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  • Electronic Resource  (172)
  • Loose Leaf
  • 2000-2004  (172)
  • Immunohistochemistry  (100)
  • Therapy  (72)
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  • Electronic Resource  (172)
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  • 1
    Electronic Resource
    Electronic Resource
    Immunohistochemical localization of cathepsin D in colorectal tumors (2000)
    Springer
    Diseases of the colon & rectum 43 (2000), S. 396-401 
    Details
    ISSN: 1530-0358
    Keywords: Colorectal carcinoma ; Cathepsin D ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Although it has been suggested that cathepsin D, a lysosomal protease, is involved in tumor invasion and metastasis in human colorectal cancers, conflicting studies have also been reported recently. In addition, this issue has been only rarely studied in human colorectal tumors by use of immunohistochemical methods. The aim of the study presented here was to clarify not only the correlation between cathepsin D expression and tumor invasion or metastasis but also the correlation between the intracellular immunostaining pattern of cathepsin D and tumor invasion and metastasis in human colorectal tumors. METHODS: Thirty-four primary colorectal adenocarcinomas and 24 adenomas were immunostained by use of an anticathepsin D antibody. Both the incidence and the immunostaining patterns of cathepsin D were investigated in all tissue samples. RESULTS: Three different immunostaining patterns,i.e., supranuclear, basal, and diffuse, were observed in samples containing cathepsin D. Although the incidence of cathepsin D-positive carcinomas was not correlated with tumor progression, invasion, or metastasis, the immunostaining pattern was significantly correlated with lymphatic invasion. CONCLUSIONS: The results of this study suggest that abnormal cathepsin D immunostaining patterns (basal or diffuse) can be used to predict a potential for lymphatic invasion in colorectal carcinoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02258308
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  • 2
    Electronic Resource
    Electronic Resource
    Sentinel Node Biopsies in Melanoma Patients: A Protocol for Accurate, Efficient, and Cost-Effective Analysis by Preselection for Immunohistochemistry on the Basis of Tyr-PCR (2000)
    Springer
    Annals of surgical oncology 7 (2000), S. 51-54 
    Details
    ISSN: 1534-4681
    Keywords: Melanoma ; Sentinel node analysis ; Tyrosinase RT-PCR ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Immunohistochemistry (IHC) of serial sectioning is considered the gold standard for detection of melanoma activity in sentinel node (SN) biopsies. However, this is cost and labor intensive. In contrast, tyrosinase reverse transcription-polymerase chain reaction (RT-PCR) is simple and quick, but it is hampered by its extreme sensitivity. This study was performed to test whether a strategy that combines the two methods, using tyrosinase RT-PCR to preselect nodes for IHC, could be accurate and cost effective. Methods: In 36 patients, SNs were identified by scintigraphy and patent blue uptake. Of each SN, one cross section was analyzed first by hematoxylin and eosin staining. Next, all nodes were examined by serial sectioning and IHC of one-half and tyrosinase RT-PCR of the other. Before comparison, all results were documented in a blinded manner. Material costs and workload estimates were noted per SN. Results: Fifty-five SNs were retrieved from the 36 patients. Hematoxylin and eosin staining of the first cross section revealed tumor positivity in 3 patients (6 SN). Tyrosinase RT-PCR was positive in 11 of the remaining 33 patients (19 of 49 SN). Of these same 11 patients, only 5 were shown to have tumor-positive SNs by using IHC on serial sections (7 SN). All these nodes had been positive for tyrosinase on PCR. For IHC, an average of 40 sections were prepared and examined per SN at a cost of $200(U.S.)/SN. In contrast, routine tyrosinase RT-PCR costs $37(U.S.)/SN, and takes 5% of the time necessary for IHC. A strategy including hematoxylin and eosin staining on the first cross section, followed by tyrosinase RT-PCR on half of each negative (half) node, could preselect nodes to be taken through serial sectioning. In these series, such a strategy would have prevented serial sectioning and IHC of 30 SN from 22 patients. Apart from a considerable gain in efficiency, this would have reduced material costs by a minimum of $6000 (U.S.). This iscrepancy would be even higher if work intensity of analysts and pathologists were considered. Conclusions: In routine analysis of SN biopsies in melanoma patients, tyrosinase RT-PCR can be used effectively to preselect nodes for further IHC of serial sections. This method seems both time and cost effective.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s10434-000-0051-8
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  • 3
    Electronic Resource
    Electronic Resource
    Micrometastasis in lymph nodes of mucosal gastric cancer (2000)
    Springer
    Gastric cancer 3 (2000), S. 91-96 
    Details
    ISSN: 1436-3305
    Keywords: Key words Mucosal gastric cancer ; Micrometastasis ; Cytokeratin ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. Endoscopic mucosal resection is frequently used in the treatment of mucosal gastric cancer. Micrometastasis in the lymph nodes of mucosal gastric cancer remains unclear. Methods. We examined 2526 lymph nodes from 84 patients with mucosal gastric cancer. Two consecutive sections were prepared, for simultaneous staining with hematoxylin and eosin and immunostaining with CAM 5.2 monoclonal antibody against cytokeratin (CK), respectively. A clinicopathological comparison was made between patients with and without lymph node involvement. Results. Lymph node involvement was detected in 45 of 2526 (1.8%) lymph nodes. The incidence of nodal involvement was significantly increased, from 1.2% (1/84 patients) with hematoxylin and eosin staining, to 19% (16/84 patients) with CK immunostaining. Although no significant difference was found, micrometastasis to lymph nodes was more frequently detected in tumors larger than 1.0 cm (15/72 patients, 21%) than in those less than or equal to 1.0 cm (1/12 patients; 8%, P = 0.307). However, discrete CK-positive cancer cells or clusters of CK-positive cancer cells were detected only in tumors larger than 2 cm. Conclusion. Because mucosal gastric cancer of more than 1.0 cm in superficial diameter may indicate a risk of micrometastasis to lymph nodes, endoscopic mucosal resection is not recommended for these patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00011702
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  • 4
    Electronic Resource
    Electronic Resource
    Immunohistochemical investigation of a pulmonary surfactant in fatal mechanical asphyxia (2000)
    Springer
    International journal of legal medicine 113 (2000), S. 268-271 
    Details
    ISSN: 1437-1596
    Keywords: Key words Surfactant-associated protein A ; Immunohistochemistry ; Asphyxia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Law
    Notes: Abstract We evaluated the usefulness of pulmonary surfactant protein A (SP-A) as a practical diagnostic marker of fatal mechanical asphyxia in forensic autopsy cases. ¶A total of 27 cases of asphyxia were examined histologically and immunohistochemically and compared with a control group consisting of 16 cases of poisoning (n = 9) and peracute death (n = 7). Both groups showed histological findings of local atelectasis and local emphysema, congestion, intra-alveolar and interstitial edema in most cases and pulmonary hemorrhages in some cases. The mechanical asphyxia group showed a significantly increased intensity of SP-A staining in the intra-alveolar space accompanied by many massive aggregates in approximately 60% of cases, which was not found in the control group. These structures may be interpreted as aggregates of pulmonary surfactant released from the alveolar wall due to enhanced secretion caused by strong forced breathing or over-excitement of the autonomic nervous system by mechanical asphyxia. The results of our investigation suggest the practical usefulness of the immunohistochemical detection of SP-A in distinguishing mechanical asphyxia from other types of hypoxia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004149900109
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  • 5
    Electronic Resource
    Electronic Resource
    The time course of the vascular response to human brain injury – an immunohistochemical study (2000)
    Springer
    International journal of legal medicine 113 (2000), S. 288-292 
    Details
    ISSN: 1437-1596
    Keywords: Key words Brain injury ; Cortical contusion ; Vascular ¶reaction ; Immunohistochemistry ; Wound age
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Law
    Notes: Abstract In a total of 104 individuals who had sustained traumatic brain injury (TBI), the time-dependent vascular response was investigated at the injured cortical area during the first 30 weeks after the trauma. The immunohistochemical staining of the cerebral blood vessels was performed with antibodies against laminin, type IV collagen, tenascin, thrombomodulin and factor VIII associated antigen. Compared to the immunoreactivity in unaltered control tissue, a significantly increased vascular expression could be detected in cortical contusions after a postinfliction interval of at least 3 h for factor VIII, after 1.6 days for tenascin or after 6.8 days for thrombomodulin, whereas the immunostaining for laminin and type IV collagen was regularly positive even in the vascular endothelium of uninjured brain tissue.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004149900126
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  • 6
    Electronic Resource
    Electronic Resource
    Diagnostisches und therapeutisches Management von Begleitverletzungen beim komplexen Beckentrauma (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. 28-38 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Beckenverletzung ; Begleitverletzung ; Diagnostik ; Therapie ; Algorithmus ; Keywords ; Pelvic trauma ; Concomitant lesions ; Diagnosis ; Therapy ; Algorithm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: The injuries that typically accompany pelvic fractures are lesions of the urogenital tract, the lumbosacral plexus, and the retroperitoneal and intra-abdominal organs. The prognosis depends heavily on early recognition of the abdominal- and retroperitoneal injuries, which are frequently a primary threat to vital functions. Missing these injuries would be very serious, as the mortality with early diagnosis and adequate treatment is normally low; according to the results reported in the literature, delayed therapy leads to increasing mortality rates of up to 80%. Experience in trauma centres has shown that for complete ascertainment of accompanying injuries it is necessary to perform a systematic diagnosis according to a fixed algorithm. The treatment of the concomitant injuries accompanying a complex pelvic trauma is fundamentally different from the treatment of patients with isolated injuries. A high survival rate with a low postoperative complication rate cannot be achieved except with specialist surgical management tailored to the primary life-threatening lesions. After determination and recording of the injury pattern a therapy concept must be made at once. A trauma algorithm can be helpful when treatment is selected. Step-by-step treatment with several operative phases alternating with recovery and stabilization periods under intensive care conditions has proved worthwhile.
    Notes: Typische Begleitverletzungen von Beckenfrakturen sind Verletzungen des Urogenitaltrakts, des Plexus lumbosacralis und intraabdominaler Organe. Entscheidend für die Prognose ist das rechtzeitige Erkennen v. a. der häufig primär vital gefährdenden Abdominal- und Retroperitonealverletzungen. Das Übersehen dieser Verletzungen ist besonders tragisch, da bei rechtzeitiger Diagnostik und adäquater Versorgung die Letalitätsrate in der Regel gering ist; bei verzögerter Therapie resultieren nach den Angaben in der Literatur Letalitätsraten bis zu 80%. Die Erfahrung in Traumazentren hat gezeigt, dass zur vollständigen Erfassung der Begleitverletzungen die systematische Diagnostik nach einem festgelegten Algorithmus erfolgen sollte. Die Behandlung der Begleitverletzungen im Rahmen eines komplexen Beckentraumas unterscheidet sich prinzipiell von der bei Monoverletzten. Voraussetzung für eine hohe Überlebensrate mit geringer postoperativer Komplikationsrate ist ein prioritätenorientiertes chirurgisches Vorgehen. Nach Erfassung des Verletzungsmusters muss bereits initial ein Therapiekonzept erstellt werden. Zur Entscheidungsfindung kann ein Traumaalgorithmus herangezogen werden. Es hat sich eine abgestufte Versorgung mit mehreren operativen Phasen und zwischengeschalteten Erholungs- und Stabilisierungsphasen unter Intensivbedingungen bewährt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100390050088
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  • 7
    Electronic Resource
    Electronic Resource
    Komplexverletzung des Schultergürtels (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. 240-248 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Komplexe Schultergürtelverletzung ; Diagnostik ; Therapie ; Interdisziplinäres ¶Management ; Keywords ; Complex shoulder girdle trauma ; Diagnosis ; Therapy ; Interdisciplinary management
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: The particular injury pattern of complex joint trauma means that a standardized operative procedure would be difficult to devise and an individual therapy plant is therefore essential for each patient. One of the main problems consists in the recognition and adequate treatment of associated vascular and neural lesions. The treatment of a complex joint trauma makes extremely high demands on the trauma-team in terms of both diagnostis and therapy and is an interdisciplinary challenge. On the basis of a detailed literature search and evaluation of the procedures we have adopted in sample cases, we suggest an algorithm for interdisciplinary management of severe combination injuries of the shoulder region.
    Notes: Die Problematik des komplexen Gelenktraumas besteht darin, dass aufgrund des besonderen Verletzungsmusters ein standardisiertes operatives Vorgehen erschwert und deshalb ein individuelles Therapiekonzept essenziell ist. Ein Hauptproblem besteht in ¶der Erkennung und der adäquaten Behandlung assoziierter Gefäß- und Nervenläsionen. Die Behandlung eines komplexen Gelenktraumas stellt höchste diagnostische und therapeutische Ansprüche an das Traumateam und bedeutet eine interdisziplinäre Herausforderung. Aufgrund einer eingehenden Literaturrecherche und der Auswertung des eigenen Vorgehens anhand exemplarisch ausgewählter Fälle wird versucht, einen Algorithmus der interdisziplinären Komplexversorgung schwerer Kombinationsverletzungen der Schulterregion zu erstellen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/
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  • 8
    Electronic Resource
    Electronic Resource
    Was man über die kindliche Fraktur des Ellbogengelenks wissen sollte (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. S51 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Ellbogenverletzungen ; Wachstumsalter ; Diagnostik ; Therapie ; Key words ; Ellbow joint injuries ; Adolescence ; Diagnosis ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Fractures and dislocations of the elbow are some of the most common injuries in childhood and adolescence. The majority occur in the course of sport and play, for example as the result of falling from apparatus used in gymnastics or a bike, or falling while engaging in such popular sports as in-line-skating or skateboarding. Elbow injuries can be divided into dislocations of the joint alone and fractures, of the distal humerus or the proximal radius and ulna, or combinations of both dislocation and fracture. In addition, a differentiation is made between extra- and intraarticular fracture types, the latter being seen as either partial or complete joint lesions.
    Notes: Zusammenfassung Luxationen und/oder Frakturen am Ellbogen gehören zu den häufigsten Verletzungen im Wachstumsalter überhaupt. Sie entstehen überwiegend bei Sport und Spiel, z. B. durch Sturz von einem Turngerät, von Zweirädern oder während der Ausübung moderner Sportarten wie In-line-Skating, Rollschuhlauf und Skateboardfahren. Bei den Verletzungen werden reine Luxationen von Frakturen entweder am körperfernen Oberarmende oder an den gelenkbildenden Anteilen von Radius und Ulna unterschieden. Ein weiteres Unterscheidungsmerkmal ist die Abgrenzung extraartikulärer von intraartikulären Frakturformen, wobei letztere entweder als partielle oder komplette Bruchform imponieren.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014924
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  • 9
    Electronic Resource
    Electronic Resource
    Stumpfe Schultergelenkverletzungen und ihre Begutachtung (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. S186 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter Schultergürtel ; Stumpfe Verletzungen ; Rotatorenmanschettenruptur ; Schulterluxation ; Therapie ; Keywords Shoulder girdle ; Blunt injuries ; Rupture of rotator cuff ; Shoulder dislocation ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract It is difficult to assess blunt injuries in the region of the shoulder girdle because of the overlying acute and chronic processes. In assessments of rotator cuff ruptures in particular, in over 50% of cases the rupture could be explained by a degenerative process. This makes the assessment difficult, and also the decision as to whether or not the injury is due to an occupational accident. The diagnostic procedures applied should exclude a degenerative aetiology immediately after an accident in all cases. Rupture of the rotator cuff is often associated with an impingement syndrome and leads to corresponding symptoms in the subacromial space. Treatment of a rotator cuff rupture always involves a diagnostic arthroscopy as the first step, after which a reconstruction can be undertaken, either by way of the anterolateral approach after Neer or, in many cases, arthroscopically. Reconstruction of the rotator cuff must include outward mobilization of the muscles and a secure, mostly transosseous suture. Transference of a pedunculated tendon is indicated for large defects in the rotator cuff. In the case of dislocation of the shoulder with subsequent shoulder instability degenerative change and any possible multidirectional instability should be defined. Unidirectional instability with a demonstrable Bankart lesion has a good prognosis when surgery is performed without delay. In view of the high recurrence rate early treatment is indicated especially in young persons and in patients with a high activity level. Following detection of the Bankart lesion an arthroscopic procedure with refixation of the capsule–labrum complex is the method of choice.
    Notes: Zusammenfassung Stumpfe Verletzungen im Bereich des Schultergürtels sind aufgrund einer Überlagerung akuter und chronischer Prozesse schwer beurteilbar. Insbesondere bei der Beurteilung der Rotatorenmanschettenruptur ist diese nachweislich in über 50% der Fälle auf dem Boden eines degenerativen Prozesses begründet. Dies macht die Begutachtung und die Abgrenzung eines Arbeitsunfalls schwierig. Die Diagnostik sollte auf jeden Fall unmittelbar nach einem Unfall eine degenerative Genese abgrenzen. Zusätzlich muss die Schmerzsymptomatik gezielt untersucht und von vertebragenen Beschwerden abgegrenzt werden. Die Rotatorenmanschettenruptur geht häufig mit einem Impingementsyndrom einher und führt zu entsprechenden Beschwerden im Subakromialraum. Die Behandlung der Rotatorenmanschettenruptur beinhaltet immer im ersten Schritt ¶eine diagnostische Arthroskopie, anschließend kann entweder über den anterolateralen Zugang nach Neer oder in vielen Fällen auch arthroskopisch eine Rekonstruktion vorgenommen werden. Die Rekonstruktion der Rotatorenmanschette muss eine ausgiebige Mobilisation der Muskulatur und eine ¶sichere, meist transossäre Naht beinhalten. Der gestielte Sehnentransfer ist bei großen Defekten der Rotatorenmanschette angezeigt. Bei der Schulterluxation mit anschließender Schulterinstabilität sind ebenfalls ¶eine degenerative Veränderung und eine mögliche multidirektionale Instabilität abzugrenzen. Bei unidirektionaler Instabilität mit nachweisbarer Bankart-Läsion ist die Prognose bei unmittelbarer operativer Versorgung gut. Gerade beim jungen Menschen und bei Patienten mit hohem Aktivitätsniveau ist aufgrund der hohen Reluxationsrate ein frühes Vorgehen angezeigt. Nach Nachweis der Bankart-Läsion ist ein arthroskopisches Vorgehen mit Refixation des Kapsel-Labrum-Komplexes die Methode der Wahl.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014885
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  • 10
    Electronic Resource
    Electronic Resource
    Psychische Beeinträchtigungen als Unfallfolgen aus ärztlicher Sicht (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. S456 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter Trauma ; Akute Belastungsstörung ; Posttraumatische Belastungsstörung ; Therapie ; Medizinische Begutachtung ; Keywords Trauma ; Acute stress disorder ; Posttraumatic stress disorder ; Therapy ; Medico-legal expertise
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract ‘Psychopathology after trauma’ mostly refers to cognitive or affective impairment after direct or indirect damage to brain tissue. Patients who have suffered a whiplash injury of the cervical spine, even without direct trauma to brain tissue, also often complain of cognitive or affective dysfunction for prolonged periods after the injury. Even more difficult to evaluate is psychopathology arising in the aftermath of severely distressing events, such as major disastrous accidents, natural catastrophes or assault. The medical expert must be aware of a variety of posttraumatic psychiatric disorders with different courses and symptoms and must be able to distinguish these from endogenous or merely coincident psychiatric disorders. In this paper, we outline the relevant diagnoses and diagnostic criteria, with special refrence to posttraumatic stress disorder (PTSD). It should be emphasized that while acute stress disorder is common after stressful experiences, PTSD is most likely to develop in the presence of personality traits or a concurrent psychiatric illness predisposing to the disorder. The nature of the trauma sustained is significant: for example, trauma inflicted by human aggression causes PTSD significantly more often than similar injuries suffered as the result of a motor vehicle accident. Finally, therapeutic strategies for posttraumatic disorders are briefly reviewed.
    Notes: Zusammenfassung Mit posttraumatischen psychischen Störungen sind in der Regel kognitive oder affektive Beeinträchtigungen in der Folge direkter oder indirekter Hirngewebeschäden gemeint. Aber auch Patienten mit Halswirbelsäulenschleudertrauma beklagen häufig und über lange Zeit kognitive oder affektive Störungen ohne Nachweis einer Hirnschädigung. Noch problematischer sind psychische Störungen in der Folge erheblich belastender Ereignisse, wie Unfälle katastrophalen Ausmaßes, Naturkatastrophen oder Überfällen, zu beurteilen. Dem ärztlichen Gutachter obliegt die Aufgabe, eine Reihe posttraumatischer Störungen, die sich hinsichtlich des Verlaufs und der Symptome unterscheiden, zu kennen und von anlagebedingten oder koinzidierenden psychischen Störungen zu differenzieren. In der vorliegenden Arbeit werden die relevanten Diagnosen ¶und diagnostischen Kriterien mit besonderer Behandlung der posttraumatischen Belastungsstörung (PTSD) besprochen. Hervorzuheben ist, dass es nach erheblich belastenden Erlebnissen recht häufig zu akuten Belastungsreaktionen kommt, während die PTSD in der Regel dann auftritt, wenn eine besondere persönliche Disposition oder psychiatrische Komorbidität vorliegen. Ferner kommt der Art des belastenden Erlebnisses Bedeutung zu. So wird eine PTSD häufiger nach Ausbrüchen menschlicher Aggression als nach z. B. Verkehrsunfällen gefunden. Abschließend wird ein kurzer Überblick über therapeutische Möglichkeiten bei posttraumatischen Störungen gegeben.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014970
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  • 11
    Electronic Resource
    Electronic Resource
    Arthroskopische Behandlung der traumatischen Schulterinstabilität (akut – chronisch) (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. S400 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter Schulterinstabilität ; Arthroskopische Stabilisierung ; Therapiestrategie ; Akut ; Chronisch ; Keywords Instability of the shoulder ; Arthroscopic repair ; Therapy ; Acute ; Chronic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Traumatic instability of the shoulder has to be distinguished from instability due to capsular hyperlaxity if a stable shoulder and good functional results are to be achieved after surgery. Physical examination, radiological studies and arthroscopy are the most important diagnostic tools for this distinction. On the basis of our own experience and the results reported in the literature, we propose a strategy of patient selection for an arthroscopic stabilizing procedure. This procedure is indicated for first-time, traumatic dislocation and for chronic instability with a history of fewer than five recurrences without hyperlaxity.
