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Judith Sandbank

Publications and source records attributed to Judith Sandbank.

At least 19 recordsLinked to original sources
PubMed2006

Can hamartoma of the breast be distinguished from fibroadenoma using fine-needle aspiration cytology?

In an attempt to determine if it is possible to distinguish hamartoma of the breast from fibroadenoma using fine-needle aspiration cytology, we reviewed the cytological slides of 13 histopathologically confirmed cases of hamartoma of the breast and compared them with the cytological features of 13 histologically confirmed fibroadenomas. In each case, we studied the epithelial and stromal features. Cytologic characteristics were retrospectively evaluated in a semiquantitative manner. In conclusion, the finding of intact lobular units and a relative paucity of stroma may suggest the diagnosis of hamartoma.

Adolescent↗
PubMed2006

Sentinel node mapping for gastric cancer.

BACKGROUND: Sentinel lymph node mapping is the standard of care for patients with malignant melanoma and breast cancer. Recently, SLN mapping was introduced to the field of gastric cancer. OBJECTIVES: To evaluate SLN mapping in patients with gastric cancer. METHODS: In 43 patients with gastric cancer, open intraoperative subserosal dye injection in four opposing peritumoral points was used. Ten minutes following dye injection, stained LNs were located, marked and examined postoperatively from the surgical specimen. RESULTS: SLN mapping was performed in 43 patients with gastric cancer; 782 lymph nodes were harvested and evaluated. SLNs were stained in 34 of the patients (79.1%) with a mean of 2.85 SLNs per patient. The false negative rate was 20.9%, the positive predictive value 100%, the negative predictive value 78.6% and the sensitivity 86.9%. CONCLUSIONS: SLN mapping in patients with gastric cancer is feasible and easy to perform. SLN mapping may mainly affect the extent of lymph node dissection, and to a lesser degree gastric resection. However, more data are needed.

Adult↗
PubMed2005

Tracheal reaction to three different intraluminal stents in an animal model of tracheomalacia.

Three different internal airway stents were studied in an animal model of tracheomalacia: the Palmaz stent (Johnson & Johnson, Warren, New Jersey) and the NIR stent (Medinol Ltd., Tel Aviv, Israel)--both made of stainless steel in the form of tubular mesh--and the Nitinol stent, made of nickel-titanium formed into a spiral shape. All three stents could be adequately stabilized in the malacic tracheal segment. The Nitinol stent (Medinol Ltd., Tel Aviv, Israel) proved to be less reactive to the tracheal mucosa, demonstrated higher biocompatibility with significantly less granulation tissue formation, and showed superior radial resistance. Extraction of the Nitinol stent also proved to be much smoother. This stent may be the stent of choice in the treatment of tracheo- and bronchomalacia.

Airway Obstruction↗
PubMed2005

Differentiated thyroid carcinoma in children and young adults: evaluation of response to treatment.

AIM: The aim of this study was to evaluate response to treatment of children and young adults with differentiated thyroid carcinoma (DTC). PATIENTS AND METHODS: Thirty-one children and young adults (27 female, 4 male, <25 years) with DTC were treated with radioiodine between 1987 and 2003. All patients had previously undergone total (or near-total) thyroidectomy with lymph node dissection (if enlarged lymph nodes were present). Initial radioiodine therapy was given 4 to 6 weeks after surgery. Repeated doses were given 4 to 6 weeks after l-thyroxine withdrawal. Effect of therapy was evaluated by radioiodine whole-body scans and serum thyroglobulin levels. RESULTS: Age range at diagnosis was 12 to 25 years (median, 21 years). Follow-up duration range was 16 to 150 months (mean, 60 months). Histologic classification was papillary in 28 (90%) patients (follicular variant in 7) and follicular in 3 (10%). Multifocal carcinoma was found in 9 (29%) patients and neck lymph node metastases in 19 (61%) patients. Fifteen (48%) patients had pulmonary or mediastinal metastases at the time of diagnosis, and 1 developed bone metastases. Lung metastases demonstrated a pattern of diffuse radioiodine uptake in 7 patients and focal uptake in 8. Total radioiodine dose range was 80 to 1086 mCi given in 1 to 7 treatments. Fourteen (45%) patients were disease-free, including 1 patient with pulmonary metastases who achieved complete remission. Three (10%) patients had persistent metastases in neck lymph nodes. Nine (29%) patients with pulmonary metastases showed good response, 4 (13%) had stable persistent disease, and 1 had progression of the disease and died after 11.5 years of follow up. All surviving patients (97%) are asymptomatic and leading normal lives. CONCLUSIONS: Children and young adults with DTC had a high incidence of multifocal disease, lymph node involvement, and pulmonary metastases. Although complete remission of pulmonary metastases after radioiodine therapy was difficult to achieve, a partial response with reduction of metastatic disease was possible. In general, the patients had a good quality of life with no further disease progression and a low mortality rate.

