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V Russack

Publications and source records attributed to V Russack.

17 recordsLinked to original sources
PubMed1997

A comparison of thoracoscopic talc insufflation, slurry, and mechanical abrasion pleurodesis.

The purpose of this study was to compare the anatomic and histopathologic results of four different methods of pleurodesis in 10 dogs. Each animal was randomly assigned to receive two of the following methods of pleurodesis: thoracoscopic talc insufflation (poudrage), talc slurry administration, focal gauze abrasion by limited thoracotomy, and mechanical abrasion by thoracoscopy using a commercially available pleural abrader. Animals were killed 30 days after pleurodesis. At autopsy, the efficacy of pleurodesis was graded by evaluating the gross appearance of each pleural cavity and lung (pleurodesis score), and by determining the extent of adhesion formation (obliteration grade). Pleural and lung biopsy specimens were obtained from the areas most representative of adhesion formation for histopathologic evaluation. Pleurodesis scores (on a scale of 0 to 4) were 3.0 +/- 0.7 for talc poudrage (p < 0.05 when compared with talc slurry), 2.2 +/- 1.7 for thoracotomy, and 1.6 +/- 1.1 for talc slurry. Adhesions produced by gauze abrasion during thoracotomy were mostly peri-incisional. Thoracoscopic pleural abrasion using the pleural abrader was uniformly unsatisfactory. Granulation tissue formation was greatest in both talc models. The degree of parietal pleural thickening was greatest in the talc slurry model, but fibrosis and inflammation occurred mostly in gravity-dependent areas within the pleural cavity. Although differences were not statistically significant, thoracoscopic talc insufflation consistently produced the most widespread, firm fibrotic adhesions as evidenced by higher obliteration grades.

Animals↗
PubMed1997

New ophthalmic manifestations of presumed rifabutin-related uveitis.

Rifabutin-related uveitis has been reported in AIDS patients who take a daily dose of 300 to 1800 mg of this drug. Presumed rifabutin-related uveitis is characterized by unilateral or bilateral anterior chamber inflammation with hypopyon accompanied by hyperemia, pain, photophobia, and vitritis. However, retinal manifestations or vitreous cytology of this entity have never been reported. This report describes a patient who had retinal vascular changes associated with uveitis while being treated with oral rifabutin. Fundus photographs and fluorescein angiograms documented resolved retinal vasculitis. Vitreous cytology of this case showed acute inflammatory cells. To the authors' knowledge, this is the first report of retinal vasculopathy in a patient with rifabutin-related uveitis and the first analysis of the vitreous cytologic aspects of this disease.

AIDS-Related Opportunistic Infections↗
PubMed1996

Microsatellite instability correlates with reduced survival and poor disease prognosis in breast cancer.

Size changes in microsatellite sequences have been detected in many types of cancer, but the influence of this form of genetic instability on disease progression remains unclear. We determined the incidence of microsatellite instability in breast cancer by comparing PCR-amplified sequences from paraffin-embedded samples of normal and tumor tissue from affected individuals. This analysis showed that at least 30% of breast cancers exhibit microsatellite instability (MI). Of importance, MI correlated with indicators commonly associated with poor disease prognosis, including lymph node status, tumor size, and advanced tumor stage. Individuals with MI+ tumors also showed significantly reduced disease-free and overall survival. These data contrast with studies showing that MI correlates with improved prognosis in colon and gastric cancers. We propose that defects resulting in MI promote disease progression and result in a poor prognosis in breast cancer.

Breast Neoplasms↗
PubMed1996

Rhegmatogenous retinal detachments in HIV-positive patients with ocular syphilis.

The purpose of this study is to report retinal manifestations of lues in human immunodeficiency virus (HIV)-positive patients and to suggest a method for treatment of rhegmatogenous retinal detachments in these patients. Two HIV-positive patients with bilateral retinitis were examined and treated at the authors' institution for a period of 14 months. Ocular syphilis was diagnosed clinically, confirmed by cerebrospinal fluid serologic testing, and treated with intravenous penicillin. Both patients experienced bilateral rhegmatogenous retinal detachments complicated by proliferative vitreoretinopathy after resolution of the active retinitis. All four eyes underwent surgical repair with trans pars plana vitrectomy, epiretinal membrane delamination, gas-fluid exchange, endolaser, scleral buckle, and silicone oil instillation. The recognition of ocular syphilis as a cause of retinal detachment in HIV-positive patients is important. Prompt intervention with the appropriate medical and surgical treatments may result in the preservation of vision in these patients.