    Notes: Zusammenfassung Die traumatische Schulterinstabilität muss von der Instabilität aufgrund hyperlaxer Kapsel-Band-Strukturen unterschieden werden, um dem therapeutischen Ziel einer stabilen und in ihrer Funktion nicht gestörten Schulter nahe zu kommen. Hierzu sind die klinische, radiologische und arthroskopische Diagnostik entscheidend. Auch der Enstehungsmechanismus und die Häufigkeit der Luxationen müssen berücksichtigt werden. Aufgrund der bisher gemachten Erfahrung und den in der Literatur verfügbaren Ergebnissen entstand eine Therapiestrategie der traumatischen Schulterinstabilität, die in Abhängigkeit von der präoperativen Reluxationsrate, den anatomischen Gegebenheiten und dem Anspruch des Patienten eine Selektion für oder wider eine arthroskopische Stabilisierungsoperation vorschlägt. Die Indikation zu diesem Eingriff sehen wir bei der traumatischen Erstluxation und der rezidivierenden traumatischen Schulterinstabilität ohne Hyperlaxität, wenn weniger als 5 Rezidive in der Anamnese zu erheben sind.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014955
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  • 12
    Electronic Resource
    Electronic Resource
    Clinical significance of disordered beta-catenin expression pattern in human gastric cancers (2000)
    Springer
    Gastric cancer 3 (2000), S. 193-201 
    Details
    ISSN: 1436-3305
    Keywords: Key words Gastric cancer ; Beta-catenin ; E-cadherin ; Immunohistochemistry ; Western blot
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Background. Beta-catenin plays two distinct roles, in intercellular adhesion by E-cadherin, and in transcriptional activation via TCF/LEF. Theoretically, the former role is tumor-suppressive, while the latter is oncogenic. We investigated the involvement of beta-catenin in the histogenesis and clinical outcome of gastric cancers. Methods. The expression pattern of beta-catenin was evaluated in stomach and lymph nodes from 82 patients with gastric cancer by immunohistochemistry and Western blot. Its association with E-cadherin expression and clinicopathological factors, including histological type and postoperative survival, was examined. Results. Beta-catenin expression was classified into two patterns, normal (23.2%; 19 patients) and disordered (76.8%; 63 patients), the latter being subclassified as overexpressed (7.3%; 6 patients) and reduced (69.5%; 57 patients). A disordered beta-catenin expression pattern was significantly correlated with diffuse type adenocarcinoma and deep tumor infiltration (P = 0.0154), but was not associated with lymph node metastasis (P = 0.7877). E-cadherin was always expressed at the cell membrane, and disordered beta-catenin expression was significantly associated with reduced E-cadherin expression (P 〈 0.0001). On univariate analysis, the beta-catenin pattern, as well as depth of invasion and lymph node metastasis, was associated with postoperative prognosis; however, only lymph node metastasis was an independent prognostic factor on multivariate analysis. Interestingly, different disordered patterns of beta-catenin expression, both overexpressed and reduced, were associated with E-cadherin reduction and poorer postoperative survival. Conclusion. Although disordered patterns of beta-catenin expression varied in gastric cancers, they were consistently associated with cancer progression.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00011717
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  • 13
    Electronic Resource
    Electronic Resource
    Die ausgedehnte venös-aneurysmatische Malformation der V. poplitea (2000)
    Springer
    Gefässchirurgie 5 (2000), S. 188-191 
    Details
    ISSN: 1434-3932
    Keywords: Schlüsselwörter Venöses Poplitealaneurysma ; Differentialdiagnose ; Knieschmerz ; Therapie ; Keywords Popliteal venous aneurysm ; Differential diagnosis ; Knee pain ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract  A rare cause of painful swelling of the knee cavity can be an aneurysm of the popliteal vein. Only 28 cases are reported in the literature. We treated a 20-year-old male patient who underwent three arthroscopies, one operation and one MRI; finally, phlebography detected a popliteal vein aneurysm and a malformation of the deep venous system of the popliteal and proximal calf veins. To avoid the threat of pulmonary embolism a resection of the aneurysm with interposition of a venous autograft was performed. Twelve months after the operation the patient is free of symptoms with a patent autograft.
    Notes: Zusammenfassung  Eine seltene Ursache schmerzhafter Schwellungen in der Kniekehle kann ein Aneurysma der V. poplitea sein. Bisher wurden 28 Fälle dieser Fehlbildung in der Weltliteratur beschrieben. Wir sahen einen 20-jährigen männlichen Patienten, bei dem nach 3 Arthroskopien, einer Arthrotomie und einer MRT durch eine Phlebographie ein venöses Aneurysma der V. poplitea mit venös-aneurysmatischer Malformation der proximalen Unterschenkelvenen festgestellt wurde. Um eine potentiell tödliche Lungenembolie zu vermeiden, erfolgte die Resektion mit Interposition der kontralateralen gedoppelten V. saphena magna. 12 Monate nach der Operation hat der Patient bei duplexsonographisch gutem Flow im Interponat keine Beschwerden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00010592
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  • 14
    Electronic Resource
    Electronic Resource
    Gelenkfortsatzfrakturen (2000)
    Springer
    Mund-, Kiefer- und Gesichtschirurgie 4 (2000), S. S110 
    Details
    ISSN: 1434-3940
    Keywords: Schlüsselwörter ; Unterkiefer ; Gelenkfortsatzfrakturen ; Diagnostik ; Therapie ; Key words ; Mandible ; Condylar neck fracture ; Diagnostic ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Among mandibular fractures, those of the condylar neck hold a special position due to the exceptional anatomical situation. Computer assisted tomography and magnetic resonance tomography have improved diagnostic evaluation. Indication for surgical treatment is given in cases of severely displaced or dislocated fractures. In surgical management, the preauricular, submandibular, retromandibular, and oral approach have been established. For sufficient fixation of fragments, procedures rendering a functional stability, like osteosynthesis with lag screw or by miniplating, are required.
    Notes: Zusammenfassung Die Gelenkfortsatzfrakturen nehmen aufgrund der besonderen anatomischen Situation eine Sonderstellung innerhalb der Unterkieferfrakturen ein. Die Computertomographie und das MRT haben die Diagnostik wesentlich verbessert. Die Indikation zur operativen Behandlung besteht bei stark dislozierten oder luxierten Frakturen. Als operativer Zugang sind der präaurikuläre-, sub- bzw. perimandibuläre, retromandibuläre und orale Zugang etabliert. Zur Fixation der Fragmente sollten ausschließlich funktionsstabile Verfahren, wie die Miniplatte oder Zugschraube verwendet werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014531
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  • 15
    Electronic Resource
    Electronic Resource
    Malignes Melanom der Kopf-Hals-Region (2000)
    Springer
    Mund-, Kiefer- und Gesichtschirurgie 4 (2000), S. S177 
    Details
    ISSN: 1434-3940
    Keywords: Schlüsselwörter ; Malignes Melanom ; Inzidenz ; Diagnostik ; Therapie ; Key words ; Malignant melanoma ; Incidence ; Diagnostic procedure ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Malignant melanoma is one of the most frequent malignancies of the skin. This is particularly true of malignant melanoma in juveniles. Its incidence has more than doubled from the 1970s to the mid-1990s. Presently, 15 new cases are recorded per 100,000 inhabitants a year in Germany. At Fachklinik Hornheide, a tumor center specializing in skin neoplasm with patients being referred from all over Germany, the number of melanoma patients treated per year has been approximately 500–¶550 for the past 10 years. In the present study, the state-of-the-art therapy for primary melanoma and treatment of the regional lymph node system is discussed. The radical treatment formerly advocated with wide tumor resection plus radical neck dissection is no longer justified for this immunogenic malignant tumor caused by endogenic as well as exogenic factors. “Sentinel lymph node” imaging by means of radioactive substances for diagnosing possible melanoma metastases in adjacent lymph nodes has changed the therapeutical concept. Tumor staging by means of ultrasound, CT, MRT, or PET allows the differentiation of tumors without distant metastases and a favorable prognosis, from melanomas which have to be considered as generalized disease. In addition to surgical resection of the tumor and neck dissection for removal of lymph nodes, adjuvant immunotherapy with interferon-α is capable of prolonging survival without a recurrence. Palliative chemotherapy or immunotherapy are valuable options for cases with generalized melanoma. Vaccination with a melanoma-associated antigen or dendritic cells is at an experimental stage and may become part of future treatment strategies.
    Notes: Zusammenfassung Das maligne Melanom gehört, insbesondere in jugendlichen Altersgruppen, zu den häufigsten malignen Tumoren der Haut. Seine Inzidenz hat sich von den 70er Jahren bis zur Mitte der 90er mit etwa 15 Fällen/¶100.000 Einwohnern und Jahr mehr als verdoppelt. In der Fachklinik Hornheide, einer Tumorklinik der Haut mit bundesweiten Zuweisungen, hat sich dagegen im letzten Jahrzehnt die Zahl der behandelten Patienten auf etwa 500–550 Fälle pro Jahr stabilisiert. Die vorliegende Arbeit soll den aktuellen Standard der Therapie der Primärtumoren und der regionären Lymphabflussregion darstellen. Dabei soll vermittelt werden, dass das frühere radikale Behandlungskonzept mit großflächigen lokalen Tumorresektionen und einer radikalen Ausräumung aller Lymphknotenstationen des Halses diesem immunogenen bösartigen Tumor, dessen Entwicklung teils endogenen und teils exogenen Faktoren unterliegt, nicht mehr gerechtfertigt ist. Schon im Bereich der Diagnostik der fraglichen lymphogenen Metastasierung des Melanoms hat die Darstellung des „sentinel-lymph-node“ mit radioaktivem Material eine Änderung des Therapiekonzepts erzwungen. Das Tumorstaging mit Hilfe der Sonographie, der CT-, der MRT- und PET-Untersuchungen vermag prognostisch günstige Tumoren ohne Nachweis von Fernmetastasen von solchen Melanomen zu unterscheiden, die als generalisierte Erkrankung zu bewerten sind. Neben der operativen Entfernung des Tumors und der Ausräumung der Lymphknotenstationen des Halses ist in bestimmten Stadien die adjuvante Immuntherapie mit Interferon α geeignet, das rezidivfreie Überleben zu verlängern. Bei einer Generalisierung besteht die Option einer palliativen Chemo- oder Immunochemotherapie. Experimentelle Behandlungsansätze überprüfen den Einsatz von Vakzinierungsstrategien mit melanomassoziierten Antigenen und dendritischen Zellen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014539
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  • 16
    Electronic Resource
    Electronic Resource
    Histological study on pN upgrading of oral cancer (2000)
    Springer
    Virchows Archiv 437 (2000), S. 116-121 
    Details
    ISSN: 1432-2307
    Keywords: Key words Oral cancer ; pN upgrading ; Immunohistochemistry ; Micrometastasis ; Semiserial sectioning
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The International Union Against Cancer (UICC) does not define the number of sections required from each regional lymph node to record pTNM classification. This study was designed to clarify the incidence of occult metastasis and to assess the pN upgrading of patients with oral cancer. Ultimately, this study led to a proposal for appropriate semiserial sectioning guidelines. Five hundred fifty-four nonmetastatic cervical lymph nodes taken from 73 patients with oral cancer were subjected to hematoxylin-eosin (HE) staining and keratin immunohistochemistry. Micrometastases, defined as foci ≤3 mm, were detected in 29 sites of 23 lymph nodes (4.2%) of 16 patients (21.9%). In 9 patients (12.3%) pN upgrading was needed: in 6 from pN0 to pN1, in 1 from pN0 to pN2b, and in 2 from pN1 to pN2b. The remaining 13 lymph nodes with occult metastasis were found in 5 pN2b and 2 pN2c patients, resulting in no pN upgrading. Occult metastasis was also detected in 6 small lymph nodes ≤5 mm in diameter. The average minor axis of the micrometastasis was 1.36±0.85 mm. We propose that the lymph nodes should be cut and examined at 1-mm intervals to detect micrometastatic foci and to evaluate the pN classification accurately.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280000199
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  • 17
    Electronic Resource
    Electronic Resource
    In situ reverse-transcriptase polymerase chain reaction demonstration of the EWS/FLI-1 fusion transcript in Ewing’s sarcomas and peripheral primitive neuroectodermal tumors (2000)
    Springer
    Virchows Archiv 437 (2000), S. 234-240 
    Details
    ISSN: 1432-2307
    Keywords: Keywords Small round cell tumors ; Ewing’s sarcoma ; Translocation ; Immunohistochemistry ; Differential diagnosis ; RT-PCR
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  It is now widely accepted that the EWS/FLI-1 fusion transcript is associated with tumors of the Ewing family. To test whether it is possible to detect the fusion transcript by means of combining polymerase chain reaction (PCR) methodology and immunohistochemistry, we investigated tumors of the Ewing family using in situ reverse transcriptase (RT)-PCR. We were able to demonstrate the t(11;22) fusion transcript in five of six cases of Ewing’s sarcoma and four of four peripheral primitive neuroectodermal tumors. These results were confirmed using fluorescence in situ hybridization in seven tumor samples. In situ RT-PCR-labeled fusion transcripts were found in virtually all tumor cells within a given sample, indicating that each cell possessed the t(11;22) transcript. We conclude from these results that in situ RT-PCR can be used for the rapid detection of EWS/FLI-1 fusion transcripts in biopsy material. The findings also suggest that all cells of the tumors of the Ewing family carry the EWS/FLI-1 fusion transcript.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280000252
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  • 18
    Electronic Resource
    Electronic Resource
    Detection of gonadotropin-releasing hormone receptor in normal human pituitary cells and pituitary adenomas using immunohistochemistry (2000)
    Springer
    Virchows Archiv 437 (2000), S. 264-269 
    Details
    ISSN: 1432-2307
    Keywords: Keywords Gonadotropin-releasing hormone receptor ; Pituitary gland ; Immunohistochemistry ; Colocalization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Gonadotropin-releasing hormone (GnRH), which is a well-known regulator of gonadotroph function, has recently been considered to be a paracrine factor involved in the control of somatotroph, lactotroph, and corticotroph cells. GnRH action is initiated by binding to a specific cell surface receptor, the gonadotropin-releasing hormone receptor (GnRHR), which is expressed by follicle-stimulating hormone/luteinizing hormone (FSH/LH) cells. Using in situ hybridization techniques, GnRHR messenger ribonucleic acid (mRNA) has recently been detected in normal human anterior pituitary gland and in various pituitary adenomas, including FSH/LH-cell, growth hormone (GH)-cell, adrenocorticotropic hormone (ACTH)-cell, and null-cell adenomas. However, immunohistochemical studies indicating the specific cell distribution of GnRHR in normal pituitary cells have never been reported. The aim of the present investigation was to evaluate the immunohistochemical expression of GnRHR in different types of normal pituitary cells and related tumors. Using double-label immunohistochemical techniques on formalin-fixed and paraffin-embedded tissues and specific antibodies directed against pituitary hormones and GnRHR, we found GnRHR immunoreactivity not only in FSH/LH cells, but also in GH- and thyroid-stimulating hormone (TSH) cells. GnRHR was detected in FSH/LH-cell, GH-cell, mixed GH- and prolactin (PRL)-cell, and α-subunit (α-SU)/null-cell adenomas. The findings of this study suggest that the interaction between GnRH and GnRHR may play a role in paracrine/autocrine regulation of different types of normal pituitary cells and pituitary adenomas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280000247
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  • 19
    Electronic Resource
    Electronic Resource
    CD99 immunoreactivity in gastrointestinal and pulmonary neuroendocrine tumours (2000)
    Springer
    Virchows Archiv 437 (2000), S. 270-274 
    Details
    ISSN: 1432-2307
    Keywords: Keywords CD99 antigen ; Neuroendocrine tumours ; Immunohistochemistry ; Cell-to-cell adhesion ; Proliferative activity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Although considered a specific marker for Ewing’s sarcoma/peripheral neuroectodermal tumour, the MIC2 gene product (CD99) has been immunolocalised in a variety of human tumours. The present study evaluated immunohistochemically the prevalence of CD99 expression in a series of 68 neuroendocrine tumours of different gastrointestinal and pulmonary sites. We now report on membrane and/or granular cytoplasmic immunoreactivity in 25% of these tumours, independent of their anatomical sites. In lung neuroendocrine tumours, CD99 was preferentially confined to typical carcinoids (P=0.009). A statistically significant relationship was observed between the number of CD99 positive cells but not the immunostaining patterns and the presence of local invasion and/or distant metastases (P〈0.001). Moreover, there was a tendency for CD99-reactive tumours to show a reduced proliferative activity expressed by a Ki67 index of 2% (P=0.119). The number of CD99 immunoreactive cells or patterns of immunoreactivity did not correlate with the presence of associated clinical syndrome or particular hormonal immunostaining. Although the molecular basis underlying CD99 expression in neuroendocrine tumours is still poorly understood, our data suggest that CD99 may be involved in cell-to-cell adhesion of neuroendocrine tumour cells and in downregulation of their proliferative activity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280000240
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  • 20
    Electronic Resource
    Electronic Resource
    Characterization of Wue-1, a novel monoclonal antibody that stimulates the growth of plasmacytoma cell lines (2000)
    Springer
    Virchows Archiv 437 (2000), S. 372-379 
    Details
    ISSN: 1432-2307
    Keywords: Keywords Monoclonal antibody ; Lymphoma ; Myeloma ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A new monoclonal antibody, Wue-1, which specifically recognizes normal and malignant plasma cells, is characterized. Biochemical studies showed that monoclonal antibodies (mAbs) recognize a protein of 94 kDa. Using triple-staining flow cytometry and double-labeling immunohistochemical techniques, two populations of plasma cells, i.e. lymphoplasmocytoid plasma cells located in the germinal center of lymphoid organs and reticular plasma cells at the paracortex or medullary cords of secondary lymphoid tissues, were distinguished. Wue-1 is expressed when B-cell markers become lost and secretory activity with plasma cell morphology appears. Cell surface markers were identified on normal plasma cells and compared with their malignant counterpart in vivo. Terminal plasma–cellular differentiation of malignant low- and high-grade B-cell lymphoma and anaplastic plasmacytoma, otherwise difficult to identify with conventional B-cell markers on tissue sections or fluorescence-activated cell sorter analyses, were detectable by Wue-1. In cell culture, Wue-1 enhanced the proliferation of myeloma cell lines but not normal plasma cells in a dose-dependent manner. Since Wue-1-induced proliferation was increased by interleukin (IL)-6, Wue-1 recognizes a so far unidentified antigen with functional properties. Therefore, Wue-1 represents a useful new tool for therapy and for the in vivo and in vitro studying of B-cell lymphomas and the mechanisms of B-cell differentiation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280000258
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  • 21
    Electronic Resource
    Electronic Resource
    Solitary fibrous tumour of the adrenal gland associated with pregnancy (2000)
    Springer
    Virchows Archiv 437 (2000), S. 445-449 
    Details
    ISSN: 1432-2307
    Keywords: Keywords Solitary fibrous tumour ; Adrenal gland ; Pregnancy ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Solitary fibrous tumour (SFT), first described as a pleural lesion, has been reported in several extrathoracic sites over the past 10 years. We describe a SFT of the left adrenal gland incidentally discovered in a 23-year-old, 22-week pregnant woman and characterised by a rapid growth during the third trimester of pregnancy. Elevated serum and urinary levels of cortisol and elevated blood levels of delta 4 androstendione and 17-OH progesterone were observed. After spontaneous delivery, the patient underwent laparoscopic resectioning of the mass and of the left adrenal gland from which the tumour was apparently originating. The kidney was not involved, and no other abdominal tumours were found. Histological and immunohistochemical features were typical of SFT of pleura and other locations. Only one case of adrenal SFT is on record, and the adrenal gland is to be added to the long list of extrathoracic locations of SFT. The association with pregnancy was a previously unrecognised event in SFT. The focal expression of progesterone receptors in the tumour cells may be related to pregnancy. This observation prompted an analysis of steroid hormone receptors in SFT of classical sites (pleura). Two of five cases had focal progesterone receptors too, a finding which deserves further investigations in a much larger series of SFTs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280000268
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  • 22
    Electronic Resource
    Electronic Resource
    A case of anaplastic lymphoma kinase-positive anaplastic large cell lymphoma presenting with spontaneous splenic rupture: an extremely unusual presentation (2000)
    Springer
    Virchows Archiv 437 (2000), S. 459-464 
    Details
    ISSN: 1432-2307
    Keywords: Keywords Non-Hodgkin’s lymphoma ; Immunohistochemistry ; ALK1 ; T-cell lymphoma ; Splenic rupture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  In a 22-year-old male with a 10-day history of fever, painful swelling in the left groin, and abdominal complaints, emergency surgery was performed because of spontaneous splenic rupture. At histology, a cellular infiltrate of intermediate-sized atypical lymphocytes was seen in the splenic white pulp, staining for T-cell markers. In addition, CD30 and anaplastic lymphoma kinase 1 (ALK) were diffusely positive, thus, representing a case of anaplastic large cell lymphoma (ALCL), T-cell, ALK-positive, small cell monomorphic variant. ALK-positive ALCL patients generally bear a much better prognosis than patients with T-cell lymphomas, unspecified, or ALK-negative ALCL. Therefore, besides the very unusual clinical presentation, this case highlights the importance of immunostaining for CD30 and ALK in all T-cell lymphomas. This report is the first extensive description of ALK-positive ALCL involvement of the spleen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280000251
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  • 23
    Electronic Resource
    Electronic Resource
    Dopamine D1-D5 receptor protein immunohistochemistry in dog pial arteries (2000)
    Springer
    The journal of headache and pain 1 (2000), S. 163-168 
    Details
    ISSN: 1129-2377
    Keywords: Key words Dopamine receptors ; Pial arteries ; Immunohistochemistry ; Prejunctional receptors ; Post-junctional receptors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The localization of dopamine D1-D5 receptor protein was investigated in different sized dog pial arteries. This was done to further understand the pathophysiology of cerebrovascular dopaminergic system in migraine. The study was performed in sections of dog brain including the pia-arachnoid membrane, which were processed for indirect immunohistochemistry using antibodies raised against dopamine D1-D5 receptor protein. A faint dopamine D1 receptor protein immunoreactivity was observed in smooth muscle of the tunica media of different sized pial arteries. Dopamine D2 receptor protein immunoreactivity was located in the adventitia and adventitia-media border of pial arteries. In the same area tyrosine hydroxylase immunoreactive nerve fibers were found. No dopamine D3 receptor immunoreactivity was detectable in dog pial arteries. A faint dopamine D4 receptor protein immunoreactivity was observed in dog pial arteries, with a localization similar to that of D2 receptor protein. A moderate dopamine D5 receptor protein immunostaining was observed in smooth muscle of the tunica media. These findings indicate that dog pial arteries express dopamine D1-like (D1 and D5) and D2-like (D2 and D4) receptor subtypes and display, respectively, a muscular (post-junctional) and probably prejunctional localization. These results, the first analysis of dopamine D1-D5 receptor subtype distribution in the cerebrovascular tree, suggest that dopamine is involved in the regulation of cerebral circulation. These finding may help evaluate the role of cerebrovascular dopaminergic mechanisms in the pathogenesis of migraine.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s101940070038
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  • 24
    Electronic Resource
    Electronic Resource
    Excitatory amino acids, monoamine, and nitric oxide synthase systems in organotypic cultures: biochemical and immunohistochemical analysis (2000)
    Springer
    Amino acids 19 (2000), S. 33-43 
    Details
    ISSN: 1438-2199
