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  • 1
    ISSN: 1432-0428
    Keywords: Diabetic nephropathy ; heparan sulphate ; heparan sulphate proteoglycan ; glomerular basement membrane ; extracellular matrix
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Diabetic nephropathy is characterized by albuminuria which proceeds to overt proteinuria. The highly negatively stained HS side chain of heparan sulphate proteoglycan (HSPG) is a major determinant of the charge-dependent permeability of the GBM. We set out to study the presence of HS and HSPG in the GBM of patients with diabetic nephropathy using newly developed monoclonal antibodies, and to compare HSPG expression to the expression of other previously investigated glomerular extracellular matrix compounds. Immunohistochemically, glomerular extracellular matrix components were analysed in 14 renal biopsies of patients with diabetic nephropathy and compared with those of normal control subjects. Monoclonal antibodies used were: JM403 against the HS side chain of GBM HSPG and JM72 against the HSPG-core protein. Also, a polyclonal antiserum (B31) against human GBM-HSPG-core protein was used. Additionally, antibodies were used against collagen types I, III, IV and against α1(IV)NC, α3(IV)NC and fibronectin. Staining was scored for intensity and for staining pattern by four independent observers who had no previous knowledge of the sample origin. No glomerular staining was seen for collagen type I. Collagen type III was present in some diabetic nodules. Anti-collagen type IV showed a decreased GBM staining in patients with diabetic nephropathy (p = 0.04). With anti-α1(IV)NC no changes in GBM staining intensity were observed; with anti-α3(IV)NC brilliant GBM staining was seen in both groups. Increased mesangial staining (p = 0.003) was seen with anti-collagen type IV in biopsies with nodular lesions. No differences were observed for fibronectin although it was abundantly present in the mesangial area of biopsies from patients with diabetic nephropathy. In biopsies with mesangial expansion and in biopsies with diabetic nodules, we observed a decreased GBM (p = 0.001) HS side chain staining (JM403) without changes in HSPG-core protein staining (JM72,B31). The HS staining pattern regularly changed from a linear to a more granular and irregular pattern. In patients with a creatinine clearance of more than 15 ml/min, the intensity of GBM HS staining showed an inverse correlation with the rate of proteinuria (r = -0.85, p = 0.004), suggesting a functional relationship. The decreased HS staining in the GBM may reflect the potentially disrupted charge barrier in diabetic nephropathy.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Melanom ; Gesicht ; Schnittrandkontrollierte Chirurgie ; Lokalrezidiv ; Keywords Melanoma ; Face ; Micrographic surgery ; Local recurrence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Background and objective. Malignant melanomas on sun-exposed skin are often poorly circumscribed and thus recur frequently. The aim of our clinical trial was to compare conventional to a modified micrographic surgery of primary melanoma. Patients/Methods. 28 patients with in-situ (n=7) and invasive (n=21) melanoma were treated with conventional surgical excision with wide margins; eight of these patients developed a local recurrence. In comparison, 20 patients with primary in-situ (n=7) and invasive (n=13) melanoma as well as four patients with recurrence after conventional surgery underwent modified micrographic surgery with delayed closure of the wound. Results. Paraffin specimens of the margins revealed in half of the patients remnants of melanoma although excision was extended to non-lesional skin. Within a mean follow-up period of 21.3 months, none of our patients treated by modified surgery developed a recurrence. Conclusions. Local recurrencies of melanoma on sun exposed skin may be avoided by means of a modified micrographic surgery using permanent histologic sections.
    Notes: Zusammenfassung Hintergrund und Fragestellung. Flächige Melanome sind in aktinisch geschädigter Haut zu den Seiten hin schlecht abgrenzbar und rezidivieren daher häufig. Anhand einer vergleichenden Studie stellen wir die Vorteile einer lückenlos schnittrandkontrollierten Chirurgie bei diesen Melanomen vor. Patienten/Methodik. 28 Patienten mit In-situ- (n=7) und invasiven Melanomen (n=21) wurden mit einem Sicherheitsabstand bis zu 3 cm operiert. Im Folgenden traten bei 8 Patienten Lokalrezidive auf. Im Vergleich zu diesem Kollektiv wandten wir bei 20 Patienten mit vergleichbaren In-situ- (n=7) und invasiven (n=13) Melanomen sowie 4 Patienten mit einem Melanomrezidiv ein lückenlos schnittrandkontrolliertes, 2-zeitiges operatives Vorgehen an. Ergebnisse. Die modifizierte Schnittrandaufarbeitung am Paraffinschnitt zeigte in 50% der Patienten trotz Exzision in klinisch gesunder Haut noch Melanomanteile. Bisher entwickelte keiner der Patienten innerhalb eines mittleren Nachbeobachtungszeitraums von 21,3 Monaten ein Lokalrezidiv. Schlussfolgerung. Die lückenlos schnittrandkontrollierte Chirurgie scheint die hohe Rezidivrate von Melanomen im Gesichtsbereich zu senken.
    Type of Medium: Electronic Resource
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