PCR-SSCP: nonradioisotopic detection with biotinylated primers and streptavidin-alkaline phosphatase conjugate.
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Alkaline Phosphatase↗
Biomedical subjects
T Binder
Publications and source records attributed to T Binder.
[The value of fine needle aspiration cytology in suspected neoplastic salivary gland enlargement].
Imaging offers little support in the management of salivary gland masses suggestive of a neoplastic lesion. There are also contraindications for a surgical biopsy in many cases. Fine-needle aspiration cytology (FNAC) is not yet widely recognized as a diagnostic tool. To date, 206 FNAC were carried out from 1986 through 1993 on 181 consecutive patients and were reviewed in the present study. Histological confirmation was possible in 174 tests, while 32 were confirmed on clinical follow-up. In sum, 192 samples were sufficient for interpretation, 10 were questionable by our standards and 4 were non-diagnostic. One hundred-seventy-one samples were true-negative, 27 true-positive, 4 false-negative and 4 false-positive. Sensitivity was 87.1% and specificity 97.7%. Out of 141 primary diagnostic procedures in which a final histologic diagnosis was available, FNAC was able to determine histogenesis in 113/124 benign lesions and 9/17 malignant masses. These included 65/67 pleomorphic adenomas and 21/22 adenolymphomas. In 8 cases a diagnosis of "adenoma" was made. Difficulties in interpretation were found in lesions that were mucoepidermoid carcinomas and, in part, adenoid cystic carcinomas. No complications occurred. Provided that there was sufficient experience in performing the aspiration technique and in cytologic interpretation, FNAC was found to be a quick, reliable, low-cost, easy-to-perform method with low risk in the management of nearly all benign and most malignant salivary gland lesions.
Adolescent↗
[Fetal fibronectin in cervico-vaginal secretions--an indicator of incipient premature labor using a membrane immunoassay].
The objective of the investigation was to test the presence of foetal fibronectin in the cervicovaginal secretion in symptomatic pregnancies and assess the possible prediction of imminent premature delivery. Prospectively 84 pregnant women were examined who were admitted to hospital with symptoms of imminent premature delivery between the 24th and 34th week of pregnancy (more than 20 contractions per day or a cervical score higher than the critical value for the given week of gestation). The secretion was collected by means of a dacron brush from the posterior labium of the portio vaginalis uteri and examined by a single-use kit FFN (Fetal Fibronectin Membrane Immunoassay, Adeza Co.). From the total of 84 specimens of secretions examined for the presence of foetal fibronectin 32 were positive and 52 negative. Of 32 pregnant women with a positive test 19 women delivered within two weeks, 13 were discharged and the deliveries took place after the 36th week of pregnancy. In the group of 52 women with a negative result of the test 50 women were discharged and the deliveries occurred after the 36th week of gestation; only two women who remained in hospital had premature deliveries within two weeks after collection of the specimen. In no patient discharged from hospital delivery occurred before the end of the 36th week of gestation. The finding of positive foetal fibronectin can be interpreted only as an increased risk of premature delivery (positive predictive value 59.4%). A negative test has a better predictive value. If the test is negative, there is a 96.1% probability that premature delivery will not occur (negative predictive value).
Cervix Uteri↗
Detection of allelic loss within the beta 1-interferon gene in childhood acute lymphoblastic leukemia using differential PCR.
Deletion of the short arm of chromosome 9p involving the beta 1-interferon (IFN) gene has been implicated in the process of malignant transformation in lymphomas and acute lymphoblastic leukemias. Since cytogenetic analysis is frequently unsuccessful in clinical samples, we used a recently described differential PCR technique to detect losses within the beta 1-IFN gene in 86 acute leukemias. Using differential PCR, no beta 1-IFN deletion was detected in 44 acute myeloid leukemia (AML) and eight control samples. However, five of 42 acute lymphoblastic leukemia (ALL) probes (12%) exhibited loss of the beta 1-IFN gene (three common ALL, two T-ALL). Cytogenetic analysis was performed independently in three of these five cases and revealed abnormalities of chromosome 9p in two samples. Two of five T-ALL cases exhibited a loss within the beta 1-IFN gene, compared with 3/29 c-ALLs, suggesting a predominance of IFN gene loss in T-ALLs. These data indicate that PCR can be used for rapid detection of gene dosage phenomena in clinical leukemia samples.
Acute Disease↗
Perioperative infusion of nifedipine and metoprolol provides antiischemic and antiarrhythmic protection in patients undergoing elective aortocoronary by-pass surgery.
