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Biomedical subjects

P Dalquen

Publications and source records attributed to P Dalquen.

At least 19 recordsLinked to original sources

[Comparative DNA hybridization, cytology and histology of condylomatous and precancerous lesions of the cervix uteri].

Cell scrapings from 552 consecutive women attending the colposcopy outpatient unit were examined by radioactive isotopic DNA hybridisation using the Dot-Blot technique, and by conventional Papanicolaou-smear cytology. In 315 out of these patients, punch biopsies were submitted for histological examination. HPV DNA-sequences were detected in 72% (n = 167) of 232 cytologically diagnosed CIN cases and in 77% (n = 97) out of 126 histological diagnoses of CIN. The proportion of HPV positive cases increased proportionally to the grade of CIN. The frequency of HPV type 6/11 decreased proportionally to the grade of the CIN, and HPV type 16/18 increased at the same time. The most frequent HPV type was 16/18 (26.3%), followed by the HPV types 31/33/35 (16.3%) and 6/11 (4.2%). Furthermore, HPV positivity was detected in 16.5% of patients with negative cytologic smears, in 21.7% of those with negative histology and in 8.9% of women with both negative histology and cytology. Histological and moreover cytological criteria of HPV infection decreased dramatically and proportionally inverse to the grade of the CIN. These changes were not followed entirely by HPV positivity. The discrepancy between HPV positivity (66.1%/67.6%) and morphological evidence of HPV infection (cytology 4.9%, histology 21.6%) was higher in CIN III than in lower grade CIN. Neither cytology nor histology is able to detect all HPV-related cervical lesions. Hybridisation techniques are helpful in the detection of latent HPV infections as well as of CIN lesions have been missed either by cytology or by histology or both. Thus both morphological methods are supplemented by HPV hybridisation.(ABSTRACT TRUNCATED AT 250 WORDS)

Cervix Uteri

Extranodal multilobated B-cell lymphoma: diagnosis by fine needle aspiration.

Malignant lymphoma with multilobated nuclei is a rare variant of follicle centre cell lymphoma. We describe a 34-year-old patient who initially presented with enlarged cervical and inguinal lymph nodes due to a histologically proven centroblastic-centrocytic lymphoma. Two years later, she developed a soft tissue mass in the gluteal area and malignant lymphoma with multilobated nuclei was diagnosed on fine needle aspiration.

Adult

Renal graft rejection or cyclosporin toxicity? Early diagnosis by a combination of Papanicolaou and immunocytochemical staining of urinary cytology specimens.

A method is described for distinguishing between graft rejection and cyclosporin nephrotoxicity in renal allograft recipients by analyzing fresh morning urine samples. The technique combines classic Papanicolaou with immunocytochemical staining and was performed in urine specimens from a series of 42 patients. Early-stage cyclosporin toxicity was usually associated with increased numbers of proximal tubular cells only, whereas in rejection and late-stage toxicity there were increases in both tubular cells and in lymphocytes and monocytes (greater than 2000 cells/ml urine). Differentiation between these two clinical conditions was achieved by immunostaining, which revealed that increased numbers of CD25+ and CD8+ cells, as well as an increase in the HLA-DR/Lu5 ratio, were typical of rejection. CD25 positivity proved to be the best indicator of rejection, with a sensitivity and specificity of more than 90%. A cytodiagnostic algorithm is presented that is based on cell numbers and types, including immunophenotypes. The proposed method has the advantage of being noninvasive and appears to represent a reliable and rapid adjunct for the monitoring of graft function, especially in high-risk patients on cyclosporin immunosuppression.

Adolescent

Transbronchial needle aspiration in routine fiberoptic bronchoscopy.

The objective of this study was to evaluate the yield of transbronchial needle aspiration (TBNA) in a clinical routine setting of a teaching hospital for the diagnosis and staging of bronchogenic carcinoma in comparison to the results of controlled clinical studies. We reviewed our results with Wang retractable needle catheters during a 9-month period. The needle catheters were used in 72 patients. 43 patients had a final diagnosis of bronchogenic carcinoma. Classical bronchial washes, brushings and forceps biopsies led to the diagnosis in 28 patients (65%). The addition of TBNA increased the diagnostic yield by 14% (6 patients) to 79% overall. In 32 patients staging of mediastinal lymph nodes was attempted. Positive TBNA proved inoperability in 9 patients. In 7 patients TBNA was used to investigate peripheral masses. Two patients had a malignant tumor, of which one was diagnosed by TBNA. Overall, TBNA revealed important information with clinical consequences in 16 of 72 patients (22%). There were no complications. We conclude that TBNA significantly increases the diagnostic yield of fiberoptic bronchoscopy and carries only a minimal risk. Our results, obtained in the clinical routine setting of a teaching hospital, are comparable to the reported results of controlled studies.