    Keywords: Keywords: Amino acids ; Basal ganglia ; Dopamine ; Nitric oxide ; Excitatory amino acids ; Organotypic culture ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary. The nigrostriatal and mesolimbic systems of the rat have been re-constructed using the organotypic culture model, whereby neonatal brain tissue is grown in vitro for approximately one month. The nigrostriatal cultures consisted of tissue from the substantia nigra, dorsal striatum and frontoparietal cortex; while the mesolimbic cultures included the ventral tegmental area, ventral striatum and cingulate cortex. The cultures were grown at 35°C in normal atmosphere, using a tube-roller device placed in a cell incubator and changing the medium every 3–4 days. The in vitro development was evaluated with an inverted microscope equipped with a variable relief contrast function. Samples were taken directly from the medium in the culture tube and analysed for several amino acids with HPLC. After a month the cultures were fixed and processed for immunohistochemistry. High levels of glutamate and aspartate were observed every time the medium was changed, but the levels rapidly decreased reaching a steady state after approximately 24 h. A decrease in the levels was also observed along development, reaching stable values (∼2 μM and ∼0.12 μM for glutamate and aspartate, respectively) at approximately two weeks, but only when the cultures showed an apparently healthy development. The levels were approximately 10 times higher in deteriorating or apparently damaged cultures. Glutamine levels were in the mM range and remained stable along the entire experiment. No differences were observed among nigrostriatal and mesolimbic cultures. Immunohistochemistry confirmed the impressions obtained from microscopic and biochemical analysis along the in vitro development, revealing apparently healthy neuronal systems with characteristics similar to those observed in vivo, when tyrosine hydroxylase and nitric oxide synthase, markers for dopamine and nitric oxide containing neurons, respectively, were analysed. In the substantia nigra, nitric oxide synthase-positive networks surrounded tyrosine hydroxylase-positive neurons, while in the striatum nitric oxide synthase dendrites were surrounded by tyrosine hydroxylase-positive nerve terminals, suggesting a reciprocal interaction among dopamine and nitric oxide containing neurons. Thus, the organotypic model appears to capture many of the neurochemical and morphological features seen in vivo, providing a valuable model for studying in detail the neurocircuitries of the brain.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007260070031
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  • 25
    Electronic Resource
    Electronic Resource
    Neurotrophic factors influence upregulation of constitutive isoform of heme oxygenase and cellular stress response in the spinal cord following trauma (2000)
    Springer
    Amino acids 19 (2000), S. 351-361 
    Details
    ISSN: 1438-2199
    Keywords: Keywords: Amino acids ; Spinal cord injury ; Heme oxygenase ; Heat shock protein ; Carbon monoxide ; Growth factors ; BDNF ; IGF-1 ; Immunohistochemistry ; Cell injury ; Spinal cord edema
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary. The influence of brain derived neurotrophic factor (BDNF) or insulin like growth factor-1 (IGF-1) on spinal cord trauma induced carbon monoxide (CO) production and cellular stress response was examined using immunostaining of the constitutive isoform of the hemeoxygenase (HO-2) enzyme and the heat shock protein (HSP 72 kD) expression in a rat model. Subjection of rats to a 5 h spinal trauma inflicted by an incision into the right dorsal horn at T10–11 segment markedly upregulated the HO-2 and HSP expression in the adjacent spinal cord segments (T9 and T12). Pretreatment with BDNF or IGF-1 significantly attenuated the trauma induced HSP expression. The upregulation of HO-2 was also considerably reduced. These results show that BDNF and IGF-1 attenuate cellular stress response and production of CO following spinal cord injury which seems to be the key factors in neurotrophins induced neuroprotection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007260070066
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  • 26
    Electronic Resource
    Electronic Resource
    Expression of extracellular matrix proteins in the fetal rat gastric mucosa (2000)
    Springer
    Anatomy and embryology 201 (2000), S. 149-156 
    Details
    ISSN: 1432-0568
    Keywords: Key words Cell differentiation ; Cell proliferation ; Collagen ; Fetal development ; Fibronectin ; Immunohistochemistry ; Keratin ; Laminin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  At gestational day 16 the epithelium of the rat stomach consists of a stratified layer of undifferentiated cells, and two days later glandular structures appear. The present study was carried out to identify extracellular matrix proteins that could be involved in the epithelial cell proliferation and differentiation processes that occur in the fetal rat stomach during this period. For comparative purposes the expression of the same components in the adult gastric mucosa was examined. Pregnant Sprague-Dawley rats received an intraperitoneal injection of 5-bromo-2’-deoxyuridine to label proliferating cells. One, 3.5, or 6 h post-injection the stomachs were excised and immediately frozen. The specimens were sectioned and stained with hematoxylin and eosin or for 5-bromo-2’-deoxyuridine, cytokeratin no. 8, H,K-ATPase, and the extracellular matrix proteins fibronectin, laminin, and collagens type I and IV. A stratified layer of proliferating cells was observed in the epithelium of the fetal stomachs, while in adult stomachs proliferating cells were detected in the isthmus/neck region of the glands. Cytokeratin, an epithelial cell marker, was sparse at gestational day 16 but abundant both at gestational day 18 and in the isthmus/neck region of gastric glands of the adult stomach. The parietal cell marker H,K-ATPase could not be detected in the fetal stomachs during this period. Fibronectin was observed in the stroma of both fetal and adult stomachs. Collagen type I could only be detected in the stroma close to the oesophagus at gestational day 16. Two days later, collagen type I was abundant in the lamina propria, the submucosa and in the serosa of the fetal stomachs. In adult tissue collagen type I was detected in the surface epithelium, the submucosa and in the serosa of the stomach. Collagen type IV and laminin were expressed in the lamina propria, the basement membranes around blood vessels, muscle cells, and nerve bundles, as well as in the serosa of both 16- and 18-day-old fetal and adult rat stomachs. In conclusion, a high cell proliferation rate was observed in the epithelium at both gestational days 16 and 18. The increased expression of cytokeratin observed during this period indicates that the epithelial character of the embryonic cells becomes more distinct, while the remarkable change in the expression of collagen type I might reflect an important role of collagen type I in the development of the gastric epithelium.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00008236
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  • 27
    Electronic Resource
    Electronic Resource
    Mandibular deformities in parathyroid hormone-related protein (PTHrP) deficient mice: possible involvement of masseter muscle (2000)
    Springer
    Anatomy and embryology 202 (2000), S. 85-93 
    Details
    ISSN: 1432-0568
    Keywords: Key words Intramembranous ossification ; Immunohistochemistry ; Muscle fiber type
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Previous studies using parathyroid hormone-related protein (PTHrP) null mutant mice have indicated severe abnormalities in the endochondral ossification, suggesting that PTHrP affects chondrocyte differentiation. In this study, we found in newborn PTHrP-deficient mice some deformities in the mandible that is formed via intramembranous ossification. The mandibular ramus was bent downwards and a prominent bone crest to which the deep layer of masseter muscle was tendinously attached was observed in the mandibular body. Transmission electron microscopic studies showed that active bone formation was progressing along the tendon fibers of the masseter muscle. The examination of 3-D reconstruction models indicated that the mandibular ramus was bent at the site of muscle attachment, which was shifted in the direction of the muscle fibers. Muscle fiber type analysis using myosin ATPase staining showed that the masseter muscle in the newborn PTHrP-deficient mice contained numerous type 2B fibers, demonstrating premature maturation of this muscle. Based on these findings, we speculated that premature maturation of the masseter muscle leads, probably due to increased tensile forces, to accelerated bone crest formation and subsequent bending of the mandibular ramus. These results further suggest that PTHrP is involved in the regulation of muscle development in normal animals.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004290000100
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  • 28
    Electronic Resource
    Electronic Resource
    Organ-specific expression of the intestinal epithelium-related antigen A33, a cell surface target for antibody-based imaging and treatment in gastrointestinal cancer (2000)
    Springer
    Cancer chemotherapy and pharmacology 46 (2000), S. S27 
    Details
    ISSN: 1432-0843
    Keywords: Key words Monoclonal antibody ; A33 ; Gastric cancer ; Immunohistochemistry ; Tumor targeting
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Murine monoclonal antibody A33 (mA33) was developed by the Memorial Sloan-Kettering Cancer Center and by the New York Branch of the Ludwig Institute for Cancer Research. It is an immunoglobulin (Ig)G2a antibody that detects a protease- and neuraminidase-resistant, periodate-sensitive epitope. Serological analysis of the antigen showed that it is expressed in a few colorectal cancer cell lines and a pancreatic cancer cell line, but is basically not reactive with other types of cell line. Normal fibroblasts and normal kidney cell lines reacted negatively to mA33. Immunohistochemical study of normal tissues identified the large and small intestinal mucosa as the principal site of A33 expression. Tests in tumor samples demonstrated that only tumors of the gastrointestinal tract are consistently A33 positive. A33 is found in 95% of primary and metastatic colorectal cancers, with uniform expression throughout the tumors in most cases. A33 is also detected in 63% of gastric cancers, with uniform expression in 45% of cases. Eighty-three percent of intestinal-type gastric cancers were positive for A33, and about 50% of the diffuse-type and mucinous cancers were mA33 positive. A33 was expressed in 50% of the pancreatic cancers but with marked heterogeneity. Other epithelial cancers, sarcomas, neuroectodermal tumors, and lymphoid neoplasms were generally A33 negative. A33 is the first example of a constitutively expressed, organ-specific epithelial membrane antigen permitting highly specific tumor targeting in patients with gastrointestinal cancer. Encouraged by the success of the biodistribution and imaging characteristic studies performed at Memorial Sloan-Kettering Cancer Center by the New York Branch of the Ludwig Institute in colorectal cancers, a new clinical study of humanized monoclonal antibody huA33 against A33 antigen-positive gastric cancers has been initiated in Japan.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014045
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  • 29
    Electronic Resource
    Electronic Resource
    Heat shock protein 72 expression in chondrosarcoma correlates with differentiation (2000)
    Springer
    Journal of cancer research and clinical oncology 126 (2000), S. 667-670 
    Details
    ISSN: 1432-1335
    Keywords: Key words Chondrosarcoma ; Heat shock protein ; Differentiation ; Diagnosis ; Immunohistochemistry ; Chondroma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: Heat shock proteins (hsp) are involved in tumor immunity, and a correlation with survival, occurrence of metastases, and drug resistance has been reported. It was the aim of this study to investigate the expression of heat shock proteins in chondrosarcomas and chondromas. Methods: Hsp expression was investigated immunohistochemically on paraffin-embedded sections of 37 consecutive patients (24 male and 13 female, mean age 48 years) with chondrosarcoma and of ten patients (six male, four female, mean age 36 years) with chondroma. Results: Chondromas showed a positive staining for hsp27 in 100%, for hsp60 in 30%, for hsp72 in 80%, for hsp73 in 80%, and for hsp90 in 90%. In chondrosarcoma a decreased expression was found for hsp27 (62% positive, P 〈 0.05) and hsp72 (43% positive, P 〈 0.05), whereas no significant difference to chondromas was detected in the expression of hsp60 (49% positive), hsp73 and hsp90 (73% and 81% positive, respectively). In addition, hsp72 expression showed a correlation with differentiation of the tumors (P 〈 0.05); the lowest hsp72 expression was found in G3 chondrosarcomas (only 13% positive). No correlation with respect to differentiation was found for the expression of the other hsps. Conclusions: This study shows a different expression of hsps in chondrosarcomas and chondromas. Together with the correlation of hsp72 expression with low differentiation, this finding could lead to new experimental and diagnostic strategies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004320000167
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  • 30
    Electronic Resource
    Electronic Resource
    Tibiale Torsionsfehler (2000)
    Springer
    Der Orthopäde 29 (2000), S. 802-807 
    Details
    ISSN: 1433-0431
    Keywords: Schlüsselwörter Unterschenkel ; Torsion ; Tibiatorsion ; Untersuchung ; Therapie ; Kind ; Adoleszente ; Bein ; Entwicklung ; Osteotomie ; Keywords Tibia ; Torsion ; Adolescence ; Child ; Osteotomy ; Diagnosis ; Therapy ; Developmental ; Leg
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Tibial torsion defects are usually not clinically evident and, hence, are often overlooked. Clinical examination and CT scan have proved to be the best ways of measuring static tibial torsion, whereas dynamic measurements are usually performed in the clinic and the “gait laboratory.” Only few studies have determined there to be a connection between a torsion defect in the lower leg and expected pathological conditions of the knee and ankle joints. However, patellofemoral instability, Osgood-Schlatter disease, osteochondrosis dissecans are increasingly being found in cases of increased external tibial torsion and arthrosis in reduced torsion. Although spontaneous correction may occur in certain cases, in others the only way to correct the condition is by employing physiologic torsion. Conservative treatment methods such as bandages or ortheses have been shown to not have any effect on torsion; thus, surgical treatment is the only successful way to correct a pathologic angle of rotation of the tibia. For this, supramalleolar osteotomy with fixation using Kirscher wires and plaster or an external fixator are the most common treatments.
    Notes: Zusammenfassung Tibiale Torsionsfehler sind meistens klinisch nicht sehr evident und werden deshalb häufig übersehen. Zur Messung der statischen Tibiatorsion hat sich am besten die klinische Untersuchung und das CT bewährt, während für die dynamische Messung die Klinik und das Ganglabor zum Einsatz kommen. Es gibt nur wenige Studien, die einen Zusammenhang zwischen einem Torsionsfehler des Unterschenkels (US) und zu erwartenden Pathologien des Knie- und Sprunggelenks nachweisen. Immerhin wurden vermehrt patellofemorale Instabilitäten, Morbus Osgood-Schlatter, Osteochondrosis dissecans bei erhöhter Tibiaaußentorsion und Arthrose bei veminderter Torsion nachgewiesen. Während die Korrektur nach Frakturen in gewissen Fällen spontan erfolgen kann, ist bei andern Ursachen keine Korrektur außer der physiologischen Torsion zu erwarten. Konservative Maßnahmen wie Bandagen oder Orthesen haben nachgewiesenerrmaßen keinen Effekt auf die Torsion, sodass bei pathologischem Drehwinkel der Tibia nur die operative Korrektur zum Erfolg führt. Diese wird meistens in Form einer supramlleolären Osteotomie mit Fixation durch Kirscher-Drähte und Gips oder durch einen Fixateur externe durchgeführt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001320050529
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  • 31
    Electronic Resource
    Electronic Resource
    Identifizierung eines Nasenrachenkarzinoms mit Hilfe der EBV-Diagnostik (2000)
    Springer
    HNO 48 (2000), S. 314-317 
    Details
    ISSN: 1433-0458
    Keywords: Schlüsselwörter ; Nasenrachenkarzinom ; Epstein-Barr-Virus ; Immunhistologie ; Polymerasekettenreaktion ; Keywords ; Nasopharyngeal carcinoma ; Epstein-Barr virus ; Immunohistochemistry ; Polymerase chain reaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract We report the case of a 36-year-old women who was found to have a malignant tumor extending from the side of her right nasal cavity to the nasopharynx. Magnetic resonance imaging and computed tomography were not able to define the primary site of the tumor. Histologic evaluation demonstrated an undifferentiated squamous cell carcinoma. Because of the different treatment concepts for carcinomas of the nasal cavity and nasopharynx, we tried to identify the primary site by diagnosing Epstein-Barr virus (EBV) infection, which is associated with carcinoma of the nasopharynx. By using immunohistochemistry and polymerase chain reaction EBV could be identified in the cells of the carcinoma. This showed that the primary site of the tumor was located in the nasopharynx and resulted in the patient being treated with simultaneous radiochemotherapy.
    Notes: Zusammenfassung Eine 36 Jahre alte Patientin stellte sich mit einem ausgedehnten Tumor der rechten Nasenhöhle und des rechten Nasenrachens vor. Die histologische Untersuchung ergab ein undifferenziertes Plattenepithelkarzinom. Sowohl mit Hilfe der computertomographischen, als auch der kernspintomographischen Befunde, war keine eindeutige Bestimmung der Primärtumorregion möglich. Anhand der bekannten Assoziation zwischen Karzinomen des Nasenrachens und Epstein-Barr Virus (EBV) wurde versucht, die Primärlokalisation des Tumors zu klären. Immunhistologisch und durch „polymerase chain reaction” war es möglich, eine EBV-Infektion im Tumor nachzuweisen. Die Primärlokalisation des Tumors wurde damit dem Nasenrachen zugeordnet und die entsprechende Therapie für diese Lokalisation in Form einer simultanen Radiochemotherapie eingeleitet.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001060050572
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  • 32
    Electronic Resource
    Electronic Resource
    Kraniomandibuläre Dysfunktion Eine Standortbestimmung (2000)
    Springer
    Manuelle Medizin 38 (2000), S. 335-341 
    Details
    ISSN: 1433-0466
    Keywords: Schlüsselwörter Kiefergelenk ; Kraniomandibuläre Dysfunktion (CMD) ; Kraniozervikale Dysfunktion (CCE) ; Kraniosakrale Dysfunktion (CSD) ; Diagnostik ; Therapie ; Keywords Temporomandibular joint ; Craniomandibular disorder ; Craniocervical disorder ; Craniosacral disorder ; Diagnosis ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Evaluating the current understanding of craniomandibular disorders means attempting to discern structures among the dysfunctions of this functional disturbance rather than recording the multitude of different forms. Most dentists understand the functioning and dysfunctions of the craniomandibular system (CMS) while most orthopedists have knowledge in the functioning and dysfunctions of the craniocervical systems (CCS), and some are well trained in the disturbances of the craniosacral system (CSS). In clinical practice, however, the specific data and the structural and functional connections are not provided by associative connections. Therefore the figure at the end of the article will help those lacking substantial experience to keep in view the variety of disorders, recognize the inner structure of the dysfunction, consult with colleagues, and begin effective therapeutic procedures.
    Notes: Zusammenfassung Eine bewertende Standortbestimmung zum Thema kraniomandibuläre Dysfunktion vorzunehmen bedeutet nicht, dass versucht wird, die facettenreichen vielgestaltigen Formen von Funktionsstörungen vollständig nachzuzeichnen, sondern vielmehr, das Krankheitsbild – anhand vereinfachter Denkmodelle – durchgängig zu strukturieren. Die meisten Zahnärzte haben Kenntisse über die Funktionen und Dysfunktionen des kraniomandibulären Systems (CMS). Dagegen kennen sich die meisten Orthopäden und Physiotherapeuten gut mit den Funktionen und Dysfunktionen des kraniozervikalen Systems (CCS) aus, etliche auch mit dem kraniosakralen System (CSS). Es sind aber eher die Einzeldaten, die strukturellen und funktionellen Zusammenhänge, die oft nicht durch Assoziationsketten strukturiert sind. Eine tabellarische Übersicht soll deshalb dem noch nicht so Erfahrenen helfen, den Überblick zu behalten und die innere Struktur der Funktionsstörungen zu erkennen, Kollegen gezielt hinzuziehen und die Therapie sinnvoll einzuleiten.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003370070005
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  • 33
    Electronic Resource
    Electronic Resource
    Tufted Angioma Fallbeschreibung und Besprechung der aktuellen Therapieoptionen (2000)
    Springer
    Monatsschrift Kinderheilkunde 148 (2000), S. 475-478 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Tufted Angioma ; Büschelartiges Hämangiom ; Kutane Tumoren ; Therapie ; Key words Tufted angioma ; Hemangioma ; Cutaneous tumor ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Case report: A 16-month-old girl was admitted with a 6-month history of multiple redishblue plaques on the right abdomen. These proved to have increased in size and number daturing a 1.5-year follow-up. Histologically (including histochemistry and electron microscopy), these skin changes were classified as tufted angioma. Tufted angioma is a rare, often multiple benign tumor. Half of the tumors reported develop in children 5 years and younger. The exclusion of malignant tumors (leukemia, lymphoma, neuroblastoma) is important. A punch biopsy is not very traumatic. A subsequent histological examination is highly sensitive and specific. Therapy: There are a few active therapeutic options with rather severel side effects.
    Notes: Zusammenfassung Fallbericht: Bei einem Mädchen im Alter von 16 Monaten traten seit einem halben Jahr am rechten Abdomen multiple, disseminierte rötliche bis bläulich-bräunliche infiltrierte Plaques auf, die innerhalb des 1,5-jährigen Beobachtungszeitraums weiter an Größe und Anzahl zunahmen. Mittels konventioneller Histologie, Immunhistologie und Elektronenmikroskopie sicherten wird die Diagnose eines Tufted Angioma. Das Tufted Angioma ist ein sehr seltener, häufig multipel vorkommender Tumor gutartigen Charakters. Die Hälfte der berichteten Tumoren entwickelte sich innerhalb der ersten 5 Lebensjahre. Deshalb ist der differenzialdiagnostische Ausschluss eines malignen Geschehens (Leukämie, Lymphome, Neuroblastom) von außerordentlicher Bedeutung. Hierzu ist eine Stanzbiopsie ideal geeignet, da sie einfach durchführbar und nur gering traumatisch ist. Die nachfolgende Histologie hat eine hohe Sensitivität und Spezifität. Therapie: Die aktiven therapeutischen Möglichkeiten müssen eher als eingeschränkt und nebenwirkungsreich gewertet werden. Eine spontane Rückbildung ist möglich.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050578
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  • 34
    Electronic Resource
    Electronic Resource
    Okuläres vernarbendes Pemphigoid Retrospektive Analyse von Risikofaktoren und Komplikationen (2000)
    Springer
    Der Ophthalmologe 97 (2000), S. 113-120 
    Details
    ISSN: 1433-0423
    Keywords: Schlüsselwörter Okuläres vernarbendes Pemphigoid ; Therapie ; Komplikationen ; Glaukom ; Key words Ocular cicatricial pemphigoid ; Therapy ; Complications ; Glaucoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Cicatricial pemphigoid (CP) is a rare autoimmune disease characterized by subepidermal blistering and progressive cicatrization affecting the skin and mucosa. Ocular involvement occurs in approximately 70% of the patients. Methods: The course of the disease, complications and putative risk factors in patients with ocular cicatricial pemphigoid (OCP) treated at the Departments of Ophthalmology and Dermatology were analyzed retrospectively from 1986 to 1998. Results: Eighteen of 28 patients (64%) with CP demonstrated ocular involvement. The mean age of patients with OCP was 73 years; 61% were female. At the time of referral to our hospital, all patients had reached advanced stage III (83%) or IV (17%) of OCP. In 38% of patients vision was already reduced to 〈20/200 at first presentation. Twenty-eight percent of patients additionally suffered from glaucoma. Two patients exhibited life-threatening extraocular manifestations of CP (larynx stricture, esophagus stricture). Conjunctival or mucosal biopsies were performed in 15 patients with OCP and showed typical immunodeposits at the basement membrane zone in 12/15 patients. Therapy with dapsone (12 patients), oral steroids (11 patients), azathioprine (5 patients), cyclophosphamide (4 patients), colchicine (2 patients) and methotrexate (1 patient) was used concomitantly or consecutively. Complications of OCP including entropion, recurrent epithelial erosions, corneal ulcers, keratitis, and corneal perforations required multiple surgical interventions such as entropion surgery (8 patients), tarsorrhaphy (3 patients), mucous membrane grafting (1 patient), amniotic membrane transplantation (1 patient), tectonic keratoplasty (1 patient), keratoprosthesis (1 patient) and enucleation (1 patient). Despite control of the inflammatory process, further visual loss occurred in 53% of eyes. Reading visual acuity could only be maintained in 35% of eyes. Discussion: Early diagnosis and therapy can prevent ocular complications of OCP. This study indicates that advanced stages of the disease often result in irreversible visual loss despite institution of immunosuppressive therapy. Whether or not the high association of OCP with glaucoma and/or anti-glaucomatous treatment in our patients represents part of the underlying disease process or plays a role in the pathogenesis of OCP must still be clarified.