A randomised study was performed on 70 patients undergoing elective coronary by-pass procedure to examine whether the combined, perioperative, 24-hour infusion of nifedipine and metoprolol reduces the incidence of perioperative myocardial ischemia and arrhythmias. The control group received nifedipine only. Repeated assessments of serum enzyme levels and 12-lead-ECG together with a 3-channel Holter monitoring over 48h were used to classify perioperative myocardial ischemia and supraventricular and ventricular arrhythmias. The two groups did not differ with respect to their demographic data, extracorporeal circulation, aortic cross-clamping time, or number of distal anastomosis. No perioperative myocardial infarction in either group was detected. However, a significantly lower incidence of transient ischemic event was observed in the NM group as compared transient ischemic events was observed in the NM group as compared to the N group. In addition, there was a tendency towards lower CK-MB-level and peak-values of CK- and CK-MB-enzymes in the NM group. With regard to perioperative dysrhythmias, there was a significantly lower incidence of sinus tachycardia and atrial flutter/fibrillation in the NM group as compared to the N group. In addition, postoperative heart rate was lower in the NM group starting from the 6th hour after opening the aortic cross-clamp. In conclusion, the combined perioperative infusion of nifedipine and metoprolol is superior in preventing perioperative myocardial ischemia and decreasing the incidence of supraventricular arrhythmias as compared to a single-drug regimen with nifedipine.
Arrhythmias, Cardiac↗
Successful radiofrequency ablation of both atrioventricular nodal reentrant and circus movement tachycardia.
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Cardiac Pacing, Artificial↗
Impaired subsidiary pacemaker function in patients with a right bundle branch block created prior to complete catheter ablation of the AV junction.
The impact of a right bundle branch block (RBBB), inadvertently created prior to complete ablation of the atrioventricular (AV) junction, on the intrinsic subsidiary pacemaker function was investigated. In 31 patients suffering from intractable supraventricular tachyarrhythmia, catheter ablation of the AV junction was performed using direct current (n = 13) or radiofrequency (n = 18) energy. In 16/31 patients a RBBB was created prior to complete AV ablation. Subsidiary pacemaker function was evaluated after a mean period of 5 months. Following 5 min of ventricular pacing (70 beats.min-1) escape interval and spontaneous heart rate were measured. In patients with a RBBB there was a trend towards a longer escape interval (2979 +/- 2559 vs 1867 +/- 1254 ms, P = ns) and a significantly lower intrinsic heart rate (38 +/- 14 vs 47 +/- 8 beats.min-1, P < 0.05). Pacemaker dependency was only observed among patients with a RBBB (4/16 vs 0/15, P < 0.05). HV intervals were shorter in those energy discharges resulting in a RBBB as compared to those inducing a complete heart block (52 +/- 8 vs 66 +/- 6 ms, P < 0.05). Creation of a RBBB prior to complete ablation of the AV junction results in impaired intrinsic subsidiary pacemaker function; the most proximal catheter position should be carefully sought to minimize the risk of pacemaker dependency.
Atrial Fibrillation↗
[Fine needle aspiration cytology of metastatic malignant melanoma. Improvement of results with ultrasound control].
A review of 315 fine-needle aspiration cytologies (FNAC) carried out from 1984 through 1992 in 157 patients with suspected metastatic melanoma was carried out: 176 results were confirmed by histological examination and 139 by clinical follow-up. In the first period, from 1984 through 1988, we observed 5 false-negative results out of 123 evaluable FNACs. All were caused by technical failure. In the second period, from 1988 through 1992, all fine-needle biopsies of impalpable masses were done with ultrasound guidance. Thus, we were able to avoid further false-negative results. No errors in interpretation were found. We obtained 219 true-positive and 91 true-negative results with 97.8% sensitivity, 100% specificity, 98.4% accuracy, 100% positive and 94.8% negative predictive value. In 3 cases with metastatic melanoma the cytological diagnosis only was 'malignant tumor', while in another 5 patients the cytodiagnosis of melanoma was not definitive. Immunocytology was helpful in these cases in identifying melanoma. FNAC allowed the correct diagnosis of a second malignancy in 4 cases (one papillary thyroid cancer, one Hodgkin's disease, two non-Hodgkin's lymphomas). No complications occurred. In our opinion, FNAC--for poorly defined lesions with ultrasound guidance--is a very rapid, safe and accurate method that allows reliable diagnosis of metastatic melanoma.
Adolescent↗
Prognostic value of heart rate variability in patients awaiting cardiac transplantation.
