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Biomedical subjects

T Ekfors

Publications and source records attributed to T Ekfors.

At least 37 records · Page 2Linked to original sources

Alveolar soft part sarcoma. Immunohistochemical evidence for muscle cell differentiation.

Seven cases of alveolar soft part sarcomas (ASPSs) were studied immunohistochemically for the presence of a number of differentiation markers in an attempt to define the cellular nature of this tumor. Desmin-positive tumor cells were found in three and muscle actin-positive cells in four cases when studied in formaldehyde-fixed and paraffin-embedded material. In one case studied in frozen sections, focal desmin positivity but no other intermediate filaments were found. Immunostaining for synaptophysin, a general neuroendocrine marker, was negative in all cases. All tumors were positive with a monoclonal antibody NK1C3, which consistently stains melanomas, and three cases showed significant numbers of S-100 protein-positive tumor cells, but immunostaining with HMB-45, a melanoma-specific monoclonal antibody, was negative in all cases. However, several rhabdomyosarcomas studied for NK1C3 and S-100 protein for comparison were also at least focally positive. Electron microscopic examination, performed in three cases, showed uniform paucity of all kinds of filaments in the tumor cells of ASPS, and it specifically failed to reveal any signs of smooth or striated muscle cell differentiation. Thus, the results of the present study do not unequivocally define the nature of ASPS but speak against its paraganglionic character and present evidence for muscle cell differentiation.

Actins↗

Roux-en-Y reconstruction for severe postoperative duodenogastric reflux disease.

Thirty-two patients underwent Roux-en-Y diversion because of symptomatic postoperative duodenogastric reflux. Operative mortality was nil, but eight patients had transiently delayed gastric emptying postoperatively. At follow-up 45 months (range 9-89 months) after the Roux-en-Y operation 28 (88%) patients were in good clinical state; four patients were classified as poor. The main cause for a poor clinical outcome was a stomal ulcer in three patients. Atrophic gastritis was seen in the operative specimens of 22 patients. Severity of gastritis evaluated by gastroscopic biopsies at follow-up was less marked in 16 patients as compared to the histology of the samples from the original operation (P less than 0.001). Intestinal metaplasia had regressed in nine cases and proceeded in three cases (NS). Severe postoperative duodenogastric reflux can be treated by the Roux-en-Y reconstruction with good subjective relief of symptoms and beneficial histologic changes in the gastric stump mucosa.

Adult↗

Lymphocyte homing receptors and adhesion molecules in intravascular malignant lymphomatosis.

Intravascular malignant lymphomatosis (IML) is a highly malignant, recently recognized form of lymphoma. It is characterized by multifocal proliferation of malignant lymphocytes within small blood vessels, primarily in the central nervous system and skin, frequently resulting in circulatory disturbances. The cause of the impaired capability of the malignant lymphocytes to extravasate has remained unclear. We analyzed the presence of immunoreactivity for certain homing receptor and adhesion molecules associated with lymphocyte extravasation in 3 patients with this disease. Compared with non-neoplastic leukocytes, large malignant lymphocytes appeared either negative or only weakly positive for the leukocyte surface glycoprotein, CD18 that is the beta chain of the CDIIa/CD18 complex (lymphocyte-function associated antigen-I, LFA-I), which mediates cell-to-cell adhesion of lymphocytes. On the other hand, antibody to one of the proposed ligands for this complex, intercellular adhesion molecule-I, gave positive reactivity both on lymphocytes and on endothelial cells. Further, the malignant lymphoid cells stained positively with Hermes-3 antibody, which recognizes a common structure of CD44 class of molecules involved in lymphocyte homing. It was also shown that HECA-452 antigen, a marker of high endothelial venules (HEV) supporting lymphocyte extravasation, can be synthesized by an IML patient even at the site of inflammation but it is not prerequisite for extravasation of inflammatory lymphocytes. Our results suggest that the deficiency or absence of the adhesion molecule CDIIa/CD18 may contribute to the inability of the malignant lymphoid cells to extravasate in IML, and perhaps also to the high malignancy of this form of lymphoma.

Aged↗

Urethral recurrence after cystoprostatectomy for bladder carcinoma.

Eighty-nine male patients underwent cystoprostatectomy for bladder carcinoma. Prophylactic urethrectomy was performed only on 7 patients whose tumour extended to or beyond the bladder neck. During the follow-up period 9 of 82 patients (11%) developed a urethral recurrence. Eight out of these 9 patients had carcinoma in situ or multiple papillary tumours in the bladder. Of all those patients who had carcinoma in situ, either primary or concomitant with papillary tumour, 18% developed urethral recurrence. The corresponding figure for patients with multiple tumours in the bladder was 15%. Thus the presence of carcinoma in situ or multiple tumours in the bladder seem to be important risk factors for urethral recurrence after cystoprostatectomy.

