growth. We evaluated the density and area of Langerhans cells (LC) using S-100 immunohistochemistry in seven atypical molluscum contagiosum. LC density was quantified by three different methods using computer-assisted morphometry as well as estimating the relative area of LC with respect to epidermal area. Results were compared with two control groups (normal skin specimens and molluscum contagiosum affecting non-AIDS healthy patients). We found a virtual absence of LC in areas of molluscum lesions affecting both HIV+ and non-AIDS patients. Likewise we observed an evident decrease in LC density in perilesional epidermis of atypical molluscum with respect to both control groups. Upon comparing the counts and areas, we observed that this reduction in LC count was statistically significant only when considering LC related to length of basement membrane in atypical molluscum with respect to normal skin specimens. Our finding of a reduced number of LC in the perilesional epidermis of HIV+ patients with atypical molluscum could explain the high frequency and clinical challenge of molluscum contagiosum in immunocompromised people. In spite of these results, further studies of LC kinetics and functions are required to precisely elucidate their role in the course of molluscum contagiosum in HIV+ patients.

Adolescent↗

PubMed2001

[Cholesterol crystals embolization. A case report].

Cholesterol Crystals Embolization is not a very frequent entity that happens in people with atheromatous disease of spontaneous for or after the realization of vascular manipulation (angiographic, angioplasty procedures, cardiovascular surgery) or more rarely with the treatment with oral anticoagulants and after thrombolytic therapy. The clinical presentation is according to the arterial affected territory and so from diagnosed cases in autopsy reports to florid clinic forms exist. The more frequent are the cutaneous manifestations with apparition of livedo reticularis and purple toes that could go accompanied of necrosis of lower limbs, consecutive from the renal manifestations and the gastrointestinal tract one. The diagnosis is based on the biopsy of organ affected lesions to level of arterioles, that revealed characteristic cholesterol clefts, above all the cutaneous biopsy, muscular and in any case renal. As for the treatment is symptomatic with analgesics, antiplatelet agents, anti-inflammatory, etc ... but it doesn't after the presage and the evolution of the illness. A clear contraindication exists to the use of oral anticoagulants and heparin.

Adult↗

PubMed2000

Morphometric study of tumor angiogenesis as a new prognostic factor in nasopharyngeal carcinoma patients.

The aim of this study was to determine the possible prognostic significance of tumor angiogenesis (TA) in nasopharyngeal carcinoma (NPC) patients. Fifty-five NPC patients were evaluated in relation to survival. Endothelial cells were immunohistochemically stained with anti-von Willebrand factor (F-VIII), CD-31 and CD-34 antibodies, and microvessels counted in the most active areas of tumor neovascularization or hotspotsusing both a manual and an automatic method. Overall survival analysis calculated by the Kaplan Meiertest revealed that both methods were correlated with a statistical significance between intratumoral microvessel density (IMD) and overall survival, using either manual (p=0.0141) or automatic counting (p=0.0117). Other angiogenic parameters studied were perimeter, roundness and accumulative area of the microvessels using a morphometric analyzer. Moreover, our results show that cases with high IMD demonstrated a prognostic significance in relation to the accumulative area (p=0.0072).

Adult↗

PubMed2000

Immunohistochemical absence of CD21 membrane receptor in nasopharyngeal carcinoma cells infected by Epstein-Barr virus in Spanish patients.

OBJECTIVES/HYPOTHESIS: The aim of this study was to analyze the relevance of the CD21 membrane receptor in nasopharyngeal carcinoma (NPC). CD21 is implicated in the introduction of the Epstein-Barr virus (EBV) genome into epithelial cells and B lymphocytes. STUDY DESIGN: Immunohistochemical analysis of CD21 in NPC. METHODS: Paraffin-embedded samples of NPC of different histological types with demonstrated presence of EBV were analyzed for CD21 expression using immunohistochemistry. RESULTS: We detected EBV by non-isotopic in situ hybridization (NISH) and nested polymerase chain reaction (PCR) in 100% of samples, regardless of histological type, supporting the previous view that all the types of NPC are variants of an EBV-associated malignancy. CD21 was not detected in NPC, and this absence was a typical feature in our data group. CONCLUSIONS: The loss of the CD21 membrane receptor could be one of the immunophenotypical changes of the neoplastic cells that occur in the evolution of the NPC malignancy.

Adolescent↗

PubMed2000

[Amaurosis fugax as the early manifestation of orbital schwannoma].