Time and frequency domain parameters of heart rate variability (HRV) were determined in patients with severe endstage heart failure awaiting cardiac transplantation (HTX). These parameters were then correlated with mortality to investigate the performance of HRV in discriminating between groups with high and low risk of death. The standard deviation of five consecutive RR intervals (SDANN) was found to be the parameter with the greatest sensitivity (90%) and specificity (91%). Patients with SDANN values of < 55 msec had a twenty-fold increased risk of death (90% confidence limits: 4-118, P < 0.001). The results furthermore suggest that measurements of HRV are superior to other prognostic markers such as left ventricular ejection fraction, pulmonary artery wedge pressure, cardiac index, and serum sodium levels. We conclude that HRV is a powerful, noninvasive tool to assess the risk of death in candidates for HTX. HRV measurements can therefore be used as a supplement to other markers of risk to determine the optimal therapeutic strategy in patients with severe congestive heart failure.
Adult↗
[Free intraperitoneal tumors cells in pancreatic cancer--significance for clinical course and therapy].
Intraoperative peritoneal cytology was performed in 36 patients with pancreatic ductal adenocarcinoma. 12 patients (33%) showed malignant cells in the peritoneal cavity. In the further course these patients developed more non-local metastases and had a significantly shorter survival rate. Peritoneal carcinomatosis became evident in 75% of the patients with free cancer cells in contrast to only 14% of the patients without. Detection of free cancer cells was directly related to the histological tumor stage (TNM-system). Iatrogenic shedding of malignant cells by surgical tumor manipulation or needle biopsy was not observed. The technique of intraoperative peritoneal lavage with consecutive cytology and its possible effects on further treatment is discussed.
Adult↗
Reduction of biological effluents in purge and trap micro reaction vessels and detection of endothelium-derived nitric oxide (edno) by chemiluminescence.
Various analytical approaches have been used to measure endothelium-derived nitric oxide (NO). We have detected NO in perfusates with a sample size as low as 2 ml after acidification with 4 N HC1 to pH less than 2 at 25 degrees C by using a Nitric Oxide Analyser (Sievers, Colorado). This procedure had the advantage that the detectable level of NO was enhanced by the self-decomposition of HNO2 when the PH less than pKa of NHO2 (pKa = 3.15) and also the reaction temperature of 25 degrees C substantially increased the half-line of NO. Palmer, et al., measured NO released by cultured porcine endothelial cells by chemiluminescence after passing cell effluents continuously at a rate of 5 ml/min into 75 ml of 1% sodium iodide in glacial acetic acid. The larger volumes involved in this method for continuous refluxing, made it less desirable for the detection of endothelium-derived nitric oxide. Feelisch et al. utilized the activation of soluble guanylate cyclase, as well as, the quantitative oxidation of oxyhemoglobin to methemoglobin in aqueous solutions by NO as a means of measuring nitric oxide. We describe here a modification of our earlier micromethod which now enables us to detect NO after complete reduction with glacial acetic acid and sodium iodide. A comparison of the two procedures indicate that while freshly prepared NO standard solutions gave identical chemiluminescence response with and without reduction, effluents from bovine intrapulmonary artery under basal conditions gave substantially higher values upon reduction.
Animals↗
The use of microcarrier beads in the production of endothelium-derived relaxing factor by freshly harvested endothelial cells.
This study is concerned with the use of freshly harvested bovine endothelial cells attached to microcarrier beads in the production of the endothelium-derived relaxing factor (EDRF). The results are compared to production of EDRF by endothelial cells grown in tissue cultures. We found that freshly harvested cells attach themselves to microcarrier beads within minutes. This results in large surface/area volume ratio and permits superfusion of cells suspension on a filter (pore size of 25-30 microns), resulting in cell free filtrate. When superfusing an endothelium-deprived pulmonary artery strip, the effluent causes relaxation; the response depends on the number of superfused endothelial cells. The number of viable freshly harvested cells attached to microcarrier beads in 5 ml Krebs-Henseleit solution is small (30%), as compared to almost 100% for cultured cells. Despite this difference, percent relaxation induced for the same number of viable cells is identical for both groups. Scanning electromicrographs confirm anchorage of endothelial cells to microcarrier beads. While cultured cells cover the entire surface and are individually attached, freshly harvested cells are anchored as cell aggregates leaving some of the surface free. Attachment of freshly harvested endothelial cells to microcarrier beads offers an alternative for the study of the role of endothelial cells in the production of vasoactive substances.
Animals↗
Cytokine expression in T-cell lymphomas and Hodgkin's disease. Its possible implication in autocrine or paracrine production as a potential basis for neoplastic growth.
