PubMed Health⌕ Search

Biomedical subjects

H Rotterdam

Publications and source records attributed to H Rotterdam.

At least 37 records · Page 2Linked to original sources
PubMed1996

Increased expression of the cyclin D1 gene in Barrett's esophagus.

Previous studies have found a 3-10-fold amplification and overexpression of the cyclin D1 gene in about 32% of human esophageal squamous cell carcinoma. The purpose of this study was to evaluate the prevalence of increased expression of the cyclin D1 protein in Barrett's esophagus. Using 69 formalin-fixed and paraffin-embedded human esophageal specimens, which had been removed endoscopically or obtained at surgery during 1993 and 1994, all immunohistochemical analyses were performed using an avidin-biotin complex immunoperoxidase technique. Increased nuclear expression of the cyclin D1 protein was noted in 32 of 69 samples (46%; 44% of the samples from males and 50% of the samples from females). Positive nuclear staining for the cyclin D1 protein in Barrett's disease with intestinal metaplasia was found in 38% of the male cases and 25% of the female cases, whereas in gastric metaplasia it was positive in 33% of men and 48% of women. Nuclear accumulation of the cyclin D1 protein was also found in both dysplastic and nondysplastic lesions, and it was not associated with sex, age, or cigarette or alcohol consumption. Samples from patients taking proton pump inhibitors tended to be less frequently positive (32%) for cyclin D1 nuclear staining when compared to patients taking H2 antagonists (45%) or antacids (55%). These studies suggest that increased expression of cyclin D1 is an early event in the tumorigenic process of esophageal adenocarcinomas and that the increased expression of this gene might predispose the epithelium to malignant transformation.

Adenocarcinoma↗
PubMed1995

Pancreatic adenocarcinoma: CT versus MR imaging in the evaluation of resectability--report of the Radiology Diagnostic Oncology Group.

PURPOSE: To compare findings with computed tomography (CT) and magnetic resonance (MR) imaging in pancreatic adenocarcinoma and to determine optimal pulse sequences for MR imaging. MATERIALS AND METHODS: CT scans and MR images were compared of 189 adult patients with known or suspected adenocarcinoma of the pancreas. Levels of confidence were correlated with surgical and pathologic results. RESULTS: The accuracy of CT was 0.73 and of MR imaging was 0.70. The negative predictive value of CT was 0.28 and of MR imaging was 0.23. The positive predictive value of CT was 0.89 and of MR imaging was 0.88. Gradient-echo and T1-weighted spin-echo sequences ranked equally in evaluation of vascular invasion, T1-weighted spin-echo sequences were preferred for assessing lymphadenopathy, and T2-weighted spin-echo sequences were preferred for detecting hepatic metastases. CONCLUSIONS: Cross-sectional imaging modalities are useful in the identification of unresectable pancreatic carcinoma. CT is recommended for initial imaging assessment.

Adenocarcinoma↗
PubMed1994

Gastrointestinal disease in the immunocompromised patient.

Gastrointestinal (GI) disease is frequent in all types of immunocompromised patients but occurs with greatest frequency in patients with acquired immunodeficiency syndrome (AIDS). Thus, much of this review deals with human immunodeficiency virus (HIV)-related GI diseases. Gastrointestinal diseases in other immunocompromised patients are compared with those in patients with AIDS. Conditions unique to transplant recipients, such as graft-versus-host disease (GVHD) and posttransplant lymphoproliferative disorders (PTLDs), are discussed separately. We have divided these GI diseases into four main categories: (1) HIV-related inflammatory conditions other than opportunistic infections (HIV-related enteropathy, proctocolitis, and CD8 lymphocytosis); (2) inflammatory conditions unrelated to HIV or opportunistic infections (neutropenic enterocolitis, regional enteritislike enteropathy, and GVHD); (3) opportunistic infections (illnesses caused by herpesvirus, cytomegalovirus, and miscellaneous other viruses; Mycobacterium, Candida, Histoplasma, Cryptococcus, Cryptosporidium, Microsporida, Isospora, Leishmania, Toxoplasma and Strongyloides organisms as well as Pneumocystitis carinii; and (4) neoplasias (Kaposi's sarcoma [KS], AIDS-related non-Hodgkin's lymphoma [NHL], HIV-related Hodgkin's disease [HD], PTLDs, and miscellaneous neoplasms). The prevalence, pathogenesis, clinical manifestations, gross pathological findings, and microscopic features of each disease entity are discussed.

AIDS-Related Opportunistic Infections↗
PubMed1993

Retinoid hepatitis.