PURPOSE/METHODS: We report a case of a 51-year-old woman who clinically presented amaurosis fugax in her left eye of four months' duration. RESULTS/CONCLUSIONS: Computed tomography showed a well defined intraconal mass suggestive of cavernous hemangioma. A left lateral orbitotomy was performed. A red and encapsulated mass was removed in its entirety without violation of its capsule. Microscopically, it was composed of areas of spindle-shaped cells disposed in form of palisade (Antoni type A) mixed with cystic areas where the cells were scattered in a loose myxoid matrix (Antoni type B). Some nuclei were large, hyperchromatic, pleomorphic and multilobulated. The diagnosis was made on the basis of the histopathologic findings.

Amaurosis Fugax↗

PubMed1999

C-erbB-2 expression and its relationship with ploidy, p53 abnormalities and epidermal growth factor receptor content in human non-small cell lung cancer.

This study attempts to clarify the role of c-erbB-2 overexpression in human non-small cell lung cancer (NSCLC) and relate it with the p53 alterations, DNA index (D.I.) and epidermal growth factor receptor (EGFR) content in sixty four patients with NSCLC. c-erbB-2 and EGFR quantification were carried out from tissue homogenates using quantitative ELISA procedures. p53 alterations were determined by immunohistochemical (IHC) detection with the monoclonal antibody DO-7 and analysis for p53 mutations on exons 4 to 8 by single strand conformation polymorphism (SSCP). The D.I. was performed by flow cytometry. c-erbB-2 hyperexpression was found in 13 of 58 LC (22%), and it was closely associated with hyperdiploid tumors (D.I. >1.3; P = 0.00). The p53 abnormalities detected by SSCP were statistically more frequent in hyperdiploid tumors (16/25; P = 0.015) than in diploid ones (8/30). No relationship between the results of IHC p53 and SSCP was found. The patients with c-erbB-2 hyperexpressing tumors were prone to have frequent relapses (P = 0.03), although the patients with hyperdiploid NSCLC are the ones with the highest relapse rate (P = 0.008). From the results obtained in this study the following conclusions can be drawn: (a) c-erbB-2 hyperexpressing NSCLC are associated with abnormalities in other biological markers and with a greater rate of relapses; (b) SSCP seemed to be more specific that IHC to detect p53 molecular abnormalities; and (c) the D.I. is the parameter more tightly related with relapse.

Carcinoma, Non-Small-Cell Lung↗

PubMed1999

Liver disease as primary manifestation of multiple myeloma in a young man.

We report a 27-year-old man who presented with fatigue, moderate weight loss and progressive abdominal distension as primary manifestations of a light-chain multiple myeloma (MM). Liver scan showed an enlarged liver with multiple low attenuation areas. Liver biopsy revealed sinusoidal infiltration by small size cells identified as Kappa light chain-producing primitive plasma cells by immunohistochemistry. The patient responded to three courses of EDAP. Subsequently he received intensive therapy with busulfan/melfalan and a peripheral blood stem cell transplantation enriched for CD34+ cells from his HLA-identical brother. No acute graft-versus-host disease was detected. Now, 12 months after transplant, the patient is asymptomatic.

Adult↗

PubMed1999

[Extracranial meningioma presenting as a polyp of the outer ear canal].

Meningiomas are the most frequent benign intracranial tumor. Up to 20% of these neoplasms may eventually extend beyond the skull, particularly when tumor spread affects the temporal bone. We report a clinicopathological observation of an extracranial meningothelial meningioma that was diagnosed morphologically using immunohistochemical techniques. The tumor presented as polyp in the ear canal of a 70-year-old woman who had a history of ear disease and seizures and was under medical treatment. The growth was associated with a right temporal lobe tumor involving the petrosal bone that had been detected 6 years earlier on computed axial tomography.

Aged↗

PubMed1998

Relationship of p53 molecular abnormalities with flow cytometry and growth factor receptor content in lung cancer.

This study attempts of clarify the oncological significance of the p53 molecular abnormalities and p53 expression in lung cancer (LC) and their relationship with flow cytometry (FC) parameters and epidermal growth factor receptor (EGFR). The study includes 65 samples taken from both LC and normal lung (NL). The p53 molecular abnormalities of exons 4-8 were studied by single strand conformation polymorphisms (SSCP) and the loss of heterozygosity (LOH) of exon 4 by the Metzler method. P53 protein was detected by Western blot. EGFR was determined by a radioligand assay using [125I]EGF. The FC parameters S phase fraction (SPF), DNA index (D.I.), G1G0 and growth rate (G2M + SPF) were evaluated from cellular monosuspensions. The LC with SSCP p53 molecular abnormalities have a significantly higher EGFR content (P < 0.001), SPF (P < 0.007), D.I. (P < 0.017) and a lower proportion of G1G0 cells (P < 0.04) than LC with no molecular abnormalities. No relationship between p53 molecular abnormalities and tumor TN or evolutive events was found. Neither the relationship between the molecular results and p53 expression detected by Western blot nor that of the p53 expression detected by Western with FC parameters or EGFR could be shown. In NL the growth fraction cells decrease significantly (P < 0.05) with the intensity of p53 expression. The lack of biological functionality of p53 with molecular abnormalities seemed to relate to fast growing LC whereas p53 expression detected by Western seemed more related to the wild type of p53.

