PubMed Health⌕ Search

Biomedical subjects

Z Atay

Publications and source records attributed to Z Atay.

At least 19 recordsLinked to original sources

Effect of BCG vaccine on tuberculin skin tests in 7-11-year-old children.

AIM: To determine the effect of Bacillus Calmette Guerin (BCG) vaccination on tuberculin skin test responses in 7-11-year-old children, and also to clarify whether the number of vaccinations and the time interval between vaccination and tuberculin skin test have an effect on the test responses. METHOD: 1200 primary school children were evaluated for the presence and number of BCG scars. They were then given 5 TU PPD-S intra-dermally. Seventy-two hours after the application of tests, PPD indurations were measured. RESULTS: Mean indurations were 3.7 +/- 3.9, 6.5 +/- 5.4 and 9.2 +/- 7.1 mm in children with no scar, one scar and two scars, respectively. No statistical difference was found between mean induration of children with one scar and those with two scars. CONCLUSION: The effect of the number of BCG vaccinations and the time interval between vaccination and tuberculin skin test application on tuberculin skin test responses was statistically insignificant.

Analysis of Variance↗

Increasing sensitivity of morphological diagnosis in hepatocellular carcinoma (HCC) by combination of cytological and fine-needle histological examination after ultrasound guided fine needle biopsy.

UNLABELLED: Increasing sensitivity of morphological diagnosis by combination of cytological and fine-needle histological examination after ultrasound guided fine needle biopsy in hepatocellular carcinoma (HCC). AIM: We investigated the factors which may affect the sensitivity of morphological diagnostics (cytology and fine-needle histology) in HCC after ultrasound guided biopsy. METHOD: In 62 patients, an ultrasound guided cytological (n = 62) and fine-needle histological (n = 45) biopsy was performed. In addition, the smears were investigated by cytophotometry (n = 62). RESULTS: Considering each method separately, the sensitivity of both cytological and histological diagnostics was about 80%. The sensitivity could be raised to 89% by combining the two methods. In seven patients, the HCC could not be primarily confirmed morphologically. In nine patients, the result of histological and cytological investigation was not congruent. With regard to the size of the biopsied lesion, tumor stage, cytophotometric finding and survival these 16 patients (group A) were compared with the 46 patients in whom the HCC could be primarily confirmed morphologically (group B). The statistical analysis did reveal a significantly lower percentage of tumors with diploid or tetraploid (euploid) cells in group B. Euploid tumors were significantly more highly differentiated. In patients with euploid tumors, the sensitivity of the cytological investigation was 67% and respectively 75% of the histological investigation. The sensitivity could be raised to 82% in this population by combining the two investigations. On the other hand in aneuploid tumors, the sensitivity could only be increased from 93% and 88% respectively to 97% by combining cytology and fine-needle histology. SUMMARY: Our investigations show that the sensitivity of morphological diagnostics can be raised especially in the highly differentiated HCC with a physiological DNA content by combination of cytological and fine-needle histological investigations.

Adult↗

Effect of BCG vaccine on tuberculin skin tests in 1-6-year-old children.

UNLABELLED: Bacillus Calmette Guerin (BCG) vaccination used in the prevention of tuberculosis may cause problems in interpreting the tuberculin skin test (TST), which is commonly used in the diagnosis of infection. A limited number of studies have been undertaken to investigate how length of time after BCG vaccination affects TST results. TST induration values of unvaccinated children were compared with those of children vaccinated once in order to determine the changes in TST responses after BCG vaccination. Mantoux TSTs were administered to 1145 children aged 1-6 y and induration was measured at 72 h. BCG scar status and average TST induration diameters were identified for each age group. CONCLUSION: Average TST induration in vaccinated children is significantly higher than that in unvaccinated children, and in the vaccinated group there is no statistically significant difference between induration values in the different age groups. BCG vaccination at the age of 0-2 mo affects TST for a long period and this condition does not change until 6 y of age.

BCG Vaccine↗

Postpartum maternal levels of hemoglobin A1c and cord C-peptide in macrosomic infants of non-diabetic mothers.

OBJECTIVE: This study was designed to test the hypothesis that macrosomia in infants born to non-diabetic mothers is associated with an increased incidence of hyperinsulinemia and normal maternal glucose regulation in late pregnancy. METHODS: Twenty mothers and their macrosomic infants were chosen as the study group, and 20 mothers with their appropriate-for-gestational-age infants were chosen as the control group. RESULTS: No difference in postpartum mean hemoglobin A1c levels was observed between the mothers of macrosomic infants and those of control infants. Cord plasma C-peptide levels were significantly higher in macrosomic than in control infants. CONCLUSIONS: This study revealed that macrosomic infants of non-diabetic mothers were significantly more likely to have hyperinsulinemia than were normal-sized infants, and this hyperinsulinemia was not caused by dysregulation in glucose metabolism.

