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J van Baarlen

Publications and source records attributed to J van Baarlen.

17 recordsLinked to original sources
PubMed2005

Microscopic colitis: prevalence and distribution throughout the colon in patients with chronic diarrhoea.

BACKGROUND: Microscopic colitis presents with chronic diarrhoea with or without abdominal pain. Microscopic colitis is an important cause of chronic diarrhoea. It can be distributed throughout the colon, as well as limited to the right colon. Microscopic colitis is associated with coeliac disease. We studied the prevalence and distribution of microscopic colitis in patients with diarrhoea and normal colonoscopy and we studied the association with coeliac disease. METHODS: Colonoscopy was performed. Biopsies were taken from every segment of the colon. Lymphocytic colitis was defined as the presence of more than 20 lymphocytes per 100 epithelial cells and collagenous colitis was defined as thickening of the basal membrane of more than 10 microm. Upper endoscopy was performed if upper intestinal symptoms were present. If this was the case, small bowel biopsies were taken. RESULTS: Microscopic colitis was found in 13 out of 103 patients. The distribution was diffuse throughout the colon in ten and restricted to the right colon in three patients. In seven patients, upper endoscopy was performed. Marsh I/II lesions were found in six out of seven patients. CONCLUSION: Microscopic colitis was limited to the right colon in 23% of patients. Biopsies of macroscopically normal colonic mucosa in patients with diarrhoea is mandatory.

Adolescent↗
PubMed2004

Duodenal versus jejunal biopsies in suspected celiac disease.

BACKGROUND AND STUDY AIMS: In the past, small-bowel biopsies for diagnosis of celiac disease were taken from the jejunum with a suction capsule, but nowadays most physicians take endoscopic biopsies from the distal duodenum. To validate that practice we compared the diagnostic yield of endoscopic duodenal biopsies with that of endoscopic jejunal biopsies. In addition, we describe a method of orienting biopsy specimens optimally. PATIENTS AND METHODS: Upper endoscopy was performed with a colonoscope. Four jejunal and four duodenal biopsies were taken and oriented immediately thereafter. The pathologist rated the orientation as poor, adequate, or good, and histopathological results were expressed according to the Marsh classification. Jejunal and duodenal biopsy results were compared. RESULTS: 146 patients were included. Jejunal biopsies were taken in 142 patients, and Marsh I-II lesions were found in 56 and Marsh III lesions in 15 patients. In three patients duodenal biopsies were normal while jejunal biopsies showed Marsh I-II lesions. No discrepancies were found in patients with Marsh III lesions. Orientation was good in all biopsies. CONCLUSION: Duodenal biopsies are sufficient to diagnose full-blown celiac disease (Marsh III), but Marsh I-II lesions may be missed in some cases.

Adult↗
PubMed1996

Treatment of the Budd-Chiari syndrome by insertion of a wall-stent in the hepatic vein after percutaneous transluminal angioplasty: the necessity of follow-up.

Budd-Chiari syndrome is a rare disease and, with or without treatment, the prognosis is usually poor. Percutaneous transluminal angioplasty of the hepatic vein in Budd-Chiari syndrome is a safe method, although recurrent stenosis makes it necessary to repeat it several times in most cases. Insertion of a wall-stent in the hepatic vein seems to be a more long-lasting treatment. Monitoring the blood flow through the wall-stent every 6 months is important because of the apparent obliteration of the wall-stent by intimal fibrosis of the hepatic vein. Further follow-up investigations of this method are necessary.

Angioplasty, Balloon↗
PubMed1995

An important role for chromosome 17, band q25, in the histogenesis of alveolar soft part sarcoma.

A cytogenetic study of two cases of alveolar soft part sarcoma showed near-diploid karyotypes with multiple chromosomal rearrangements. An abnormality of the long arm of chromosome 17, involving band q25, is present in both cases and in 2 of 4 cases in the literature. This recurrent structural abnormality probably plays an important role in the histogenesis of this unusual neoplasm and therefore is important for further molecular investigation.

Adult↗
PubMed1995

Tophus-like cholesterol nodules in 2 patients with rheumatoid disease.

We describe 2 patients, both with rheumatoid disease, with tophus-like nodules that contained cholesterol crystals. A tophus-like cholesterol nodule had developed in a tendon sheath of the left little finger of one. The other presented with multiple tophus-like nodules on his left elbow and both forefeet. We discuss the etiology and pathogenesis of crystalline deposits of cholesterol. Nodules at sites of local pressure in patients with rheumatoid arthritis may be deposits of cholesterol crystals.

Aged↗
PubMed1994

Treatment of localized non-Hodgkin's lymphomas of the head and neck.