Adolescent↗
PubMed2005

Epidermoid cyst and teratoma of the testis: sonographic and histologic similarities.

OBJECTIVE: The classic sonographic description of an epidermoid cyst is a mass with a target or onion ring appearance of alternating rings of hyperechogenicity and hypoechogenicity. This study presents a pathologic-sonographic assessment of classic and nonclassic appearances of an epidermoid cyst of the testis and reports the possible similarity between a classic epidermoid cyst and a teratoma on sonography. METHODS: We reviewed the sonographic and histologic features of 8 testicular tumors that either had a classic onion ring pattern or were found at pathologic examination to be epidermoid cysts but did not have the classic sonographic pattern. RESULTS: Three epidermoid cysts had a typical onion ring appearance. Histologic sections of these tumors revealed a squamous epithelial layer lining the cyst and multiple concentric laminated layers of keratin. Two tumors did not have a typical sonographic appearance of epidermoid cysts but were found to be epidermoid cysts at pathologic examination. One was homogeneously hypoechoic, and the other had irregular cystic and solid components, but neither had a target or onion ring appearance. Histologically, both of these tumors consisted of cystic cavities lined by squamous epithelium and contained desquamated keratinized epithelium. Notably, 3 other tumors pathologically diagnosed as teratomas had a sonographic appearance of classic epidermoid cysts. These tumors contained layers of keratin, but the cyst was lined by both squamous cells (ectodermal origin) and cylindrical epithelium (endodermal origin), thereby precluding the diagnosis of epidermoid cysts. CONCLUSIONS: There is considerable overlapping of the sonographic appearances of teratomas and epidermoid cysts of the testis. Although the onion ring appearance of an intratesticular tumor is suggestive of an epidermoid cyst, this appearance may also be found in cases of a teratoma. Whereas the former condition can be treated by local enucleation, the latter requires radical orchiectomy.

Adult↗
PubMed2005

[Transient lower limbs paralysis--a rare presenting symptom of Sjögren's syndrome].

Sjögren's syndrome is commonly presented with eye and mouth dryness caused by an autoimmune destruction of lacrimal and salivary glands. Kidney involvement is not common but may appear in patients with long standing disease. We present a patient with Sjögren's syndrome whose first manifestation of the disease was related to type 1 renal tubular acidosis (RTA) causing severe hypokalemia with lower limb paralysis. The uneven distribution of limb weakness necessitated the exclusion of cord compression.

Acidosis↗
PubMed2005

[Long-term follow-up of radical retropubic prostatectomy for prostate cancer in 400 consecutive patients].

