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Biomedical subjects

J Lindeman

Publications and source records attributed to J Lindeman.

At least 55 records · Page 3Linked to original sources

Prevalence of genital HPV infections in a regularly screened population in The Netherlands in relation to cervical cytology.

To determine the prevalence of human papilloma virus (HPV) genotypes in relation to cervical cytology, 1,290 cervical samples from a regularly screened population of 30-55-year-old women were investigated. Gynaecological specimens, obtained from the cervix, were cytologically classified and screened for the presence of HPVs 6/11 and 16/18 using dot-spot DNA hybridisation. Of the cervical samples containing unequivocally normal cells, 21 of 1,271 (1.6%) were found positive for HPV, and of the cervical samples containing cells with mild dysplasia, 6 of 14 (43%) were found positive for HPV. All five samples containing cells consistent with severe dysplasia or carcinoma in situ were found positive for HPV. Approximately 50% of the HPV-positive samples contained HPV 16 and/or HPV 18 DNA.

Adult↗

Human serum antibody response in Campylobacter jejuni enteritis as measured by enzyme-linked immunosorbent assay.

An ELISA for detection of IgG, IgA, and IgM antibody using an acid-glycine extract from Campylobacter jejuni as antigen was developed. To determine the value of this assay for the diagnosis of acute Campylobacter jejuni infections, the IgG, IgA, and IgM immune response against Campylobacter jejuni was investigated at various timepoints after infection in patients with culture-proven infection. A total of 112 sera from 46 patients and 78 sera from a control group were tested. All but one of the 46 patients with culture-proven Campylobacter jejuni enteritis developed IgG antibodies against Campylobacter jejuni. IgA and IgM ELISA both showed 97% specificity, and sensitivity of 63% and 30% respectively. IgG antibody titers generally remained at a constant level for more than 50 days, whereas IgA and IgM antibody titers declined more rapidly to normal values within 30 to 50 days after onset of clinical symptoms. Detection of Campylobacter jejuni specific IgA antibodies in a single serum sample provided the most useful assay for serological diagnosis of Campylobacter jejuni enteritis. The presence of Campylobacter jejuni specific IgM antibodies was the sole diagnostic criterion in three cases. Serological diagnosis of Campylobacter jejuni enteritis should therefore include both IgA and IgM antibody determination.

Antibodies, Bacterial↗

Detection of Chlamydia trachomatis in culture and urogenital smears by in situ DNA hybridization using a biotinylated DNA probe.

The detection of Chlamydia trachomatis by in situ DNA hybridization in urogenital smears was investigated using a commercially available biotinylated DNA probe. Intracellular staining of inclusion bodies was used as the criterion for positivity. Of 35 patients with a culture proven chlamydial infection 19 had smears in which C. trachomatis was detected by in situ DNA hybridization, indicating a sensitivity of 54%. Of 57 patients with a negative culture, two had positive smears by in situ DNA hybridization. To compare whether the criterion for positivity had influenced the sensitivity obtained with in situ DNA hybridization, 14 duplicate smears from culture positive patients were analysed with in situ DNA hybridization and immunofluorescence. Both methods detected intracellular inclusion bodies in seven of these smears, suggesting that the presence of infected cells mainly determines the sensitivity. The DNA probe did not cross-react with micro-organisms commonly found in the urogenital tract.

Biotin↗

Zollinger-Ellison syndrome in a cat.

Zollinger-Ellison Syndrome in a 12-year old castrated male European Shorthair cat is described. The clinical symptoms were vomiting, weight loss, listlessness and alternating diarrhoea and obstipation. An endocrine tumour near the pancreatic duct had metastasised to the liver. Many duodenal ulcers were present. Immunohistochemistry revealed cells positive for gastrin and neuron-specific enolase (NSE) scattered throughout the tumour.

Animals↗

Cytology, immunopathology and flow cytometry in the diagnosis of pleural and peritoneal effusions.