Blood Glucose↗

Acute infantile haemorrhagic oedema associated with hepatitis A.

Acute infantile haemorrhagic oedema (AIHO) is characterised by purpura, ecchymosis and inflammatory oedema of the face and extremities. It is seen in children aged 4-24 months. The atiology is not known. We report a case of AIHO diagnosed by skin biopsy demonstrating leukocyte-elastic vasculitis. Laboratory studies showed positive hepatitis A IgM and IgG antibodies. The liver function tests were normal, indicating subclinical hepatitis. Cryoglobulinaemia was detected, suggesting that the disease was related to hepatitis A.

Acute Disease↗

Detection of pancreatic metastases by EUS-guided fine-needle aspiration.

BACKGROUND: Metastases to the pancreas are usually found incidentally. Tissue diagnosis is imperative because imaging alone is incapable of differentiating them from primary pancreatic tumors. This study tested whether it is possible to differentiate metastases from other focal pancreatic lesions by using EUS-guided fine-needle aspiration (EUS-FNA) for cytodiagnosis. METHODS: One hundred fourteen consecutive patients (mean age 61 years) with focal pancreatic masses, detected on CT, underwent EUS-FNA by using a linear-array echoendoscope and 22-gauge needles. RESULTS: Adequate specimens were obtained from 112 lesions. Carcinomas were identified in 68 cases (60.7%), 56 (50%) of pancreatic origin and 12 (10.7%) from distant primary tumors. The metastases were all located in the head and body of the pancreas and measured 1.8 to 4.0 cm. The echo-texture was heterogeneous or hypoechoic in all cases and resembled that of primary tumors. Six of the 12 patients with metastatic disease had a prior diagnosis of cancer (breast, 3; renal cell, 2; salivary gland, 1), 4 of them with a recurrence and 2 with a second carcinoma metastasizing to the pancreas. Six patients without a prior diagnosis of cancer had metastases from renal cell, colonic, ovarian, and esophageal carcinomas; one metastasis was from an unknown primary and another was from a malignant lymphoma. These findings influenced the therapeutic strategy in 8 patients who underwent nonsurgical palliation. There were no complications. CONCLUSIONS: Pancreatic metastasis is an important cause of focal pancreatic lesions, but the EUS features are not diagnostic. Simultaneous EUS-FNA allows cytodiagnosis and can have a decisive influence on the selection of appropriate therapeutic strategies.

Adult↗

Can semi-automated image cytometry on induced sputum become a screening tool for lung cancer? Evaluation of quantitative semi-automated sputum cytometry on radon- and uranium-exposed workers.

The correlations between semi-automated sputum cytometry (ASC), conventional cytology and the final diagnosis was investigated in industrially-exposed workers. Slides of sputum samples from 201 former uranium miners with silicosis, 100 patients with asbestosis, 103 workers resected for lung cancer, and 200 controls (50% smokers), were stained using the Papanicolaou (Pap) method and the Feulgen reaction with thionin. Cytometry was performed using the Cyto-Savant automated system. Atypical nuclei were found in 72 of 404 patient samples, 327 samples were normal and five were inadequate for ASC analysis. Thirteen tumours (Pap IV, Pap V) and 11 cases of severe dysplasia were identified by cytology. Lung cancer was confirmed in 20 patients. Compared to the final diagnosis of lung cancer, the sensitivity of ASC was 75% (15 out of 20) and specificity 89.8% (520 out of 579). The results represent a diagnostic efficiency of 89.3%. The combination of ASC with cytology increased sensitivity to 80% (16 out of 20) without significant loss of specificity (89.7% or 523 out of 581). In this investigation of a limited number of patients with occupational radon or asbestos exposure, semi-automated sputum cytometry appears to be sensitive and reliable for the detection of malignant changes in the tracheobronchial mucosa. Together with conventional cytology, it would be reasonable to test the validity of the combined methods in a large-scale feasibility study of early lung cancer detection.

Adult↗

[Automated quantitative image cytometry of bronchial washings in suspected lung cancer: comparison with cytology, histology and clinical diagnosis].