Adult↗

PubMed1998

Psammomatous melanotic schwannoma localized in the mediastinum: diagnosis by fine-needle aspiration cytology.

The cytological characteristics are presented in a case of psammomatous melanotic schwannoma localized in the mediastinum, diagnosed by fine-needle aspiration cytology (FNAC), with later histological confirmation. This lesion affected a 38-year-old male, with a tumor measuring 5 cm in diameter located in the posterior mediastinum in contact with the spinal cord, with erosion of the adjacent vertebra (T5), that caused constant pain localized in the right scapular region with an evolution of several weeks. The cytological characteristics of psammomatous melanotic schwannoma are discussed, along with the histological and immunohistochemical features of this infrequent neural tumor, which aid in establishing a differential diagnosis. The importance of a correct histological diagnosis of this tumor is of particular clinical relevance after having been identified as one of the possible components of Carney's complex. This possibility demands a meticulous patient exploration in search of any other components that make up this complex, given the aggressive character of some of them. These lesions could, if not detected early enough, produce fatal consequences for the patient, fundamentally in those patients with cardiac myxomas. In this case, following an exhaustive clinical examination there was no pathology associated with this complex. It is therefore considered to be an isolated psammomatous melanotic schwannoma, and not a part of Carney's complex.

Adult↗

PubMed1998

Warthin-like tumor of the thyroid: a papillary carcinoma with mitochondrion-rich cells and abundant lymphoid stroma. A case report.

Papillary carcinoma is the most common form of thyroid carcinoma and, generally, it has a more favorable prognosis than other carcinoma types, although diverse variants or subtypes have been described, some of which appear to have a less favorable prognosis. Recently, a new variant, the so-called "Warthin-like tumor" or "tall-cell variant with extensive lymphocytic infiltration of papillary thyroid carcinoma" with behavior similar to the usual papillary carcinoma, has been described. We present a case with the cytohistological pattern of "Warthin-like tumor" of the thyroid. Immunohistochemistry revealed reactivity at the epithelium lining papillae for antimitochondrial 113-I antibody and also membranous positivity for CD15 (Leu M1). Lymphoid stroma showed an immunoprofile similar to chronic lymphocytic thyroiditis. These findings point to the consideration of "Warthin-like tumor" as being a hybrid neoplasm between the tall-cell variant and oxyphilic papillary carcinoma associated to a lymphoid-rich stroma.

Adenolymphoma↗

PubMed1998

[Assessment of the tunica muscularis mucosae of the bladder wall: necropsy study].

INTRODUCTION: The bladder has traditionally been considered to lack a muscularis mucosae (MM). However in the last decade a number of studies based on biopsies or neoplastic cystectomy specimens have report the presence of a MM. Likewise, and based on the existence of such structure proposals have been made to subclassify T1 superficial bladder tumors into T1a/T1b or T1a/T1b/T1c. MATERIALS AND METHODS: A homogeneous analysis was made of the presence of a MM in 20 necropsies of fetuses and newborns of either sex, without urological pathology. Seven different locations of the bladder wall were evaluated following intracavitary formalin fixation. A total of 140 bladder locations were thus histologically evaluated. The presence of a MM was appraised according to the patterns established by Ro et al. (1987). RESULTS: A focal pattern was the most common presentation (62.14%) followed by a discontinuous pattern. In 32 of the 140 bladder locations (23.6%) no MM could be visualized. The location that most often exhibited a MM was the anterior bladder wall. No relations was observed between age or sex and the presence or absence of a MM. It is concluded that MM distribution in the bladder is heterogeneous and random, with a predominantly focal pattern. The MM structure was only detected over 7.78% of the mucosal surface of the bladder. DISCUSSION: In recent years a modification of the TNM system has been proposed, based on the presence of infiltration of the bladder MM (T1a/T1b). The results of the present study suggest that such a classification would not very realistic since the the MM is irregular in its presentation. Nevertheless, and wherever possible, that pathologist should specify the level of infiltration of superficial bladder tumors with respect to the MM, in view of the prognostic and therapeutic implications.

Cadaver↗

PubMed1997

Immunohistochemical expression of Bcl-2 oncoprotein in EBV-associated nasopharyngeal carcinoma correlated to histological type and survival.

