Biomedical subjects

Nicole Berger

Publications and source records attributed to Nicole Berger.

9 recordsLinked to original sources

PubMed2006

[Familial patterns in disorders of attention and impulse control].

Attention deficit hyperactivity disorder (ADHD) persists into adulthood in about 30 to 50% of cases. Symptoms of ADHD in parents might affect effective therapeutic approaches in children. The objective of this study was to investigate (1) the retrospective rate of ADHD in biological parents of children with a diagnosis of ADHD, (2) the relation between retrospective ADHD symptomatology and current attention problems and impulsivity in parents, (3) whether the degree of ADHD severity and comorbidty in ADHD children depends on parental ADHD symptoms. The Wender-Utah-Rating Scale for the retrospective assessment of childhood attention deficit hyperactivity disorder was administered to the biological parents of n = 68 ADHD patients and detected high rates of ADHD in fathers (31%) and mothers (25%) of patients with ADHD. Retrospectively assessed symptoms in parents correlated significantly with current symptoms of attention problems (ADD-Brown scales) and impulsivity (17). In children, the highest degree of ADHD symptoms and comorbidty was found in children with both parents suffering from ADHD in childhood compared to those with only one or none affected parent.

Adult↗

PubMed2004

Predictive factors for recurrence from a series of 74 children and adolescents with differentiated thyroid cancer.

The influence of clinical and treatment factors on the risk of recurrence was analyzed from a retrospective series of 74 children and adolescents with thyroid cancer (55 girls, 19 boys; age 2-20 years). Two groups, comparable in terms of age, sex, and previous radiotherapy, were compared according to the presence (group 1) or absence (group 2) of cervical lymph nodes identified by palpation or ultrasonography. Total thyroidectomy (TT) with lymph node dissection (LND) was performed in the 19 group 1 patients, whereas in group 2 patients (n = 55) lobectomy was performed in 29, TT in 26, and LND in 7. Pathology studies showed papillary thyroid carcinoma in 95% of cases. In group 1, tumors were more frequently multifocal (89% vs. 16% in group 2), invasive with extension beyond the thyroid capsule (68% vs. 5% in group 2), and of the diffuse sclerosing variety (63% vs. 4% in group 2) (p < 0.001). With a median follow-up of 61 months, lymph node recurrence was seen in 53% of group 1 patients and in no patients in group 2. Three group 2 patients (10%) were reoperated for a local recurrence after lobectomy. Risk factors for reintervention were young age (< 15 years) (p < 0.01) and cervical lymph nodes (p < 0.001). Survivals without reintervention at 5 and 10 years were, respectively, 58% and 38% for group 1 and 94% and 90% for group 2 (p < 0.001). At the time of analysis, 68% of group 1 patients and 98% of group 2 patients were in remission. In conclusion, the presence of palpable cervical lymph nodes at diagnosis is associated with more invasive forms of malignancy and is a predictive factor of recurrence regardless of the extent of the initial surgery.

Adolescent↗

PubMed2004

[Miscellaneous benign lesions of the bladder and the urinary tract].

Miscellaneous benign lesions of the bladder are composed of morphologic aspects of the urothelial mucosa. They are epithelial lesions (von Brunn nests, glandularis cystitis, nephrogenic adenoma, polypoid cystitis and epidermoid metaplasia), myofibroblastic proliferations and heterotopias (endometriosis, endocervicosis, endosalpingiosis and ectopic prostatic tissue). Etiology, morphologic aspects and differential diagnosis are discussed.

Adenoma↗

PubMed2004

[Spermatocytic seminoma. A clinicopathological and immunohistochemical study of 7 cases].