A 65-year-old woman treated with etretinate for pityriasis rubra pilaris developed chronic active hepatitis. The elevated transaminases were noted 2 months after initiation of therapy and peaked 2 months after discontinuation of etretinate. The spectrum of liver toxicity induced by etretinate is reviewed. We suggest that reported cases of retinoid-induced liver disease can be divided into four distinct categories: nonspecific reactive hepatitis, acute hepatitis, chronic active hepatitis, and severe fibrosis or cirrhosis.

Aged↗
PubMed1993

Mycoplasma-like organism induced murine cardiac microvasculopathy. A transmission electron microscopic study.

Mycoplasma-Like Organisms [MLO] are intracellular cell wall deficient bacteria that cause ocular chronic vasculitis in man and chronic vascular disease in plants. Since MLO do not grow in culture, diagnosis of MLO-induced disease requires identification of the organisms by electron microscopy. Ultrastructurally, MLO appear as pleomorphic tubulo-spherical and filamentous organisms. In human ocular disease MLO have been detected in parasitised leucocytes and retinal pigment epithelial cells. We have previously reported the results of injecting MLO infected human vitreous into mouse eyelids. Two thirds of the mice developed chronic disease at the inoculation site, but, more importantly, the mice also developed lethal systemic MLO disease. Carditis with histologic features similar to those of various types of human carditis occurred in 18% of the mice. This report describes the ultrastructural features of the cardiac microvascular MLO disease in those 18 mice that died of carditis after inoculation with human MLO-infected vitreous. MLO were identified in leucocytes and endothelial cells of the murine vascular lesions. The vascular lesions were characterized by destruction of vessel walls as well as proliferation of endothelial cells. Electron dense deposits were seen in basement membranes and pericytial tissues. Similar features have been described in other bacterial vascular infections and in human idiopathic carditis. We suggest that MLO could be a cause of human cardiovascular disease and should be looked for in such cases.

Animals↗
PubMed1993

Long term survival in non-encapsulated primary liposarcoma of the mediastinum.

An elderly woman presented with dyspnoea secondary to extensive mediastinal invasion by a primary well differentiated liposarcoma of the mediastinum. Five years after partial resection and postoperative radiotherapy (45 Gy) she is alive and well. To our knowledge, long term survival has not previously been reported for a non-encapsulated mediastinal liposarcoma treated by incomplete resection and subsequent radiation therapy.

Aged↗
PubMed1991

Mixed (composite) glandular-endocrine cell carcinoma of the stomach. Report of a case and review of literature.

A case of mixed (composite) glandular-endocrine cell carcinoma of the stomach is presented. Whereas the admixture of rare endocrine cells in ordinary adenocarcinoma of the stomach is a rather frequent occurrence, gastric tumors with an approximately equal proportion of glandular and endocrine cells are rare, and only 20 well-documented cases have been reported. Our case is unique in its range of histopathologic patterns, including well-differentiated and poorly differentiated adenoendocrine carcinoma as well as amphicrine differentiation. Immunohistochemical and electron microscopic findings are documented and the clinical characteristics of all reported cases tabulated. From the limited experience of these 21 cases, glandular-endocrine carcinoma of the stomach is found to have the following clinicopathologic features: It affects adults aged 32 to 74 years, (mean, 52.5 years) and has a male:female ratio of 1.3:1. It is located with almost equal frequency in the gastric body and antrum and has a poor prognosis, similar to that of advanced ordinary gastric carcinoma.

Adult↗
PubMed1991

Cytomegalovirus appendicitis in a patient with acquired immune deficiency syndrome.

We report a homosexual patient with the acquired immune deficiency syndrome (AIDS) and histopathologic evidence for cytomegalovirus (CMV) appendicitis in a patient with no prior history of CMV infection. The patient presented with right lower quadrant pain and intermittent fevers. The diagnosis of appendicitis was difficult to make in this patient because of the presumptive diagnosis of tuberculosis ileitis and the frequent presentation of abdominal pain with fever in AIDS patients. Although CMV colitis is frequently seen in AIDS patients, the prevalence of CMV appendicitis is exceedingly rare. The problems related to making a diagnosis of CMV appendicitis and the therapeutic management of CMV infections are reviewed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Cytomegalovirus esophagitis in AIDS: diagnosis by endoscopic biopsy.

