Biomedical subjects

G Krag Jacobsen

Publications and source records attributed to G Krag Jacobsen.

10 recordsLinked to original sources

PubMed2002

US-guided fine-needle aspiration biopsy of thyroid nodules.

PURPOSE: To determine which nodular areas provide most adequate and accurate material for cytology during US-guided fine-needle aspiration biopsy (FNAB) of thyroid nodules. MATERIAL AND METHODS: In a prospective multicentre study, US-guided FNAB (0.8 mm) was performed in 342 thyroid nodules (338 patients, 285 women, 18-83 years, 285 palpable). Histology was obtained in 169 nodules, revealing 75 neoplasms (44.4%) including 18 cancers (10.7%). In 206 solid nodules, 2 passes (central and peripheral) were compared. In 82 complex nodules, 2 passes (solid area and cystic area) were compared. RESULTS: The inadequacy rate was 16.4% and the false-negative rates were 2.2% and 28.1% for the diagnosis of cancer and neoplasm, respectively. In solid nodules, material was more adequate with peripheral passes compared to central passes, but the difference was not significant. In complex nodules, the inadequacy rate was much higher for passes in cystic areas (80.5%) compared to passes in solid areas (46.3%). CONCLUSION: Cystic areas due to degeneration seldom provided adequate material when aspirated. Aspiration should always be obtained from solid areas, at best using US-guidance. Adenomas and non-neoplastic nodules were difficult to distinguish.

Biopsy, Needle↗

PubMed1998

Treatment of malignant pleural effusion: pleurodesis using a small percutaneous catheter. A prospective randomized study.

The aim of this prospective, randomized study was to investigate the possibility of performing pleurodesis using a small percutaneous catheter (Cystofix catheter, CH10, 65 cm) inserted at bedside in patients with recurrent malignant pleural effusion and to compare this catheter with a conventional large bore chest tube (CH24) placed in connection with diagnostic thoracoscopy. After drainage pleurodesis was performed with tetracycline as sclerosing agent. Of 18 evaluable consecutive patients (mean age 67.8 years) nine were randomized for pleurodesis with the small and nine for the large catheter. In the former group, the majority (seven of nine) did not find insertion of the catheter more unpleasant than thoracentesis. In the latter group only a few (two of nine) found insertion comparable with thoracentesis (P < 0.05). All patients found the presence of the large catheter very or somewhat unpleasant (two and seven patients), whereas this was only the case for a few (no and two patients) treated with the small catheter (P < 0.05). In the former group three patients required new thoracentesis, whereas this was only the case for two patients in the latter group (P > 0.05). No complications were seen. We conclude that pleurodesis in patients with recurrent malignant pleural effusion can be performed with a small percutaneous catheter (Cystofix) with an effect similar to that obtained with a large-bore chest tube and with less discomfort for the patient.

Aged↗

PubMed1998

BAX protein is not expressed by basal cell carcinomas.

BAX and related proteins encoded by the BCL2 gene family are involved in the regulation of apoptosis. BAX is an apoptosis-promoting protein. The slow growth of basal cell carcinoma (BCC) has so far been explained by a high apoptotic activity. We investigated immunohistochemically 27 BCCs for expression of the apoptosis-promoting BAX protein. BCC did not express detectable amounts of BAX immunohistochemically. The results indicate that apoptosis in BCC does not involve BAX protein. We propose that the apoptotic pathway in BCC is regulated by either less common members of the BCL2 gene family or bypasses the regulation of the BCL2 gene family.

Apoptosis↗

PubMed1992

Melanotic neuroectodermal tumour as a predominant component of an immature testicular teratoma. Case report with immunohistochemical investigations.

A case of melanotic neuroectodermal tumour (MNT), or so-called retinal anlage tumour, as a predominant component of an immature testicular teratoma is presented. The patient was a 17-year-old man who furthermore had a mature mediastinal teratoma. The MNT was composed mainly of two cell types: small immature neuroblast-like cells and large columnar or cuboidal epithelial-like cells with or without melanin granules. The tumour cells were arranged in solid formations, nests, cords, alveolar and pseudoglandular structures with cleft-like or glomeruloid-like spaces. Myogenic differentiation was found in minor foci. Immunohistochemistry showed both neuroepithelial and mesenchymal features with positive staining reaction for neuron-specific enolase (NSE), S-100 protein (S-100), melanoma antigen (HMB45), cytokeratin and vimentin. Vimentin, desmin and actin were present in the myoid cells. To the best of our knowledge this is the first reported case of MNT originating in the testis. As this tumour component occurred in an immature teratoma, neuroectodermal differentiation of germ cell origin is considered most likely.

Adolescent↗

PubMed1992

Expression of cytokeratin and erbB-2 oncoprotein in Paget's disease of the nipple. An immunohistochemical study.

The occurrence of epithelial membrane antigen (EMA), low molecular weight cytokeratin (CK) and erbB-2 oncoprotein was investigated in twenty-eight cases of Paget's disease of the nipple (PD) to determine their diagnostic usefulness. The ABC technique with monoclonal antibodies was used on formalin-fixed, paraffin-embedded tissue. The Paget's cells showed positive immunoreactivity for all three antigens investigated in a high percentage of PD. Immunoreactivity for CK and erbB-2 oncoprotein was restricted to the Paget's cells, whereas EMA in some cases also stained the adjacent keratinocytes. Since CK and/or erbB-2 oncoprotein occurred in 93% of the cases, we conclude that demonstration of both antigens is useful in the diagnosis of PD. ErbB-2 oncoprotein was also found to be expressed in a high percentage of the underlying intraductal and invasive carcinomas.