There were 106 pleural and peritoneal effusions studied in order to investigate the contribution of immunocytochemistry and flow cytometry to routine cytologic diagnosis. A panel of antibodies (to cytokeratin, vimentin, human milk fat globule, epithelial membrane antigen and carcinoembryonic antigen) was applied to aceton-fixed slides, using immunoperoxydase and immunofluorescence methods. Flow cytometry was performed using a double labeling method, i.e., propidium iodide for DNA staining and keratin for labeling of epithelial cells. In this way DNA aneuploidy was more evident in the histograms when the fluid contained many reactive nonepithelial cells (lymphocytes). A designation of marker profiles was made for the three most frequently occurring diagnoses, i.e., reactive mesothelial proliferation (I), adenocarcinoma (II), and malignant mesothelioma (III). For the differentiation between adenocarcinoma and malignant mesothelioma, carcinoembryonic antigen was the most useful marker as 75% of the adenocarcinomas was carcinoembryonic antigen-positive and the malignant mesotheliomas were consistently negative. Furthermore, evident DNA-aneuploidy strongly supported the diagnosis of adenocarcinoma, as most malignant mesotheliomas were DNA-euploid, even though occasional DNA-aneuploidy was found in malignant mesotheliomas when different effusions from the same patient were examined. For the differentiation between reactive mesothelial cells and malignant mesothelioma human milk fat globule and/or epithelial membrane antigen, in this study proved to be most reliable, their presence strongly indicating malignancy. It is stressed that the method used (fixation, antibodies, washing procedures) can influence these findings. In 16 patients (17%) performing immunopathology and/or flow cytometry meant an important contribution to diagnosis.

Adenocarcinoma↗

Comparison of in situ DNA hybridization and immunological staining with conventional virus isolation for the detection of human cytomegalovirus infection in cell cultures.

The sensitivity of immunochemical staining and in situ DNA hybridization for the detection of human cytomegalovirus (HCMV) was compared with that of virus isolation. Human diploid fibroblasts were infected with serial, 10-fold dilutions of HCMV strain AD169 and examined at various intervals between 1 and 42 days after inoculation, using the three methods being compared. HCMV-DNA was detected by in situ hybridization using a biotin-labeled HCMV probe and CMV early antigen (EA) by immunochemistry using a specific monoclonal antibody. During the first 2 days after inoculation detection of EA appeared to be the most sensitive method. After the fifth day the sensitivity of the immunochemical and in situ hybridization methods was similar and equalled that of conventional virus isolation. However, 2-5 times more HCMV-DNA than HCMV-EA positive cells were detected. Our results indicate that both detection of HCMV-EA by immunological staining and HCMV-DNA by in situ hybridization are suitable methods for rapid and sensitive detection of HCMV infections.

Antigens, Viral↗

Prospective evaluation of prognostic value of morphometry in patients with primary breast cancer.

In a prospective study the predictive value of a multivariate morphometric prognostic index was evaluated in 195 patients with primary breast cancer who had not been treated with any form of chemotherapy or hormonal treatment. The presence or absence of distant tumour recurrence combined with the scores of the prognostic index were compared with the survival curves predicted in a previous study. The value of the presence of lymph node metastases, number of positive nodes, tumour size, mitotic activity index, and oestrogen receptor status in prediction of prognosis were also investigated. In agreement with the results of the previous retrospective study, the prospective use of the index had the strongest predictive prognostic value, followed by the mitotic activity index. Statistical analysis showed that the actual prognoses of 43 of the 195 patients (22%) were more accurately determined by the prognostic index rather than by using the presence of the lymph node metastases as the classifying variable. The prognostic index is consistently reproducible by different technicians; it is a reliable method of predicting distant recurrence of tumour and hence the prognosis of patients with primary breast carcinoma. It provides more prognostic information than the presence of lymph node metastases alone, and the index should be incorporated in routine pathology reports.

Adult↗

Campylobacter-associated appendicitis: prevalence and clinicopathologic features.

To determine the prevalence of Campylobacter fetus subspecies jejuni-associated appendicitis, we studied, retrospectively, by means of immunohistochemistry, the appendectomy specimens of 116 consecutive patients, operated upon because of suspected acute appendicitis. We found immunohistochemical evidence of Campylobacter fetus subspecies jejuni infection in three patients. These findings were confirmed by electron microscopy. Based upon these three cases and five additional appendectomy specimens from patients with Campylobacter enteritis diagnosed by stool cultures, the clinical and histologic picture of Campylobacter-associated appendicitis is described. It is concluded that Campylobacter infection may present with an acute appendicitis-like clinical picture. In contrast with acute phlegmonous appendicitis, the histologic abnormalities in Campylobacter-associated appendicitis are limited to the appendiceal mucosa.