INTRODUCTION: Automated image cytometry represents a new method for the quantitative analysis of nuclear structure and DNA-content of exfoliative airway epithelial cells. In the present investigation, we examined the correlation between automated cytometry, conventional cytology and histopathology with the final diagnosis as the "gold standard". METHODS: In 142 patients (100 males and 42 females) with suspected lung cancer and 50 controls (COPD, asthma), bronchial washings (5-10 ml) were obtained during bronchoscopy before taking biopsies for cytological and/or histological examinations. The washings were collected in 20 ml Saccomanno's fixative and centrifuged (500 g, 15 min). The cell pellet was resuspended in Saccomanno's solution. Two specimens were stained according to Papanicolaou and another two using the Feulgen reaction with thionine. Image cytometry was performed by means of a special, trainable classifier for exfoliative cells of the respiratory tract, using the Cyto-Sacant (Oncometrics, Vancouver). RESULTS: In the patients with suspected lung cancer we found numerous abnormal nuclei in 97 samples, 36 samples contained normal cells only, and 9 samples were insufficient. In our control group there was no sample with abnormal nuclei, and all washings were evaluable. Compared to the final diagnosis of lung cancer, we found a sensitivity of 90% (92/102) and a specificity of 84% (26/31). For histology sensitivity was 91% (73/80) and specificity 100%, while we found a sensitivity of 92% (92/100) and specificity of 100% for cytology. For automated cytometry the positive predicted value was 95%, the negative predicted value 71%. CONCLUSIONS: In the investigation of patients with suspected lung cancer, automated image cytometry of bronchial washings is a sensitive and reliable method for the detection of malignant changes in the tracheobronchial mucosa. The automated procedure seems well suited not only for analysing bronchial washings, but also for a screening procedure.

Adult↗

[Endosonographically controlled fine needle aspiration cytology--indications and results in routine diagnosis].

UNLABELLED: The usefulness and clinical utility of routine EUS-guided fine needle aspiration cytology (FNA) in the diagnosis of lesions adjacent to the upper gastrointestinal tract was prospectively studied. METHODS: EUS/FNA was performed in 122 patients for 125 lesions: Mediastinal lymph nodes (n = 56), pancreatic lesions (n = 45), paragastric masses (n = 12), submucosal tumors (n = 4) and small hepatic lesions (n = 2) were successfully punctured for cytological diagnosis. RESULTS: Adequate material was gained in 119 out of 125 punctures (95%). Overall sensitivity, specifity, positive and negative predictive value were 90%, 98%, 98% and 89%. Results of EUS/FNA in mediastinal lymph nodes were superior (95%, 100%, 100%, 90%) to those in pancreatic lesions (80%, 100%, 100%, 80%). In paragastric masses sensitivity was 100% whereas specifity was only 67%--due to one false-positive result. Out of four submucosal tumors diagnosis was revealed in three. Two liver metastasis were successfully punctured. 35 out of 56 mediastinal nodes showed malignancy. 27 metastases of lung-, three of gastric-, two of renal cancer and three Non-Hodgkins's lymphoma were diagnosed. The cytological results of 45 pancreatic lesions showed cancer in 19 and chronic inflammation in 21, two abscesses and three benign cysts. There were no complications. 37 patients were treated on outpatient's basis. CONCLUSIONS: EUS-guided FNA is an accurate and safe technique to sample cytology from lesions adjacent to the wall of the upper gastrointestinal tract. New indications may be established for the diagnosis of lung cancer or metastases of other spreading out into the mediastinum or the celiac axis.

Adult↗

[Basic principles of LIFE--autofluorescence bronchoscopy. Results of 194 examinations in comparison with standard procedures for early detection of bronchial carcinoma--overview].

BACKGROUND: Conventional bronchoscopy in the identification of preneoplasias and carcinoma in situ (CIS) has been inadequate to date. Tissue autofluorescence was found to differentiate normal mucosa from dysplastic or carcinomatous bronchial mucosa. This principle resulted in the development of the LIFE System (Light Imaging Fluorescence Endoscope, Xillix Techn., Vancouver, BC), now in routine use worldwide at 35 centres. In a prospective multicentric study in North America the relative sensitivity for diagnosing intraepithelial neoplasias of combined white light (WLB) and LIFE bronchoscopy in 173 at-risk patients was 6.3 as compared to WLB alone. A similar European multicentric study will be completed by spring of 1998. PATIENTS AND RESULTS: We report on our experience with the routine use of the LIFE System over 23 months. 194 examinations (165 patients) were performed. Moderate to severe dysplasias and in situ carcinomas were diagnosed with a relative sensitivity of 2.7 by the combined WLB-LIFE examination as compared to WLB alone. CONCLUSION: Autofluorescence bronchoscopy as a routine investigation without need of photosensitizers in patients with a high risk for lung cancer can lead to a substantial increase in the detection rate of CIS and moderate to severe dysplasias compared to white light bronchoscopy alone.

Adult↗

[Cytochemical studies for determining the histogenesis of anaplastic and poorly differentiated lung tumors].