Adult↗
PubMed1995

Comparison of wedge to forceps videothoracoscopic lung biopsy. Gross and histologic findings.

BACKGROUND: The decreased morbidity and rapid recovery after thoracoscopic lung biopsy compared with open lung biopsy by thoracotomy is increasingly recognized, as is the ability to obtain satisfactory diagnostic material thoracoscopically. To our knowledge, however, there has been no systematic comparison of specimen quality using different thoracoscopic biopsy techniques. The purpose of this study was to compare histologic features of lung parenchyma obtained by videothoracoscopic forceps and wedge biopsy techniques. METHODS: Five adult swine were anesthetized, intubated, and ventilated. Sequential left and right videothoracoscopies were performed to obtain biopsy specimens of lung parenchyma using 5-mm endoscopic cupped forceps. Specimens were obtained from fully inflated lung and from partially atelectatic (deflated) lung. Electrosurgery was applied during forceps biopsy for airleak closure. Limited wedge biopsy specimens were obtained using an endoscopic stapler. One hundred thirteen forceps biopsy specimens (55 inflated, 58 deflated) and 24 sections from 8 wedge biopsy specimens were examined. Specimens were assessed for overall histologic quality and ease of microscopic interpretation. Specific histologic features were then evaluated including presence of artifact, congestion and hemorrhage, degree of alveolar inflation, and number of bronchioles and vessels per cross-sectional area. Whole lungs from two animals were examined for extent and depth of lung injury at the areas of biopsy. RESULTS: No major differences in overall microscopic specimen quality were detected among the different techniques nor were significant differences noted between lung inflated and lung deflated forceps biopsy technique. Wedge sections contained more vessels per unit area (p < 0.001), perhaps reflecting the more peripheral nature of forceps biopsy. Small amounts of thermal or crush artifact were noted on the surface of forceps biopsy specimens, but did not affect overall specimen quality. CONCLUSIONS: Multiple 5-mm forceps biopsy specimens were of comparable quality to single wedge biopsy specimens obtained by endoscopic stapling. Although greater numbers of vessels were present in endoscopic stapled wedge biopsy specimens, multiple forceps biopsy specimens in fact, contain amply sufficient vessels for histologic analysis.

Animals↗
PubMed1995

Immunohistochemical evaluation of E-cadherin and epidermal growth factor receptor in non-small cell lung cancer.

Enhanced expression of the epidermal growth factor receptor and loss of expression of the cell-cell adhesion molecule E-cadherin have each been implicated in the development and progression of a variety of human malignancies. There is some evidence for a correlation between the expression of these two genes and the possible influence of the E-cadherin gene product on the expression of epidermal growth factor receptor. We evaluated 33 matched primary and metastatic non-small cell lung cancer specimens using immunohistochemical staining. There was a statistically significant correlation between staining intensity for epidermal growth factor receptor and E-cadherin in the primary tumors (P = 0.017, by Spearman correlation test). No difference was noted between primary and metastatic disease for either gene product. Studies that include clinical data are needed to clarify the significance of these findings and to evaluate whether these markers will help predict prognosis in tumors.

Biomarkers, Tumor↗
PubMed1995

Immunolocalization of E-cadherin in human head and neck cancer.

Loss of expression of the cell-cell adhesion molecule E-cadherin has been shown to have a potential role in the dedifferentiation and progression of many human malignancies. We applied immunohistochemical staining for E-cadherin to eight formalin-fixed, paraffin-embedded primary and matched metastatic human head and neck carcinomas. In tumors that contained both well-differentiated and poorly differentiated components, staining was notably reduced in the poorly differentiated cells. Staining was nearly identical or only slightly reduced in metastases compared to primary tumors. As found in previous reports, E-cadherin expression may be involved in the dedifferentiation of these tumors.

Blotting, Western↗
PubMed1994

Image cytometry: current applications and future trends.

Image cytometry has numerous clinical and research applications and is particularly useful in anatomic pathology for the study of malignant lesions. Modern image systems encompass morphometry, densitometry, neural networks, and expert systems. Rapid advances in technology and the development of user-friendly systems have provided pathologists with an alternative to flow cytometry, particularly useful in the evaluation of small or hypocellular specimens. The most common current application of image cytometry is for DNA analysis, followed by quantitation of immunohistochemical staining. Newer uses under active investigation include development of expert systems that may act as diagnostic consultants in the future. Beyond DNA analysis, image cytometry holds great promise for improved tumor classification, for screening and surveillance in high-risk populations, and as a tool to improve diagnostic ability. This article discusses types of image analysis systems, specimen preparation, data acquisition, current applications in specific organ sites, and possible future applications.