    Notes: Zusammenfassung Das vernarbende Pemphigoid (cicatricial pemphigoid, CP) ist eine seltene, mit subepidermaler Blasenbildung und Vernarbung einhergehende Autoimmunerkrankung, die sich an Haut und Schleimhaut manifestiert. Eine Augenbeteiligung liegt bei etwa 70% der Patienten vor. Methode: Retrospektiv wurden Krankheitsverlauf, klinische Komplikationen und mögliche Risikofaktoren von Patienten der Augen- und Hautklinik mit vernarbendem Pemphigoid von 1986–1998 untersucht. Ergebnisse: 18/28 Patienten (64%) mit CP hatten eine okuläre Beteiligung. Das Durchschnittsalter der Patienten mit okulärem vernarbendem Pemphigoid betrug 73 Jahre, 61% der Patienten waren weiblich. Bereits bei Erstvorstellung in unserer Klinik bestand bei allen Patienten ein Krankheitsstadium III (83%) oder IV (17%), mit einem Visus 〈0.1 in 38% der Augen. Bei 28% der Patienten wurde zusätzlich ein Glaukom diagnostiziert. Zwei Patienten zeigten eine lebensgefährliche extraokuläre Schleimhautbeteiligung (Larynx- bzw. Ösophagusstriktur). Bei 15 Patienten mit okulärem vernarbendem Pemphigoid wurde eine Bindehaut- bzw. Schleimhautbiopsie aus dem Mund oder Nasen-Rachen-Raum durchgeführt, welche die Verdachtsdiagnose bei 12/15 Patienten immunhistologisch sicherte. Eine Therapie mit Dapson (12 Patienten), oraler Kortikosteroidgabe (11 Patienten), Azathioprin (5 Patienten), Cyclophosphamid (4 Patienten), Colchizin (2 Patienten) und Methotrexat (1 Patient) wurde in Folge oder Kombination eingesetzt. Komplikationen wie Lidfehlstellungen, rezidivierende Epitheldefekte, Hornhautulzera, Keratitiden und Hornhaut-Perforationen erforderten multiple operative Eingriffe wie Entropium-Operation (8 Patienten), Tarsorrhaphie (3 Patienten), Kryoepilation (2 Patienten), Mundschleimhaut-Transplantat (1 Patient), Amniontransplantat (1 Patient), tektonische Keratoplastik (1 Patient), Keratoprothese (1 Patient) und Enukleation (1 Patient). Trotz befriedigender Kontrolle des okulären vernarbenden Pemphigoids kam es bei 53% der Augen zum weiteren Visusabfall. Ein Lesevisus konnte nur in 35% der Augen erhalten werden. Schlußfolgerung: Wahrscheinlich kann die Früherkennung und rechtzeitige Behandlung des okulären vernarbenden Pemphigoids okuläre Komplikationen verhindern. Diese Studie zeigt, daß trotz immunsuppressiver Therapie in Spätstadien häufig ein irreversibler Visusverlust resultiert. Es bleibt zu untersuchen, ob die auffällig hohe Assoziation von okulärem vernarbendem Pemphigoid zu Glaukom bzw. antiglaukomatöser Therapie in unserem Patientenkollektiv als Folge der Grunderkrankung oder als pathogenetischer Faktor zu werten ist.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003470050021
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  • 35
    Electronic Resource
    Electronic Resource
    Mikroangiographische Darstellung der Gefäßversorgung des medialen Kollateralbandes am Kniegelenk (2000)
    Springer
    Der Unfallchirurg 103 (2000), S. 208-214 
    Details
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Kniegelenkverletzung ; Mediales Kollateralband ; Ruptur ; Gefäßversorgung ; Therapie ; Key words Knee injury ; Medial collateral ligament ; Rupture ; Vascularization ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Because the vascularization of ligaments is an important factor in ligament healing we wanted to examine the vascularization status of the medial collateral ligament of the knee. The type of vascularization was examined by mikroangiographie of 21 postmortem preparations. We could observe a vascularization from the proximal end of the ligament by one or two major vessels in all cases. These vessels were mostly localized in the ventral third of the ligament. From the proximal to the distal part of the ligament we found a decreasing density of blood vessels. We could not observe vessel free ligament areas. Due to this vascularization status we would advise the differentiation of two ligament areas respecting the following therapy. Because of the good vascularization in the proximal part of the ligament we can accept good conditions concerning complete healing after a non-operative treatment and an operative therapy by suture or refixation. In the case of interligamentous and distal ruptures operative reconstruction by sutures often is difficult and a conservative therapy leads to a high rate of poor results. Therefore we advise fibrin bonding in these ligament areas if a surgical procedure is indicated because of the high risk of vessel strangulation after suture.
    Notes: Zusammenfassung Da die Durchblutungsverhältnisse bei Bandrupturen einen wesentlichen Parameter insbesondere bezüglich der Erfolgsaussichten einer chirurgischen Versorgung darstellen, sollte in der vorliegenden Arbeit die Vaskularisation des Knieinnenbandes dargestellt werden. Die spezielle Durchblutungssituation wurde mittels Mikroangiographie an 21 Leichenpräparaten untersucht. Es zeigte sich dabei eine Versorgung von proximal durch 1 oder 2 Hauptgefäßstämme, die bevorzugt in den ventralen Bandanteilen verliefen. Die Gefäßdichte nahm von proximal nach distal sowie von ventral nach dorsal ab. Gefäßfreie Bandabschnitte waren nicht nachweisbar. Aufgrund des proximalen Versorgungstyps kann im proximalen Bandanteil im Vergleich zum distalen Abschnitt mit günstigeren Heilungsvoraussetzungen sowohl nach operativer als auch nach konservativer Therapie gerechnet werden. Dies entspricht den klinischen Erfahrungen. Prognostisch ungünstiger einzustufen sind interligamentäre und distale Bandverletzungen, die insbesondere nach konservativer Behandlung h6auml;ufig unbefriedigende Resultate zeigen. Angesichts der geringeren Vaskularisation der distalen Bandanteile würden wir hier die Bandrekonstruktion mittels Fibrinklebung empfehlen, die eine atraumatische Wiederherstellung ohne die Gefahr der nahtbedingten Gefäßstrangulation erlaubt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050524
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  • 36
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    Electronic Resource
    Diagnostik und Therapie von Pseudotumoren der Orbita (2000)
    Springer
    HNO 48 (2000), S. 665-670 
    Details
    ISSN: 1433-0458
    Keywords: Schlüsselwörter Pseudotumor orbitae ; Histopathologie ; Therapie ; Rhinochirurgische Zugänge ; Keywords Pseudotumor orbitae ; Histopathology ; Therapy ; Rhinosurgical approaches
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Orbital pseudotumor is a nonspecific inflammatory process of unknown etiology that can be divided histopathologically into three basic types: granulomatous, lymphoid, and sclerosing. Between 1995 and 1998, 12 patients with pseudotumor orbitae were treated in the ENT Department of the University of Saarland. Histopathological examination showed granulomatous type of pseudotumor in six, lymphoid in three, and sclerosing in three patients. In seven cases the pseudotumor orbitae were medially located and in four cases laterally. In one patient nearly all orbital structures were infiltrated. Diagnostic biopsy was taken endonasally in six cases, via medial orbitotomy in two cases, and via lateral orbitotomy in four cases. Due to their good delimitation lymphoid and sclerosing tumors were extracted completely during diagnostic biopsy and patients were free of complaints after a few weeks. The six patients with granulomatous pseudotumor were treated primarily with steroids after the diagnosis had been definitely confirmed by histology. In three of those six cases a second course of steroid therapy had to be given, with positive results in two cases. Follow-up was between 6 and 28 months (mean 16 months). There were no postoperative complications. The clinical and radiographic presentation of the pseudotumors can vary greatly. Therefore, the differential diagnosis of specific infections or neoplasms can only be established through diagnostic biopsy. Different rhinosurgical approaches provide clear biopsy results and in some cases the pseudotumor is even completely removed.
    Notes: Zusammenfassung Der Pseudotumor der Orbita ist ein unspezifischer entzündlicher Prozess dessen Genese unbekannt ist und der histologisch in 3 Gruppen unterteilt wird: der granulomatöse, lymphoide und sklerosierende Typ. Zwischen 1995 und 1998 haben wir 12 Patienten mit einem Pseudotumor der Orbita behandelt. Es handelte sich dabei um Fälle vom granulomatösen (n=6), lymphoiden (n=3) und sklerosierenden (n=3) Typ. Bei 7 Patienten war der Pseudotumor im medialen Bereich der Orbita und in 4 Fällen im lateralen Bereich lokalisiert. Bei einer Patientin lag eine diffuse Infiltration annähernd aller orbitalen Strukturen vor. Die Probebiopsie wurde in 6 Fällen endonasal, in 2 Fällen über eine mediale Orbitotomie und bei 4 Patienten über eine laterale Orbitotomie durchgeführt. Die gut abgrenzbaren lymphoiden (n=3) und sklerosierenden (n=3) Pseudotumoren konnten im Rahmen der Probebiopsie komplett entfernt werden, so dass die Patienten nach wenigen Wochen beschwerdefrei waren. Bei den 6 Patienten mit einem granulomatösen Pseudotumor wurde nach der definitiven Histologie eine primäre Kortikosteroidtherapie durchgeführt. In 3 der 6 Fälle kam es dadurch zu einem Rückgang der Beschwerden mit kompletter Ausheilung. Bei den restlichen 3 Patienten war eine erneute Kortisontherapie erforderlich wobei diese nur in 2 Fällen erfolgreich war. Der Nachbeobachtungszeitraum betrug 6–28 (Mittel 16) Monate. Postoperative Komplikationen traten nicht auf. Die klinische Symptomatik und die radiologische Darstellung der Pseudotumoren kann sehr variabel sein, so dass nur durch eine Probebiopsie eine genaue Differenzierung von spezifischen Infektionen und malignen Raumforderungen möglich ist. Die rhinochirurgischen Zugänge erlauben eine sichere Biopsie und in einigen Fällen auch eine komplette Entfernung des Pseudotumors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001060050636
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  • 37
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    Electronic Resource
    Hydroa vacciniformis Klinik, Differenzialdiagnosen und therapeutische Möglichkeiten der seltenen Photodermatose am Beispiel einer Kasuistik (2000)
    Springer
    Monatsschrift Kinderheilkunde 148 (2000), S. 895-899 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Hydroa vacciniformis ; Klinik ; Differenzialdiagnosen ; Verlauf ; Therapie ; Keywords Hydroa vacciniformis ; Clinical features ; Differential diagnoses ; Course ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Case report. This case of a 6 year old boy presents hydroa vacciniformis, a rare skin disease in children which may also affect the eyes and is caused by UVA exposure. It presents as hemorrhagic small blisters in sun exposed areas that heal with a tendency to scarring, usually with recurrent onset at the beginning of the sunny season until adult age. Differential diagnosis. As possible differential diagnoses polymorphic light eruption, erythropoetic protoporphyria and photodermatitis due to external or systemic photosensitizers must be excluded. In rare cases congenital erythropoetic porphyria, hepatic erythropoetic porphyria, Epstein-Barr virus infection, lymphomatoid papulosis and angiocentric cutaneous T-cell lymphoma may cause the clinical symptoms of hydroa vacciniformis. Therapy. Appropriate therapy consists in protection of skin and eyes against direct and indirect UV radiation, especially UVA-radiation.
    Notes: Zusammenfassung Fallbericht. Anhand der Kasuistik eines 6-jährigen Jungen wird die Hydroa vacciniformis, eine seltene, durch UVA-Exposition ausgelöste Dermatose mit möglicher Augenbeteiligung bei Kindern, vorgestellt. In lichtexponierten Bereichen treten zu Beginn der lichtreichen Jahreszeit rezidivierend bis zum Erwachsenenalter akut zahlreiche hämorrhagische Bläschen auf, die narbig abheilen. Differenzialdiagnose. Differenzialdiagnostisch müssen eine polymorphe Lichtdermatose, eine erythropoetische Protophorphyrie und eine Photodermatose durch exogene bzw. systemische Photosensibilisatoren ausgeschlossen werden. In seltenen Fällen können eine Porphyria erythropoetica congenita, eine hepatoerythropoetische Porphyrie, eine Infektion durch Epstein-Barr-Virus, eine lymphomatoide Papulose und ein angiozentrisches kutanes T-Zell-Lymphom klinisch ähnliche Symptome verursachen. Therapie. Die effektive Therapie besteht im Schutz vor direkter und indirekter UV-Exposition für Haut und Augen, insbesondere im UVA-Bereich.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050666
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  • 38
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    Büschelartiges Hämangiom (“tufted angioma”) des Unterarms Fallbericht und Literaturübersicht (2000)
    Springer
    Monatsschrift Kinderheilkunde 148 (2000), S. 832-836 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Hämangiom ; Büschelartiges Hämangiom ; Diagnostik ; Therapie ; Keywords Haemangioma ; Tufted angioma ; Vascular lesion ; Diagnostic ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Background: Tufted angioma represents a benign vascular lesion of the skin. The knowledge of this distinctive entity is important in distinction of clinically more aggressive and malignant neoplasms respectively. Case report. We report a 8-months-old girl who developed a deep seated tufted haemangioma on her right forearm. Sonography and MRI showed a good vascularized tumor with interseptal spreading. Histological examination of the incisional biopsy revealed a cellular capillary haemangioma with morphological features of rare tufted haemangioma. Discussion. Characteristic morphological features of tufted haemangioma allow accurate diagnosis and differential diagnosis to clinically more aggressive and malignant neoplasms of skin and soft tissues, wheras radiological methods are rather unspecific and do not distinguish reliably between these vascular lesions. It is of special clinical importance that tufted haemangioma represents an enlarging but biologically benign vascular neoplasm.
    Notes: Zusammenfassung Hintergrund: Das büschelartige Hämangiom (“tufted angioma”) ist ein benigner vaskulärer Tumor der Haut, dessen Kenntnis in der Differenzialdiagnose zu aggressiveren und malignen Tumoren wichtig ist. Fallbericht. Es wird über ein 8 Monate altes Mädchen mit diesem Tumor im Unterarmbereich berichtet. Sonographie und Magnetresonanztomographie zeigten einen gut vaskularisierten Weichgewebetumor, bei dem aufgrund interseptaler Ausbreitung ein maligner Prozess nicht ausgeschlossen werden konnte. Die Histologie der Inzisionsbiopsie ergab ein zellreiches kapillares Hämangiom, dessen morphologische Veränderungen eine Einordnung als ein seltenes büschelartiges Hämangiom erlaubten. Diskussion. Eine Abgrenzung des büschelartigen Hämangioms gegenüber aggressiveren und malignen vaskulären Läsionen der Haut ist aufgrund des typischen histologischen Bilds möglich, während eine Differenzierung mit Hilfe bildgebender Verfahren nicht gelingt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050651
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  • 39
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    Electronic Resource
    Rezidivierende paraneoplastische Zerebellopathie und limbische Enzephalitis Fallbericht bei einer Patientin mit Mammakarzinom (2000)
    Springer
    Der Nervenarzt 71 (2000), S. 295-298 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Paraneoplastische zerebelläre Degeneration ; Opsoklonus-Myoklonus-Syndrom ; Limbische Enzephalitis ; Therapie ; Prognose ; Key words Paraneoplastic cerebellar degeneration ; Opsoclonus-myoclonus syndrome ; Limbic encephalitis ; Therapy ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Paraneoplastic neurological syndromes are rare diseases that occur in relation to cancer. Supporting the hypothesis of an autoimmune mechanism, specific antineuronal antibodies have sometimes been detected. The current possibilities for treatment are limited. A female patient, aged 57, suffering from a breast cancer, developed a severe paraneoplastic cerebellar syndrome and limbic encephalitis within a few weeks. It is possible that the impressive partial remission that occurred during the ensuing 6 months was not due to therapy. Although the patient was still bound to a wheelchair, discharge from hospital was possible because she was still able to perform daily tasks by herself. A recurrence of the cerebellar symptoms with mild alterations of mental status occurred 2 months later but again showed a good remission.
    Notes: Zusammenfassung Paraneoplastische neurologische Syndrome sind seltene Erkrankungen in Assoziation mit einem Tumor, die bei vermutetem Autoimmunmechanismus mit antineuronalen Antikörpern einhergehen können und deren Verlauf therapeutisch nur bedingt beeinflussbar ist. Berichtet wird von einer 57-jährigen Patientin mit Mammakarzinom, die in engem zeitlichen Rahmen sowohl eine schwere paraneoplastische Zerebellopathie als auch eine limbische Enzephalitis entwickelte. In unklarem Zusammenhang zur Therapie kam es innerhalb von 6 Monaten zu einer vergleichsweisen guten Rückbildung beider Syndrome, so dass zwar noch eine partielle Rollstuhlpflichtigkeit bestand, bei weitgehender Selbständigkeit aber eine Entlassung nach Hause möglich war. Ein Rezidiv 2 Monate später mit im Vordergrund stehender zerebellärer Symptomatik verlief ebenfalls günstig.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050560
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  • 40
    Electronic Resource
    Electronic Resource
    Die isolierte Zungenbeinfraktur (2000)
    Springer
    Der Unfallchirurg 103 (2000), S. 996-998 
    Details
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Zungenbeinfraktur ; Diagnostik ; Therapie ; Keywords Hyoid bone fracture ; Diagnosis ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract We present a rare case of isolated hyoid bone fracture caused by direct trauma. We will describe the mechanism of injury, how to find diagnosis and our treatment.
    Notes: Zusammenfassung Wir berichten über den seltenen Fall einer isolierten Zungenbeinfraktur bei einem Jugendlichen durch ein direktes Trauma. Erörtert werden Unfallmechanismus sowie Diagnostik und Therapie.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050658
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  • 41
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    Der vergrößerte ventrikuläre Sacculus beim Larynxkarzinom – ein erhöhtes tumorchirurgisches Risiko (2000)
    Springer
    HNO 48 (2000), S. 689-692 
    Details
    ISSN: 1433-0458
    Keywords: Schlüsselwörter Larynxkarzinom ; Sacculus laryngis ; Therapie ; Keywords Laryngeal carcinoma ; Sacculus laryngis ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The case of a 60-year-old female patient with a supraglottic larynx carcinoma (T3N2CM0) and bilateral enlargement of the laryngeal sacculus is presented. On one side, the sacculus opened atypically into the left vestibular fold. The sacculus is a physiologic part of the roof of Morgagni's ventricle, the size of which can vary greatly. These canal-like structures can be the point of origin of cysts, laryngoceles, mucoceles, and pyoceles. Laryngoceles are present in about 5% of larynx carcinomas; their cause is not precisely known. Frequently, a computer tomogram suggests the coincidence of larynx carcinoma and laryngoceles or a large laryngeal sacculus. In oral panendoscopy, these ventricular distensions are difficult to detect even using 70° rigid endoscopes. A planned supraglottic partial resection must take into account early tumor growth along the preformed canals in the preepiglottic space. In this patient, a laryngectomy was performed due to the bilateral involvement of the vocal process and the anterior commissure.
    Notes: Zusammenfassung Es wird der Fall einer 60-jährigen Patientin mit einem supraglottischen Larynxkarzinoms (T3 N2c M0) und beidseitiger Vergrößerung des Sacculus laryngis vorgestellt. Einseitig mündete der Sacculus untypisch auf der linken Taschenfalte. Der Sacculus laryngis ist eine physiologische Ausstülpung des Daches des Morgagni-Ventrikels, dessen Größe sehr variieren kann. Diese gangartigen Strukturen können Ausgangsort von Zysten, Laryngozelen, Mukozelen und von Pyozelen sein. In ca 5% von Larynxkarzinomen liegen Laryngozelen vor, wobei der disponierende Faktor nicht genau bekannt ist. Oftmals ist der Verdacht der Koinzidenz von Larynxkarzinom und Laryngozele oder großem Sacculus laryngis in der Computertomographie zu stellen. In der Panendoskopie sind diese Erweiterungen der Ventrikel auch mit starren Winkeloptiken schwer zu sehen. Bei geplanter supraglottischer Teilresektion muss man an ein frühes Tumorwachstum entlang der präformierten Gänge in den präepiglottischen Raum denken. Bei der Patientin wurde bei beidseitiger Beteiligung der Processus vocales und der vorderen Kommissur eine Laryngektomie durchgeführt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001060050640
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  • 42
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    Electronic Resource
    Stellenwert von Hydrodistension und Blasentraining (2000)
    Springer
    Der Urologe 39 (2000), S. 539-541 
    Details
    ISSN: 1433-0563
    Keywords: Schlüsselwörter Interstitielle Zystitis ; Blasendehnung ; Hydrodistension ; Blasentraining ; Keywords Interstitial cystitis ; Bladder distension ; Bladder training ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Although hydrodistension of the bladder is generally considered standard therapy for interstitial cystitis, scientific data are largely lacking. With the mechanism of action unknown, prospective studies non-existent and the therapeutic effect at best very short-lived, hydrodistension cannot be regarded as a therapeutic standard concept with scientifically validated efficacy. The value of behavioral therapy and bladder training is equally unclear; success can only be anticipated in the very rare subset of patients without pain.