PURPOSE: To evaluate the long-term outcomes following radical retropubic prostatectomy for localized prostate cancer. STUDY DESIGN AND METHODS: The charts of 401 patients who underwent radical retropubic prostatectomy between 1992 and 2004 were reviewed. RESULTS: The average age was 63 years with a median PSA of 8.5 and median Gleason score of 5. Ninety one percent of the cases were diagnosed by a single prostate biopsy set (average 7 cores, range 3-16). Pelvic lymph node dissection was performed in 84 patients (21.7%). Nodal involvement was noted in 5 (6%). Capsular invasion was found in 91 patients (24%), positive surgical margin in 78 (20.1%) and seminal vesicle involvement in 37 (9.5%). The average admission stay was 5.2 days (3-22). Fever (11.4%), urine leakage (8%), wound infection (4%) and pulmonary embolism (1.5%) were the most common early complications. One year after the operation 72% of the patients were fully continent. Of the 172 patients who underwent nerve-sparing procedure, 80 patients (46.5%) regained their sexual potency one year after the operation and did not require pharmacological assistance. Median follow-up time was 84 months. The five and eight years overall survival rates were 85% and 73%, respectively. Ten years survival of 136 patients (35%) with clinical stage T1C was 95%. Biochemical failure was observed in 68 patients (18%). The average time to biochemical failure was 12.5 months (range 0-76. median 12). Forty five patients (12%) died, twenty one (5.4%) due to metastatic disease. Mortality correlated to pre-operative PSA, clinical stage and Gleason score. CONCLUSION: At one year follow up, most of the patients are continent and 46.5% have spontaneous erection following nerve-sparing procedure. The overall survival and the long-term outcomes of radical retropubic prostatectomy are equal to those reported in the current literature.

Follow-Up Studies↗
PubMed2005

[Tissue microarray--an infrastructure for prostate cancer outcome research].

UNLABELLED: In tissue microarray (TMA) approximately 500 clinical formalin fixed and paraffin embedded tissue cores are reorganized into a new recipient block. Each recipient block may be sectioned up to 200 times. MATERIAL AND METHODS: Radical prostatectomy specimens of 405 patients operated for prostate cancer (CaP) between 1992 and 2004 were considered. A large database was created incorporating clinical and pathological data. Median follow-up time was 84 months. A full pathological revision was performed. We allocated and marked sites of interest on patients' slides: CaP, normal prostate, capsular or seminal vesicles invasion and the appropriate controls. The corresponding paraffin blocks served as donor blocks for harvesting tissue cores sequentially incorporated into the TMA recipient block. RESULTS: The specimens of 264 patients out of 405 qualified for inclusion into the TMA (yield 65%). Two TMA copies were prepared containing 4 blocks each. Each copy includes approximately 2000 tissue cores. CONCLUSIONS: We have constructed a large scale TMA associated with a detailed clinical database. This TMA will serve for prostate cancer outcome studies by using immunohistochemical as well as other molecular staining. Our TMA is unique because it contains sites of interest for CaP local invasiveness and metastasis.

Biopsy↗
PubMed2004

The characteristics of malignant breast tumors in hormone replacement therapy users versus nonusers.

BACKGROUND: The purpose of this study was to investigate the characteristics of breast cancer in hormone replacement therapy (HRT) users vs. nonusers. METHODS: We investigated the characteristics of all patients between the ages of 50 and 75 years with breast tumors. Then, an age-adjusted group of 55 nonusers was chosen to match and compare with HRT users. RESULTS: Of the 243 patients available for evaluation, 55 (22.6%) used HRT. Disease stages in HRT users vs. nonusers were as follows: ductal carcinoma in situ (DCIS), 20% and 17.1%; stage I, 45.5% and 41.7%; stage II, 30.9% and 26.2%; stage III, 3.6% and 13.4%; and stage IV, 0% and 1.6% (P =.27). In the age-adjusted cohort, stages in nonusers were as follows: DCIS, 7.3%; stage I, 47.3%; stage II, 25.5%; stage III, 20%; and stage IV, 0% (P =.03). Tumor grades in HRT users vs. nonusers were as follows: grade I, 30.4% and 15.7%; grade II, 52.2% and 52.2%; and grade III, 17.4% and 32.1% (P =.035). Grades in cohort nonusers were as follows: I, 13.2%; II, 52.8%; and III, 34% (P =.05). In the invasive tumors, the positive estrogen receptor (ER) rates were 81.6% and 85.7% (P =.89); positive progesterone receptor (PR) rates were 53.1% and 54% (P =.95); and Her 2-neu positive rates were 18.4% and 17.6% (P =.95), respectively. No significant difference was found in intratumor DCIS, vascular invasion, and Ki-67 (P =.14,.9, and.79, respectively). The rate of lobular and favorable histological types was higher in the HRT user group: 26.6% vs. 15%. CONCLUSIONS: Breast tumors in HRT users vs. nonusers were of a significantly lower stage and grade and accounted for a higher number of favorable histological types, but all other parameters were similar in the two groups.