Cell Division↗
PubMed1993

Quantitative cerebrospinal fluid cytology in patients receiving intracavitary chemotherapy.

Cytological evaluation of cerebrospinal fluid (CSF) is an important means of following response to intracavitary chemotherapy for leptomeningeal malignancy. We studied the feasibility of quantitative cytological evaluation by retrospective analysis of serial CSF specimens from 7 patients receiving phase I intracavitary chemotherapy for leptomeningeal malignancy who had persistent malignant cytology. Three to 34 CSF specimens per patient obtained over a 3- to 48-week period were reviewed. Significant (five- to 10-fold or greater) reductions in numbers of malignant cells in CSF during treatment could be identified in specimens otherwise diagnosed as positive. Quantitative CSF cytological evaluation is neither overly time consuming nor tedious to perform and may provide useful clinical information.

Adult↗
PubMed1993

Evaluation of cytologic specimens obtained during experimental vitreous biopsy.

Vitreous specimens can be useful for diagnosis of intraocular infection, inflammation, and neoplasms. Concern has been raised that obtaining vitreous specimens through a guillotine cutter might result in suboptimal cytologic changes. To determine if aspiration yields better cytologic information than vitrectomy, the authors performed experimental vitreous biopsies on rabbit eyes with vitritis to compare specimens taken by aspiration or vitrectomy with cutting rates of 100, 300, 600 per minute. The specimens were processed by cytospin preparations and stained with Papanicolaou and May-Grünwald-Giemsa stain. There was no difference in the adequacy of the specimens. Cell loss or damage to cell morphologic features when obtaining specimens through aspiration or vitrectomy at different cutting rates could not be differentiated by a blinded cytologic evaluation. A theoretical model of shear stress on cells passing through a guillotine cutter was also developed. The experimental and theoretical data show that vitrectomy with a cutting rate as fast as 600 per minute yields an adequate specimens with a sufficient number of well preserved cells to make definite cytologic interpretations, and that vitreous aspiration is not necessary.

Animals↗
PubMed1993

Anterior mediastinal lesions: transsternal biopsy with CT guidance. Work in progress.

PURPOSE: To assess the technique, results, and patient tolerance of transsternal biopsy of anterior mediastinal lesions under computed tomographic (CT) guidance. MATERIALS AND METHODS: Seven patients (four women and three men) with anterior mediastinal lesions underwent eight transsternal biopsies. Patients were included in the study if there was a risk of injury to internal mammary vessels or a danger of tranversing the lung by the biopsy needle. Patients were specifically questioned about the pain caused by the transsternal needle. A pain scale was not used. Conscious sedation and local anesthesia requirements provided gross evaluation of the patients' tolerance to the procedure. CT scans were used to guide and confirm optimal alignment of the transsternal needle with the lesion. RESULTS: Patients experienced minimal discomfort when the sternum was traversed. No instances of pneumothorax, postprocedural pain, or infection were encountered. In six of the seven patients, biopsy specimens were diagnostic. CONCLUSION: The transsternal approach for biopsy of anterior mediastinal lesions appears safe and is well tolerated.

Biopsy, Needle↗
PubMed1992

Surgical management of the thyroid nodule: patient selection based on the results of fine-needle aspiration cytology.

To determine whether the routine use of fine-needle aspiration (FNA) cytology reduces the rate of unnecessary surgery, the surgical pathology of 54 thyroidectomy patients who had preoperative FNA was compared to the results obtained with 24 thyroidectomy patients who did not have preoperative FNA. Twenty-nine (85.3%) of the 34 patients who had a positive FNA were confirmed by histology to have a thyroid neoplasm; in 24 patients, the neoplasm was malignant. Two of the 17 patients who had a negative FNA but underwent thyroidectomy based on other factors were found to have thyroid cancer. Only 8 (33.3%) of the 24 surgical specimens of patients who did not have an FNA were found to be malignant. FNA had a sensitivity of 93.5% and a specificity of 75.0%. The results indicate that the routine use of FNA for patients with thyroid nodules reduces the incidence of unnecessary surgery. Furthermore, FNA alone is sufficient to identify most patients at risk and is, therefore, cost-effective. However, the presence of other findings suspicious of malignancy should preclude clinical decision making based on FNA alone.

