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Biomedical subjects

L Bondeson

Publications and source records attributed to L Bondeson.

At least 19 recordsLinked to original sources
PubMed1998

Factors associated with cirrhosis development in chronic hepatitis C patients from an area of low prevalence.

The aim of this study was to evaluate the importance of different endogenous and exogenous factors associated with cirrhosis development among hepatitis C virus (HCV)-positive individuals from an area of low prevalence. We studied 106 consecutive HCV RNA positive patients who had undergone liver biopsy. Each patient was assessed with special attention to risk factors for hepatitis C infection, average daily alcohol consumption and analysis of plasma levels of alpha1-antitrypsin (alpha1AT) and alpha1-antichymotrypsin (alpha1ACT). Viral RNA, amplified from serum with the polymerase chain reaction (PCR) technique, was used for genotyping. Liver biopsies were assessed according to conventional histopathological criteria, and for necroinflammatory activity (grade) and fibrosis (stage) according to a numerical scoring system. The presence of cirrhosis (stage 4) was used as the dependent variable in multivariate logistic regression analysis. Alcohol abuse (P = 0.007), age at entry (P < 0.001), immigrant status (P = 0.017) and a low alpha1ACT level (P = 0.008) were all independent determinants of progression to cirrhosis whereas HCV genotype 1, estimated duration of HCV infection and positivity for antibodies to hepatitis B core antigen (HBcAb) were not. Cirrhosis occurred at a significantly younger age (P = 0.00(5) among alcohol abusers. Hence, both endogenous and exogenous factors such as subnormal alpha1ACT levels and alcohol appear to contribute to the rate of progression to cirrhosis among HCV-positive patients.

Adult↗
PubMed1998

Rapid increase in volume of the remnant after hemithyroidectomy does not correlate with serum concentration of thyroid stimulating hormone.

OBJECTIVE: To study the effect of postoperative thyroxine on the volume of the thyroid remnant after lobectomy for benign nontoxic goitre. DESIGN: Prospective, randomised study. SETTING: University hospital, Sweden. SUBJECTS: 50 consecutive patients who underwent lobectomy for benign non-toxic goitre. INTERVENTIONS: Patients were randomised postoperatively to take thyroxine 0.1 mg or placebo daily. MAIN OUTCOME MEASURES: The median volume of the remaining thyroid lobe measured by ultrasound. Serum concentrations of thyroxine, triiodothyronine (T3) and thyroid stimulating hormone (TSH) were measured preoperatively and 1, 3, 6, 12 months postoperatively. RESULTS: The median volume of the remaining lobe had increased significantly compared with preoperatively by 1 month postoperatively by 30% in the thyroxine group and 25% in the placebo group (p < 0.01). The difference between the groups was not significant. After the first month the volume did not change significantly. In the thyroxine group, the TSH concentration was unchanged and the thyroxine concentration increased significantly throughout the study. In the placebo group there was a significant increase in TSH concentration and a significant decrease in that of thyroxine at all follow-up examinations. CONCLUSIONS: There is a significant increase in the volume of the remaining thyroid 1 month after lobectomy that persisted throughout the first year. Thyroxine given in a dose that kept the serum TSH concentration at the same level as preoperatively did not seem to influence volume changes; consequently we consider that these are caused by factors other than TSH.

Adult↗
PubMed1998

Cytogenetic comparison of primary tumors and lymph node metastases in breast cancer patients.

Chromosome banding analysis of primary tumors and axillary lymph node metastases from 10 breast cancer patients revealed abnormal karyotypes in all samples with cytogenetic similarities between the primary tumor and the metastasis in all informative pairs. Although karyotypically unrelated clones were also found in the lymph node samples, they were less numerous than in the primary tumors, indicating that there was more genetic heterogeneity among the neoplastic cells in the primary than in the secondary tumors. On the other hand, some of the clones had become more complex in the metastases as a result of clonal evolution, and by and large these metastatic breast cancer cases had more karyotypic anomalies than do unselected primary breast carcinomas. Among the aberrations occurring more frequently, and that consequently may predispose to disease spread, were losses of chromosomes 17 and 22 and homogeneously staining regions, a cytogenetic sign of gene amplification.

Adult↗
PubMed1997

Karyotypic abnormalities in fibroadenomas of the breast.

Short-term cultures of 50 fibroadenomas of the breast were cytogenetically analyzed. Nine tumors were found to display clonal chromosome aberrations. One had multiple, cytogenetically unrelated clones, whereas the others had a single abnormal clone each. Four cases had one balanced translocation as the sole anomaly, and one had a complex intrachromosomal rearrangement of chromosome 3, leading to loss of 3p material. One fibroadenoma had a single numerical aberration, and one had supernumerary ring chromosomes. The remaining 2 cases had both numerical and structural aberrations. The only recurrent alterations were trisomy 20 and rearrangement of chromosome arm 1p. The finding of similar chromosomal aberrations in fibroadenomas and carcinomas suggests that women with karyotypically abnormal fibroadenomas may have an increased risk of developing subsequent breast cancer. If so, different chromosome anomalies might have different pathogenetic and/or prognostic significance.