Aged↗
PubMed2004

Monitoring of intracellular enzyme kinetic characteristics of peripheral mononuclear cells in breast cancer patients.

A new methodology for the detection of functional response of peripheral blood mononuclear cells against breast cancer (BC) antigens was developed. The method is based on cellular enzymatic activity measurements, using a fluorogenic substrate. We used this method to estimate the kinetic activity of lymphocytes derived from cancer patients and healthy donors. The aim of the study was to determine a possible correlation between the basic characteristics (K(m) and V(max)) of biochemical enzymatic reactions in live peripheral white mononuclear cells and common clinical-pathological characteristics in BC patients. Our method shows that the enzymatic activity, upon interaction with mitogen or tumor antigens, of the peripheral blood cells in BC patients is different from the enzymatic reactions in healthy individuals. This holds true in the early stages, and the difference persists throughout all of the stages of the disease. This difference is manifested, primarily, by an increase in the K(m) values after cell incubation with tumor tissue. It was also demonstrated that higher K(m) values of tumor tissue-activated peripheral blood mononuclear cells are associated with a better prognostic status of the BC patients (lymph node-negative tumors, hormone receptor preservation, and the absence of Her-2/neu protein overexpression). Thus, the present methodology may serve as an additional criterion for prognosis and monitoring, both in BC patients, and in individuals associated with high cancer risk.

Adult↗
PubMed2004

Adrenocortical oncocytic tumors: report of 10 cases and review of the literature.

Ten additional adrenocortical oncocytic tumors are presented: 2 benign oncocytomas, 4 borderline oncocytomas of uncertain malignant potential, and 4 oncocytic carcinomas. Histologically all tumors were entirely or predominantly composed of oncocytes. Immunohistochemically all tumors were immunoreactive for mitochondrial antigen mES-13. Electron microscopy was performed in 8 cases and was confirmatory of the oncocytic cell change. The morphologic parameters of the Weiss system, considered to be predictive of the biologic behavior of conventional (nononcocytic) adrenocortical tumors, are reviewed in the context of their possible application to the oncocytic tumor variant. Proposed major criteria (high mitotic rate, atypical mitoses, venous invasion) and minor criteria (large size and huge weight, necrosis, capsular invasion, sinusoidal invasion) in distinguishing malignant tumors are discussed, and definitional criteria (predominantly cells with eosinophilic and granular cytoplasm, high nuclear grade, diffuse architectural pattern) in common with all types of oncocytic tumors are outlined. The authors' proposed working rules for diagnostic categorization of oncocytic adrenocortical tumors are defined, with the presence of 1 major criterion indicating malignancy, 1 to 4 minor criteria indicating uncertain malignant potential (borderline), and the absence of all major and minor criteria indicative of benignancy. Using these criteria, the diagnosis of malignancy was straightforward in 3 of the 4 cases designated as oncocytic carcinoma (presence of at least 2 major criteria and all the minor criteria), while in 1 case the original diagnosis of benign oncocytoma was reversed to malignant following critical review of the original pathologic material after local tumor recurrence. Tumor recurrence occurred in 2 carcinomas at 8 and 20 months, respectively, and was followed in 1 case by the patient's death. The third patient expired at 6 months from unrelated causes, and the fourth patient is free of disease at the relatively short follow-up interval of 6 months. Regarding the 4 patients with borderline tumors, all are alive with no evidence of disease, with follow-up ranging from 10 to 61 months (mean 38.7 months). The 2 benign tumors have a follow-up of 25 and 30 months, respectively. Diagnostic difficulties are delineated and a complete review of the literature on this topic has also been performed.

Adenoma, Oxyphilic↗
PubMed2004

Leydig cell tumors of the testis: gray scale and color Doppler sonographic appearance.