Spermatocytic seminoma is an uncommon tumor, representing less than 1% of the testicular tumors, occurring most often in old patients. We report 7 cases of this entity. The average age at presentation was 66 years. Tumors had a polymorphic appearance with small, intermediate and large cells, and "spireme" figures. They were pure, with no sarcomatous component. In all cases, the tumor was limited to the testis. In the peritumoral tissue, there was no intratubular germ cell proliferation, and no atrophic testis. Immunostaining was negative for all the classical antibodies tested (cytokeratins, PLAP, lymphoid markers), but all the cases expressed c-kit (100%). This membranous positivity was focal in 4 cases, very strong, and diffuse in the 3 others. Spermatocytic seminoma must be recognized, because its favorable evolution in absence of a sarcomatous component. Adequate treatment consists of orchidectomy alone. Positive staining for c-kit may be helpful for the diagnosis of spermatocytic seminoma.

Adult↗

PubMed2003

Evaluation of the interobserver reproducibility of Gleason grading of prostatic adenocarcinoma using tissue microarrays.

The Gleason system is the internationally recognized standard for grading prostate cancer, due mainly to its strong prognostic capability. However, interobserver reproducibility is variable in the community setting. Herein we present a novel approach to evaluating Gleason grading among pathologists using high-density tissue microarrays (TMAs). A CD-ROM containing 537 different TMA spot images of 0.6-mm diameter was sent to 10 genitourinary pathologists in France. The pathologists were expected to score each TMA spot based on their experience evaluating standard prostate biopsies, transurethral resections, and prostatectomy samples. There was no consensus meeting beforehand to agree on how the group would apply the Gleason grading system for this project. Percentage of agreement and kappa value were used to assess the level of agreement. A short questionnaire was sent to assess pathologists' opinion on this new approach to evaluating Gleason grading. An average of 311 images were analyzed (range, 104 to 537; median, 256.5). Four of the pathologists evaluated all 537 images and assigned Gleason grades to 149 images with an overall kappa for interobserver agreement for the exact score between 0.31 and 0.52 and between 0.45 to 0.69 if 3 Gleason categories (</=6, 7, and >7) were used. When 2 categories were considered (</=7 or >7), kappa ranged from 0.58 to 0.83. All pathologists analyzed 104 images. Similar results were obtained with an agreement between 0.28 and 0.54 for the 3 Gleason categories. After finishing this test, 90% of genitourinary pathologists considered this approach useful for resident training and 90% for pathology teaching. We conclude that a Gleason score can be easily assigned to each TMA spot of a 0.6-mm-diameter prostate cancer sample. These data also indicated that using TMA spot images may be a good approach for teaching the Gleason grading system due to the small area of tissue.

Adenocarcinoma↗

PubMed2003

Pericarotid bone splinter: a microscopic appearance in hanging.

The investigation of the neck structures drawn from 145 cases of asphyxia involving pressure on the neck, for which microscopic examination was required at the Pathology Laboratory of the "Hotel Dieu" Hospital from Lyon, France, during January 1, 1999, to May 1, 2001, has pointed out in 3 cases, besides the classic signs already known, a particular lesion unmentioned yet in the literature, namely, a pericarotid bone splinter, placed in the proximity of the common carotid artery bifurcation. The bone splinters had dimensions between 0.25 and 0.7 mm and a certain antemortem character, surrounded by hemorrhagic areas and by fibrin. The 3 cases deal with adult males who had died through complete hanging, with the knot placed lateral, the hanging mark having the maximum depth in the laterocervical region, correspondent with our finding. Given the location of the bone splinter, we believe that this was produced by the tearing out from the transverse apophysis of the fourth cervical vertebra, as a consequence of the sudden traction during hanging. This sign appeared neither at other types of hanging nor at strangulation by hand or by ligature.

Asphyxia↗

PubMed2003

A case report in favor of a multistep adrenocortical tumorigenesis.