Proper histogenetic classification of pulmonary tumours is most important in choosing the best possible treatment. Since this is very difficult especially in case of anaplastic or poorly differentiated tumours, additional pointers on histogenesis, supplied by complementary histochemical examinations, are very helpful. 105 bronchial carcinomas were examined cytochemically by means of air-dried smear preparations (imprint, brush an puncture smears). Cytochemical examinations were performed in respect of alkaline phosphatase, acid phosphatase, PAS reaction and unspecific esterase. It was found that the dedifferentiated squamous cell carcinomas were alkaline phosphatase-negative and weakly positive to acid phosphatase and unspecific esterase, whereas dedifferentiated adenocarcinomas were strongly positive to acid phosphatase and unspecific esterase. The PAS reaction was always slightly to moderately positive. Small-cell bronchial carcinomas were negative in all cytochemical examinations.

Adenocarcinoma↗

[T4/T8 ratio in bronchoalveolar lavage in sarcoidosis--a marker of activity and/or prognosis?].

In 158 patients with histologically confirmed intrathoracic sarcoidosis the T4/T8 quotient was checked in broncho-alveolar lavage (BAL) for its informative value with regard to activity and prognosis of the disease. In asymptomatic patients with x-ray type I and normal lung function, in radiological remissions of x-ray types I and improvement in the course of disease in patients whose disease had initially been classified acute, we found statistically significantly higher T4/T8 quotients than in the other patient groups; we did not observe any deterioration in the course of the disease. High T4/T8 quotients will thus not generally point to an active or progressing disease; the information conveyed by these data is of limited clinical usefulness in individual cases only.

Adult↗

[Cytomorphologic concomitant reactions in malignant pleural effusions].

This study was undertaken to establish whether there might be certain cytological findings in the pleural effusions which, with a high degree of possibility, point to the presence of a malignant process despite the absence of tumour cells. In tumour cell-containing effusions we found LE cells in 26.5%, and psammoma bodies in 31.9% of the cases. In non-tumour cell-containing effusions with, nevertheless, malignant genesis, we detected LE cells in 12.5% and psammoma bodies in 0.8% of the cases. In three out of 6 rheumatogenic effusions, LE cells were also found. Otherwise, neither LE cells nor psammoma bodies were to be seen in any of the benign effusions (74 cases). Furthermore, in all the malignant pleural effusions, extremely atypical mesothelial cells were always detected, the identification and description of which proved difficult.

Diagnosis, Differential↗

[Cytomorphologic criteria of bronchioloalveolar cell cancer].

Cytological material obtained from 100 patients with histologically proven bronchiolo-alveolar cell carcinoma was evaluated on the basis of 27 criteria. Particular features observed were a monocytoid nuclear delimitation (98.4%), central position of the nucleus (90.2%), light-coloured nuclear sap (52.5%), double-nucleation (98.4%), multinucleation (72.1%), phagocytosis (55.7%). Of the features of the accompanying reaction, psuedoproteinosis (9.8%), the presence of hyperplastic pneumocytes II (75.4%) and psammoma bodies (1.6%) are worthy of mention.

Adenocarcinoma, Bronchiolo-Alveolar↗

[Cytomorphologic criteria of small cell bronchial cancer and its value in the determination of malignancy and histogenesis].

On the basis of 100 cases in which the diagnosis "small cell lung cancer" was confirmed both histologically and cytologically, the cytological criteria that indicated the presence of a small cell bronchial carcinoma were investigated. It was established that on the basis of cytological criteria, not only is differential diagnosis possible, but also, in contrast to the opinions of other authors (4), a clear differentiation of the subtypes. Furthermore, in a prospective study involving 455 biopsies obtained from the bronchus which were investigated histologically and cytologically at the same time, these criteria were checked. It was established that a 100% agreement with histology was achieved in the determination of the types of small cell bronchial carcinoma. In small cell carcinoma of the lung, a diagnostic gain of 7.7% is achieved.

Carcinoma, Small Cell↗

[Cytological diagnosis of intrathoracic epithelioid-cellular inflammations].

In the period between 1987 and 1989, 441 epitheliodcell granulomas were diagnosed on the basis of cytological investigations, and confirmed histologically. The material involved was obtained via perbronchial puncture, imprint preparations from bronchial biopsies, transbronchial biopsies and thoracoscopic biopsies. The sensitivity of the cytological investigations of imprint preparations in the case of small biopsies is some 7-12.5% better than that of the histological examination. Thus, the histological diagnosis is supplemented by cytology. In 92.9% of the cases, granulomatous disease was diagnosed on the basis of the evaluation of the perbronchial puncture material alone, so that in these cases, mediastinoscopy could have been avoided.

Biopsy, Needle↗