    Notes: Zusammenfassung Obwohl die Hydrodistension der Harnblase ein häufig angewendetes Konzept in der Behandlung der intestitiellen Zystitis (IC) darstellt, ist die wissenschaftliche Datenlage zur therapeutischen Blasendehnung spärlich. Bei ungeklärtem Wirkungsmechanismus, fehlenden prospektiven und kontrollierten Studien und bestenfalls kurzfristiger Effektivität kann die Hydrodistension nicht als therapeutisches Standardkonzept mit wissenschaftlich nachgewiesenem Behandlungserfolg angesehen werden und besitzt eher den Stellenwert eines Heilversuchs. Die Wertigkeit von Blasentraining oder ähnlichen Miktonsverhaltensmodifikationen bei der IC bleibt ebenfalls unklar, ein gewisser Effekt kann allenfalls für die vergleichsweise kleine Untergruppe von IC-Patienten ohne Schmerzkomponente erwartet werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001200050405
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  • 43
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    Electronic Resource
    Optionen einer kausalen Therapie der männlichen Infertilität (2000)
    Springer
    Der Gynäkologe 33 (2000), S. 104-112 
    Details
    ISSN: 1433-0393
    Keywords: Schlüsselwörter Männliche Infertilität ; Therapie ; Medikamente ; Spermatogenese ; Oligozoospermie ; Asthenozoospermie ; Key words Male infertility ; Therapy ; Drugs ; Spermatogenesis ; Oligozoospermia ; Asthenozoospermia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Causal treatment regimens of proven effectiveness in controlled studies are only available for cases of male infertility resulting from hypogonadotropic hypogonadism. Drug treatment of retrograde ejaculation is also effective but has so far not been tested in double-blind, placebo-controlled randomized studies. The results of immunosuppressive therapy in cases of immunological male infertility are still controversial . In addition, antiphlogistic and antibiotic treatment of chronic male genital tract infections has not been shown to improve male fertility. Inconsistent results have been obtained with empirical therapy – e.g., with kallikein, tamoxifen, clomiphene, pentoxifylline, mast cell blockers, testolacton, vitamin E, captopril, alpha receptor blockers, glutathione, indometacin, interferon alpha, growth hormone, zinc salts, ketoprofen, mesterone or testosterone undecanoate – or the studies performed are not sufficient to allow a final judgement. Recent studies have indicated a possible impairment of sperm function by pure FSH, while GnrH and FSH have no influence on spermatogenesis in normogonadotropic men.
    Notes: Zusammenfassung Kausale medikamentöse Therapieregime mit in kontrollierten Studien zweifelsfrei nachgewiesener Wirksamkeit stehen nur bei männlicher Infertilität als Folge des hypogonadotropen Hypogonadismus zu Verfügung. Eine medikamentöse Therapie der retrograden Ejakulation ist ebenfalls effektiv, wurde aber bisher nicht durch doppelblinde, placebokontrollierte, randomisierte Studien ü,berprü,ft. Auch immunsuppressive Therapien bei Nachweis von Spermatozoenantikörpern werden bezüglich ihrer klinischen Wirksamkeit uneinheitlich bewertet. Gleiches trifft auf die Gabe von Antibiotika bei chronisch-entzündlichen Veränderungen oder asymptomatischen Infektionen des Urogenitaltraktes zu. Im Gegensatz dazu sind die Angaben bei empirischer Therapie mit z. B. Kallikrein, Tamoxifen, Clomiphen, Pentoxifyllin, Mastzellblockern, Testolakton, Vitamin E, Captopril, α-Rezeptorenblockern, Glutathion, Indometacin, Interferon-α, Wachtumshormon, Zinksalzen, Ketoprofen, Mesterolon oder Testosteronundecanoat entweder widersprüchlich oder die vorgelegten Studien reichen für eine abschließende Bewertung noch nicht aus. Neuere Studien weisen möglicherweise auf eine Beeinflussung von Spermatozoenfunktionen durch pures FSH hin. Dahingegen haben GnRH und FSH bei normogonadotropen Männern keinen Einfluss auf die Spermatogenese.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001290050018
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  • 44
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    Electronic Resource
    Der benigne tenosynoviale Riesenzelltumor im Bereich des oberen Sprunggelenks Seltene Differentialdiagnose eines Weichteiltumors am Fuß (2000)
    Springer
    Der Unfallchirurg 103 (2000), S. 479-481 
    Details
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Riesenzelltumor ; Sprunggelenk ; Differentialdiagnose ; Therapie ; Keywords Giant cell tumor ; Ankle joint ; Differentialdiagnosis ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The giant cell synovialoma is a benign neoplasia classically located in the fingers. It mostly rises from tendon sheaths, sometimes from the synovia. Other locations than the fingers are rare. Making a differential diagnosis to lipomas, gangliomas or even malignant soft tissue tumors can be very difficult especially in rare locations. We report the case of a 21 years old man suffering from a giant cell synovialoma in the area of the right ankle joint. The clinical, radiological and patho-morphological findings are documented. The tumor was excised totally, other foci were not found. The problems of making the right diagnosis are described.
    Notes: Zusammenfassung Bei dem tenosynovialen Riesenzelltumor handelt es sich um eine benigne Neoplasie, die klassischerweise im Bereich der Finger zu finden ist. Dort geht sie in der Regel von Sehnenscheiden aus, seltener aus der Synovialis hervor. Gerade bei den seltenen und atypischen Lokalisationen kann die differentialdiagnostische Abgrenzung gegenüber Lipomen, Ganglien oder malignen Weichteiltumoren schwierig sein. Es wird über einen 21jährigen Patienten mit einem Riesenzellsynovialom im Bereich des linken Innenknöchels berichtet. Die klinischen, radiologischen und pathologisch-anatomischen Befunde werden dokumentiert. Der Tumor wurde in toto reseziert, andere Herde konnten nicht gefunden werden. Die Problematik der richtigen diagnostischen Einordnung wird dargestellt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050569
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  • 45
    Electronic Resource
    Electronic Resource
    Progressive posthämorrhagische Ventrikelerweiterung des Frühgeborenen Inzidenz, Prognose und Therapie (2000)
    Springer
    Monatsschrift Kinderheilkunde 148 (2000), S. 1072-1077 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Posthämorrhagische Ventrikelerweiterung ; Frühgeborene ; Therapie ; Keywords Posthemorrhagic ; Hydrocephalus ; Preterm ; Infant ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Background. 35% of preterm infants with intraventricular hemorrhage develop ventricular dilatation. The posthemorrhagic ventricular dilatation can persist, be transient or be progressive. Finally 1–2% of all very low birthweight (VLBW 〈1500 g) infants require shunt placement for the treatment of the posthemorrhagic hydrocephalus. Outcome. The neurodevelopmental outcome is extremely poor in children surviving progressive posthemorrhagic ventricular dilatation. Therapy. There are no uniform guidelines for the treatment of preterm infants with progressive posthemorrhagic ventricular dilatation. Randomised multicenter trials demonstrated, that inhibition of cerebrospinal fluid production with acetazolamide and furosemide or early cerebrospinal fluid tapping did not reduce the need for shunt placement and may worsen the outcome or can be associated with adverse side-effects. Preterm infants with posthemorrhagic ventricular dilatation should be treated by standard therapy with uniform guidelines for cerebrospinal fluid tapping and shunt placement.
    Notes: Zusammenfassung Hintergrund. 35% der Frühgeborenen entwickeln nach einer intraventrikulären Blutung eine Ventrikelerweiterung. Die posthämorrhagische Ventrikelerweiterung kann persistieren, transient oder progressiv sein. Letztlich entwickeln 1–2% der Frühgeborenen mit einem Geburtsgewicht 〈1500 g einen shuntpflichtigen posthämorrhagischen Hydrozephalus. Prognose. Die Prognose von Frühgeborenen mit progressiver posthämorrhagischer Ventrikelerweiterung ist hinsichtlich Mortalität und neurologischer Morbidität noch sehr ungünstig. Therapie. Bisher gibt es keine einheitlichen Therapierichtlinien für Frühgeborene mit progressiver posthämorrhagischer Ventrikelerweiterung. Multizenterstudien zeigten, dass die medikamentöse Hemmung der Liquorproduktion mit Azetazolamid und Lasix oder frühzeitige serielle Liquorpunktionen die Shuntpflichtigkeit nicht vermindern und den Verlauf und die Prognose sogar ungünstig beeinflussen. Die Erkenntnisse aus diesen Studien mahnen zur Vorsicht. Frühgeborene mit posthämorrhagischer Ventrikelerweiterung sollten außerhalb von Studien möglichst konservativ und zurückhaltend mit einheitlichen Kriterien für Liquorpunktion und Shuntimplantation behandelt werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050696
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  • 46
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    Electronic Resource
    Therapie des Kleinwuchses mit Wachstumshormon Entwicklungen 10 Jahre nach der Einführung von rekombinantem Wachstumshormon (2000)
    Springer
    Monatsschrift Kinderheilkunde 148 (2000), S. 746-761 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Wachstumshormon ; Kleinwuchs ; Therapie ; Demographie ; Pharmakoepidemiologie ; KIGS [Kabi] Pharmacia & Upjohn International Growth Study) ; Key words Growth hormone ; Short stature ; Therapy ; Demography ; Pharmaco-epidemiology ; KIGS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Recombinant growth hormone (rGH) therapy in the treatment of children with short stature was introduced 10 years ago, and experience has shown that progress in implementing this mode of therapy depends increasingly on analyses of large pharmaco-epidemiological studies. These studies prove that the diagnosis of growth hormone deficiency, whatever the cause or pathogenetic form, is the most frequent indication for GH therapy. The remaining problems are timely and precise diagnosis, and the best possible and individual therapy aiming at the projected height and taking safety and costs into account. We are closer to solving these problems today than ever before. Apart from this, the use of GH in treating short stature in Turner syndrome and renal insufficiency has led to its acceptance as a suitable therapy for these patients. Height improvement in a number of other growth disorders is, in certain cases, also possible through GH therapy. In the light of current experience, GH therapy can thus be attempted on a rational basis in individual cases. This form of treatment clearly holds wider possibilities and its implementation is likely to go beyond short stature in the future.
    Notes: Zusammenfassung 10 Jahre nach der Einführung von rekombinantem Wachstumshormon (WH) in die Therapie kleinwüchsiger Kinder werden unsere Erfahrungen zunehmend auch durch Analyse umfangreicher pharmako-epidemiologischer Beobachtungen geprägt. Wachstumshormonmangel: Diese zeigen, daß der Wachstumshormonmangel in seinen unterschiedlichen Ursachen und pathogenetischen Erscheinungsformen nach wie vor die häufigste Indikation für WH darstellt. Die Probleme bestehen weiterhin in der rechtzeitigen und rationellen Diagnostik und in der Optimierung und Individualisierung der Therapie zum Erreichen der Wachstumsziele unter ökonomischen Gesichtspunkten und bei gleichzeitiger therapeutischer Sicherheit. Diese Probleme sind für den WH-Mangel heute lösbar. Weitere Indikationen: Ferner zeigt sich, daß auch der Kleinwuchs beim Ullrich-Turner-Syndrom und bei der Niereninsuffizienz, für welche WH zugelassen ist, erfolgreich behandelt werden kann. Bei einer Vielzahl anderer Wachstumsstörungen ist die Möglichkeit zur Größenverbesserung im Einzelfall gegeben. Vor dem Hintergrund heutiger Erfahrungen kann ein individueller Heilversuch so auf eine rationale Basis gestellt werden. Zukunftsperspektiven: In Zukunft wird das breite Wirkpotential von Wachstumshormon über die Indikation des Kleinwuchses hinaus ausgeschöpft werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050633
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  • 47
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    Electronic Resource
    Tarsaltunnelsyndrom (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. 341-343 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Tarsaltunnelsyndrom ; Ätiologie ; Trauma ; Diagnose ; Therapie ; Keywords ; Tarsal tunnel syndrome ; Aetiology ; Trauma ; Diagnosis ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: In this paper we describe the tarsal tunnel syndrome with reference to our own experience in 10 cases and the literature. Compared with the numerous injuries involving the ankle and foot, the diagnosis of tarsal tunnel syndrome is rare. In the case of a painful foot of unknown aetiology, the differential diagnosis should therefore include tarsal tunnel syndrome. Our presentation discusses the aetiology and pathology of the tarsal tunnel syndrome, and particularly that caused by trauma. We also describe an effective therapeutic approach based on surgical decompression.
    Notes: Anhand der Literatur und eigenen Erfahrungen von 10 Operationen wird das Tarsaltunnelsyndrom dargestellt. Gemessen an der Vielzahl der Traumen im Sprunggelenk- und Fersenbeinbereich wird die Diagnose selten gestellt. Bei unklaren Fußschmerzen sollte daher differenzialdiagnostisch ein Tarsaltunnelsyndrom in Erwägung gezogen werden. Es wird auf die Ätiologie, die Pathologie sowie auf den Zusammenhang zu Traumen eingegangen und die effektive Therapie durch operative Dekompression beschrieben.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100390000310
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  • 48
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    Schultergelenknahe Oberarmfrakturen einschließlich Endoprothetik (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. S180 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter Humeruskopffraktur ; Diagnostik ; Therapie ; Keywords Fracture of the head of the humerus ; Diagnosis ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Fractures of the head of the humerus present a challenge both at the stages of diagnosis and treatment. Fortunately, 70–80% ¶of all fractures of the humeral head can be treated conservatively because they are not dislocated. When dislocation is present detailed understanding of the morphology of such fractures and purposeful application of internal fixation techniques are essential for the achievement of good shoulder function. Every step of the treatment is aimed at stability of the joint with its components as close as possible to their original anatomical positions. This can generally be managed with minimally invasive approaches and/or with the bone fragments preserved. We regard depression fractures of the humeral head (〉 45%) in active, older patients –¶who are frequently affected – as a primary indication for a shoulder replacement. Four-fragment fractures with displacement of the head fragment in an older, physically active patient can also occasionally be an indication for primary joint replacement. Both for conservatively treated and for operatively treated fractures of the humeral head a customized schedule of follow-up treatment should be applied, to avoid the precipitation of secondary frozen shoulder by too-passive behaviour. On the other hand, neither should the follow-up treatment programme lead to a secondary dislocation. For restoration of the function it is therefore absolutely essential that the trauma surgeon monitor the treatments applied.
    Notes: Zusammenfassung Humeruskopffrakturen stellen eine Herausforderung an die Diagnostik und die Therapie dar. Glücklicherweise können 70–80% davon konservativ behandelt werden, da sie nicht disloziert sind. Im Fall der Dislokation sind ein differenziertes Verständnis der Frakturmorphologie und der zielgerichtete Einsatz osteosynthetischer Techniken unabdingbare Voraussetzung einer guten Schulterfunktion. Ziel jedweder Behandlungsmaßnahme ist das Erreichen einer stabilen Situation in möglichst anatomiegerechter Position. Dies kann überwiegend mit minimalinvasiven Zugängen bzw. unter Schonung der Knochenfragmente erreicht werden. Besonders im Fall der Humeruskopfimpressionsfrakturen (〉 45%) beim häufig betroffenen älteren, aktiven Patienten sehen wir eine primäre Indikation zur Schulterendoprothese. Ebenso stellen die 4-Fragment-Frakturen mit Verschiebung des Kopffragments bei älteren, biologisch aktiven Patienten eine gelegentliche Indikation zum primären Gelenkersatz dar. Sowohl für die konservativ als auch für die operativ behandelten Humeruskopffrakturen sollte ein differenziertes Nachbehandlungsschema Anwendung finden, um nicht durch zu passives Verhalten eine sekundäre Schultersteife zu initiieren. Auf der anderen Seite sollte ein Nachbehandlungsprogramm auch nicht zur sekundären Dislokation führen. Die unfallchirurgische Kontrolle der Behandlungsmaßnahmen ist daher zwingende Voraussetzung einer bestmöglichen Wiederherstellung der Funktion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014884
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  • 49
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    Arbeitsunfall und psychische Gesundheitsschäden (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. S450 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter Psychisches Trauma ; Psychische Störungen ; Versicherungsschutz ; Kausalität ; Heilverfahrenssteuerung ; Therapie ; Begutachtung ; Keywords Psychological trauma ; Psychological disorders ; Insurance cover ; Legal causality ; Case management ; Therapy ; Expert reviewing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Accident insurance agencies are confronted with an increasing number of cases in which psychological damage occurs immediately at the time of the traumatic events, or in their aftermath. This article reviews the stipulations governing insurance cover and benefits and the legal principles of causality issues in the case of psychological traumas and disorders resulting from such incidents. Insurance agencies face special challenges for case mangagement, since there are no well-established procedures for physicians and hospitals to follow in such cases. Irrespective of the often difficult causality and liability issues, immediate therapy should be given absolute priority. More attention should be paid to psychological damage, with the aims of improving methods of medical rehabilitation and establishing guidelines for expert review in such cases.
    Notes: Zusammenfassung Die Unfallversicherungsträger sind mit einer zunehmenden Zahl von Fällen konfrontiert, bei denen psychische Gesundheitsschäden unmittelbar bei dem Unfallereignis auftreten oder sich nachfolgend entwickeln. Der Beitrag gibt einen Überblick über Grundsätze des Versicherungsschutzes und Kausalitätsfragen bei psychischen Traumen und psychischen Störungen als Folge eines Versicherungsfalls. Für die Unfallversicherungsträger ergeben sich besondere Anforderungen an die Steuerung des Heilverfahrens, da nicht auf das für organische Verletzungen etablierte System besonderer Heilverfahrensarten, wie z. B. das Durchgangsarztverfahren, zurückgegriffen werden kann. Unter allen Umständen hat die Therapie unbedingten Vorrang, unabhängig von der kausalrechtlichen Fragestellung nach dem zuständigen Leistungsträger. Psychischen Gesundheitsschäden ist vermehrt Aufmerksamkeit zu schenken mit dem Ziel, geeignete Maßnahmen der medizinischen Rehabilitation weiterzuentwickeln und Konventionen für die Begutachtung zu schaffen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014969
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  • 50
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    Electronic Resource
    Frakturen und Luxationen am proximalen Unterarm (2000)
    Springer
    Trauma und Berufskrankheit 2 (2000), S. S194 
    Details
    ISSN: 1436-6274
    Keywords: Schlüsselwörter Fraktur ; Luxation ; Radiusköpfchen ; Olekranon ; Processus coronoideus ; Behandlung ; Keywords Fracture ; Dislocation ; Radial head ; Olecranon ; Coronoid process ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Because of its central location, the elbow joint is considered the most important joint within the upper extremity from the viewpoint of function. Trauma to osseous and ligamentous structures of the proximal forearm confronts trauma surgeons and orthopedic specialists with numerous diagnostic and therapeutic challenges. Conditions following elbow trauma are often accompanied by chronic pain and diminished range of motion, leading to functional deficits of the entire arm. There is now practically no doubt that primary osteosynthesis, anatomical joint reconstruction and early onset of functional treatment are essential for a good ¶final outcome. With our expanding knowledge of the anatomical and biomechanical condtions in the proximal lower arm in the last few decades the basic principles of therapy have also changed, and current standards of treatment for proximal forearm trauma are presented in this paper with reference to the relevant literature.
