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Biomedical subjects

V Roger

Publications and source records attributed to V Roger.

At least 73 records · Page 4Linked to original sources
PubMed1986

Behavior of mild cervical dysplasia during long-term follow-up.

Five hundred and fifty-five women with cervical cytologically diagnosed mild cervical dysplasia were followed by cytology without major treatment. Biopsies were performed in 14% resulting in no significant influence on the outcome of the studied material. Regression to normal occurred in 62% (follow-up 39 months), progression to severe dysplasia/carcinoma in situ/invasive carcinoma in 16% (invasive carcinoma: two patients), and persistence of dysplasia in 22%. Life table analysis calculated the risk of progression of mild dysplasia to be 250 to 800/100,000 women/year. A comparison with the incidence of carcinoma in situ, four of 100,000 women/year, illustrates the yearly risk for a woman with mild dysplasia as 560 times greater than for a woman without cervical dysplasia to develop severe dysplasia/carcinoma in situ/invasive carcinoma.

Actuarial Analysis↗
PubMed1986

Endometrial carcinoma diagnosed by the Gynoscann method.

A simple method for screening of the endometrium is a desirable complement to the gynecological examination. Between February and June, 1984, 94 patients underwent cytological sampling by the Gynoscann method immediately before dilatation and curettage at the Department of Gynecological Oncology, Radiumhemmet, and at the Department of Obstetrics and Gynecology, Karolinska Hospital, Stockholm. Ninety-six per cent of the cytological samples were adequate for cytological diagnosis and the same proportion of the curettage specimens for histology. The correlation between cytology and histology was correct in 84% of the cases. Among the 26 cases of endometrial carcinoma, 21 (80%) were correctly diagnosed by cytology. There were no false-positive diagnoses for carcinoma. Atypical hyperplastic endometrium was found in 2 cases by curettage and was correctly correlated with cytology in one case. The sensitivity for endometrial carcinoma was 81% and the specificity 100%. Our conclusion is that the Gynoscann method is safe, easy to use and has proved reliable for the diagnosis of endometrial carcinoma. Further evaluation with larger series giving the cytopathologists increased experience is needed before optimal sensitivity can be achieved.

Adenocarcinoma↗
PubMed1985

[Recurrent systemic arterial embolism in patients with valve prostheses].

The first 400 cases of 1,436 patients undergoing cardiac valve replacement were analysed to determine the clinical features of recurrent systemic embolism. The average follow-up period was 87 months. Three groups of patients were compared: A: 289 cases without embolic complications (72.5 p. 100) B: 78 cases with a single systemic thrombo-embolic event. (TEE) (19,5 p. 100) C: 33 cases with recurrent TEE (8.25 p. 100). The incidence of recurrence is high (30 p. 100 of cases, 8,1 p. 100 per patient year, compared to 3.8 p. 100 for the first TEE). The site of recurrent embolism was the same in 45 p. 100 of cases. The consequences were serious, 30 to 40 p. 100 of events being associated with death or invalidating sequellae. Four factors predisposed to TEE: mitral valve prosthesis, atrial fibrillation, left atrial dilatation and poor anticoagulant control. Fifty-four months after the first TEE, 60 p. 100 with inadequate anticoagulation had a recurrence compared to 20 p. 100 of patients with satisfactory control. Twenty-six patients (Groups B and C) had operative or autopsy examination of the prosthesis: thrombosis was found in 12 out of 18 cases in Group B, and in 7 out of 8 cases in Group C. Reoperation may be necessary to change the valve (27 out of 1,436 patients). Strict adherence to anticoagulant therapy remains the best prophylaxis against TEE and their recurrence.

Adolescent↗
PubMed1984

Recurrent systemic embolic events with valve prosthesis.

Among 1436 patients who underwent valve replacement, the 400 first cases were studied to assess the features of recurrent systemic embolic event. The mean follow-up was 87 months. Three groups of patients were compared: groups A-289 patients without any thromboembolic event (72.25%); group B-78 patients with only one embolic event (19.5%); group C-33 patients with several embolic events (8.25%). The frequency of recurrence was high: one patient out of three (linearized mean 8.9% in group C considering only one recurrence, vs 3.8% in group B). The recurrence have the same location in 45% of patients. The consequences of these embolisms are serious; each event has a 30 to 40% risk of death or major disability. Four variables seem statistically to promote the occurrence of embolic events: mitral prostheses, pre-operative fibrillation, left atrial enlargement, poor anticoagulant therapy. 54 months after the first embolic event, 60% of the patients with poor anticoagulant therapy experience a recurrent thromboembolism vs 20% with adequate therapy. Twenty-six patients of groups B and C had a pathological study of prostheses. Thrombosis of the prostheses was found in 12 out of 18 patients in group B and in 7 out of 8 patients; in group C. Strict observance of anticoagulant therapy is the better way to prevent thromboembolism and especially recurrences. A reoperation is sometimes necessary. Valve re-replacement was performed in 27 cases out of 1436 patients.