Acute Disease↗

Morphometry of breast cancer. I. Comparison of the primary tumours and the axillary lymph node metastases.

In 234 patients with primary breast cancer, morphometry was performed of three groups of tumour cells: 1. in the primary tumours without lymph node metastases (PRN); 2. in primary tumours with lymph node metastases (PRP) and; 3. in the axillary lymph node metastatic deposits (LMD). The morphometrical analysis included the cellularity index, the mitotic activity index and seven nuclear features. The highest mitotic activity indices (mean: 14.1) were found in the metastatic deposits (LMD), the lowest (mean: 12.5) in the lymph node negative primary tumours (PRN), whereas the lymph node positive primary tumours (PRP) fell in between (mean: 13.2). The cellularity index shows a similar, though reciprocal, trend. The largest standard deviations of the nuclear features were found in primary tumours with lymph node metastases (PRP). In contrast, the metastatic (LMD) nuclei had the smallest standard deviations. The nuclei of the latter are therefore more regular in size and shape. The differences found are not sufficiently large to distinguish PRN and PRP with an acceptable accuracy (the efficiency, sensitivity or specificity did not exceed 67% irrespective of the decision threshold used). Comparison of primary tumours with lymph node metastases and the metastatic deposits, from the same patients, revealed significant correlations of all morphometric features with the exception of the nuclear shape factor and the nuclear axes ratio. Thus, the nuclei of the metastatic cells in general are identical to the nuclei in the primary tumour from which they arise, but in a subset of patients the metastatic tumour cells have much more monomorphous ellipsoid nuclei. Further investigations are needed to see whether this phenomenon indicates a different malignant course.

Adult↗

Immuno- and enzyme-histo/cytochemical analysis of resin sections and cell suspensions: a comprehensive diagnosis of bone marrow on a single aspiration sample.

A protocol is described in which a single bone marrow aspiration specimen is used to prepare resin sections and cell suspensions. Using this protocol, a full battery of morphological, enzyme-histochemical, immuno-histochemical and cyto-pathological techniques can be applied. This allows a definitive bone marrow diagnosis to be established without resorting to bone marrow biopsy in the majority of patients.

Antigens↗

Morphometry and breast cancer. II. Characterisation of breast cancer cells with high malignant potential in patients with spread to lymph nodes: preliminary results.

The prognostic value of clinical, quantitative, and qualitative microscopical features of both the primary tumour and also of the affected lymph nodes were investigated in 71 patients with breast cancer with spread to lymph nodes (T X N + M0). Age, tumour size, and localisation of the tumour comprised the clinical features; morphometry included assessment of the cellularity index, the mitotic activity index, and seven nuclear indices; the qualitative features investigated were histological type and grade, nuclear grade, oestrogen receptor content, number of lymph nodes affected, capsule infiltration of the nodes, presence of metastatic deposits in the efferent lymph vessels, percentage area of lymph node occupied by tumour. Immunohistochemistry was performed to show the presence of carcinoembryonic antigen and peanut agglutinin. All the patients had a minimum follow up of 24 months (maximum 48 months, mean 36 months). Analysis of the results showed that the combined results of morphometry (of the primary tumour and the axillary lymph node metastatic deposits) yielded more information than analysis of axillary lymph node state, or morphometry of the primary tumour, or the lymph node metastases alone. Patients with a nuclear axes ratio of greater than 1.41 in the primary tumour and greater than 1.36 in the lymph node metastatic deposits were less likely to develop distant metastases than patients with values below any of these thresholds (recurrence rates 5.2% and 46%, respectively). Thus the preliminary results of this prospective study indicate that morphometry provides important prognostic information in patients with breast cancer that has spread to lymph nodes.

Adult↗

Quantitative analysis of immunoglobulin-containing cells in gastrointestinal pathology.

The morphometric quantitative analysis of immunoglobulin-containing cells in gastrointestinal biopsies was explored as a possible additional parameter in making the histologic diagnosis of gastrointestinal diseases. Determination of immunoglobulin-containing cells was useful in the differential diagnosis of small intestinal disorders and may be useful in inflammatory diseases of the colon. However, before its general application in diagnosing inflammatory diseases of the colon can be advocated, prospective studies are necessary to determine the specificity and sensitivity of the quantitative analysis of immunoglobulin-containing cells in individual cases of large bowel disease.