The detection of an increasing number of cytokines and the demonstration of autocrine and paracrine mechanisms perpetuating tumor growth prompted the investigation of the expression of the cytokines IL-2, IL-3, IL-4, IL-5, IL-6, IFN gamma, Tac, and GMCSF in primary lymph-node biopsies of patients with peripheral T-cell lymphoma (n = 11), Hodgkin's disease (n = 13), and large-cell anaplastic lymphoma (n = 6) by means of Northern blot analysis and in situ hybridization (ISH); 15 of 28 cases had IL-6 message, predominantly in cases of Hodgkin's disease (HD) and large-cell anaplastic lymphomas (LCAL). Interferon gamma was found in about 50% of the cases among all entities. Other cytokine expression was rare except two cases of HD with high amounts of IL-4 mRNA. These results indicate that large amounts of growth factor transcripts are present in a variety of malignant lymphomas. The meaning of this expression is still unclear. It may be a loss of physiologic regulation within the cytokine network which may thus influence neoplastic cell growth as some cases have a quantity of cytokine expression which is similar or even above that of stimulated T cells. ISH demonstrates in individual cases that the expression is at least in part due to malignant cells.
Antibodies, Monoclonal↗
An unusual presentation of staphylococcal pericarditis.
An atypical presentation of purulent pericarditis caused by Staphylococcus aureus is described. A bacterial etiology was initially not taken into consideration because the clinical course was torpid and afebrile. Therefore, the appropriate treatment was delayed. The patient recovered after percutaneous pericardial drainage of his purulent pericardial effusion and antimicrobial therapy. The importance of a high index of suspicion of a bacterial cause in patients with pericardial effusion of unexplained etiology is emphasized.
Bacteriuria↗
Establishment and characterization of a new Epstein-Barr virus transformed cell line from a human B cell lymphoma.
We have established a new cell line from a patient with centrocytic B cell lymphoma. Highly purified peripheral blood B cells from patient DUL (WBC counts 158,000/microliters) were infected in vitro with Epstein-Barr virus (EBV), and CD20+ B cells were cloned into 96 well culture plates with the aid of a cell sorter autoclone device. As shown by GTG-banding and Southern blot analysis, out-growing EBV-positive clones had the same chromosomal abnormalities and identical monoclonal IgH gene rearrangement as the original EBV-genome-negative leukemic B cell clone. Surface marker analysis with a panel of monoclonal antibodies revealed identical patterns on EBV-negative and -positive clones, with the exception of PCA1 (reactive with plasma cells) which was negative on freshly explanted leukemic B cells but positive on EBV-converted clones.
Antigens, Surface↗
Diagnosis of a false left ventricular aneurysm with magnetic resonance imaging.
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Female↗
[Comparison of ultrasound-controlled fine needle and coarse needle puncture of defined lesions in the abdomen].
Within a 2-year period 677 diagnostic fine needle (DFP) and coarse needle punctures (DGP) were performed in 536 patients. In 34 patients (14 women; 20 men; 54 +/- 17.6 years) the abdominal tumour mass was punctured with the fine needle (22 g) as well as with the coarse (18 g) needle. Sensitivity of DGP accounted for 72%, sensitivity of DFP was 82.6%. Specificity was 100%, respectively. Complications could not be observed, neither with the coarse needle nor with the fine needle. Due to the high sensitivity of DFP this method should be employed first in the diagnostic work up of abdominal tumours.
Abdominal Neoplasms↗
Pressure-induced contractions in bovine pulmonary artery preparations.
Experiments were conducted in a superfusion bioassay system in which the effluent of a bovine main pulmonary artery (generator) was allowed to superfuse a spirally cut precontracted bovine arterial strip (detector), which had been deprived of endothelium. Effluents of endothelium-intact generator relaxed the precontracted detector by an average of 22 +/- 4.1%. Following removal of endothelium of the generator, the relaxing effect of the effluent was only 1%. A rapid increase of transmural pressure in the generator to about 40 mm Hg for 3 min induced contraction of the detector (8.4 +/- 2%) above the histamine-induced tension. In the absence of endothelium, smaller contractions were obtained from the pressurized generator (4.9 +/- 1.8%). This effect was reversible after pressure release. Effluents of endothelium-deprived generator showed no significant vasoactivity. NG-Mono-methyl-L-arginine (L-NMMA, 3.3 x 10(-5) mol/l), a specific inhibitor of nitric oxide (NO), also depressed endothelium-dependent relaxation and caused a 10.5% increase in contraction of the endothelial effluent. When the endothelium-intact generator was exposed to both pressure and L-NMMA, an additive effect was noted. Based on these observations, it was concluded that transient increase of transmural pressure in bovine main pulmonary arteries depresses the endothelium-dependent relaxation and unmasks a small but significant contractile activity of the endothelial effluent.
Animals↗