The mechanisms of adrenocortical tumorigenesis are still not fully understood. Data from clonal analysis, comparative genomic hybridization, and allelotyping suggest that it involves a multistep process during which several genetic defects are progressively acquired, leading to the malignant transformation. The events involved in the first steps of this process are not well known, and most of the abnormalities described in adrenocortical tumors to date are associated with the malignant phenotype. We report a case that suggests that adrenocortical tumorigenesis may be a multistep process. A 43-yr-old patient underwent surgery for an incidentally discovered adrenal mass. Pathological analysis showed that this tumor consisted of two parts: a central part with features of malignancy surrounded by another part with a strictly benign appearance. These data were confirmed by molecular analysis and comparative genomic hybridization that were consistent with either a malignant or benign presentation. The apparently malignant part of the tumor exhibited molecular abnormalities [17p13 loss of heterozygosity (LOH), 11p15 uniparental disomy and overexpression of the IGF-II gene] as well as chromosomal gains and losses (comparative genomic hybridization) that have been previously described in malignant tumors. No abnormalities were found in the surrounding benign tissues. Although this observation is not definitive proof that adrenocortical tumorigenesis occurs via a multistep process, it suggests that there is a progressive change from the benign to the malignant state in some adrenocortical tumors.

Adrenal Cortex Neoplasms↗

PubMed2002

Thyroid carcinomas with distant metastases: a review of 111 cases with emphasis on the prognostic significance of an insular component.

Distant metastases (DM) are rare in well-differentiated thyroid carcinomas and correlate with a poor survival. Among the histologic subtypes, insular carcinoma has an intermediate prognosis that lies between well and undifferentiated carcinomas. To assess the characteristics that could predict a worse prognosis, we reviewed the initial thyroid cancer slides from patients with DM. We achieved a comparative statistical analysis with a control group without DM. Among 1230 differentiated carcinomas treated from 1960 to 1999, 9% developed DM. In this group the mean age was 53 years, with a 73% rate of death. The histologic slides were available in 80 cases. The primary thyroid tumors were classified as papillary (51 cases), follicular (25), and pure insular carcinomas (4). Extrathyroidal extension was present in 47% of papillary carcinomas. The mean tumor size was above 5 cm for all the histologic subtypes, and at least a vascular invasion was found in 69%. Fifty-four percent of these tumors had an insular component compared with only 6.5% in the control group. The statistical analysis confirmed by univariate and multivariate logistic regression that the risk of DM was highly elevated in the presence of insular carcinoma. Our study indicates that elevated age, large tumor size, vascular invasion, and extrathyroidal extension are important prognostic factors in well-differentiated carcinomas. We also demonstrate that the presence of an insular component in an otherwise differentiated carcinoma is a strong independent poor prognostic factor.

Adolescent↗

PubMedDate not supplied

Prevalence of differentiated thyroid cancer in 810 cases of surgically treated goiter in Yemen.

BACKGROUND: In 1990, the World Health Organization (WHO) suggested that severe iodine deficiency exists in Yemen. Therefore, we looked at the prevalence of differentiated thyroid goiter in 810 cases consecutively treated by surgery for goiter. METHODS: This was a retrospective study of 810 surgically operated cases of goiter over a 5-year period (1999-2003). All cases were evaluated on H&E stained sections from embedded, 10% buffered formalin fixed tissue blocks. Special stains and immunohistochemical analysis were done in Yemen and abroad. Most patients were older than 20 years of age and were from the high altitude areas (2000 to 2600 meters above sea level), where iodine deficiency disorders (IDD) are well documented. RESULTS: In the 810 cases, 729 (90%) were females and the remaining 81 (10%) were males, with female-to-male ratio of 9:1. Differentiated thyroid cancer (DTC) was found in 170 (21%) cases, including 148 (86.4%) females and 22 (13.6%) males. Nearly 60% of the cases were in the age group of 21-40 years. Papillary carcinoma was the most common type of DTC (164 cases, 96.5%). CONCLUSIONS: In a Yemeni population, which has a high prevalence of iodine deficiency, 21% of patients operated on for nodular goiter without pre-operative fine needle aspiration biopsy had thyroid cancer, mostly of the papillary type. In this study, males and elderly patients with goiter had a higher chance of having malignancy.

Adolescent↗