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  • 1
    Electronic Resource
    Electronic Resource
    Fine needle aspiration cytology in the work-up of mammographic and ultrasonographic findings in breast cancer screening: an attempt at differentiating in situ and invasive carcinoma[Paper pres] (2002)
    Oxford UK : Blackwell Science Ltd
    Cytopathology 13 (2002), S. 0 
    Details
    ISSN: 1365-2303
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Fine needle aspiration cytology in the work-up of mammographic and ultrasonographic findings in breast cancer screening: an attempt at differentiating in situ and invasive carcinoma This study evaluated the results of fine needle aspiration cytology (FNAC) from the first four years of organized mammography screening for breast cancer in Oslo, particularly our policy in differentiating in situ and invasive carcinoma. Lesions were aspirated directly, ultrasound guided, by stereotaxic device or biopsy localization plate. All lesions were aspirated by cytopathologists working with the radiologists at the breast diagnostic centre. Smears were evaluated immediately for assessment of adequacy and a preliminary diagnosis was given to the surgeon. When FNAC revealed malignancy, diagnostic terms were as follows: (1) invasive carcinoma; (2) ductal carcinoma in situ of comedo type (high nuclear grade), cannot evaluate infiltration; (3) ductal carcinoma in situ of low nuclear grade and (4) papillary tumour, cannot evaluate infiltration. There were 953 cases, 70% of which were nonpalpable. Insufficient material was obtained in 5.8%. Absolute and complete sensitivity were 81% and 91%, respectively. Specificity was 85%. There were 448 histologically proven carcinomas. 383 of these were invasive. 362 carcinomas (in situ and invasive) (80.8%) were diagnosed directly on FNAC. Distinction between invasive and in situ carcinoma was possible in 294 of 320 directly diagnosed invasive carcinomas (91.8%). PPV of a diagnosis of invasive carcinoma was 97%. Our data showed that definitive cytological diagnosis of invasive carcinoma was possible in more than 90% of fully diagnostic smears and allowed definitive primary surgery in these women.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2303.2002.00372.x
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  • 2
    Electronic Resource
    Electronic Resource
    Adrenal cortical carcinoma in Norway, 1970–1984 (1992)
    Springer
    World journal of surgery 16 (1992), S. 663-667 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le corticosurrénalome (ACC) est une tumeur rare de haute malignité. Cette étude rétrospective comprend 99 cas (57 hommes et 42 femmes) enregistrés dans le registre des cancers de Norvège pendant une période de 15 ans. L'incidence ajustée sur l'âge était de 1,5 par million par an. Le diagnostic de corticosurrénalome a été porté chez 81 patients de leur vivant et dans 18 cas le diagnostic a été fait lors de l'autopsie. L'âge moyen lors du diagnostic était de 54 ans (extrêmes: 2–88 ans) et il y avait une légère prédominance masculine. Des informations sur les symptômes initiaux étaient disponibles chez 67 patients parmi lesquels 26 (18 femmes et 8 hommes) présentaient des signes cliniques endocriniens. Un syndrome de Cushing et une virilisation étaient le plus souvent rencontrés. Seulement 28 (35%) des 81 patients chez qui le diagnostic avait été porté de leur vivant avaient une tumeur limitée à la surrénale. La moitié des patients avait des métastses à distance, le plus souvent pulmonaires et hépatiques. Soixante et un patients ont été opérés; 51 ont eu une intervention radicale ou une exérèse élargie et 10 une laparotomie pour biopsie. Après un suivi total d'au moins 6 ans (extrêmes: 6–21 ans), seulement 9 patients étaient encore en vie. Le stade précoce (stade I et II) et l'exérèse curative avaient un impact significatif sur l'évolution de cette maladie. Pour améliorer le pronostic, un diagnostic précoce et une chirurgie radicale, si elle est réalisable, sont impératifs.