Adolescent↗
PubMed1990

Aspergillus terreus myocarditis: report of a case and review of the literature.

Aspergillus terreus is an uncommon cause of myocarditis, with only six reported cases in the world literature. This report describes a case of severe disseminated Aspergillus terreus infection with extensive involvement of the heart in an immunosuppressed patient after aortic valve replacement surgery. Pathologic findings are similar to those found in Aspergillus fumigatus myocarditis. All six previously reported cases of A. terreus carditis occurred in postoperative cardiac surgery or immunocompromised patients. This pathogen should not be dismissed as simply a colonizing organism or a contaminant in fungal cultures, particularly those from hospitalized or seriously ill patients.

Aspergillosis↗
PubMed1990

Xanthogranulomatous endometritis. Report of six cases and a proposed mechanism of development.

Xanthogranulomatous endometritis is a rare pathologic finding with only five cases reported in the literature. On review of our files over the past 12 years, we found six cases of xanthogranulomatous endometritis, all associated with endometrial adenocarcinoma that had been irradiated by external beam and/or intracavitary implants prior to surgery. Histologically, these cases were characterized by foamy histiocytes with variable amounts of associated multinucleated giant cells, other chronic inflammatory cells, necrosis, calcium, cholesterol clefts, and hemosiderin. Xanthogranulomatous features were not present in the pretreatment endometrial biopsy specimens from any of the six patients. Contributory factors to the development of xanthogranulomatous endometritis such as necrosis, hemorrhage, obstruction, tumor bulk, or delay in treatment were identified. The mechanism of development of xanthogranulomatous endometritis may involve a complex interaction of elements common to the development of xanthogranulomatous change in other organs (obstruction, inflammation, and a lipid source) as well as elements unique to irradiated tissue (generation of free radicals and lipid peroxidation). These cases indicate that radiation injury in the setting of endometrial adenocarcinoma is an additional etiopathologic finding ofulomatous endometritis.

Adenocarcinoma↗
PubMedDate not supplied

Myositis ossificans of the foot.

A 37-year-old woman with myositis ossificans of the left foot is reported. A faint density was seen on foot radiographs, whereas computed tomography images showed a rim of mineralization inferior to the second and third metatarsal bones. On short tau inversion recovery-weighted magnetic resonance images, a hyperintense lesion was demonstrated with hyperintensity extending to the surrounding soft tissues. The rim of ossification appeared hypointense. Other non-neoplastic soft tissue processes with bone formation such as pseudomalignant osseous tumor of soft tissues, florid reactive periostitis, and bizarre parosteal osteochondromatous proliferation occur more commonly in the foot than myositis ossificans. A differential diagnosis of these lesions including periosteal and parosteal osteosarcoma, periosteal chondroma, and osteomyelitis is discussed.

Adult↗
PubMedDate not supplied

Comparison of morphologic features of benign hepatocytes associated with nonmalignant and malignant liver lesions.

In fine needle aspirates (FNAs) of focal liver lesions, the absence of neoplastic cells and presence of hepatocytes with prominent reactive changes often raise the question of whether the lesion was adequately sampled or whether the aspirate represents an area adjacent to the neoplasm. To study this problem we reviewed 51 FNAs of focal liver lesions: 29 metastatic deposits, 4 primary malignancies and 18 nonneoplastic lesions. Fifteen cytologic features were scored on a scale of 0-3 by two independent observers using conventional light microscopy. Hepatocytes in 18 aspirates of nonneoplastic lesions showed considerable degrees of cytoplasmic vacuolation, nuclear enlargement, cytoplasmic pigmentation, binucleation, anisonucleosis and intranuclear inclusions. In contrast, hepatocytes in 29 aspirates of metastatic deposits displayed a considerably lower degree of some of these features (cytoplasmic pigment, binucleation, anisonucleosis and nuclear enlargement.) The four aspirates of hepatocellular carcinoma showed nuclear enlargement of hepatocytes comparable to that in the nonmalignant aspirates; other accompanying features, however, were less conspicuous. We conclude that marked cytologic alterations in hepatocytes are seen most frequently in FNAs of nonneoplastic liver lesions, such as focal nodular hyperplasia, cirrhosis, abscess and hepatitis, and that hepatocytes accompanying metastatic deposits typically show less-pronounced cytologic alterations.

Adenocarcinoma↗