We have reviewed 28 esophageal biopsies from 28 patients with the acquired immune deficiency syndrome (AIDS), over a 1-yr period. Indications for esophageal biopsy were dysphagia persisting after antifungal therapy and/or radiologic evidence of esophageal ulcer. We compared the frequency of detecting cytomegalovirus (CMV) infection on hematoxylin and eosin (H&E) stain with immunoperoxidase staining for CMV antigens. Five biopsies were positive for CMV by H&E stain and immunoperoxidase. Infected cells could often be identified in the granulation tissue and, in one severe case, in stromal papillae of the intact mucosa. Squamous cells were never positive. Thirteen biopsies consisted only of squamous epithelium, and all of these were negative by both techniques. Among the remaining 10 cases, no CMV inclusions were identified by H&E. Three of these biopsies displayed staining for viral antigens. In all cases positive by immunoperoxidase, numerous cells positive for viral antigens did not display any of the CMV-specific morphologic diagnostic criteria. Other coexisting diagnoses included candidiasis, Kaposi's sarcoma, and malignant lymphoma. We conclude 1) CMV infection of the esophagus is common in AIDS patients with esophageal ulcer or esophagitis resistant to antifungal therapy; 2) multiple infections or neoplasms may coexist; 3) since CMV apparently does not infect squamous epithelium and only rarely endothelium in stromal papillae, deep biopsies are necessary for diagnosis; and 4) immunoperoxidase staining is required for maximum diagnostic yield.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Intestinal microsporidiosis as a cause of diarrhea in human immunodeficiency virus-infected patients: a report of 20 cases.

Chronic diarrhea accompanied by weight loss is a common and often debilitating problem associated with human immunodeficiency virus (HIV) infection. Enterocytozoon bieneusi, a newly identified species of the phylum of protozoa, Microspora, has been reported associated with chronic diarrhea and wasting in 11 acquired immunodeficiency syndrome (AIDS) patients in the United States, Europe, and Africa. Diagnosis has been based solely on the ultrastructural identification of this small, intracellular parasite in bowel biopsies. Seventy-one small bowel biopsies from 67 homosexual AIDS and AIDS-related complex patients with chronic diarrhea and with no pathogens identified by light microscopy on paraffin sections, were embedded in plastic and studied by light and transmission electron microscopy. Enterocytozoon bieneusi microsporidiosis was diagnosed by electron microscopy in 20 (22 biopsies) of the patients. More jejunal biopsies (16 of 36) were positive than duodenal biopsies (six of 35). Parasites and spores were clearly visible at the light microscopic level in the semi-thin plastic sections from 17 and 21 of the biopsies, respectively. In retrospect, parasites could be identified by light microscopy in standard hematoxylin and eosin-stained paraffin sections. Infection was confined to enterocytes covering the villi, especially the tips, and was associated with villous atrophy and cell degeneration, necrosis, and sloughing. Release of spores into the bowel lumen was evident. Colorectal biopsies from two of the patients with small bowel microsporidiosis were negative for microsporidia. Enterocytozoon bieneusi infection of the small bowel may be an important cause of diarrhea in HIV-infected persons.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Solitary splenic metastasis of an adenocarcinoma of the lung.

Splenic metastasis of solid tumors is a rare event, most often diagnosed at the time of autopsy. Whereas in cases of widely disseminated cancer, splenic involvement may be fairly common, solitary splenic metastasis in the absence of other metastases is exceedingly rare. The authors report a case of a 63-year-old woman in whom the sole detectable distant metastasis of a lung carcinoma was a splenic mass. The splenic lesion was detected before the resection of the primary lung lesion during a complete metastatic work-up. At that time, however, it was considered unlikely that the mass in the spleen represented a metastasis because of the lack of metastatic disease elsewhere.

Adenocarcinoma↗
PubMed1990

Eosinophilic cholangitis: a self-limited cause of extrahepatic biliary obstruction.

The first case of eosinophilic cholecystitis with radiographically documented biliary tract obstruction is presented. Differences between eosinophilic cholecystitis with and without obstruction in terms of gender predilection and the incidence of associated cholelithiasis suggest these may be two distinct disease processes. The dense eosinophilic infiltration of the porta hepatis seen in the present case has led us to believe that extrahepatic obstruction was due to "eosinophilic cholangitis." The self-limited nature of eosinophilic cholangitis makes it an essential consideration in the evaluation of presumed neoplasms of the porta hepatis.

Bile Duct Neoplasms↗
PubMed1990

Antemortem diagnosis of giant cell aortitis.

A 67-year-old man well while receiving steroid therapy for giant cell arteritis, developed symptoms of ischemic heart disease and was found to have critical left main coronary stenosis. An aortic biopsy at the time of bypass grafting revealed giant cell aortitis. We discuss the finding of clinically discordant aortitis; the etiology of the concurrent coronary stenosis and therapy with prednisone-dapsone.

Aged↗