Adolescent↗
PubMed1997

Cytopathological variables in parathyroid lesions: a study based on 1,600 cases of hyperparathyroidism.

Fine-needle aspirates and tissue sections from 120 surgically treated parathyroid (PT) lesions and histologic archive material from PT lesions in 1,500 additional cases of hyperparathyroidism were reviewed to assess the importance of various features in distinguishing PT disease from other types of lesions by aspiration cytology. We conclude that the morphologic variation shown by PT lesions is so many-sided that this distinction cannot be based on the presence or absence of a single feature only. Instead the cytologic picture as a whole must be taken into account and evaluated with full knowledge of the anatomical conditions pertaining to the lesion examined. If still in doubt, the diagnosis can be substantiated by supplementary immunocytochemical examinations.

Adenoma↗
PubMed1997

Prediction of invasiveness by aspiration cytology applied to nonpalpable breast carcinoma and tested in 300 cases.

In a retrospective study, fine-needle aspirates from 300 nonpalpable breast carcinomas, including 199 invasive tumors and 101 cases of ductal carcinoma in situ, were analyzed to assess the value of 11 features in predicting invasiveness in malignant breast lesions by aspiration cytology. Four findings appeared to be useful in this context: (1) malignant cell clusters with tubular structure, (2) cytoplasmic lumen formation in malignant cells, (3) fibroblast proliferation, and (4) fragments of elastoid stroma. When any combination of two or more of these key features was seen in a smear being diagnostic of malignancy, the positive predictive value regarding invasiveness was 96%. The accuracy of this prediction in terms of sensitivity and specificity was 48% and 96%, respectively. The clinical use of these observations is discussed.

Biopsy, Needle↗
PubMed1997

Non-invasive assessment of inflammatory activity and fibrosis (grade and stage) in chronic hepatitis C infection.

BACKGROUND: Much effort has been expended in finding non-invasive alternatives to percutaneous liver biopsy for assessing the histological extent of liver damage. METHODS: We have evaluated the relationship between various histological features of liver of biopsies and plasma levels of immunoglobulin G (IgG), procollagen III propeptide (PIIIP) and type-IV collagen (CL-IV) in 109 patients with chronic hepatitis C (HCV) infection. RESULTS: The serum IgG level was the best single marker for distinguishing chronic persistent hepatitis (CPH) from chronic active hepatitis (CAH). The mean serum levels of PIIIP and CL-IV increased with the progression of liver disease, though the three variables manifested considerable overlap in individual values as markers of CPH, CAH and cirrhosis. The various biochemical markers correlated weakly but significantly to both histological grade and stage of liver disease, as assessed with the scoring system of Knodell. The correlation appeared to be non-specific and to reflect inflammatory activity as well as fibrogenesis. CONCLUSIONS: Serum levels of PIIIP. CL-IV and IgG are of limited use in predicting the histological grade and stage of liver disease in patients with chronic HCV infection.

Adolescent↗
PubMed1996

Cytologic features in fine-needle aspirates from a sclerosing mucoepidermoid thyroid carcinoma with eosinophilia.

Fine-needle aspirates from a sclerosing mucoepidermoid thyroid carcinoma with eosinophilia showed peculiar but nonspecific features. The overall picture seems more important than individual elements in recognizing this rare entity cytologically, since the predominant type of malignant cells has a deceptively bland appearance. The differential diagnoses include other primary thyroid malignancies, as well as metastatic growth and Hashimoto's thyroiditis.

Aged↗
PubMed1996

Chromosome aberrations in prophylactic mastectomies from women belonging to breast cancer families.

Short-term cultures of samples from eight prophylactic mastectomies from five unrelated women who were genetically predisposed to breast cancer were analyzed cytogenetically. Clonal chromosome abnormalities were detected in five breasts. Three samples from two women had aberrations involving the short arm of chromosome 3, with a breakpoint in 3p14 in common. Three samples from three women had rearrangements of 1q. Two of them, one of which also displayed a 3p14 rearrangement, shared a breakpoint in 1q41. Both 1q41 and, in particular, 3p14 have been reported to be rearranged frequently in malignant breast proliferations. Whether alterations of genes in these bands are essential in mammary tumorigenesis and, if so, whether they are equally important in sporadic and in hereditary cases remains to be explored.

Adult↗
PubMed1995

Histopathological diagnosis of parathyroid diseases.