    Notes: Zusammenfassung Das Ellbogengelenk ist aufgrund seiner zentralen Lage aus funktionellen Gesichtspunkten als das bedeutendste Gelenk der oberen Extremität anzusehen. Knöcherne und ligamentäre Verletzungen im Bereich des proximalen Unterarms konfrontieren den behandelnden Arzt mit einer Anzahl von diagnostischen und therapeutischen Problemen. Posttraumatische Zustände am Ellbogengelenk, die mit chronischer Schmerzsymtomatik und Bewegungseinschränkungen einhergehen, mindern zwangsläufig die Gebrauchsfähigkeit des gesamten Arms. Es besteht heute kaum noch ein Zweifel daran, dass in der Mehrzahl der Fälle eine primäre definitive osteosynthetische Versorgung mit exakter Rekonstruktion der Gelenkfläche für ein befriedigendes Resultat ebenso unverzichtbar ist wie ein frühzeitiger Beginn physiotherapeutischer Übungsmaßnahmen. Mit zunehmendem Verständnis der anatomischen und biomechanischen Besonderheiten des proximalen Unterarms vollzog sich in den letzten Dekaden ein entscheidender Wandel der therapeutischen Grundsätze, deren aktueller Stand in der vorliegenden Arbeit unter Berücksichtigung der relevanten Literatur vorgestellt wird.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014886
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  • 51
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    Immunohistochemical investigations on the course of astroglial GFAP expression following human brain injury (2000)
    Springer
    International journal of legal medicine 113 (2000), S. 70-75 
    Details
    ISSN: 1437-1596
    Keywords: Key words Brain injury ; Cortical contusion ; GFAP ¶expression ; Immunohistochemistry ; Wound age
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Law
    Notes: Abstract The course of GFAP expression by astrocytes has been immunohistochemically investigated during the first 30 weeks after human brain injury. In order to provide reliable data for a forensic wound age estimation, a quantitative morphometric analysis was performed considering the different topographic regions of the cortex as well as of the white matter. Compared to the GFAP immunoreactivity in unaltered control tissue, significantly increased numbers of GFAP positive astroglial cells could be detected adjacent to the cortical contusion from 1 day up to 4 weeks after brain injury.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00007711
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  • 52
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    Demonstration of morphine in ganglion cells of the hippocampus from victims of heroin overdose by means of anti-morphine antiserum (2000)
    Springer
    International journal of legal medicine 113 (2000), S. 117-120 
    Details
    ISSN: 1437-1596
    Keywords: Key words Ganglion cells ; Hippocampus ; Immunohistochemistry ; Mean optical density (MOD) ; Morphine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Law
    Notes: Abstract To investigate the topography of morphine distribution in the human brain, a method has been developed to detect morphine immunohistochemically. In this study hippocampus tissue from victims of heroin overdose (blood morphine concentrations 220 ng/g–1500 ng/g; 6-MAM positive urine sample), known for its high concentration of μ-opiate receptors was used. The immunohistochemical staining was performed with an anti-morphine antiserum originally developed for radio-immuno-assays. In comparison with control specimens from cases of sudden death without morphine exposition or a history of heroin abuse, the brains from victims of heroin overdose showed selectively stained ganglion cells, axons and dendrites, suggesting a massive concentration of morphine in the neuronal structures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004140050012
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  • 53
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    Immunohistochemical localization of mitogen-activated protein kinase (MAPK) family and morphological changes in rat heart after ischemia-reperfusion injury (2000)
    Springer
    Medical electron microscopy 33 (2000), S. 74-81 
    Details
    ISSN: 1437-773X
    Keywords: Key words Mitogen-activated protein kinase (MAPK) ; Ischemia reperfusion injury ; Heart ; Ultrastructure ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The mitogen-activated protein kinase (MAPK) family is considered to be activated by stress, but the role of the MAPK family is still unknown in cardiac pathology. In the present study, not only the localization of MAPKs such as the extracellular responsive kinase (ERK), c-jun N-terminal kinase (JNK), and p38 MAPK (p38), but also ultrastructural changes were investigated in the ischemia-reperfusion model of Wistar rats. At 5, 10, 30, 60, and 180 min reperfusion after 30 min ischemia by occluding the coronary artery, the expression of these MAPKs was increased in blood vessels and cardiomyocytes by Western blotting and immunohistochemical methods. In addition, after ischemia reperfusion, various ultrastructural changes such as decreased glycogen granules, mitochondrial swelling, and myolysis were observed in the blood vessels and cardiomyocytes. These results suggest that protein kinases may regulate numerous biological processes, including the regulation of contraction and ion transport.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007950070005
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  • 54
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    An immunohistochemical and ultrastructural study of a follicle-stimulating hormone-secreting gonadotroph adenoma occurring in a 10-year-old girl (2000)
    Springer
    Medical electron microscopy 33 (2000), S. 25-31 
    Details
    ISSN: 1437-773X
    Keywords: Key words Gonadotroph adenoma ; FSH ; Childhood ; Ultrastructure ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Female gonadotroph adenomas with endocrinological symptoms are uncommon. Six cases of such adenomas have been reported in the literature: two were girls who presented with precocious puberty and four were premenopausal women with accompanying multiple ovarian cysts. We describe here a 10-year-old Japanese girl with a gonadotroph macroadenoma and present detailed morphological findings of the tumor. The patient's chief complaints were nausea, abdominal distention, and abdominal pain. Abdominopelvic ultrasonography and magnetic resonance imaging (MRI) revealed bilateral multiple ovarian cysts. Endocrinological assays showed elevated serum follicle-stimulating hormone (FSH) (33.7 mIU/ml) and estradiol (3840 pg/ml). MRI of the head showed a large pituitary tumor. Two transsphenoidal operations and subsequent radiation therapy were performed. Immunohistochemically, more than half the tumor cells were positive for anti-FSH-β monoclonal antibody. Ultrastructurally, the tumor cells exhibited a fairly uniform picture of rounded cells. Their nuclei were slightly irregular and contained heterochromatin, and their cytoplasm contained many round, dense core granules, measuring 140–260 nm in diameter, together with well-developed organelles. An in vitro study showed that the tumor cells in primary culture produced FSH (1089.0 mIU/ml). To our knowledge, this is the first immunohistochemical and ultrastructural study of an FSH-secreting gonadotroph adenoma occurring in childhood.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007950000004
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  • 55
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    Mesangial myofibroblastic transformation in steroid-dependent minimal change nephrotic syndrome (2000)
    Springer
    Medical electron microscopy 33 (2000), S. 102-107 
    Details
    ISSN: 1437-773X
    Keywords: Key words Minimal change nephrotic syndrome ; α-Smooth muscle actin ; Vimentin ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Patients with minimal change nephrotic syndrome (MCNS) occasionally show frequent relapses with proteinuria after cessation of steroid treatment, even though no significant pathological abnormalities are found in the glomeruli, compared with those in nonrelapsed and good-prognosis cases of MCNS. To resolve this contradiction, we immunohistochemically and ultrastructurally examined a biopsied renal tissue of a patient who showed glomerular features of MCNS and frequent clinical relapses. Immunohistochemistry demonstrated the overexpression of α-smooth muscle actin (ASMA) and vimentin in glomerular mesangial cells despite no mesangial cell proliferation, compared with nine nonrelapsed cases of MCNS. These facts may be an important clue to the investigation of the pathogenesis of steroid-dependent MCNS with frequent relapses. Furthermore, the immunohistochemical examination of ASMA and vimentin may be useful to detect mesangial myofibroblastic transformation that is not demonstrated in conventional light microscopy and immunofluorescence study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007950070009
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  • 56
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    Electronic Resource
    Chemokines: new target molecules in renal diseases (2000)
    Springer
    Clinical and experimental nephrology 4 (2000), S. 273-280 
    Details
    ISSN: 1437-7799
    Keywords: Key words Chemokine ; Chemokine receptor ; Kidney ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The presence of leukocytes in the diseased kidneys is a hallmark of almost any kind of renal disease. Activated leukocytes are implicated in playing a crucial role in the pathogenesis of renal diseases. Recent investigations of the pathophysiological roles of chemokines and their cognate receptors have shed light on the detailed molecular mechanisms of leukocyte trafficking and activation in the diseased kidneys. This study summarizes findings that: (1) chemokine/chemokine receptor systems may be essentially involved in the pathogenesis of phase-specific renal disorders, (2) the measurement of urinary levels of chemokines may be clinically useful for monitoring different disease phases and activities in human renal diseases, and (3) interventions in chemokine/chemokine receptor systems may have potential as particular immunotherapeutic strategies to combat specific phases of renal diseases. Further investigations of anti-chemokine therapies for renal diseases will be required before clinical application is feasible.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s101570070001
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  • 57
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    Electronic Resource
    Structural immaturity of the pylorus muscle in infantile hypertrophic pyloric stenosis (2000)
    Springer
    Pediatric surgery international 16 (2000), S. 282-284 
    Details
    ISSN: 1437-9813
    Keywords: Key words Desmin ; Infantile hypertrophic pyloric stenosis ; Immunohistochemistry ; Fetus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Recent reports indicate that extracellular matrix and cytoskeleton plasmalemmal elements are altered in infantile hypertrophic pyloric stenosis (IHPS). Desmin is a cytoskeletal protein that is important for the organization and function of muscular fibers. It has been found to be increased in the smooth muscle in chronic intestinal pseudo-obstruction and in skeletal muscle in some forms of myopathies as well as in unexplained hypertrophic cardiomyopathies. The aim of this study was to analyze the expression of desmin in IHPS. Full-thickness muscle-biopsy specimens were obtained from 8 IHPS patients (age range 23 to 41 days) at pyloromyotomy, from 8 age-matched controls without evidence of gastrointestinal (GI) disease at autopsy, and from 2 stillborns who died at 27 and 30 weeks of gestation without evidence of GI disease. Indirect immunohistochemistry was performed using the avidin-biotin-peroxidase complex method with anti-desmin and visualized by development with 3-diaminobenzidine tetrahydrochloride. Pyloric muscle in IHPS demonstrated strong desmin immunoreactivity. The expression of desmin was also strong in the muscular layers of fetal pylorus. In the age-matched controls absent or weak desmin immunoreactivity was seen in the pyloric muscle layer. The increased amount of desmin in hypertrophied pyloric muscle in IHPS may result in inco-ordination of contraction and relaxation of the pylorus, thus causing motility dysfunction. The similar pattern of desmin expression in IHPS and fetal pylorus suggests that the organization of intermediate filaments in IHPS is in a fetal stage of development.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050745
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  • 58
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    Electronic Resource
    Organ-specific distribution of major histocompatibility antigens in rats (2000)
    Springer
    Pediatric surgery international 16 (2000), S. 285-292 
    Details
    ISSN: 1437-9813
    Keywords: Key words Major histocompatibility complex (MHC) ; Rat ; Immunohistochemistry ; Distribution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The present study systematically investigated the expression and distribution of the major histocompatibility complex (MHC) classes I and II in the rat. About 150 native tissue probes from eight adult Lewis rats were taken, representative for most organs, tissues, and the vascular system. MHC expression was analyzed by two monoclonal antibodies (mAb) generated against the non-polymorphic determinants of rat MHC class I (Ox-18) and class II (Ox-6). Immunoreactivities were compared to those of different endothelial (HIS52, TLD-3A12, Ox-43, REHA-1 antigen), histiocytic (ED1, ED2), B-cell (RLN-9D3), and T-cell (MRC Ox-52) markers. A nonspecific mAb (MR12/53) served as a negative control. Pretested concentrations on various tissues and the alkaline phosphatase-anti-alkaline phosphatase technique allowed semiquantitative evaluation of serial cryostat tissue sections. MHC class I expression was detected on most immunocompetent cells. Endothelial cells were stained heterogeneously along the vascular system and the organ-specific microcirculation. Furthermore, some organs showed staining of parenchymal cells. MHC class II was found on all immunocompetent cells positive for the B-cell marker and about 15% of cells positive for the histiocytic markers. Besides the well-known expression of MHC class II in the outer zone of the renal proximal tubule, further organ-specific cell forms were found positive. In conclusion, the present study outlines tissue-specific distribution of MHC I/II and implies that each organ carries a variable immunologic burden that needs to be considered for any transplantation model.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050746
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  • 59
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    Electronic Resource
    Peutz-Jeghers syndrome: is family screening needed? (2000)
    Springer
    Pediatric surgery international 16 (2000), S. 437-439 
    Details
    ISSN: 1437-9813
    Keywords: Key words Peutz-Jeghers syndrome ; Intestinal polyposis ; Intussusception ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a 7-year-old boy, a small-bowel polyp was found intraoperatively as a lead point of an intussusception. Histologically, a hamartoma was found and the clinical work-up revealed Peutz-Jeghers syndrome (PJS). Additionally, all four asymptomatic siblings showed intestinal polyposis. All children in a family with PJS should be properly investigated. In case of an intussusception with a polyp in a critical location, a surgical procedure should follow.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003839900296
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  • 60
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    Electronic Resource
    Appearance of denuded hepatic stellate cells and their subsequent myofibroblast-like transformation during the early stage of biliary fibrosis in the rat (2000)
    Springer
    Medical electron microscopy 33 (2000), S. 217-230 
    Details
    ISSN: 1437-773X
    Keywords: Key wordsα-Smooth muscle actin ; Transforming growth factor-β1 ; Bile ductule ; Bile duct ligation ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To investigate the early in vivo response of hepatic stellate cells in biliary fibrosis, we examined rat livers during the first 7 days after bile duct ligation using light microscopy, immunohistochemistry, electron microscopy, and immunoelectron microscopy. At day 1 after bile duct ligation, α-smooth muscle actin-positive fibroblasts appeared and then increased in number around the proliferating bile ductules. With time, the destruction of the external limiting plate became accentuated because of the invasion of the proliferating bile ductules and periductural fibrosis. At day 7, stromal cells containing fat droplets appeared in the fibrous tissue adjacent to the periportal parenchyma; these are termed denuded hepatic stellate cells. In the fibrous tissue disconnected from the liver parenchyma, the denuded hepatic stellate cells were replaced by myofibroblast-like cells. Meanwhile, the expression of transforming growth factor-β1 on biliary epithelial cells increased. These results indicate the dual origin of myofibroblasts in experimental biliary fibrosis, the periductural and periductal fibroblasts in the initial stage, and the denuded hepatic stellate cells in the subsequent stage. These two types of stromal cells may undergo myofibroblastic transformation by the transforming growth factor-β1 secreted by the proliferating biliary epithelial cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007950000022
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  • 61
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    Electronic Resource
    Anti-retroviral treatment in Nigeria: a review (2000)
    Springer
    Journal of infection and chemotherapy 6 (2000), S. 196-199 
    Details
    ISSN: 1437-7780
    Keywords: Key words Anti-retroviral ; Therapy ; Nigeria
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Research studies in Nigeria have been done primarily in the areas of epidemiology, clinical practice, virology, and laboratory diagnosis. Therapy for infection with human immunodeficiency virus (HIV) types 1 and 2 has largely focussed on the treatment of the HIV disease (AIDS) rather than the infection. Therefore, opportunistic infections such as tuberculosis, diarrhea, Herpes zoster, and other skin conditions, and tumors (Kaposi's sarcoma) are essentially the targets for therapy. Two reasons are responsible for the dearth of data on anti-retroviral therapy in Nigeria: there was scepticism about zidovudine, the first anti-retroviral drug to be developed, because of its toxicity, and the subsequent reluctance of the Federal Government to allow it into the country. The other reason was the prohibitive cost, making it impossible for patients to afford. That notwithstanding, there have been several uncoordinated and unpublished clinical trials by hospitals in the private sector, as expected, without firm laboratory monitoring or back-up. This review discusses such attempts and the claims of traditional medicine practitioners, as well as pilot studies on private patients with the combination therapy of zidovudine and lamivudine, which agents were allowed into the country in the late 1990s. The patients showed appreciable rises in their CD4 counts, an indirect way of monitoring viral load. This finding was corroborated with results of clinical wellbeing, indicating that they benefitted from the administration of zidovudine and lamivudine.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s101560070002
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  • 62
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    Prognostic value of P-glycoprotein expression in bone and soft-tissue sarcoma (2000)
    Springer
    International journal of clinical oncology 5 (2000), S. 164-170 
    Details
    ISSN: 1437-7772
    Keywords: Key words P-glycoprotein ; Osteosarcoma ; Soft-tissue sarcoma ; Prognosis ; Immunohistochemistry ; RT-PCR
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. The purpose of this study was to investigate the correlation between P-glycoprotein status and outcome in adult patients with high-grade osteosarcomas and soft-tissue sarcomas. Methods. P-glycoprotein status was determined im-munohistochemically in specimens from 28 patients with osteosarcoma and 34 patients with soft-tissue sarcoma. The polyclonal antibody mdr(Ab-1) was used for either decalcified or undecalcified tissue samples which were formalin-fixed and paraffin-embedded. The expression of P-glycoprotein mRNA was also determined by the polymerase chain reaction in 23 fresh sarcoma specimens. P-glycoprotein status was analyzed in relation to the duration of event-free survival. Results. Positivity for P-glycoprotein was found in 29% of the osteosarcomas and 34% of the soft-tissue sarcomas. Consistent results were obtained at both the immunohistochemical and reverse transcriptase-polymerase chain reaction (RT-PCR) levels in 19 of 23 sarcomas (83%). In patients with osteosarcoma, the presence of increased levels of P-glycoprotein was significantly associated with a decreased probability of event-free survival after diagnosis (P = 0.022). In contrast, in patients with soft-tissue sarcoma there was no correlation between the level of P-glycoprotein and prognosis. Conclusions. In patients with high-grade osteosarcomas, the presence of increased levels of P-glycoprotein detected by polyclonal antibody mdr(Ab-1) was associated with a significantly increased risk of adverse events. This association was not found in patients with soft-tissue sarcomas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00012032
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    “Gut-feeling” or evidence-based approaches in the evaluation and treatment of human short-bowel syndrome (2000)
    Springer
    Pediatric surgery international 16 (2000), S. 155-164 
    Details
    ISSN: 1437-9813
    Keywords: Key words Short-bowel syndrome ; Intestinal adaptation ; Sugar absorption test ; Gut hormones ; Electrophysiology ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Short bowel syndrome is the malabsorptive state that often follows extensive resection of the small intestine. Long-term survival without parenteral nutrition depends on the process of intestinal adaptation, through which the remaining small bowel gradually increases its absorptive capacity. The process of intestinal adaptation is almost exclusively luminal nutrient dependent. To date the clinical management of short bowel patients is mostly based on a “trial and error” regimen because human data and randomised trials using trophic substances are lacking due to the small number of patients annually present in pediatric surgical centres. We evaluate here the currently available as well as some more recently developed methods of measuring intestinal absorption and adaptation in short bowel patients. New techniques such as measurements of (1) intestinal permeability and carbohydrate absorption using the sugar absorption test, (2) gastrointestinal hormone production of gastrin, cholecystokinin and peptide YY, (3) transmural potential difference of the gastrointestinal tract using electrophysiology and (4) mucosal enzyme expression of lactase and sucrase-isomaltase using immunohistochemistry were evaluated. These new techniques are promising in monitoring the process of adaptation of the remaining intestine and evaluating the effect of therapeutic interventions in patients with short bowel syndrome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050713
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  • 64
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    Variation among giant rice bodies: report of four cases and their clinicopathological features (2000)
    Springer
    Skeletal radiology 29 (2000), S. 525-529 
    Details
    ISSN: 1432-2161
    Keywords: Key words Giant rice body ; Ultrastructure ; Immunohistochemistry ; Histogenesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective: To report four cases of rice bodies (RBs) showing remarkable size variations and discuss their pathogenesis. Design and patients: Based on analysis of the clinical data, we speculate on the pathogenesis of RBs using immunohistochemical and ultrastructural methods. The patients comprised three men and one woman, three with RBs in the subacromial bursae and one in the wrist synovial sheath, aged 28 (woman), 44, 50 and 81 (wrist) years, respectively. Results: There were no particular differences in clinical data among the patients. T2-weighted MR imaging was very useful for diagnosis of the RBs, allowing their clear delineation from the bursal fluid. The RBs consisted of a layered protein- aceous substance with vague targetoid cut surfaces. Much fibrin and a lesser amount of collagen fibers were recognized together with various mononuclear cells, which were few in number and predominantly T cells. The bursae and synovial sheath had multiple fibrinoid spheroids at the luminal surface. Conclusion: Fibrinoid nodular deposits probably became detached, forming the nuclei of RBs and growing to a giant RB 65 mm in diameter.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000258
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    Peripheral papillary tumor of type-II pneumocytes: a rare neoplasm of undetermined malignant potential (2000)
    Springer
    Virchows Archiv 436 (2000), S. 289-295 
    Details
    ISSN: 1432-2307
    Keywords: Key words Unusual lung tumors ; Papillary adenoma ; Surfactant proteins ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Peripheral papillary adenomas of the lung are uncommon neoplasms (only ten cases have been described so far in the English literature) composed predominantly of type-II pneumocytes and generally considered benign. We describe here two additional cases of this lung tumor. In both cases histological examination revealed an encapsulated papillary neoplasm with invasion of the capsule and, in one case, invasion of the adjacent alveoli and visceral pleura too. The proliferative index (Ki67) was less than 2% and the epithelial cells were positive for cytokeratins, surfactant apoproteins (SP), and nuclear thyroid transcription factor-1 (TTF-1). Ultrastructurally, the epithelial cells showed the characteristic surface microvilli and cytoplasmic lamellar inclusions of type-II cells. Review of the literature has revealed two other cases of peripheral papillary adenoma of type-II pneumocytes with infiltrative features. Thus, we propose replacing the term peripheral papillary adenoma with peripheral papillary tumor of undetermined malignant potential.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280050043
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    Differential expression of CD44s and CD44v3-10 in adenocarcinoma cells and reactive mesothelial cells in effusions (2000)
    Springer
    Virchows Archiv 436 (2000), S. 330-335 
    Details
    ISSN: 1432-2307
    Keywords: Key words Adenocarcinoma cell ; Mesothelial cells ; Effusions ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The detection of malignant cells in serous effusions obtained from patients diagnosed with cancer marks the presence of metastatic disease and is associated with a poor outcome. The purpose of this study was to evaluate the role of CD44s and CD44v isoforms in the distinction between mesothelial cells and malignant epithelial cells in effusions. Fifty-nine fresh pleural and peritoneal effusions were studied. These consisted of 41 specimens from patients with known gynecological neoplasms, 9 from patients diagnosed with breast adenocarcinoma, and 9 effusions from patients with various nongynecological malignancies or tumors of unknown origin. Forty-three effusions contained malignant/atypical epithelial cells, and 16 effusions were diagnosed as reactive. Three effusions contained exclusively malignant cells. Specimens were stained with anti-CD44s, v3, v5, v6, v7 and v3-10. The presence of staining in cancer cells, benign mesothelial cells and lymphocytes was evaluated. CD44s immunoreactivity was seen in 10 of 43 (23%) cases in malignant/atypical epithelial cells and in 53 of 56 (94%) cases in benign cells. In contrast, CD44v3-10 was seen in 23 of 43 (55%) cases in malignant/atypical epithelial cells and in 3 of 56 (6%) cases in benign cells. We advocate the use of CD44s and CD44v3-10 immunostaining in diagnostic evaluation of difficult serous effusions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280050455
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    PE-35-related antigen expression and CD1a-positive lymphocytes in thymoma subtypes based on Müller-Hermelink classification (2000)
    Springer
    Virchows Archiv 436 (2000), S. 20-27 
    Details
    ISSN: 1432-2307
    Keywords: Key words PE-35 ; CD1a ; Immunohistochemistry ; Catalyzed signal amplification (CSA) ; Thymoma ; Thymic carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  PE-35 monoclonal antibody, detecting a cell-surface antigen of various types of carcinoma and normal epithelium, reacts exclusively with the medullary epithelium in the thymus; therefore, the antigen has been considered as a marker of medullary differentiation in thymomas. Using the catalyzed signal amplification method, which made it possible to apply PE-35 to routinely processed, archival tissues, we examined expression of this antigen, together with CD1a reactivity of lymphocytes, in 40 thymic epithelial tumors subclassified using the Mü1ler-Hermelink system. Medullary thymomas infiltrated with a small number of CD1a-negative lymphocytes were PE-35 positive, although many of the long spindle tumor cells were PE-35 negative. Mixed thymomas and predominantly cortical thymomas, both with prominent CD1a-positive lymphocytes, were also PE-35 positive, although some areas of the latter type were PE-35 negative. Cortical thymomas with decreased numbers of CD1a-positive lymphocytes were largely PE-35 negative. In well-differentiated thymic carcinomas with a few CD1a-positive lymphocytes, two cases were negative, but four cases were at least focally positive with PE-35. All high-grade thymic carcinomas infiltrated with some CD1a-negative lymphocytes were PE-35 positive. These results suggested that medullary thymoma generally possesses the medullary nature, although the latter tends to be lost in the long spindle tumor cells. Mixed and predominantly cortical thymomas may have mixed medullary phenotype and cortical function. Cortical thymoma and many well-differentiated thymic carcinomas may possess the cortical nature, while the large polygonal tumor cells tend to lose immature T-lymphocyte-retaining function.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00008194
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    Highly sensitive diagnosis of amyloid and various amyloid syndromes using Congo red fluorescence (2000)
    Springer
    Virchows Archiv 436 (2000), S. 439-448 
    Details
    ISSN: 1432-2307
    Keywords: Key words Amyloid ; Classification ; Congo red fluorescence ; Early diagnosis ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  In order to find how best to diagnose amyloid deposits as early as possible, the sensitivity of three different methods that can be applied to the diagnosis of amyloid in tissue sections have been compared: the Congo red staining method (CR), the combination of CR and immunocytochemistry (CRIC) and Congo red fluorescence (CRF). Tissue blocks were available from 25 patients, including 11 with immunohistochemically distinct and 3 with chemically undefined amyloid diseases. The results revealed (a) that CRF is more sensitive than either CR or CRIC, as shown qualitatively and quantitatively, (b) that CRF can therefore be utilized to track down even minute amyloid deposits, which can be missed by the other two methods; (c) that the specificity of CRF and CRIC is secured on double-stained sections by the demonstration of green birefringence (GB) of the CRF-marked and IC-marked areas; (d) that CRF can be performed on the spot by just changing the light source; and (e) that CRF is not hampered by the congruent IC chromogen overlay, which ensures the specific classification of the amyloid deposits as applied to different amyloid classes. In conclusion, CRF was demonstrated to be the most sensitive method for direct diagnosis of amyloid in tissue sections. This method can, therefore, allow the earliest diagnosis and classification of amyloid, which is a good basis for an amyloid class-specific therapy while organ damage is still minimal.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280050471
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    Bio-morphological events in the development of the human female mammary gland from fetal age to puberty (2000)
    Springer
    Virchows Archiv 436 (2000), S. 431-438 
    Details
    ISSN: 1432-2307
    Keywords: Key words Breast development ; Human breast ; Fetal breast ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Bio-morphological understanding of the developing human mammary glands may clarify some aspects of breast pathology, including cancer. In particular, some epidemiological data suggests that during fetal growth an altered intrauterine hormonal status, especially a change in estrogen status, could predispose to carcinogenesis. In an attempt to achieve new information on early breast growth, a series of developing human breasts have been analyzed, namely: 4 fetal breasts (28–32 weeks of gestational age), 7 infant breasts (7 h to 2 years) and 1 puberal breast (12 years). In addition to the morphological features, we studied the immunohistochemical expression of some markers involved in morphogenesis, such as MIB-1 for cell proliferation, bcl-2 for apoptosis control, CD34 for vasculogenesis, estrogen (ER) and progesterone (PR) receptors for hormonal profile, and smooth-muscle actin for myoepithelial differentiation. The results were as follows: (a) lobules, absent between 28 weeks and 2 days, were well evident at 2 years of age and at puberty; (b) myoepithelial cells appeared from 28 weeks onward and persisted later with no modification in quantity and distribution; (c) epithelial cell proliferation was constantly low; (d) in all breasts inner epithelial cells showed diffuse bcl-2 positivity, while basal myoepithelial-like cells were generally negative; (e) all breasts were well vascularized with two different patterns: periductal vascularization (PDV) and interductal vascularization (IDV), IDV being always present, whereas PDV was found only in infant breasts; (f) ER and PR were almost absent in fetal and infant breasts, while their expression was high in the epithelial cells of the puberal breast; (g) stromal cells had no hormonal receptors and were heterogeneous for proliferation and bcl-2 expression. Interestingly, two fetal breasts showed high proliferation and high ER expression, respectively, in their epithelial compartment. This could be the expression of an altered hormonal environment in utero, representing a basis for possible subsequent cancer initiation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280050470
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    Correlation Between the Expression of Methionine Adenosyltransferase and the Stages of Human Colorectal Carcinoma (2000)
    Springer
    Surgery today 30 (2000), S. 706-710 
    Details
    ISSN: 1436-2813
    Keywords: Key words Methionine adenosyltransferase ; Colorectal adenocarcinoma ; Colon ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Methionine adenosyltransferase (MAT) catalyzes the synthesis of S-adenosylmethionine (AdoMet) from ATP and L-methionine. AdoMet is the major methyl donor in most transmethylation reactions in vivo, and it is also the propylamino donor in the biosynthesis of polyamines. In the present study, we assessed MAT activity in human colons with colorectal carcinoma and the values were compared with those of morphologically normal adjacent mucosa. Higher levels of MAT activity were observed in the colorectal carcinoma than in the normal colon. The ratio of MAT activity in tumor tissue versus normal tissue seemed to be correlated well will the stage of the colorectal tumor. Furthermore, immunoblot analysis showed that the high levels of MAT activity observed in colorectal carcinoma were due to the increased amounts of MAT protein. Immunohistochemical analysis revealed that MAT was most abundant in goblet cells, particularly in granules in the supranuclear area of these cells. In the colorectal carcinoma tissues, MAT was strongly stained in the cancerous cells and localized in granules in the supranuclear region. The results of this preliminary study suggest that determination of the relative ratio of MAT activity in both normal and tumor regions in human colorectal carcinoma could be a clinically useful tool for determining the stage of malignancy of colorectal carcinomas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005950070081
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    Increased interleukin-8 (IL-8) expression is related to aseptic loosening of total hip replacement (2000)
    Springer
    Archives of orthopaedic and trauma surgery 120 (2000), S. 328-332 
    Details
    ISSN: 1434-3916
    Keywords: Key words Interleukin-8 ; Aseptic loosening ; Total hip replacement ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aseptic loosening is an increasing problem in total hip replacement (THR). Chronic inflammatory reaction against implant wear particle results in collageno- and osteolysis, leading to loosening of the implant. Cytokines are known to play a major role in this particular inflammatory process [10]. The aim of the present study was to examine interleukin-8 (IL-8) in the synovial-like interface membrane (SLIM) and pseudocapsular tissue of THRs and to compare it to normal knee synovial membrane. Eleven patients suffering from aseptically loosened THRs were included. All the SLIM and pseudocapsular tissue samples were obtained during revision operations. Ten control samples of normal synovium were collected per arthroscopy from the superior recessus of the knee. For immunohistochemical IL-8 detection, polyclonal mouse anti-human immunoglobulin (Ig)G1 IL-8-primary antibody was used with the alkaline phosphatase anti-alkaline phosphatase (APAAP) method. Results were quantitated using the Vidas image analysis system. The highest count levels (mean ± SEM) were detected in SLIM tissue (386 ± 82 cells/mm2). The difference was statistically significant compared with pseudocapsular tissue (193 ± 36 cells/mm2) and control samples (18 ± 5 cells/mm2). Count levels in control tissue were on average 5% of the SLIM tissues values. The present study determines for the first time the cellular origin of IL-8 in aseptically loosened THRs and also quantitates the IL-8-producing cells in the periprosthetic tissue. The results reveal a high rise in IL-8 concentration in SLIM and in synovial tissues. This finding moves us one step forward in solving the complex network of multiple factors affecting loosening of hip implants.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050475
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    Kraniofaziale Fehlbildungen (2000)
    Springer
    Mund-, Kiefer- und Gesichtschirurgie 4 (2000), S. S068 
    Details
    ISSN: 1434-3940
    Keywords: Schlüsselwörter ; Kraniofaziale Fehlbildungen ; Deformationen des Hirn- und Gesichtsschädels ; Therapie ; Frontoorbitales Advancement ; Key words ; Craniofacial malformations ; Craniofacial skull deformations ; Therapy ; Frontoorbital advancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Most craniofacial malformations result from a premature fusion of skull sutures. Depending on the scope of the sutures affected, the results are more or less distinct deformations of the facial and cranial skull with substantial negative effects on functional as well as esthetic aspects. The etiopathology is still unclear. Various therapies have been developed over the past 100 years. However, Tessier’s technique of fronto-orbital advancement has been an important milestone in the treatment of these malformations. Numerous adjustments have since perfected this operational technique. It is now possible to treat practically all skull malformations with the surgical techniques available today. At the same time, these techniques have also aided the advancements in tumor surgery and traumatology.