Carcinoma, Intraductal, Noninfiltrating↗

PubMed1984

Mammography is an objective diagnostic method.

Six hundred mammograms from 307 consecutive symptomatic patients with a firm retrospective diagnosis were evaluated blindly and independently by two observers. Each observer identified 43 of 47 tumors (91 per cent) with predictive values of 0.63 and 0.68, respectively, for the positive statement, and 0.98 for the negative statement. The overall interobserver agreement with respect to malignancy was 94 per cent (Kappa 0.84) and concerning the diagnosis of simple cysts 91 per cent (Kappa 0.60). The frequency of subclinical cancer demonstrated by mammography in this material was higher than the prevalence of mammary carcinoma found by screening of risk group populations. Thus, mammography remains an objective and reproducible diagnostic method with distinct complementary value to clinical examination. By utilizing certain mammographic criteria for benign lesions it may be possible to reduce the number of biopsies presently performed on the basis of unspecific palpatory findings.

Adolescent↗

PubMed1984

Testicular germ cell tumours in Denmark 1976-1980. Pathology of 1058 consecutive cases.

In the first five-year period of the Danish Testicular Carcinoma Study (DATECA) 1058 consecutive testicular germ cell tumours were examined. Of these, 554 were seminomas comprising 515 of typical type, 26 anaplastic and 13 spermatocytic; 497 were non-seminomas comprising 145 pure tumours and 352 mixed tumours of various types. Among the various subtypes of non-seminomas embryonal carcinoma (EC) was recorded in 87 per cent, endodermal sinus tumour (yolk sac tumour; EST) in 22 per cent, teratoma (T) in 55 per cent and choriocarcinoma (CC) in 17 per cent. Only very few tumours were pure EST or pure CC. Five tumours were recorded as 'others or uncertain'. The tumours were graded with regard to various histologic features. Moderate and severe necrosis, bleeding, and a large number of mitoses were significantly more frequent in non-seminomas. The presence of tumour tissue at the resection margin was also more frequent in non-seminomas. Tumours with a largest diameter of less than 2.5 cm had already caused metastases in 16 per cent of the seminomas and 29 per cent of the non-seminomas. Increasing size of the tumours was associated with increasing frequency of metastatic disease but this association was not directly proportional. Distribution of the various histologic types according to the stage of disease varied. Thus, 78 per cent of the seminomas presented in stage I while 54 per cent of the non-seminomas had localized disease. Anaplastic seminomas were distributed similarly to the non-seminomas while all spermatocytic seminomas, with one exception, were recorded as stage I. Of non-seminomatous subtypes pure EC was associated with the highest frequency of stage III, followed by mixed tumours containing CC components. Although the present series is large the heterogeneity of germ cell tumours demands further investigation of larger numbers to confirm some of the findings.

Adult↗

PubMed1984

Testicular carcinoma in Denmark 1976-1980. Stage and selected clinical parameters at presentation.

Since Jan. 1, 1976 practically all new cases of germ cell tumours of the testis in Denmark have been included in the Danish Testicular Carcinoma Study (DATECA), permitting detailed registration of data concerning histology and stage at the time of diagnosis. The incidence of carcinoma of the testis in Denmark continues to be high with a crude rate of 8 to 9/100 000 males per year. During the past 5 years the size of the primary tumours has decreased. Parallel to this, the rate of metastatic spread has decreased for seminoma, while no such change has been observed for non-seminomatous tumours. Data are presented on histology and stage for 1058 consecutive patients.

Adolescent↗

PubMed1984

Prognostic factors in testicular germ cell tumours. Experiences from 1058 consecutive cases.

Prognostic factors in carcinoma of the testis were studied in 1058 adult patients treated in Denmark from 1976 to 1980. Separate analyses of the prognostic factors were carried out within the subgroups formed by a classification of the patients according to main histologic type (seminoma, non-seminoma) and the clinicoradiologic stage (I, II and III). The prognosis was measured by relapse-free survival (stage I and II), and survival (stage II and III). The prognostic value of 19 clinical and histologic parameters was evaluated using logrank tests and multiple regression analyses. An elevated HCG level and the size of retroperitoneal metastases were associated with a significantly adverse prognosis for seminoma in stage II. For non-seminomas the following parameters had a significant influence on the prognosis. Stage I: postoperative HCG level, local invasion and number of mitoses. Stage II: size of retroperitoneal metastases, postoperative HCG level, tumour size and local invasion. Stage III: presence of liver or lung metastases, postoperative HCG level, presence of choriocarcinoma or endodermal sinus tumour, and age.

Adult↗

PubMed1984

Tumour markers in testicular germ cell tumours. Five-year experience from the DATECA Study 1976-1980.

Since Jan. 1, 1976, nearly all new cases of testicular germ cell tumours have been included in the Danish Testicular Carcinoma Study (DATECA), and have been monitored by the tumour markers alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). During the first five years, 1058 patients participated in the investigation, but only 603 of these patients were followed by preoperative as well as postoperative marker determinations in serum. The overall prevalence of marker positivity, i.e. elevated preoperative values for AFP and/or HCG, was 8 per cent for seminoma patients and 60 per cent for non-seminoma patients. Elevated levels of serum AFP and HCG were correlated to the presence of endodermal sinus tumour and choriocarcinoma elements, respectively, in the primary tumour. The presence of increased marker concentration in serum was correlated stage (higher percentage in higher stages) and to prognosis (marker negative patients had a better prognosis than marker positive patients). Marker production by seminoma patients seems to indicate a poor prognosis, especially for HCG producing seminomas.

Chorionic Gonadotropin↗