    Abstract: Resumen El carcinoma adrenocortical (CAC) es un tumor raro y de alta malignidad. El presente estudio se hizo sobre 99 casos (57 de sexo masculino y 42 de sexo femenino) reportados al Registro de Cáncer de Noruega en un periodo de 15 años. La incidencia adjustada a la edad fue de 1.5 por millón por año. Ochenta y un pacientes fueron diagnosticados como CAC cuando todavía sobrevivían, y 18 fueron diagnosticados en la autopsia. La edad media en el momento del diagnóstico fue 54 años (rango 2–88 años), y se observó una incidencia ligeramente mayor en el sexo masculino. Se encontró información sobre los síntomas iniciales en 67 casos, de los cuales 26 (18 de sexo femenino y 8 masculino) se presentaron con tumores clínicamente funcionantes, siendo el síndrome de Cushing y la virilización los más frecuentes. Sólo 28 (35%) de 81 pacientes diagnosticados en vida tenían tumores confinados a las suprarenales. La mitad de los pacientes presentaba metástasis distantes, principalmente a los pulmones y al hígado. Setenta y un pacientes fueron sometidos a cirugía; en 51 se realizó operación radical o de debultamiento, y en 10 laparotomía con biopsia del tumor. En un seguimiento completo de por lo menos 6 años (rango 6 a 21 años) sólo 9 pacientes sobrevivían. El estado temprano de la enfermedad (Estados I & II) y la realización de una resección curativa fueron los factores de mayor impacto sobre el resultado final. Para mejorar el pronóstico en esta enfermedad se requiere un diagnóstico temprano y tratamiento mediante cirugía radical.
    Notes: Abstract Adrenal cortical carcinoma is a rare and highly malignant tumor. This retrospective study includes 99 patients (57 males and 42 females) reported to The Cancer Registry of Norway during the 15 year period from 1970 to 1984. The age adjusted incidence was 1.5 per million per year. Eighty-one patients were diagnosed with adrenal cortical carcinoma when still alive. In 18 cases the diagnosis was first made at autopsy. Median age at diagnosis was 54 years (range 2–88 years) with a slight male predominance. Information about initial symptoms was available in 67 patients, of whom 26 patients (18 females and 8 males) presented with clinically functioning tumors, the Cushing syndrome and virilization being most frequently encountered. Only 28 (35%) of 81 patients diagnosed when still alive had tumors confined to the adrenals. Half of the patients had distant metastases, with lungs and liver being the most frequent sites. Sixty-one patients underwent surgery; 51 patients had a radical or debulking operation and 10 patients had laparotomy with tumor biopsy. After a complete follow-up for at least 6 years (range 6–21 years), only 9 patients were still alive. Early stage (Stage I and II) and curative resection had a significant impact on the outcome of this disease. To improve prognosis, early diagnosis and radical surgery, if feasible, are needed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02067349
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  • 3
    Electronic Resource
    Electronic Resource
    Mass screening for cervical cancer in Norway: evaluation of the pilot project (1995)
    Springer
    Cancer causes & control 6 (1995), S. 477-484 
    Details
    ISSN: 1573-7225
    Keywords: Cervical cancer ; cytologic smears ; females ; Norway ; screening
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: The Norwegian Department of Health and Social Affairs initiated a national screening program for cervical cancer in 1990, with all women aged 25 to 70 years to be offered cervical screening every three years. During the first three years of the program (November 1991–October 1994), all spontaneous cervical cytology in Norway was recorded at the Norwegian Cancer Registry. In addition, women in the counties of Vestfold and Sør-Trøndelag were invited individually to be screened. The aim of the present study was principally to evaluate the organizational aspects of a nationwide, population-based screening program for cervical cancer in Norway. Special attention was paid to the coverage, the attendance rate, and the cytologic findings in the two-county study area. A total of 1,581,379 Pap smears were recorded from November 1991 to October 1994. Most smears were taken from women under age 30 years (31.7 percent). About 25 percent of the women aged 25 to 29 years had more than one normal smear. In the study area, a coverage of about 71 percent in the age group 25 to 69 years was achieved. The pilot project also has shown that it is possible to recruit elderly women into screening. However, no difference was noted between the study and the reference area with regard to findings per smear of precursor lesions (CIN 3, modified SNOMED coding system). The experiences from three years of recording and the implementation of the pilot project have provided useful guidelines for the national screening which began in January 1995.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00054154