Expression of Bcl-2 is associated with inhibition of apoptosis and extension of cell survival. In vitro Bcl-2 protein expression is up-regulated by the EBV-latency associated antigen latent membrane protein (LMP-1). We have investigated the relationship between the presence of EBV-DNA screened by means of sensitive nested-PCR, nasopharyngeal carcinoma (NPC) histological types according to two different schemata (WHO and Micheau classifications) and Bcl-2-124 immunohistochemical expression in 55 biopsy samples of NPC. EBV genome was detected in 100% of samples with sufficient DNA quality to support the previous view that all types of NPC are variants of EBV-infected neoplasia. Bcl-2 was observed in the basal layer of normal nasopharyngeal mucosa and also at cytoplasmic level in 42 of 55 (76.4%) NPC cases. Mitotic neoplastic cells usually showed strong cytoplasmic and chromosomal staining, a finding not well referred to previously. Bcl-2 expression was significantly associated (p<0.05) to undifferentiated NPC (UNPC) when a histological classification with only two major microscopical types was applied. No close correlations were found between the presence of EBV-DNA, NPC location, clinical stage and age or sex of the patients in relation to Bcl-2 positive expression. However, when comparing Bcl-2 expression and known survival mean of the patients, significant differences were observed (p<0.001) so that mean survivals were 31.1, 24.4, 52.2 and 54.1 months respectively for NPC patients with -, +, ++ and Bcl-2 immunoreactivity. Nevertheless this better clinical outcome in Bcl-2 NPC positive cases may depend on the histological type due to close relationship with UNPC. Only studies of larger series with long-term follow-up and multivariate analyses may document whether Bcl-2 expression is an independent prognostic marker in the evolution of NPC patients.

Adolescent↗

PubMed1997

[Estrogen receptors and breast fibroadenoma with suspicious traits of malignancy].

Fibroadenomas (FAD) are the most common breast tumors. Their clinical and morphological characteristics often vary, and endocrine factors has been implicated in their etiology. The development of a breast carcinoma overlying a FAD is very rare. An immunohistochemical study is made of the presence of estrogen receptor (ER) in a series of 21 FAD with clinical, mammographic or cytological suspect of malignancy. An intraoperative biopsy evaluation was made in all cases. In three cases FAD was associated to breast cancer (three lobular carcinomas-two infiltrating and one in situ; one case was also adjacent to an infiltrating ductal carcinoma). Two of these three fibroadenomas were ER-positive. Globally, only 35% of the FAD evaluated proved ER-positive. Of all the parameters evaluated (age, tumor size, single or multiple presentation, history of breast carcinoma or oral contraceptives, and histological characteristics) no association was observed with respect to ER positivity, with the exception of patient age. Thus, ER-positive FAD were found in patients 5.4 years younger than the ER-negative women (ages 28.4 and 33.8 respectively). On the other hand, the mean age (46.6 years) of the patients with FAD and cancer was 10.2 years above the mean age (34.4 years) of the patients with FAD but no cancer; however, and despite this greater age, two of the three patients with both FAD and cancer exhibited ER positivity at FAD level.

Adult↗

PubMed1996

[Chronic autoimmune hepatitis following cholestatic hepatitis caused by droxicam].

Droxicam in a nonsteroid antiinflammatory from the oxicam family which acts as a pro-drug, being transformed into pyroxicam after being hydrolized in the stomach and has induced several cases of cholestatic or mixed hepatitis. A clinical observation in which droxicam provoked initial cholestatic hepatitis which later developed into chronic autoimmune hepatitis is presented. It has been postulated that, after causing cholestatic hepatitis by hypersensitivity and within the context of a previous autoimmune entity such as vitiligo, this drug triggered a silent autoimmune liver disease which was demonstrated clinical, analytical and histopathological manifestations 18 months later and required permanent immunosuppressive treatment.

Aged↗

PubMed1996

In vivo microarterial freezing: experimental study.

In vivo freezing of microarteries with liquid nitrogen is known to relieve spasm without inducing thrombosis. In the present study the patency rates of microanastomoses in pre- and postfrozen vessels were investigated in the rat model. Freezing of the femoral artery was done with ethyl chloride. The artery was frozen before the anastomosis was performed on the left side (prefrozen), and after on the right side (postfrozen); patency rates were recorded at 2, 10, and 30 days. Patency rates were 100% in prefrozen vessels and 100% in postfrozen ones at all three time intervals. Histologic examination showed depopulation of all vessel walls with loss of the intima layer and fragmentation of the inner elastic lamina. Progressive cellular repopulation and regeneration of the endothelium occurred later, with no differences between pre- and postfrozen arteries. It is concluded that freezing of vessels with ethyl chloride reverts arterial spasm without inducing thrombosis and that frozen arteries can be repaired by microsurgical anastomosis with patency rates comparable to those of virgin arteries.

Anastomosis, Surgical↗