BACKGROUND: Localized non-Hodgkin's lymphomas of the head and neck are generally treated with radiotherapy with or without chemotherapy, although the results of treatment of localized non-Hodgkin's lymphomas with of treatment of localized non-Hodgkin's lymphomas with chemotherapy alone appear to be favorable. It is unclear if and when combined modality therapy should be used. METHODS: The authors reviewed the records of 53 patients with Stage I or II non-Hodgkin's lymphoma of the head and neck, who were treated with radiotherapy alone (13 patients), chemotherapy according to the cyclophosphamide, doxorubicin, vincristine, prednisone- (CHOP) regimen (27 patients), or a combination of both treatments (13 patients). RESULTS: A complete remission was achieved in 43 (81%) patients. The 5-year survival for all patients was 78%. A significant difference (P = 0.03) in 5-year relapse-free survival was observed between Stages I and II disease, of 92 and 60%, respectively. Extensive tumor was a significantly poor prognostic factor (P = 0.04) with a 5-year relapse-free survival of 52 versus 84% for patients with nonextensive lymphoma. Eight relapses occurred; in five patients, a local relapse was the first presentation. Although salvage radiotherapy was successful in these five patients, a distant relapse developed in three. No relapses were observed in previously irradiated areas. CONCLUSIONS: Our results suggest that radiotherapy alone is the appropriate treatment for nonextensive Stage I intermediate grade non-Hodgkin's lymphoma of the head and neck. For extensive Stage I or II non-Hodgkin's lymphomas, chemotherapy is preferable. The value of combined modality therapy remains unclear.

Adult↗
PubMed1990

Constrictive pericarditis caused by primary liposarcoma.

A 30 year old man presented with symptoms of constrictive pericarditis. Echocardiography and computed tomography showed a mass extending from the pericardium to surround the heart and penetrating the left ventricular apex. An unresectable pleomorphic liposarcoma arising from the pericardium was found at thoracotomy.

Adult↗
PubMed1989

Acute thymus involution during infancy and childhood: immunohistology of the thymus and peripheral lymphoid tissues after acute illness.

We previously reported that the histologic grade of accidental involution of the thymus in infancy and childhood after a short period of acute illness correlates strongly with the duration of illness (Van Baarlen et al., Hum Pathol 1988;19:1155-60). We now extend this finding by reporting the phenotypic expression of thymus lymphoid and stromal cells. The thymic findings were correlated with changes in peripheral lymphoid organs. In the involuted thymus the immature and proliferating lymphoid populations that are present in the normal (uninvoluted) cortex were completely absent but the cortical epithelial network remained essentially intact even with increasing histologic grades of involution. Cells expressing the phenotype of subcapsular and medullary epithelium were found in this cortical stroma. In the subcapsular area, loss of expression of thymosin components alpha 1 and beta 4 was observed, without loss of epithelial cells. In the medulla a loss of cells expressing HLA-DR was observed, probably reflecting a loss of interdigitating cells. There was no correlation between changes in the thymus and peripheral lymphoid organs.

Acute Disease↗
PubMed1989

The thymus in acquired immune deficiency syndrome. Comparison with other types of immunodeficiency diseases, and presence of components of human immunodeficiency virus type 1.

The authors studied thymus specimens taken at autopsy from eight acquired immune deficiency syndrome (AIDS) patients and compared these with those taken from four patients with congenital immunodeficiency (unrelated to an intrinsic thymus defect) and seven patients after allogeneic bone marrow transplantation. In all cases, histology showed a severely involuted architecture, compatible with a debilitating disease before death. There were no major differences between thymus tissue in AIDS patients and in the other patients studied. This argues against the claim expressed in the literature that the epithelial microenvironment incurs particular HIV-1-induced injury in AIDS. This conclusion is substantiated by immunohistochemistry for HIV-1 gag and env proteins, and by hybridohistochemistry for gag/pol and env mRNA of HIV-1. Positive cells were observed only in low numbers, both inside the epithelial parenchyma and in the (expanded) perivascular areas. An interesting finding was the labeling of subcapsular/medullary epithelium in normal uninvoluted thymus by a number of antibodies to HIV-1 gag p17 and p24 proteins. Compatible with this labeling was the staining of epithelial stalks in hyperinvoluted thymuses irrespective of disease category. The previously reported cross-reactivity between HIV-1 core protein and thymosin alpha 1 cannot fully explain this observation, because the epithelium in the hyperinvoluted state is negative for thymosin alpha 1. This study confirms and extends previous reports on the endogenous presence of epitopes of retroviral antigens in thymic epithelium.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Multilobated non-Hodgkin's lymphoma. A clinicopathologic entity.

Multilobated non-Hodgkin's lymphomas (NHL) have recently been recognized as an NHL variant. During a period of 10 years we observed 30 individuals with NHL in which more than 30% of the malignant cells had a characteristic multilobation. The immunologic phenotype was determined in 14 of these cases. One was of T-cell lineage, and the others exhibited B-lymphoid markers. Sixty-eight percent of the patients presented with extranodal localizations. In the clinical follow-up a complete remission was observed in 78% of patients with a mean duration of 37 months (range, 5 to 120 months). The actuarial survival after 5 years was 45%. From these data we conclude that multilobated NHL are comparable to diffuse, large cleaved-cell NHL of an intermediate grade malignancy according to the Working Formulation or are comparable to the diffuse centrocytic-centroblastic NHL according to the Kiel classification. The neoplastic cells are to be considered as variants of follicle center cells, but the clinicopathologic correlation indicates that multilobated NHL represent a distinct nosologic entity.