Hyperparathyroidism is the predominant disease of the parathyroid gland. This disease is nowadays quite common and is often diagnosed at an earlier stage, mainly by means of serum calcium determinations on wide indications. This means that when detected, the glandular abnormalities may be less advanced, which could hamper differentiation of adenoma from chief cell hyperplasia, and of normal glands from slightly hyperplastic ones. Normal glands and pathological glands both show wide variations in size, cellular composition and arrangement, as described in this article. The usefulness of applying fat staining to distinguish between normal and abnormal glands is also reported. It is important to bear in mind that the parathyroid diagnosis is in fact an indirect diagnosis based on the assessment of an associated gland or glands.

Humans↗
PubMed1994

Clue helping to distinguish hyalinizing trabecular adenoma from carcinoma of the thyroid in fine-needle aspirates.

Fine-needle aspirates from four hyalinizing trabecular thyroid adenomas stained with May-Grünwald-Giemsa showed a distinctive component of purplish red stromal deposits corresponding to accumulations of basement membrane material occurring in such tumors. Recognition of these deposits helps to prevent cytologic overdiagnosis of malignancy in this rare benign tumor, which has a number of traits in common with both papillary and medullary carcinoma of the thyroid.

Adenoma↗
PubMed1993

Histopathological variables and DNA cytometry in parathyroid carcinoma.

To undertake an evaluation of histopathological variables in parathyroid carcinoma, 95 cases with this diagnosis were collected from 37 hospitals. Two tumor categories emerged from a review of tissue sections and follow-up information: 56 cases demonstrating extraglandular invasiveness or tumor recurrence were classified as definitive carcinomas, whereas 39 tumors lacking these criteria were classified as equivocal cases. Several morphological variables other than invasiveness differed between the two groups: Fibrosis, necrosis, nuclear atypia (especially macronucleoli), and mitotic figures were significantly more frequent in the carcinoma group. These variables also showed a positive correlation with an aberrant DNA pattern demonstrated by image cytometry. The triad macronucleoli, more than five mitoses per 50 high-power fields, and necrosis were associated with an aggressive behavior in terms of recurrent disease. A minority of the carcinomas had a bland cytologic appearance and differed from benign lesions only by their invasiveness. Certain patterns of fibrosis and necrosis were common but neither pathognomonic nor constant features of malignancy. Mitotic activity constituted a prognostic risk factor but was of limited diagnostic significance. In half of the carcinomas, the frequency of mitoses did not exceed values recorded in benign parathyroid lesions.

Adenoma↗
PubMed1991

Papillary carcinoma of the thyroid with mucoepidermoid features.

The significance and differential diagnoses of signet-ring cells found in the fine-needle aspirate of metastatic mucoepidermoid carcinoma from the thyroid are reported and discussed. The primary tumor occurred in a 35-year-old man, who had a history of neck irradiation during his childhood. Despite postoperative treatment with 60 Gy external radiation and 1,200 mCi 131I, the patient has at present--12 years after the initial operation--progressive disease with local recurrence in the neck as well as lung metastases.

Adult↗
PubMed1991

The influence of different degrees of chronic lymphocytic thyroiditis on thyroid function after surgery for benign, non-toxic goitre.

Of 220 patients, surgically treated for benign, non-toxic goitre with unilateral procedures during a six-year period, 201 could be followed up, on average, 8 years postoperatively. Twenty-four patients were treated with thyroxine immediately postoperatively ("recurrence prophylaxis"); in the other patients thyroxine was only given in cases of hypothyroidism (significant increase of S-TSH). Occurrence of lymphoid infiltration in the removed lobe was subjectively quantified according to a five point scale. Five of the 15 patients with pronounced inflammation developed hypothyroidism whereas 5 of the 137 patients without inflammation had hypothyroidism (p less than 0.05). There was a significant difference in S-TSH postoperatively between patients with no or, only a slight degree of, chronic inflammation, and patients with pronounced inflammation. This study indicates that histologic grading of lymphocytic infiltration in the thyroid gland may be useful for predicting the risk of postoperative hypothyroidism.

Adenoma↗
PubMed1991

Metastatic parathyroid carcinoma: dilemmas in management.

The incidence of parathyroid carcinoma in patients surgically treated for primary hyperparathyroidism at the University of Michigan Hospital was 0.4% during an 18-year period. The courses of the five patients with metastatic disease are described. Histologic reevaluation and assessment of the DNA ploidy pattern were performed in each case. Localization studies preceded all reexplorations. The number of operative procedures in each patient ranged from two to 10. Two patients are living with recurrent disease and one has been disease free for 42 months. Two patients died after 2 and 12 years, respectively. Three patients had aneuploid tumors; one had a diploid tumor. One patient had both aneuploid and diploid cell populations. Dilemmas in diagnosis, localization, and medical and surgical management were encountered in patients with metastatic carcinoma. The chosen treatment should be evaluated individually in each case because of the variability in aggressiveness of this malignancy. Surgical resection proved most effective in some of these patients for both local and distant recurrences. Bisphosphonates and gallium nitrate have been reported to be effective in controlling hypercalcemia. Only the former had some effect in one of our patients.

Adult↗