Henrik Klem Thomsen

Evaluation of the reproducibility of the revised 1988 international federation of gynecology and obstetrics grading system of endometrial cancers with special emphasis on nuclear grading

An intraobserver and interobserver analysis of the reproducibility of the revised 1988 International Federation of Gynecology and Obstetrics (FIGO) grading system of endometrial cancers was performed in 47 endometrial cancers (94 biopsy specimens). In the revised FIGO grading system the growth pattern still serves as the basic parameter, but nuclear atypia inappropriate for the architectural grade, raises the grade by 1. Ninety‐four slides were graded twice by two pathologists. Analysis by the kappa statistics (corrected for agreement by chance) showed an acceptable result for interobserver reproducibility: kappa value 0.65 (95% confidence interval, 0.480 to 0.818). Further study showed this to be a reflection of the reproducibility of the architectural grade: kappa 0.70 (95% confidence interval, 0.565 to 0.850), whereas the reproducibility of the nuclear grade was poor: kappa value 0.55 (95% confidence interval, 0.383 to 0.713). Review of the literature showed great variability in the definition of nuclear grading, indicating that the revised 1988 FIGO grading system is not applicable as standard of reference for studies of endometrial cancers, before agreeing to the definition of inappropriate nuclear atypia. Cancer 68:2303–2309, 1991.

Reproducibility of histopathological evaluation in epithelial ovarian carcinoma. Clinical implications

An interobserver analysis of the reproducibility of malignancy grade and of histological type classified according to World Health Organization criteria was performed in 261 ovarian tumours, stages IIB to IV. All available slides per patient including metastatic tumours (16%) were reviewed independently by two pathologists. Overall observed agreement regarding type was 68%. The chance‐corrected agreement expressed by the kappa coefficient was 0.55 (95% confidence interval 0.49‐0.61). Overall observed agreement regarding grade was 41% compared with a kappa coefficient of 0.19 (95% confidence interval 0.12‐0.26). Kappa coefficients, ranging from 0.18 to ‐1.00 for associations between type categories and from 0.20 to ‐0.32 for grade categories, indicated that any suggested pattern of association could be caused by chance occurrences. A more objective approach to histopathology is needed in ovarian carcinoma before its prognostic impact can be assessed.

Ulcer bed infection

We report a case of ulcer bed infection in an enlarging venous leg ulcer without clinical signs of cellulitis in the surrounding tissues. Signs of infection in the leg ulcer were: 1) cocci‐like structures and bacteria‐like rods around vessel walls in the viable ulcer bed, 2) vasculitis‐like inflammation of deeply situated vessels of the viable tissue, 3) Pseudomonas aeruginosa‐specific antibodies in the serum (other than against exotoxin A), 4) extensive epidermolysis of normal human skin by the wound exudate in vitro, and 5) P. aeruginosa exotoxin A in the wound exudate (23 ng/ml). In an in vitro cell assay, the wound exudate was cytotoxic and rabbit antibodies to exotoxin A, but not a serine proteinase inhibitor, inhibited this cytotoxicity. P. aeruginosa exotoxin A might contribute to the pathogenesis of the ulcer enlargement. The ulcer improved after the third skin graft, probably mainly due to effective treatment with a long‐stretch compression bandage.

Epidemiology of classic Kaposi's sarcoma in Denmark between 1970 and 1992.

Studies have suggested that the incidence of classic Kaposis sarcoma (KS) varies considerably within Europe. The epidemiology of classic KS in Denmark was described for the period between 1970 and 1992 and association with marital status and country of origin were evaluated.

Effects of interleukin-1α on migration of canine neutrophils in vitro and in vivo

Abstract Inflammatory cell activation by interleukin-1 (IL-1) has been the subject of studies in laboratory animals and man, and was the aim of the present study. At physiological concentrations of 0.01–100 units/ml, human recombinant IL-1α was shown to be a chemokinetic and chemotactic agent for canine neutrophils in vitro and to cause dose-dependent and selective neutrophil infiltration following intradermal injection of 1 or 250 units. The findings support a putative role for IL-1, and IL-1-induced products such as IL-8, as mediator of immunoinflammatory reactions in which neutrophil infiltration is prominent.