OBJECTIVE: To determine the gray scale and color Doppler sonographic features of Leydig cell tumors of the testis in a series of patients. METHODS: We retrospectively analyzed the sonographic appearance of 10 proven Leydig cell tumors in 9 patients aged 26 to 47 years. Sonographic features that were reviewed included the size and echogenicity of the tumors, presence of cystic areas or calcifications, and distribution pattern of detectable blood flow on color or power Doppler imaging. RESULTS: The tumors ranged from 0.4 to 3.0 cm in diameter, but most were less than 1.0 cm in diameter. In 1 testis, 2 discrete Leydig cell tumors were found. Nine (90%) of the 10 tumors were homogeneously hypoechoic. Only 1 tumor was isoechoic with the testis. None of the tumors contained calcifications. Of 8 tumors with color Doppler imaging, 7 (88%) showed a characteristic pattern of increased peripheral blood flow, which was either circumferential or punctate. Only 1 tumor was found with internal hypervascularity. CONCLUSIONS: Peripheral hypervascularity in a hypoechoic testicular tumor that has little or no internal color Doppler flow should suggest the possibility of a Leydig cell tumor, and consideration should be given to testicle-sparing surgery.

Adult↗
PubMed2003

Breast hamartoma: fine-needle aspiration cytologic finding.

BACKGROUND: Breast hamartoma is an unusual, well-circumscribed, tumor-like mass entering into the differential diagnosis of benign breast disease. To the authors' knowledge, the cytology of these lesions has not been well described. Although fine-needle aspiration is a well established procedure for the detection of breast carcinoma, its utility in classifying benign breast disease is less clear. METHODS: Fine-needle aspirates from eight patients with histologically proven hamartomas were reviewed. None of the cases had a preoperative fine-needle aspiration diagnosis of hamartoma. Cytologic characteristics were retrospectively evaluated in a semiquantitative manner and compared with the histologic findings. RESULTS: The aspirates were moderately cellular and contained sheets of both bland ductal cells and lobular units. Adipose tissue was present in varying amounts. Bipolar stromal nuclei were readily apparent, whereas intact stromal fragments were less prominent. Cytologic atypia was uniformly absent. CONCLUSIONS: The cytology of breast hamartomas shows considerable overlap with other benign breast disease and is unlikely to be interpreted as malignant. The findings of intact lobular units and a relative paucity of stroma in an aspirate from a well circumscribed breast lesion may suggest the diagnosis of hamartoma.

Adolescent↗
PubMed2003

Hyperplastic gastric polyposis, hypergastrinaemia and colorectal neoplasia: a description of four cases.

BACKGROUND AND AIMS: Previous reports have suggested a possible association between hyperplastic polyposis and colorectal neoplasms. Increased gastrin may be the link between these two conditions insofar as gastrin has been reported to be a growth-promoting tumoural agent. This report describes gastric polyposis, hypergastrinaemia and colorectal neoplasms in four elderly patients. METHODS: Four male patients with no family history of cancer, who were found to have multiple gastric hyperplastic polyps, hypergastrinaemia and colorectal cancers or an adenomatous polyp, were evaluated. Assessment included clinical evaluation, biochemical and haematological profiles, fasting gastrin levels, Helicobacter pylori serology, cobalamin, parietal cell antibodies, gastroscopy with biopsies of polyps and gastric mucosa, urease tests, and colonoscopy with biopsies of colorectal neoplasms. Immunohistochemistry of specimens from gastric polyps and colonic carcinomas was performed for chromogranin A, synaptophysin, Leu 7, neuron-specific enolase and gastrin. RESULTS: The mean age at diagnosis of gastric polyps was 71.2 years and at removal of colorectal neoplasm was 70.0 years. In two patients, the gastric lesion was diagnosed before the colonic lesion and conversely in the two remaining patients. Gastrin was very high (1604 pg/ml; normal level, < 115 pg/ml) in one patient with pernicious anaemia, and the mean level for the other three was 324 pg/ml. H. pylori were found in two patients. Immunohistochemistry failed to identify neuroendocrine cells in the hyperplastic gastric polyps and three of the colonic carcinomas. CONCLUSIONS: Occurrence of sporadic colorectal neoplastic lesion in patients with diffuse hyperplastic gastric polyposis and hypergastrinaemia may represent a new syndrome. Gastrin is not secreted by the gastric polyps or colonic carcinomas and may be related to gastric mucosal changes and H. pylori colonization. In patients with hyperplastic gastric polyposis and hypergastrinaemia, colorectal neoplasms should be ruled out.