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  • 4
    Electronic Resource
    Electronic Resource
    Human papillomavirus 16 in breast cancer of women treated for high grade cervical intraepithelial neoplasia (CIN III). (1999)
    Springer
    Breast cancer research and treatment 53 (1999), S. 121-135 
    Details
    ISSN: 1573-7217
    Keywords: HPV 16 ; breast cancer ; CIN III ; PCR ; southern blot ; in situ hybridization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Women with both a history of high grade cervical intraepithelial neoplasia (CIN III) and breast carcinoma as second primary cancer were selected for studying the presence of HPV in breast carcinomas. Paraffin embedded material from 38 patients with 41 breast carcinoma cases after CIN III were examined by polymerase chain reaction (PCR) and in situ hybridization. By PCR we detected HPV 16 DNA in 19 out of 41 cases (46%) of the breast carcinomas. One case proved to be HPV 16 positive also by in situ hybridization. HPV 16 was also detected in 32 out of the 38 patients with CIN III (84%). All HPV 16 positive breast carcinomas were HPV 16 positive in their corresponding CIN III lesions. Eight patients with diagnosed breast cancer before the CIN III lesions were used as controls. None of these had HPV positive breast carcinomas. No cases were positive for HPV 11, 18, or 33. HPV 16 was detected in the primary tumours, in local metastases from HPV 16 positive tumours, in a distant HPV 16 positive breast carcinoma metastasis to the colon, and in other primary cancers in patients with HPV 16 positive breast carcinomas and HPV 16 positive CIN III. Estrogen and progesterone receptors were quantified in the HPV positive and HPV negative breast carcinomas, and there was no significant difference in the fraction positive in the two groups. Oncogenic HPV DNA might be transported from an original site of infection to other organs by blood or lymph, and possibly be a factor in the development of cancer in different organs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006162609420
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  • 5
    Electronic Resource
    Electronic Resource
    Joint effect of HPV16 with Chlamydia trachomatis and smoking on risk of cervical cancer: antagonism or misclassification (Nordic countries) (2000)
    Springer
    Cancer causes & control 11 (2000), S. 783-790 
    Details
    ISSN: 1573-7225
    Keywords: cervix ; interaction ; misclassification ; neoplasms ; papillomaviruses
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives:To estimate the joint effects of infections with human papillomavirus type 16 (HPV16) and Chlamydia trachomatis and smoking on the risk of cervical cancer. To study whether the joint effects can be accounted for by misclassification in the HPV serology. Methods:A nested case–control study with incidence density sampling was conducted in three cohorts of 530,000 women, who donated serum samples to three Nordic serum banks in 1973–1994. The main outcome measure is the odds ratio (OR) of incidence rates of invasive cervical squamous cell carcinoma (SCC) among those seropositive for HPV16 and/or C. trachomatis and/or with increased levels of cotinine in serum compared to those negative for all the three exposures. Results:Two hundred eight women with SCC and 624 matched controls were identified during a mean follow-up of 5 years through linkage to the national cancer registries. Exposure to past infections and smoking was defined by presence of specific IgG antibodies to HPV16 and C. trachomatis and increased levels of serum cotinine. Observed ORs were compared to OR = 20 for HPV16 and accounting the differences for by misclassification bias. OR = 20 was elected as a gold standard on the basis of other studies with PCR-based analyses and a follow-up design. Each of the three exposures was associated with an increased risk of SCC (OR = 5.4 for HPV16, 3.4 for C. trachomatis and 1.8 for cotinine). The interaction was antagonistic (observed OR = 2.5 among those positive for all three exposures as compared to OR = 33 expected on the basis of multiplicative single effects (p = 0.047)). The antagonism could not totally be accounted for by any credible combination of sensitivity and specificity of HPV16 serology. Conclusion:HPV16, C. trachomatis, and smoking are likely to be risk factors of SCC with strong antagonistic joint effect. Non-differential misclassification in serology for HPV16 could be ruled out (but only some types of differential) as an alternative explanation for the observed antagonism.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008976703797
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