Biopsy, Needle

Allelic loss on the short arm of chromosome 11 in non-small-cell lung cancer.

Forty-eight samples of primary non-small-cell lung cancer (NSCLC) and normal tissue from the same patients were analyzed for allelic deletions on chromosome 11p. Five polymorphic loci were assessed to determine the incidence of 11p sequence deletions and to define hot-spots of deletions. Information was obtained from all patients in at least one locus. Our data show that the deletions observed were not randomly scattered over the short arm of chromosome 11. Rather, 2 hot-spots of deletions were observed: one in the area of the genes for catalase and beta-FSH corresponding to band 11p13, the other close to the IGF-II locus corresponding to band 11p15. A high incidence of loss of heterozygosity (LOH) was found with the probe for catalase (21/29), a locus flanking the centromeric region of the Wilms' tumor locus. Most of the samples exhibiting LOH of one or more of the alleles analyzed remained heterozygous for at least one other chromosome 11p allele. Furthermore, duplication of the intensity of the remaining allele was rarely observed. Our results indicate that LOH on the short arm of chromosome 11 is a common event in NSCLC and that the chromosomal region containing the Wilms' tumor locus is most commonly involved.

Alleles

[Morphology and function of macrophages in AIDS in broncho-alveolar lavages (BAL)].

HIV infects susceptible T-cell and mononuclear phagocyte targets. Unlike the dramatic changes that occur with T-cells during HIV disease, changes in monocyte and macrophage phenotype and function are qualitatively minimal. The aim of the study was to quantitatively analyze the morphology of macrophages in broncho-alveolar lavages in patients without AIDS, with AIDS, with AIDS complicated by Pneumocystis carinii and in carcinoma patients. In patients with AIDS, the nuclei of macrophages demonstrate a higher integrated optical density (2P less than 0.10), are bigger in size (2P less than 0.05) and have less notches (2P less than 0.02).

Acquired Immunodeficiency Syndrome

[Prerequisites for the application of statical morphometry in diagnostics].

The aims of the present paper were: 1. to test a set of parameters suitable for quantifying morphological features; 2. to create a generally valuable strategy for data storage and for a user friendly data management; 3. to examine the parameter set and the conception for an optimal data management by the quantification of cytological specimens of pleural effusions. The significance of a distinction between "primary parameters" (data directly captured during the measurement) and "secondary data" (data calculated from the primary data) is explained. In the first step of classification of the cytological specimens 81.8% of the patients with reactive alterations of mesothelial cells (n = 11) and 100% of the patients with tumours (mesotheliomas and metastasis of adenocarcinomas) (n = 19) were correctly classified with the aid of a little "expert system". In the second step (discrimination between mesotheliomas (n = 6) and metastasis of adenocarcinomas (n = 13] all patients were correctly classified.

Cytodiagnosis

Morphologic findings in central bronchi correlated to lung function data in obstructive airways disease.

Quantitative analyses of morphologic findings are the condition of clinico-pathological correlation studies. These quantitative analyses are possible by morphometry. The present correlation study shows that morphometry may therefore contribute to understanding the pathogenesis of obstructive airways disease: decreasing bronchial lumen and increasing volume of grandular ducts are correlated to increasing airways resistances (clinical parameters: RAW, FEV1). Increasing volume of bronchial muscles is correlated with resistance of airways at quiet breathing (RAW) and less with increasing residual volume (RV). Increasing volume of bronchial glands and glandular ducts is correlated with increasing resistance at forced expiration which is clinically shown by decreasing FEV1. These findings can be interpreted as follows. Airway resistances are mainly influenced by airway narrowing. At quiet breathing, muscle constriction is an additional cause of increasing airflow resistance due to bronchial narrowing. At forced expiration, however, mucus plugs probably limit the airflow because thickening of bronchial glands points to increased secretory activity. Until now it is not possible to understand why bronchial muscle volume correlates with residual volume.

Adult

Lung biopsy: methods, value, complications, timing, and indications.