Actuarial Analysis↗
PubMed1984

Thromboembolic and haemorrhagic risk in mechanical and biological aortic prostheses.

Thromboembolism, valve thrombosis and haemorrhagic events have been compared in 356 Starr-Edwards (SE) 1260, 113 Björk-Shiley (BS), and 178 aortic bioprostheses operated upon between 1968 and 1982, and reviewed by the same group with less than 2% of patients lost of follow-up. Expressed in actuarial rate at 7 years the percentage of patients free of thromboembolism event is 87% for SE, 86% for BS, 94% for bioprostheses; the linearized rate is 2.9%/patient/year for SE, 2.2 for BS, 1.9 for bioprostheses (NS). Valve thrombosis was not observed in bioprostheses; 97.9% of patients with mechanical valves were free of valve thrombosis at 6.5 years. Haemorrhagic risk was lower with bioprostheses than with mechanical valves 0.2% patient/year vs 2.33 (P less than 0.005). The most important factor influencing thromboembolic and haemorrhagic risks is the quality of anticoagulant therapy. Other contributing factors are the date of the operation and associated mitral disease.

Actuarial Analysis↗
PubMed1982

Diagnosis of endometrial carcinoma using the Mi-MarkR helix sampling technique.

The traditional Papanicolaou smear achieves only 20--60% diagnostic accuracy when applied to endometrial carcinoma. Consequently, various specially designed methods for the early detection of endometrial carcinoma have been tried out. The present study was a comparison of conventional curettage with a new technique, the Milan-Markley helix method (Mi-MarkR) for the obtaining of material from the uterine cavity for both cytological and histological evaluation. The material included 474 samples from 401 patients. The method is designed as an office procedure and is not intended to replace diagnostic curettage. It should be used as an additional diagnostic procedure in high-risk groups and in the follow-up of such patients. With cytological examination of the material the specificity was found to be 97.6% and the sensitivity 85.7%.

Adenocarcinoma↗
PubMed1978

Cytomorphological grading and Feulgen DNA-analysis of metaplastic and neoplastic bronchial cells.

Quantitative determinations of nuclear DNA were made on squamous metaplastic and neoplastic cells from sputum cytology specimens. The cellular material was processed by destaining diagnostic smears, restaining by the Feulgen method and relocating the cells for measurement. Adventitious leucocytes were used as internal controls. There was good correlation between increasing degree of aneuploidy as judged from DNA values, and increasing degree of morphologic nuclear atypia. The data indicate a progressive aberration from normality of nuclear DNA content in squamous metaplastic and neoplastic cells exhibiting a progressive degree of atypia. This implies that squamous bronchial carcinoma is preceded by sequential changes of the cellular composition which may be recorded by both quantitative DNA analysis and cytology.

Adolescent↗
PubMed1977

Clinically occult lung cancer with positive sputum cytology and primarily negative radiological findings.

Five patients with early clinically occult squamous cell carcinoma of the bronchus were reviewed with respect to previous sputum cytological examinations and clinical investigations. In one patient, selective bronchial washings demonstrated the site of the tumour and the patient was successfully operated. In the remaining four patients the interval between cytological diagnosis and radiological, bronchoscopical and/or histological demonstration of the tumour varied between 2 months and 9 years. It seems possible that the duration of bronchogenic carcinoma in situ may be of similar magnitude as that of carcinoma in situ of the cervix (10-15 years). The considerably higher frequency of early stromal invasion after semi-serial sectioning of carcinoma in situ of the bronchus compared with carcinoma in situ of the cervix is emphasized. The results stress that a diagnostic delay of several years is not acceptable, as the possibility of successful treatment will be greatly diminished in such cases.

Aged↗
PubMed1975

[Seasonal variations in the transfer of food labeled with 198Au from the worker to the queen domestic bee].

Food exchanges from a worker giver to a queen receiver were quantified throughout the year. 4 days old workers distribute great amounts of food to queens, about 74% in average, but variations are low. On the other hand workers of unknown age distribute amounts that are less high and varying terms of the season. A parallelism exists between percentage variations of food shared by workers of unknown age and the seasonal cycle of the 9-oxodec-2-enoic acid content of queens.

Age Factors↗