    Notes: Zusammenfassung Kraniofaziale Fehlbildungen entstehen überwiegend durch die vorzeitige Verknöcherung von Schädelnähten. Je nach Nahtbefall resultieren daraus mehr oder weniger ausgeprägte Deformationen des Hirn- und Gesichtsschädels, die sowohl zu einer funktionellen als auch zu einer ästhetischen Beeinträchtigung führen. Die Ätiopathogenese ist noch weitgehend ungeklärt. In den vergangenen 100 Jahren wurden verschiedene Therapieansätze entwickelt, wobei Tessier mit der Technik des frontoorbitalen Advancements der entscheidende Fortschritt gelang. Aufbauend auf dieser Operationstechnik wurden bis heute zahlreiche Verbesserungen eingebracht. Mit den heutigen Operationstechniken ist es möglich, praktisch alle Schädelfehlbildungen zu therapieren. Gleichzeitig konnten durch diese Techniken auch Fortschritte in der Tumorchirurgie und der Traumatologie erzielt werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/
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    Gefäß- und Nervenmalformationen (2000)
    Springer
    Mund-, Kiefer- und Gesichtschirurgie 4 (2000), S. S076 
    Details
    ISSN: 1434-3940
    Keywords: Schlüsselwörter ; Gefäßmalformation ; Nervenmalformation ; Neurofibromatose ; Hämangiom ; Therapie ; Key words ; Vascular malformation ; Neural malformation ; Neurofibromatosis ; Hemangioma ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The presentation of vascular and neural malformations in an understandable terminology permits accurate diagnosis, proper treatment, individualized prognosis, and also stimulates studies of pathogenesis. The descriptive classification includes: NF 1 and NF 2; hemangiomas, low- and high-flow vascular malformations, combined malformations, and hypertrophy; and syndromes such as, Parkes Weber, Klippel-Trénaunay, Maffuci’s, and multiple dysplasia syndromes. Lymphatic malformations are abnormalities of lymphatic development. The list of treatment includes surgical and nonsurgical treatment. Not all vascular malformations can be successfully treated. Coping with NF is a challenge for both, affected individuals and health care professionals. NF is often associated with a myriad of anomalies that present a lot of problems for plastic surgery. In certain cases watchful waiting seems justified but not in cases of severe problems, giant growth, and local complications.
    Notes: Zusammenfassung Die Frage der Terminologie ist im Zusammenhang mit vaskulären und nervalen Malformationen besonders wichtig. Dies gilt nicht nur im Hinblick auf die Wahl des richtigen Therapieverfahrens, sondern auch im Hinblick auf die individuell ausgerichtete Prognose und natürlich auch zur Beantwortung der die Pathogenese betreffenden Fragen. Es ist klar, dass bei Besprechung der Neurofibromatose zunächst an die NF 1 und NF 2 gedacht wird, die Hämangiome werden entsprechend ihrer Durchblutung und auch im Hinblick auf die Kombination mit den so ¶genannten Hypertrophiesyndromen, die später im Text genannt werden, eingeteilt. Dass die Bezeichnung Lymphangiom impliziert, es handle sich um einen Tumor, mag nicht ganz richtig sein, da anscheinend die für Tumoren üblichen Mitosen vermisst werden. Interessant ist das therapeutische Spektrum und dies gilt für alle Malformationen der Gefäße und Nerven, aber ganz besonders natürlich für die Neurofibromatose und die Hämangiome. Mit der NF konfrontiert zu sein, bedeutet für den Patienten und das ärztliche Personal eine lebenslange Herausforderung, darüber hinaus ist die NF häufig mit einer Unzahl von Einzelproblemen vergesellschaftet, die für die plastische Chirurgie z. T. schwere oder nicht zu lösende Probleme darstellen. Die große Zahl an Therapievorschlägen zeigt, dass die Gefäßmalformationen zum einen sehr unterschiedliche Probleme zeigen, und zum anderen, dass es kaum ein Therapieverfahren gibt, welches keinen Wunsch offen lässt. Wichtig ist der Hinweis, dass schnell wachsende Hämangiome durchaus im Anfangsstadium entfernt werden sollten, zuwartende Haltung ist in bestimmten Fällen gerechtfertigt, aber nicht, wenn sich schwere Probleme, Riesenwachstum und lokale Komplikationen einstellen.
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    Tumorchirurgie (2000)
    Springer
    Mund-, Kiefer- und Gesichtschirurgie 4 (2000), S. S142 
    Details
    ISSN: 1434-3940
    Keywords: Schlüsselwörter ; Tumoren im Kopf-Hals-Bereich ; Therapie ; DÖSAK-Richtlinien ; Key words ; Tumors in the head and neck area ; Therapy ; DÖSAK guidelines
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Surgery is still the primary therapeutic approach in treatment of tumors in the head and neck area, dating back to the early nineteenth century. More than 150 years ago, hemimaxillectomies and mandibular resections as well as hemiglossectomies were already performed by leading surgeons. The block principle we are now following dates back to Crile, who also established the principle of cervical lymph node dissection. Ablative oncologic surgery has always been closely linked with plastic and reconstructive surgery, rendering radical surgical interventions possible without disfiguring patients. The development of facial reconstructive surgery proceeded in stages, in the first instance as secondary reconstruction using tube pedicled flaps. The change to the concept of primary reconstruction occurred via arterialized skin flaps and myocutaneous flaps to the widely accepted and performed free tissue transfer. Free bone grafting, inaugurated earlier and still representing the majority of bone grafting, has been supplemented for certain reconstructive purposes by free vascularized bone transfer from various donor sites. Although the five-year-survival rate of carcinoma of the oral cavity has remained unchanged in the past 30 years, distinctive improvements in tumor surgery can be recorded. This is primarily based on improved diagnostics such as modern imaging techniques and the refinement of surgical techniques. The DÖSAK has worked out distinctive guidelines for effective ablative oncologic surgery. Surgical approaches offering wide exposure and carrying low morbidity play a decisive role in radical resections. For this reason, midfacial degloving offers an essential improvement for the resection of midface tumors, especially from an aesthetic point of view. Tumors situated deep behind the viscerocranium at the skull base can be clearly exposed either through a lateral approach following a temporary osteotomy of the mandibular ramus or a transmandibular, transmaxillar, or transfacial approach with minimal morbidity. Concerning the concept of neck dissection, radical techniques are more and more abandoned in favor of a more conservative procedure. Actual inquiries concerning present surgical procedures as to the surgical strategy in “No-neck” or marginal and segmental resection in mandibular adherent carcinomas demand scientific clarification.
    Notes: Zusammenfassung Im Zentrum der Behandlung von Tumoren im Kopf-Hals-Bereich steht immer noch die Chirurgie, deren Ansätze weit in das 19. Jahrhundert zurückreichen. Schon vor weit über 150 Jahren wurden durch wegweisende Chirurgen Halbseitenresektionen des Ober- und Unterkiefers sowie der Zunge durchgeführt. Das heute von uns verfolgte Blockprinzip geht auf Crile zurück, der auch die Prinzipien der Halslymphknotenausräumung festschrieb. Eng verknüpft mit der Tumorchirurgie war stets die plastische und rekonstruktive Chirurgie, die radikalchirurgische Eingriffe ohne Entstellung der Patienten erst ermöglichte. Die Entwicklung der wiederherstellenden Gesichtschirurgie verlief in Phasen, zunächst als sekundäre Rekonstruktion mittels Rundstiellappen. Der Wandel zur primären Wiederherstellung vollzog sich über arterialisierte Hautfettlappen und die Myokutanlappen bis zum heute aktuellen mikrovaskulär anastomosierten Gewebetransfer. Die schon früh inaugurierte und heute noch praktizierte freie Knochentransplantation wurde für spezielle Indikationen durch den mikrochirurgischen Knochentransfer aus verschiedenen Spenderregionen ergänzt. Obwohl die 5-Jahres-Überlebensraten für das Mundhöhlenkarzinom in den letzten ¶30 Jahren stagnieren, sind heute doch deutliche Fortschritte in der Tumorchirurgie zu verzeichnen. Diese beruhen zunächst auf einer verbesserten Diagnostik durch die modernen bildgebenden Verfahren und die Weiterentwicklung der Operationsverfahren. Für eine erfolgreiche Tumorchirurgie hat der DÖSAK klare Richtlinien erarbeitet. Für eine radikale Tumorresektion spielen übersichtliche und wenig destruierende Zugangswege eine entscheidende Rolle. So brachte für die Tumoren des Oberkiefers das Midfacial degloving eine wesentliche Verbesserung, insbesondere auch aus ästhetischer Sicht. Versteckt hinter dem Gesichtsschädel liegende Tumoren an der Schädelbasis lassen sich entweder über einen lateralen Zugang nach temporärer Osteotomie des Unterkieferasts oder transmandibulär, transmaxillär oder transfazial übersichtlich ohne Destruktionen darstellen. Bezüglich der Halslymphknotenausräumung ist eine Abkehr vom radikalen zum konservativen Vorgehen zu verzeichnen. Derzeit aktuelle chirurgische Fragen, wie das operative Vorgehen beim „N 0 -Hals“ oder Kastenresektion bzw. Kontinuitätsresektion des Unterkiefers bei der Mandibula adhärenten Karzinomen, bedürfen einer wissenschaftlichen Klärung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014535
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    Ganglioglioma with a tanycytic ependymoma as the glial component (2000)
    Springer
    Acta neuropathologica 99 (2000), S. 310-316 
    Details
    ISSN: 1432-0533
    Keywords: Key words Ganglioglioma ; Ependymoma (tanycytic variant) ; Neurofibrillary tangle ; Immunohistochemistry ; Ultrastructure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied a cystic ganglioglioma (GG) located in the right frontal lobe of the brain. Interestingly, the fibrillary spindle glial cells were often arranged in a fascicular pattern, and the generally uniform, round-to-oval delicate nuclei appeared to resemble those of ependymoma; and the neoplastic neurons often contained neurofibrillary tangles (NFTs). The glial component was positive for glial fibrillary acidic protein and occasionally contained granular or microvesicular structures positive for epithelial membrane antigen. Ultrastructural investigation revealed that the glial cells were ependymal in nature; intracytoplasmic lumina and intercellular microrosettes lined with cilia and microvilli, as well as long zonulae adherentes, were evident. In addition, chromogranin A-positive granular staining, neurosecretory-granule-like structures, and parallel arrays of microtubules were sometimes associated with the blood vessels. We considered the present case to be an unusual example of GG with an ependymoma, more precisely a tanycytic ependymoma, as the glial component; to our knowledge, the existence of ependymoma as the main glial component of this particular tumor has not been described before. The occurrence of NFTs, which has been reported in several cases of GG, was an additional, unusual feature.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00007443
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    Das akute Rechtsherzversagen Ätiologie – Pathophysiologie – Diagnostik – Therapie (2000)
    Springer
    Der Anaesthesist 49 (2000), S. 788-809 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Rechtsherzfunktion ; Störung ; Ätiologie ; Pathophysiologie Diagnostik ; Therapie ; Keywords Impaired right ventricular function ; RV failure ; Diagnosis ; Monitoring ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Impaired right ventricular (RV) function may be caused by pulmonary hypertension or myocardial ischemia. It is characterized by a dilation of the RV, which is followed by an increase of wall tension and O2-consumption and a decrease of RV ejection fraction (RV ‘dysfunction’). If a drop of arterial pressure occurs this my precipitate RV failure and shock (RV ‘insufficiency’). Diagnosis of RV failure and monitoring of RV function is difficult. Sometimes, even a severe impairment of RV function goes undetected or is misinterpreted. Patients in the operating room or on intensive care units seem to be especially prone to RV dysfunction and failure. Since a causative therapy often is not readily available, adequate symptomatic therapy is of utmost importance. Four basic principles have to be considered: 1) Optimizing preload: The failing RV requires adequate filling for preservation of stroke volume. On the other hand, overdistension of the RV may result in RV ischemia, thereby further deteriorating RV function Hence, volume loading is important, but requires continuous monitoring. 2) Maintenance of aortic pressure: Vasopressors are indicated if there is a critical drop of coronary perfusion pressure. Norepinephrine presently is the drug of choice for this purpose. 3) Reduction of RV afterload: Whereas intravenous vasodilators are limited in their efficacy in dilating pulmonary vessels due to systemic side effects, inhaled vasodilators result in selective pulmonary vasodilation and may improve RV function. 4) Increase of RV contractility: In RV failure and shock, norepinephrine and epinephrine are the drugs of choice. Inodilators are well suited for reducing pulmonary vascular resistance due to their positive inotropic and vasodilating effects. Since systemic vasodilation may occur, these drugs must only be used in hemodynamically stable patients.
    Notes: Zusammenfassung Eine Störung der Rechtsherzfunktion entsteht meist als Folge einer pulmonalen Hypertension, seltener bei primärer Myokardischämie. Sie ist gekennzeichnet durch eine Dilatation des rechten Ventrikels mit Anstieg von Wandspannung und Sauerstoffverbrauch bei reduzierter Ejektionsfraktion (“Dysfunktion”). Kommt es zum Abfall von arteriellem Druck und koronarem Perfusionsdruck, kann dies ein Rechtsherzversagen mit Schock auslösen (“Insuffizienz”). Diagnostik und Monitoring des rechten Ventrikels sind schwierig. Selbst eine schwere Beeinträchtigung der rechtsventrikulären Pumpfunktion bleibt daher häufig unbemerkt oder wird fehlgedeutet. Patienten in der perioperativen Phase und auf Intensivstationen scheinen besonders häufig von dem Krankheitsbild betroffen zu sein. Da eine kausale Therapie des akuten Rechtsherzversagens nur selten möglich ist, kommt der symptomatischen Therapie besondere Bedeutung zu. Sie stützt sich auf vier Prinzipien: 1) Optimierung der Vorlast: Der insuffiziente rechte Ventrikel benötigt zur Aufrechterhaltung seines Schlagvolumens ein gute Füllung. Andererseits kann eine Überdehnung des rechten Ventrikels eine Myokardischämie induzieren und seine Funktion weiter verschlechtern. Eine adäquate Volumentherapie ist daher essenziell, muss jedoch unter engmaschigem hämodynamischem Monitoring erfolgen. 2) Aufrechterhaltung des Aortendrucks: Bei kritischem Abfall des arteriellen Drucks ist die Gabe von Vasopressoren indiziert, um den rechtskoronaren Perfusionsdruck zu erhöhen. Noradrenalin gilt derzeit wegen seiner zusätzlich positiv inotropen Wirkung als Mittel der Wahl. 3) Verminderung der rechtsventrikulären Nachlast: Während sich intravenöse Vasodilatatoren wegen systemischer Nebenwirkungen nur bedingt zur Therapie der pulmonalen Hypertension eignen, dilatieren inhalierte Vasodilatatoren die pulmonale Strombahn selektiv und verbessern so die Pumpfunktion des rechten Ventrikels. 4) Steigerung der rechtsventrikulären Kontraktilität: Mittel der Wahl bei Dekompensation und Schock sind Noradrenalin und Adrenalin. Inodilatatoren weisen neben einer positiv inotropen auch eine pulmonal vasodilatierende Wirkung auf und eignen sich daher ebenfalls zur Therapie der rechtsventrikulären Dysfunktion. Sie sollten jedoch wegen der damit verbundenen systemischen Vasodilatation nur bei kreislaufstabilen Patienten eingesetzt werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010070052
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    α-Synuclein is expressed in a variety of brain tumors showing neuronal differentiation (2000)
    Springer
    Acta neuropathologica 99 (2000), S. 154-160 
    Details
    ISSN: 1432-0533
    Keywords: Key wordsα-Synuclein ; Brain tumors ; Neuronal ¶differentiation ; Immunohistochemistry ; Neuronal marker
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract α-Synuclein is presynaptic nerve terminal protein and its immunoreactivity has been observed in such neurodegenerative structures as senile plaques of Alzheimer’s disease or Lewy bodies of Parkinson’s disease. The physiological role of α-synuclein is still unknown. It is speculated that α-synuclein may be expressed in brain tumors, especially in those showing neuronal differentiation. We examined the immunohistochemical localization of α-synuclein in 77 human brain tumors. α-Synuclein was widely distributed in the brain tumors showing neuronal differentiation. As a result, positive immunostaining for α-synuclein was observed in ganglioglioma, medulloblastoma, neuroblastoma, primitive neuroectodermal tumor, pineocytoma/pineoblastoma, and central neurocytoma. Compared with other neuronal markers, the positive ratio of α-synuclein was not as high as synaptophysin, microtubule-associacted protein 2, neuron-specific enolase and tau, but it was higher than neurofilament and chromogranin A. The expression of synaptophysin was diffusely observed in the cytoplasm, cellular processes and nucleus in tumors showing neuronal differentiation; however, the expression of α-synuclein was predominantly observed in the cytoplasm of the tumors as well as in the cellular processes. On the other hand, non-neuronal brain tumors such as astrocytic tumors or meningiomas were totally negative for α-synuclein. In conclusion, the appearance of an α-synuclein-positive structure was not limited to neurodegenerative diseases, but could also be detected in neoplastic cells showing neuronal differentiation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00007419
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    Neuronal intranuclear hyaline inclusion disease with polyglutamine-immunoreactive inclusions (2000)
    Springer
    Acta neuropathologica 99 (2000), S. 589-594 
    Details
    ISSN: 1432-0533
    Keywords: Key words Neuronal intranuclear inclusion ; Neurodegenerative diseases ; Polyglutamine ; Ubiquitin ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Neuronal intranuclear hyaline inclusion disease (NIHID) is a group of neurodegenerative disorders characterized by the presence of intranuclear inclusions in neurons (NIs). We report here clinicopathological findings of a 25-year-old female patient who died after 13 years of a clinical course characterized by progressive gait disturbance and movement disorders. Histological examination revealed widespread NIs with neuronal loss in restricted regions; neuronal loss was severe in the subthalamic nucleus, internal pallidum, substantia nigra, Edinger-Westphal nucleus and Purkinje cell layer. Quantification of the NIs combined with a graded evaluation of neuronal loss revealed an overall tendency for more severe neuronal loss to be accompanied by a lower frequency of NIs. A morphological similarity to the nuclear inclusions recently identified in several CAG repeat diseases prompted us to examine the immunolocalization of ubiquitin and expanded polyglutamine stretches, which demonstrated the presence of ubiquitin at the periphery of most NIs. An expanded polyglutamine stretch was seen in the center of limited number of NIs. These findings indicate that abnormal fragments such as expanded polyglutamine regions are incorporated into the inclusion, aggregated in its center, and thereby metabolized by a ubiquitin-dependent proteolytic pathway. Although it remains to be elucidated how the formation of NIs is related to neuronal degeneration, our findings suggest that NIs are formed in the process of sequestering or degrading abnormal protein fragments and formation of NIs may not be immediately toxic to neurons.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010051166
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    Ubiquitinated filamentous inclusions in cerebellar dentate nucleus neurons in dentatorubral-pallidoluysian atrophy contain expanded polyglutamine stretches (2000)
    Springer
    Acta neuropathologica 99 (2000), S. 615-618 
    Details
    ISSN: 1432-0533
    Keywords: Key words Dentatorubral-pallidoluysian atrophy ; Cerebellar dentate nucleus neuron ; Skein-like inclusion ; Polyglutamine ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We have recently reported that, in addition to the widespread occurrence of ubiquitinated neuronal intranuclear inclusions (NIIs), the restricted occurrence of ubiquitinated intracytoplasmic filamentous inclusions in the neurons of the cerebellar dentate nucleus (CDN) is a characteristic feature of dentatorubral-pallidoluysian atrophy (DRPLA). Interestingly, these neuronal intracytoplasmic filamentous inclusions (NIFIs) were morphologically indistinguishable from the skein-like inclusions (SLIs) described previously in the spinal anterior horn cells in amyotrophic lateral sclerosis (ALS). In the present study, we examined immunohistochemically the CDN in ten patients with clinicopathologically and genetically confirmed DRPLA and the spinal anterior horns in five patients with sporadic ALS, using a monoclonal antibody (1C2) directed against long polyglutamine stretches. In all of the patients with DRPLA, both the NIFIs and the NIIs were visualized clearly with 1C2. Conversely, in the patients with ALS all structures, including the SLIs, were completely negative. These findings indicate that in DRPLA, the NIFIs in the CDN are an alteration that is directly related to the causative gene abnormality (an expanded CAG repeat encoding polyglutamine) and that, from the molecular point of view, they are distinct from the SLIs in ALS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010051171
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    Erworbene Hemmkörperhämophilie (2000)
    Springer
    Der Anaesthesist 49 (2000), S. 34-42 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter ; Erworbene Hemmkörperhämophilie ; spontane Faktor-VIII-Inhibitoren ; spontane Faktor-IX-Inhibitoren ; Diagnose ; Therapie ; Key words ; Acquired haemophilia ; Spontaneous factor VIII inhibitors ; Spontaneous factor IX inhibitors ; Diagnosis ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Although autoantibodies against factor VIII or factor IX are a rare phenomenon, they are associated with a high risk of bleeding and high mortality. The condition, termed ac- quired haemophilia, occurs equally in both sexes and is most frequent in higher age groups. Patients typically present with severe bleedings in muscles and skin. In contrast to patients with congenital haemophilia and inhibitors, joint bleedings are very rare. In approximately half of all cases an associated disease state can be identified as the cause of autoantibody formation. An immediate and comprehensive diagnosis is essential for a rapid initiation of therapy. Equally important are a careful diagnostic differentiation between congenital and acquired factor deficiencies and the exclusion of non-specific inhibitors, which increase the occurrence of thrombolic events. The inhibitor titre, quantified using the Bethesda assay, is an important criterion for selecting the appropriate therapy. A wide range of treatment options is now available for the management of bleedings in patients with acquired haemophilia, namely porcine factor VIII, recombinant factor VIIa, prothrombin complex concentrates, and immunoadsorptions. In addition, immunosuppressive therapies are used to achieve permanent reduction or elimination of inhibitors.