Six methods of lung biopsy are discussed on the basis of literature reports: 1. Aspiration biopsy by fine needle, 2. split needle biopsy (Vim-Silverman), 3. cutting needle biopsy (Travenol), 4. trephine biopsy by rotating needle, 5. transbronchial biopsy, 6. open biopsy. Because of the high risk, biopsies with thick needles (methods 2--4) should be abandoned. Transbronchial biopsy is renounced because reliable results are only achieved in sarcoidosis which can be clearly diagnosed in high percentage of cases by other less dangerous procedures. In solitary tumors which could not be diagnosed by any other means aspiration biopsy is indicated because of its low risk and its diagnostic accuracy of more than 80%. In disseminated pulmonary disorders which cannot be diagnosed by any other means open lung biopsy is the most reliable method. The lung specimens can be taken under eye control. They should contain tissue from the transitional zone between diseased and unchanged areas, however. The specimens are usually big enough for additional electron and fluorescence microscopic examinations as well as dust analyses. The pathologist must be aware of all clinical data including X-ray pictures, laboratory findings, case history, and history of occupational and nonoccupational dust exposure. If these conditions are fulfilled and adequate methods are applied, lung biopsy provides diagnosis and prognosis, makes causal therapy possible, and amplifies the medical knowledge of pulmonary diseases.

Biopsy

[Angiographic findings in hemangiopericytoma of the urinary bladder (author's transl)].

Case report of a 31 years old white female presenting with a large filling defect in the urinary bladder occupying one half of its lumen. Selective arteriography demonstrated an intramural highly vascular mass, which histologically proved to be a hemangiopericytoma. Angiography in the lateral projection in addition to the frontal projection was necessary to establish the exact location of the mass and thus permit a reasonable differential diagnosis; and angiography also facilitated surgery, of course.

Adult

[Morphometry in central bronchi and tissue sections. A supplemental method in pneumopathology].

Comparative clinical-pathological studies of pneumopathology call for quantitative analyses of bronchi and pulmonary tissue. Quantification of pathological findings is possible by morphometry. The most important stereologic definitions and the laws of morphometry are briefly described. Methodologic problems are discussed. Baseline data of central bronchi of 5 autopsy cases are calculated (volume densities of the different tissue compartments and the surface density of bronchial basement membrane in three reference volumes). The five patients had normal lung function tests during life.--Further, the grading of emphysema by point-counting on papermounted macrosections is reported. Grading of emphysema on lung slices correlated very well with grading of emphysema by point-counting.

Autopsy

[The problem of airway collapse in lung emphysema. Correlation between intravital lung function measurements and morphometric data].

Lowering of forced expired volume in one second as a percentage of vital capacity (FEV1%VC) and check-valve phenomenon of expiratory flow curve (CVPh) are clinical signs of bronchial collapse. In this study the correlations between these functional parameters and morphologic findings are studied. The study comprises autopsy cases in which lung function had been tested 1.5 years on average before death. In 138 cases emphysema was graded on papermounted macrosections and in 52 cases bronchi were studied by morphometry. 19 of the latter were analysed more thoroughly; 9 had shown CVPh. The results were as follows: 1. Collapse phenomena occur more frequently in cases with destructive emphysema than in cases without. However, it is not exclusive to the former. 2. FEV1 and CVPh correlate with hypertrophy of bronchial glands. 3. Cases with CVPh show hypertrophy, not atrophy, of the walls of central bronchi. It follows that bronchial collapse phenomena are mainly influenced by increased bronchial secretion of viscous mucus and not by emphysematous destruction of lung parenchyma. On forced expiration, mucus plugging probably leads to a decrease of intrabronchial pressure in the downstream bronchi. Thus, the downstream bronchi may collapse because the equal pressure point between intrabronchial and intrathoracic pressure shifts from the central to more peripheral bronchi.

Bronchi

[Cytological and histological methods for assessing lung tumours (author's transl)].

The accuracy of different histological and cytological methods were analysed in 240 patients with primary lung cancer. The diagnosis had been confirmed by either biopsy, surgery or autopsy. Using multiple diagnostic procedures a positive pre-operative diagnosis was obtained in 86.5%. Where the tumour was endoscopically visible and accessible to direct biopsy the correct diagnosis was made in 97.5%. In case of more peripheral tumour localisation positive results were obtained by cytological tests in 76.5%. The most accurate method of diagnosis was direct forceps biopsy of visible tumours (91% positive). Bronchial washing was positive in 64%, post-bronchoscopic sputum analysis in 60%, pre-bronchoscopic sputum in 55% and bronchial brushing in 30%.

Autopsy