Adolescent↗
PubMed1988

Acute thymus involution in infancy and childhood: a reliable marker for duration of acute illness.

To evaluate the relationship between histologic parameters and clinical data, we studied thymus histology in 234 fetuses and young children who died after a short period of acute illness. Thymus weight and volume percentages of interstitium, cortex, and medulla were significantly related to prenatal or postnatal status and age of the patient. Thymus weight was related to the duration of acute illness only in prenatal patients. The histology, categorized in five grades according to appearance of macrophages (with a starry-sky aspect) in the cortex, increase of interlobular interstitium, and lymphodepletion of the cortex, correlated significantly with the duration of acute illness and not with any other clinical parameter. This finding enables the pathologist to estimate the duration of acute disease before death.

Adolescent↗
PubMed1988

Plasmacellular hyperplasia after allogeneic bone marrow transplantation.

B lymphoid cells with monotypic immunoglobulin (Ig) expression, i.e., a single Ig heavy chain isotype combined with a single light chain type, were observed in five of nine patients after allogeneic bone marrow transplantation. Three patients exhibited plasmacellular hyperplasia of lymph nodes and spleen; in one case the monotypic cells were immunoblasts in a lymph node, and one patient suffered from an immunoblastic lymphoma along the gastrointestinal tract. We present the clinical history and the detailed (immuno) histologic analysis of lymphoid tissue from three patients. In DNA analysis of lymph node using DNA probes specific for the JH-gene segment of Ig heavy chains and for light chains, bands indicative of single Ig gene rearrangements were not observed. Thus, the monotypic B lymphoid elements represent polyclonal B cell expansion.

Adult↗
PubMed1987

Expression of restricted immunoglobulin isotypes in plasmacellular hyperplasia after allogeneic bone marrow transplantation.

Plasmacellular hyperplasia in lymphoid tissue was found in 4 out of 9 patients 1-6 months after allogeneic bone marrow transplantation as treatment for leukaemia. In the plasma cell populations, 13-85% expressed a single immunoglobulin light and heavy chain isotype (monotypic Ig expression). DNA analysis, using a DNA probe specific for heavy chain JH gene segments and for light chains, did not reveal the presence of clonally restricted B lymphocytes. The patients' sera lacked homogeneous immunoglobulins. We conclude that plasmacellular hyperplasia found after allogeneic bone marrow transplantation represents a polyclonal B-cell expansion- with a restriction in Ig isotype.

B-Lymphocytes↗
PubMed1987

Immunophenotyping of non-Hodgkin's lymphoma. Lack of correlation between immunophenotype and cell morphology.

The establishment of Clusters of Differentiation for T- and B-lymphoid cells during International Workshops on Human Leukocyte Differentiation Antigens prompted the authors to evaluate the immunophenotypes in 160 cases of non-Hodgkin's lymphoma (NHL). In this group, 130 were of B-lymphocyte lineage (117 by monotypic immunoglobulin expression), and 30 of T-cell lineage. In the B-NHL series the expression of immunoglobulin isotypes, B-cell maturation/differentiation antigens of CD9, CD10, CD19-24, CD37, and CD38 (OKT10), HLA-DR and peanut agglutinin binding showed no significant relationship with histopathologic diagnosis as defined by the Kiel classification. Of the T-cell markers, CD5, CD6, and CD7 showed lineage promiscuity by their presence on some B-NHL. Conversely, the authors grouped the cases according to phenotypes (either CD antigens or immunoglobulin isotypes) which occur in distinct stages of (physiologic) B-cell maturation/differentiation. Eighty-six of the 130 cases could be fitted according to CD phenotype expression. This approach did not yield a significant relationship between phenotype and individual histopathologic categories either. The staging by CD phenotype and by immunoglobulin isotype yielded different results in this respect. Most B-NHL had an intermediate stage of B-cell maturation/differentiation. In the T-NHL series most cases showed a phenotype (CD1-CD8, CD38, TdT, and peanut agglutinin binding capacity) compatible with mature T-lymphocyte characteristics. The exceptions were lymphoblastic convoluted lymphomas, which exhibited an immature immunophenotype. It is concluded that NHL in distinct histopathologic categories are heterogeneous in immunologic phenotypes, and that the immunophenotype of lymphoma cells has no evident association with that of their presumed counterparts in physiologic cell maturation/differentiation.

Antigens, Differentiation, B-Lymphocyte↗
PubMed1980

Evidence for the functional heterogeneity of the two sites of transferrin in vitro.

A recently developed crossed immunoelectrophoretic method for displaying and quantitating the four possible molecular species of transferrin has been utilized to assess the relative effectiveness of each site of rabbit and human diferric transferrin in providing iron to rabbit reticulocytes. The site which appears to reside in the N-terminal half of the rabbit protein was found to be at least 5 times more effective than its counterpart. However, both sites may serve as iron donors in monoferric as well as diferric rabbit transferrins. It is also possible that iron may be removed from rabbit transferrin in pairwise as well as sequential fashion. In human diferric transferrin, the site in the C-terminal domain functions as the better iron donor for rabbit reticulocytes.

Animals↗