Procollagen 1 - : a marker of fibroblastic and fibrohistiocytic skin tumors

Background:  When dealing with tumors of presumed fibroblastic or fibrohistiocytic origin, immunohistochemistry is traditionally done to exclude a tumor of non‐fibroblastic or non‐fibrohistiocytic nature, because a reliable marker of fibroblastic or fibrohistiocytic cell origin is still to be introduced. This study investigates whether procollagen 1 is a useful marker of skin tumors composed of cells derived from fibroblasts or fibrohistiocytes.

The effect of sodium hydroxide and hydrochloric acid on pig dermis. A light microscopic study

In order to compare the dermal changes after exposure to direct current (d.c.) with changes after influence of acid and base influence, the skin of fully anaesthetized Danish Landrace pigs were exposed to acid and basic solutions. Biopsies were obtained immediately after and up to day 7 after the injury. Collagen fibres with increased affinity for eosin and irregular cross-striation in polarized light together with shrunken cells with dark stained nuclei were found just beneath the epidermis immediately after application of 1 N HCl. Immediately after exposure to 1 N NaOH dispersed collagen fibres showed increased eosinophilia and a fine densely spaced cross-striation in polarized light and vesicular nuclei were present within dermal cells. During the following days a narrow demarcation zone of neutrophilic granulocytes separated the zone containing abnormal collagen fibres from normal tissue below. Calcified collagen fibres were not observed and no other abnormal histochemical reactions were present. It is concluded that the morphology of acid induced lesions and base induced lesions shows resemblance to the morphology of anode and cathode lesions, respectively, but not to heat lesions. The reason for not finding depositions of calcium salts on collagen fibres in skin exposed to basic solutions could be a non-optimal pH in the tissue or that other electrochemical processes than shift in pH are necessary for the calcification process.

The occurrence of calcium salt deposition on dermal collagen fibres following electrical injury to porcine skin

Deposition of calcium salts on collagen fibres has been shown to occur in cathode areas from 2 days to 2 months after exposure to direct current (d.c.) via contact knobs measuring 12 mm in diameter using energy level from 0.5 to 96 J and on day 7 after exposure to alternating current (a.c.) via pointed electrodes using energy level from 30 to 50 J. In order to determine the statistical relation of this histological observation to the type of energy applied 1095 biopsies from 49 pigs including biopsies from skin areas exposed to heat, 50 Hz a.c., 100 kHz a.c. and d.c. as well as from unexposed skin were examined. The specificity was 1.0 using calcium deposition as the test criterium. The sensitivity for cathode areas was found to vary from 0.52 to 1.0 depending on the biopsy technique and the number of days after exposure. Calcium salts on collagen fibres seem uniformly to be present in the cathode area from day 4 to 7, the positive test answer being depending on the biopsy technique. For 50 Hz a.c. the sensitivity using a pointed electrode was found to vary from 0.08 to 0.27 dependent on the number of days after exposure. For all other types of energy the sensitivity was 0.

β2-microglobulin expression of AIDS-related and classical Kaposi's sarcoma

The expression of β2‐microglobulin, the invariable light chain of HLA class I molecules, of Kaposis sarcoma from 11 AIDS patients and from 11 patients without known immunodeficiency was studied by immunohistochemistry using a polyclonal antibody to β2‐microglobulin. The staining intensity of spindle cells in these lesions was scored in a semiquantitative system. We found that the spindle cells of Kaposis sarcomas from AIDS patients showed significantly increased staining intensity for β2‐microglobulin compared to those of Kaposis sarcomas from non‐AIDS patients. The results may indicate that Kaposis sarcomas developing in immunocompromised individuals, such as AIDS patients, are not subject to immune selection by T cells eliminating HLA class I high‐expressing tumor cells, while this may be the case in non‐AIDS patients. Alternatively, the results may be caused by differences in the activity of cytokines, which upregulate the expression of HLA class I molecules on the cell surface.