Aged↗
PubMed2003

Quick parathormone assay in the surgical management of hyperparathyroidism.

BACKGROUND: Among the various new technologies in the field of parathyroid surgery is intraoperative quick parathormone measurements. OBJECTIVES: To evaluate the contribution of QPTH measurements during parathyroidectomy to the achievement of higher success rates. METHODS: QPTH assay using Immulite Turbo Intact PTH was measured in 32 patients undergoing parathyroidectomy: 30 for primary and 2 for secondary hyperparathyroidism. QPTH levels were measured at time 0 minutes (before incision) and at 10, 20, and 30 minutes after excision of the hyperfunctioning gland. Only a drop of 60% or more from the 0' level was considered to be a positive result. RESULTS: The mean QPTH level at time 0' for PHPT patients was 38.12 +/- 25.15 pmol/L (range 9.1-118 pmol/L). At 10 minutes post-excision of the hyperfunctioning gland (or glands), QPTH dropped by a mean of 73.80% to 9.89 +/- 18.78 pmol/L. CONCLUSIONS: Intraoperative QPTH level measurement is helpful in parathyroid surgery. A drop of 60% or more from 0' level indicates a successful procedure, and further exploration should be avoided.

Adenoma↗
PubMed2002

G-CSF induces stem cell mobilization by decreasing bone marrow SDF-1 and up-regulating CXCR4.

Granulocyte colony-stimulating factor (G-CSF) induced hematopoietic stem cell mobilization is widely used for clinical transplantation; however, the mechanism is poorly understood. We report here that G-CSF induced a reduction of the chemokine stromal cell derived factor 1 (SDF-1) and an increase in its receptor CXCR4 in the bone marrow (BM), whereas their protein expression in the blood was less affected. The gradual decrease of BM SDF-1, due mostly to its degradation by neutrophil elastase, correlated with stem cell mobilization. Elastase inhibition reduced both activities. Human and murine stem cell mobilization was inhibited by neutralizing CXCR4 or SDF-1 antibodies, demonstrating SDF-1 CXCR4 signaling in cell egress. We suggest that manipulation of SDF-1 CXCR4 interactions may be a means with which to control the navigation of progenitors between the BM and blood to improve the outcome of clinical stem cell transplantation.

Animals↗
PubMed2002

Advanced non-small cell lung cancer: induction chemotherapy and chemoradiation before operation.

BACKGROUND: Induction chemotherapy before operation is beneficial for patients with advanced locoregional non-small cell lung cancer. However, no optimal regimen has been established. This study assesses feasibility, response, resectability, and survival of chemotherapy followed by chemoradiation before operation in patients with non-small cell lung cancer. METHODS: Fifty-seven stage IIIA and selected IIIB patients with non-small cell lung cancer received 2/3 cycles of cisplatin and oral etoposide, followed in 3/4 weeks by chemoradiation with daily cisplatin before each radiation fraction. Patients achieving a resectable status underwent operation. RESULTS: Response to induction treatment was documented in 73%; 69% achieved a resectable status and 53% underwent operation. Median survival was 16 months. The 1-, 2-, and 3-year survival rates were 65%, 35% and 22%, respectively. There was no difference in survival between stage IIIA and IIIB disease. Myelotoxicity was moderate to severe (grade III/IV in 61% of patients). Three patients died of late complications of pneumonectomy. CONCLUSIONS: Our presurgery chemotherapy and chemoradiation protocol yields high response and resectability rates, with moderate to severe myelotoxicity. Pneumonectomy is associated with a relatively high rate of late complications.

Adult↗