Adult↗

F-18 fluorodeoxyglucose: its potential in differentiating between stress fracture and neoplasia.

F-18 fluorodeoxyglucose (FDG) accumulates into regions of enhanced glucose uptake and metabolism such as the brain, heart, and malignant tumors. The clinical usefulness of this positron-emitting radiopharmaceutical is illustrated in a case where the clinical picture and CT indicated a malignant bone lesion in the clavicle. Histologically a stress fracture was found secondary to chronic strain on the clavicle. On follow-up the lesion's course was benign. Planar imaging with F-18 FDG was performed twice during follow-up, and on both occasions there was no accumulation of radioactivity over the suspicious area, indicating normal glucose consumption. This case demonstrates the differential diagnostic potential of F-18 FDG and shows that clinically useful information may be obtained without a position emission tomograph.

Adolescent↗

Single-stage salvage cystectomy: results and complications in 20 patients.

Twenty patients with bladder carcinoma underwent total cystectomy and one-stage urinary diversion after a definitive external radiotherapy. The indication for surgery was a persistent or locally recurrent tumor and/or intractable voiding symptoms. There was no operative mortality. Early or late complications occurred in 14 patients (70%) and in 7 of these cases a reoperation was necessary. The overall 5-year survival rate after the operation was 61%. The prognosis of the patients was dependent on the pathological stage of the tumor in cystectomy specimens.

Adult↗

Multilocular renal lesions--a diagnostic challenge.

We present six patients with benign cystic lesions of the kidneys and one with a cystic carcinoma with preoperative diagnostic difficulties. Despite the advent of modern imaging techniques and aspiration cytology there are no unequivocally reliable diagnostic signs of benignity in multilocular renal lesions. Therefore surgery is recommended as the therapy of choice.

Adult↗

Pigmented primitive neuroectodermal tumor with multipotential differentiation in cerebellum (pigmented medullomyoblastoma). A case with light- and electron-microscopic, and immunohistochemical analysis.

A 5-year-old girl had a midline cerebellar primitive neuroectodermal tumor (PNET) with neuronal, astrocytic, rhabdomyoblastic and melanocytic differentiation (a variant of pigmented medullomyoblastoma). The tumor recurred following surgery and radiation therapy and the child died within 6 months. Autopsy revealed spread into cerebellar hemispheres, subarachnoidal space and brain stem. Neuronal differentiation was verified by electron microscopy and antiserum against neurofilament protein. Neoplastic astrocytes were identified by use of antisera to glial fibrillary acidic and S-100 proteins. Rhabdomyoblasts were identified by the use of antisera against skeletal muscle type 2 myosin and myoglobin, as well as by electron microscopy. This tumor is compared with 20 previously reported cases of cerebellar PNETs containing muscle, 2 of which showed a similar pattern of multipotential differentiation. The oncogenesis of these tumors is in dispute although origin of both the neuroectodermal and mesenchymal components from the neural crest (mesectodermal differentiation) is most widely accepted.

Cerebellar Neoplasms↗

Proton relaxation times in arterial wall and atheromatous lesions in man.

The proton relaxation times of autopsy samples of arterial intima-media were measured with an NMR spectrometer and results correlated to the microscopically estimated lipid content of the vascular wall. The normal arterial intima-media contained two T1 relaxation components. The short T1 component (T1s) was 90 +/- 13 ms and its relative weight was 11%. The long T1 component (T1l) was 523 +/- 89 ms and relative weight 88%, respectively. The average T2 was 99 +/- 18 ms. In diseased vessels, a positive correlation was found between the lipid content of the vessel wall and the relaxation rate of the fast component. T1s of the intima-media was significantly shorter (P less than .01) in severe atheromatosis compared with vessels without fat deposition. The results suggest that atheromatous lesions should be best highlighted in spin-echo images by using short TR and TE to suppress the influence of T1l and to avoid (noncontrast contributing) T2 decay of the signal intensity.

Adolescent↗

Elective treatment of regional lymph nodes in malignant melanoma.

Malignant melanoma of Clark level II to V was studied in 96 patients. An elective dissection or elective irradiation of the regional lymph nodes was performed in 45 patients, whereas 51 patients were not treated electively. No statistically significant differences were observed as to the survival or recurrence-free time in the regional lymph nodes in either of these two patient groups. Between the patient groups with or without selective treatment, there was not any significant difference either, even when the prognosis and recurrence of the patients were correlated to the invasion level of the primary melanoma according to Clark or Breslow.

Adult↗