Biopsy↗

Large cell lymphoma. II. Differential diagnosis of centroblastic and B-immunoblastic subtypes by morphometry on cytologic preparations.

Measurements were made, using semiautomatic electronic planimetry, of nuclear and nucleolar parameters of cytologic preparations from 18 cases of centroblastic and 9 cases of B-immunoblastic Non-Hodgkin's lymphomas, in order to determine whether these two subgroups of large cell lymphoma could be differentiated objectively by morphologic criteria. Statistically significant differences between centroblastic and B-immunoblastic lymphoma occurred in the mean and standard deviation of nucleolar area, the mean nuclear area, and the number of nucleoli per nucleus. The most useful discriminatory parameter was mean nucleolar area. The mean percentage of immunoblasts, defined as cells with nuclear area greater than 35 micron 2 and mean nucleolar area greater than 3 micron 2, was significantly different between the two groups of patients. The results suggest that although the groups of centroblastic and of immunoblastic lymphomas can be differentiated by measurable morphologic criteria, the individual cases form a spectrum from nodular centroblastic through diffuse centroblastic to immunoblastic, with polymorphic forms in between. A comparison with the results of a similar study on histologic sections from the same patients demonstrated that morphologic measurements on these two types of material are not interchangeable but, in general, the same conclusions were reached by morphometric study on histologic and cytologic specimens.

Adult↗

Rheumatoid factors in rheumatoid arthritis and vasculitis.

To study the occurrence of rheumatoid factors (RF) in relation to the activity of rheumatoid arthritis and the occurrence of vasculitis, RF of IgM, IgA, and IgG classes were measured in sera from 35 patients with definite or classic rheumatoid arthritis (RA) using ELISA. For 26 patients, the RF levels were studied longitudinally and compared with changes in the articular index. Although IgM RF was occasionally found in patients without RA, IgA and/or IgG RF were almost exclusively associated with RA. The titers of IgM, IgA, and IgG RF were significantly higher in sera from patients with clinically diagnosed rheumatoid vasculitis than in sera from patients without vasculitis. No significant correlation between changes in the articular index and changes in titer of any class-specific RF could be found for the group of RA patients as a whole. However, in individual patients, increases or decreases in IgM and IgG RF titer were significantly correlated with an increase or decrease in the articular index.

Adolescent↗

Carcinoembryonic antigen expression and peanut agglutinin binding in primary breast cancer and lymph node metastases; lack of correlation with clinical, histopathological, biochemical and morphometric features.

In a group of 335 patients with primary breast carcinoma the presence of immunoreactive carcinoembryonic antigen (CEA) and the binding of the lectin peanut agglutinin (PNA) in the primary carcinoma and in axillary lymph node metastases were investigated. The correlation between these results and a variety of established clinical, histopathologic, morphometric and biochemical prognosticators was studied. These features included lymph node status, tumour diameter, tumour type, nuclear grade, histologic grade, oestrogen receptor status, mitotic activity index and a number of nuclear measurements. The results indicate that CEA immunoreactivity of and PNA binding to tumour cells in primary breast carcinomas or lymph node metastases do not correlate with established prognostic factors in breast cancer.

Adult↗

Campylobacter colitis: histological immunohistochemical and ultrastructural findings.

The colonic biopsy specimens of 22 patients with colitis and positive stool cultures for Campylobacter jejuni were studied in order to obtain histological and immunohistochemical criteria to differentiate Campylobacter colitis from chronic inflammatory bowel disease. In addition we tried to identify Campylobacter inclusions by means of immunohistochemistry and electron microscopy as evidence for invasion of the colonic mucosa. The results show that the majority of patients with Campylobacter colitis have the histological picture of acute infectious colitis with increased numbers of IgA and IgM containing plasma cells in the colonic mucosa in contrast with patients with active chronic inflammatory bowel disease who show increases of IgA and IgG (ulcerative colitis) or IgA-, IgM and IgG containing plasma cells (M Crohn) in their colonic biopsies. The results of immunohistochemical stainings with Campylobacter antiserum show invasion of Campylobacter in the colonic mucosa. These findings were confirmed ultrastructurally.

Campylobacter Infections↗