    Notes: Zusammenfassung Autoantikörper gegen Faktor VIII oder Faktor IX sind ein zwar seltenes, aber mit hohem Blutungsrisiko und hoher Letalität verbundenes Phänomen. Diese als erworbene Hemmkörperhämophilie bezeichnete Erkrankung kommt bei beiden Geschlechtern gleich häufig vor und tritt gehäuft im hohen Lebensalter auf. Die Patienten fallen klinisch v. a. durch schwere Blutungen in Muskeln und Haut auf, wogegen Gelenkeinblutungen – im Gegensatz zur angeborenen Hämophilie mit Hemmkörpern – sehr selten auftreten. In etwa der Hälfte der Fälle kann eine assoziierte Grunderkrankung als Auslöser der Autoantikörperbildung identifiziert werden. Eine rasche und umfassende Diagnostik ist entscheidend für einen schnellen Therapiebeginn. Ebenso bedeutend ist eine sorgfältige differentialdiagnostische Abgrenzung gegen einen angeborenen oder erworbenen Faktorenmangel sowie der Ausschluß unspezifischer Inhibitoren, die vermehrt zu Thrombosen führen können. Wichtig für die Auswahl der geeigneten Therapieform ist der Inhibitortiter, gemessen im Bethesda-Assay. Für die Blutstillungstherapie steht heute mit porcinem Faktor VIII, rekombinantem Faktor VIIa, Prothrombinkomplexpräparaten und Immunadsorptionen ein breites Spektrum an Möglichkeiten zur Verfügung. Für eine dauerhafte Reduktion bzw. Elimination der Autoantikörper finden immunsuppressive Therapien Anwendung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050007
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    Glial pathology in development of cerebellar dysplasia in the hereditary cerebellar vermis defect (CVD) rat (2000)
    Springer
    Acta neuropathologica 99 (2000), S. 305-309 
    Details
    ISSN: 1432-0533
    Keywords: Key words Bergmann glia ; Cell migration ; Cerebellar ¶dysplasia ; Immunohistochemistry ; Mutant rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The cerebellar vermis defect (CVD) rat is a new neurological mutant characterized by a cerebellar vermis defect and dysplasia in the cerebellum, especially at the cerebellopontine junctions. In this study, the cytokinetics of glia in terms of the development of cerebellar dysplasia in the CVD rat was investigated using glial fibrillary acidic protein (GFAP) and vimentin immunohistochemistry. In the cerebellar hemispheres, dislocation of the Bergmann glia was observed from postnatal day 5 (P5) in lesions with abnormally aggregated external granule cells (EGCs). Rearranging Bergmann glia were often seen around the EGCs penetrating into the white matter. In the cerebellopontine junctional areas, Bergmann glia were induced after penetration of the Purkinje cells, identified with calbindin immunohistochemistry, and EGCs into the pons from P10. Bergmann fibers were frequently arranged perivascularly. In the clusters of Purkinje cells without EGC settlement in the pons, a small number of Bergmann fibers were observed and their alignment was completely disturbed. These findings suggest that morphological changes in the Bergmann glia depend on their contact with Purkinje cells, but that the orientation of their processes may be influenced by EGC settlement. These glial fibers in the CVD rat may play an important role in the aberrant migration of EGCs, resulting in the development of cerebellar dysplasia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00007442
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    Simultaneous loss of hamartin and tuberin from the cerebrum, kidney and heart with tuberous sclerosis (2000)
    Springer
    Acta neuropathologica 99 (2000), S. 503-510 
    Details
    ISSN: 1432-0533
    Keywords: Key words Hamartin ; Immunohistochemistry ; Tuberin ; Tuberous sclerosis ; Western blotting
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Tuberous sclerosis (TSC) is caused by a mutation in either the TSC1 or TSC2 gene. The clinical manifestations of mutations of the two genes are hardly distinguishable, for reasons as yet unknown. In this study, we examined the expression of the products of these genes, hamartin and tuberin, in control and TSC tissues. Western blotting disclosed that hamartin and tuberin are both abundant in the cerebral gray matter and that they have similar subcellular distributions and developmental patterns of expression. Immunohistochemical localizations of hamartin and tuberin were also similar, with high levels of expression being localized to the cerebral neurons and glial cells, renal uriniferous and collecting tubules, and cardiac muscles. In the cerebrum with TSC, both hamartin and tuberin were simultaneously reduced in the cortical tubers and subependymal giant cell astrocytomas, and from the normal-appearing cortex. The renal angiomyolipomas and cardiac rhabdomyomas also showed a loss of both the proteins. These results provide evidence for the co-localization and interaction of hamartin and tuberin in vivo, and suggest that a mutation in one TSC gene may secondarily affect the expression of the other in some TSC lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010051152
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    The formation of the chick ileal muscle layers as revealed by α-smooth muscle actin immunohistochemistry (2000)
    Springer
    Anatomy and embryology 201 (2000), S. 121-129 
    Details
    ISSN: 1432-0568
    Keywords: Key words α-Smooth muscle actin ; Chronological changes ; Smooth musculature ; Chick ; Ileum ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The genesis of intestinal smooth muscle layers was immunohistochemically investigated by use of an antibody to α-smooth muscle actin (α-SMA) in the developing chick ileum. Myoblast cells positive for α-SMA were already found in the presumptive circular muscle layer on E 8.5. On E 11.5 radially oriented muscle fibers were protruded from the outermost layer of the developing circular musculature and then formed a tuft-like aggregates. These radial muscle bundles were bent into an L-shape. The long distal extension of muscle bundles run parallel to the long axis of the ileal loop and developed into the longitudinal muscle layer. The obliquely oriented muscle fibers, locating at the intermuscular space of the muscularis propria, probably are to be considered a remnant of the short extension of radial muscle bundles. The muscularis mucosae was formed by the processes equivalent to the genesis of longitudinal muscle layer. On E 14.5 centripetally oriented muscle fibers emerged from the innermost layer of circular musculature. The long distal extension of centripetal fibers lay along the inner surface of developing circular musculature. On E 19.5 the longitudinal muscle layer of the muscularis mucosae was newly formed by separating from the circular musculature. The villous myoblast cells initially developed from the innermost layer of the muscularis mucosae on E 18.5, and were widely distributed in the lamina propria mucosae on E 20.5. Temporal and chronological pattern in expression of α-SMA was observed during the development of the chick intestinal smooth muscle. By E 14.5 the entire layer of the muscularis propria was intensely immunostained for α-SMA, but from E 15.5 onward the staining intensity gradually began to decrease from the outer half of the circular musculature. Finally, the immunoreactivity was localized in the inner layer of circular muscle and the longitudinal muscle layer. A possible functional role of this inner layer of circular muscle is discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00008232
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    Schädelhirntrauma und zerebrale Hypoxie Diagnostik – Monitoring – Therapie (2000)
    Springer
    Der Anaesthesist 49 (2000), S. 332-339 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Schädelhirntrauma ; zerebrale Hypoxie ; Diagnose ; Therapie ; Key words Brain damage ; Cerebral hypoxie ; Diagnosis ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The main reason for posttraumatic secondary brain damage is cerebral hypoxia. Both, severity and duration of hypoxia are crucial in determining wether irreversible cerebral infarction will occur or not. For the clinical routine, the diagnosis of hypoxia is indirectly made by low CPP, low jugularvenous oxygen saturation (SjO2) or low tissue PO2. To minimize misleading false negative SjO2, the CT-Approach for the side of monitorig and calculation of arterial-jugularvenous lactate content for detection of anaerobic metabolism is recommended. Targeted treatment of hypoxia according to the underlying cause is mandatory. Primary goal is to increase cellular oxygen delivery by correction of low arterial oxygen content and elevation of regional CBF. Within the autoregulatory range decreasing CPP causes vasodilation and increasing CPP vasoconstriction with increasing or decreasing cerebral blood volume respectively. Initially elevation of the lower autoregulatory threshold often requires CPP 70 mmHg. Targeted treatment of intracranial hypertension must avoid decreasing CPP. In the early postrautmatic phase prevention of cerebral hypoxia relies on management of CBF by means of CPP and cerebral vascular resistance. Thereafter targeted treatment of intracranial hypertension caused by cerebral edema and hypervolemia are increasingly important.
    Notes: Zusammenfassung Hauptursache der sekundären Hirnschädigung ist die zerebrale Hypoxie. Abhängig von Schweregrad und Dauer entsteht eine irreversible Hirngewebsschädigung. Zur Diagnose der Hypoxie dient unter klinischen Bedingungen die kontinuierliche Messung des zerebralen Perfusionsdrucks (CPP) in Verbindung mit der zerebrovenösen O2-Sättigung (SjO2) oder der O2-Partialdruckmessung im Hirngewebe. Zur Minimierung von SjO2-Fehlinterpretationen sollte nach CT-Approach punktiert und ein anaerober Hirnstoffwechsel durch Bestimmung der arterio-jugularvenösen Laktatkonzentrationsdifferenz (avDL) ausgeschlossen werden. Die Therapie der zerebralen Hypoxie sollte kausal erfolgen. Normalisierung des arteriellen O2-Gehalts und Steigerung der Hirndurchblutung (CBF) haben Prioritöt. Bei intakter Autoregulation der CBF wird ein CPP-Abfall durch Vasodilatation mit Zunahme des zerebralen Blutvolumens und ein CPP-Anstieg durch Vasokonstriktion mit Abnahme des CBV kompensiert. Die häufige posttraumatische Rechtsverschiebung der unteren Autoregulationsschwelle erfordert in der Initialphase mit dem höchsten Hypoxierisiko CPP-Werte 70 mmHg. Die Therapie des ICP 〉 20 mmHg erfolgt CPP-orientiert. Eine ICP-Senkung zu Lasten des CPP ist zu vermeiden. Initial nach SHT hat die individuelle Optimierung der CBF durch Sicherstellung eines adäquaten CPP und zerebrovaskulären Gefäßwiderstandes (CVR) Priorität. Nachfolgend gewinnen durch SjO2 und avDL- oder Gewebe-PO2-Messung kontrollierte Maßnahmen zur Modulation von CVR und CBV sowie die Hirnödemtherapie zunehmend an Bedeutung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050838
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    Expression of major bone extracellular matrix proteins during embryonic osteogenesis in rat mandibles (2000)
    Springer
    Anatomy and embryology 202 (2000), S. 31-37 
    Details
    ISSN: 1432-0568
    Keywords: Key words Bone ; Calcification ; Type I collagen ; Noncollagenous proteins ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  It is not known how bone proteins appear in the matrix before and after calcification during embryonic osteogenesis. The present study was designed to investigate expressions of the five major bone extracellular matrix proteins – i.e. type I collagen, osteonectin, osteopontin, bone sialoprotein and osteocalcin – during osteogenesis in rat embryonic mandibles immunohistochemically, and their involvement in calcification demonstrated by von Kossa staining. Wistar rat embryos 14 to 18 days post coitum were used. Osteogenesis was not seen in 14-day rat embryonic mandibles. Type I collagen was localized in the uncalcifed bone matrix in 15-day mandibles, where no other bone proteins showed immunoreactivity. Osteonectin, osteopontin, bone sialoprotein and osteocalcin appeared almost simultaneously in the calcified bone matrix of 16-day mandibles and accumulated continuously in 18-day mandibles. The present study suggested that type I collagen constitutes the basic framework of the bone matrix upon which the noncollagenous proteins are oriented to lead to calcification, whereas the noncollagenous proteins are deposited simultaneously by osteoblasts and are involved in calcification cooperatively.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00008242
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    SM5-1: a new monoclonal antibody which is highly sensitive and specific for melanocytic lesions (2000)
    Springer
    Archives of dermatological research 292 (2000), S. 583-589 
    Details
    ISSN: 1432-069X
    Keywords: Keywords Melanoma ; Immunohistochemistry ; SM5-1 ; HMB-45 ; S100
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Antibodies such as HMB-45 and anti-S100 protein have been widely used as markers of malignant melanoma despite evidence that HMB-45 has a sensitivity of only 67–93% and S100 is nonspecific for melanoma. Using a subtractive immunization protocol in a mouse model of human melanoma, we have generated several monoclonal antibodies with putative specificity for melanoma. After initial screenings, the antibody SM5-1 was chosen because of its intriguing reactivity with melanocytic tumors in both frozen and paraffin sections. The immunohistochemical staining of SM5-1 was studied in paraffin-embedded specimens of 401 melanomas (n = 401; 250 primary melanomas, 151 metastases), melanocytic nevi of the skin (n = 16), nonmelanocytic neoplasms (n = 84). The results were compared with HMB-45 and anti-S100 staining. All antibodies reacted with nevi and 97–99% with primary melanomas. Whereas both SM5-1 and anti-S100 stained 96% (146/151) of melanoma metastases, HMB-45 correctly identified only 83% (126/151). All HMB-45-negative metastases were positive for SM5-1. Whereas neither SM5-1 nor HMB-45 stained any of 84 specimens from 40 different nonmelanocytic neoplasms, anti-S100 was positive in 21/84 (25%). While the staining pattern of SM5-1 was mostly homogeneous, small tumor areas in some metastases remained unstained. Staining with SM5-1 was also observed in perivascular dendritic cells, in plasma cells, some myofibroblasts and the secretion of eccrine sweat glands. Nonactivated epidermal melanocytes, keratinocytes, endothelial cells, smooth muscle cells and peripheral nerves were all negative for SM5-1. These results suggest that SM5-1 is highly specific, as well as sensitive, for melanocytic lesions and is useful in the immunohistochemical evaluation of melanoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004030000186
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    Therapy of B-cell lymphomas with monoclonal antibodies and radioimmunoconjugates: the Seattle experience (2000)
    Springer
    Annals of hematology 79 (2000), S. 175-182 
    Details
    ISSN: 1432-0584
    Keywords: Monoclonal antibody ; Radioimmunotherapy ; Lymphoma ; Therapy ; Review
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050576
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    Fatal rupture of the spleen caused by infiltration of T-cell lymphoma (2000)
    Springer
    Annals of hematology 79 (2000), S. 158-160 
    Details
    ISSN: 1432-0584
    Keywords: Key words Splenic rupture ; T-cell lymphoma ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Pathological or spontaneous rupture of the spleen has been described in a variety of diseases affecting the spleen, with infections being cited as the cause in most cases. In hematological malignancies it is a rare event, despite the frequent involvement of the spleen in these diseases. It has, however, been described in patients with acute and chronic leukemia, Hodgkin's disease, non-Hodgkin's lymphoma of B-cell origin, mycosis fungoides, and so-called histiocytic lymphoma. Here, we present a fatal case of splenic rupture caused by infiltration of a peripheral T-cell lymphoma, unspecified according to the REAL classification. The importance of a correct diagnosis and fast surgery is emphasized.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050572
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    Corneal infection of herpes simplex virus type 2 – induced neuronal apoptosis in the brain stem of mice with expression of tumor suppressor gene (p53) and transcription factors (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 647-653 
    Details
    ISSN: 1432-0533
    Keywords: Key words HSV ; Immunohistochemistry ; Apoptosis ; p53 ; Transcription factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To understand the mechanism of neuronal apoptosis induced by herpes simplex virus (HSV) infection in vivo, the distribution of viral antigen, the appearance of apoptotic bodies, and the expressions of the tumor suppressor gene p53 and several transcription factors such as c-fos, c-jun and NF-κB were examined immunohistochemically and histopathologically after corneal infection of mice with HSV type 2 strain 186. Five days after HSV infection, viral antigen was diffusely detected in the corneal epithelium, the trigeminal ganglion and the pars caudalis of the spinal trigeminal nucleus. Neuronal apoptosis was observed in the brain stem ipsilateral to the HSV-infected side with the immunoreactivities of c-fos, c-jun, NF-κB and p53. Dual-labeling immunohistochemical studies revealed that almost all of the viral antigen-positive neurons and glia in the brain stem also showed p53 immunoreactivity. On the other hand, no neuronal apoptosis but only with the expression of c-jun was found in the trigeminal ganglion. Our results suggest that the different expression of transcription factors between the brain stem and the trigeminal ganglion may influence the neuronal apoptosis induced by HSV infection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010000240
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  • 90
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    Glial cell line-derived neurotrophic factor-like immunoreactivity in the cerebella of normal subjects and patients with multiple system atrophy (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 131-137 
    Details
    ISSN: 1432-0533
    Keywords: Key words Glial cell line-derived neurotrophic factor ; Human cerebellum ; Immunohistochemistry ; Multiple system atrophy ; Purkinje cells
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Glial cell line-derived neurotrophic factor (GDNF) has a trophic effect on various types of neurons, including cerebellar Purkinje cells. To investigate the role of GDNF in the human cerebellum, we examined the cerebella of eight control cases and eight patients with multiple system atrophy (MSA) immunohistochemically using a polyclonal anti-GDNF antibody. The antibody recognized a single band of approximately 34 kDa on Western blot analysis of human cerebellar homogenates. In the cerebella from normal subjects, the neuronal somata and dendrites of the Purkinje cells were immunostained intensely, as were some axons, including torpedoes, immunolabeled in the granular layer. Many axons and a few oligodendrocytes were also immunopositive in the white matter, and weak immunoreactivity was detected in the granule cells and neurons in the cerebellar nuclei. In the cerebella from patients with MSA, the general immunostaining pattern was similar to that observed in the normal subjects. Most of the remaining Purkinje cells showed strong immunoreactivity, and abundant GDNF-positive granular structures or dense arborizations of GDNF-positive dendrites were found in some areas of the molecular layer. These data suggest that GDNF may be mainly produced and localized in the Purkinje cells of the human cerebellum, even in patients with MSA, and that the functional impairment of the Purkinje cells of MSA patients might cause a focal accumulation of GDNF in the dendrites of some of the surviving Purkinje cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010050004
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  • 91
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    Electronic Resource
    Class III β-tubulin immunoreactive intranuclear inclusions in human ependymomas and gangliogliomas (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 427-434 
    Details
    ISSN: 1432-0533
    Keywords: Key words Ependymoma ; Ganglioglioma ; Immunohistochemistry ; Intranuclear inclusions ; Tubulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We have observed intranuclear inclusion bodies immunoreactive for the cytoskeletal protein class III β tubulin (C3βT) in neurons and ependymal cells of post-mortem human brain. The relationship of these inclusions, detected by light microscopy, to the intranuclear rodlets described by the classical microscopists is unknown. The present study was conducted to determine whether these proteinaceous inclusions (C3βT-NIIs) exist in the neoplastic counterparts of these cell types. Immunohistochemical staining for C3βT revealed intensely stained, predominantly rod-shaped intranuclear inclusions in a variable proportion of tumor cells in five of ten ependymomas. In addition, C3βT-NIIs were encountered in less than 1% of neuronal cells in two of five gangliogliomas. This study represents the first report of tubulin-containing intranuclear inclusions in brain tumors. The functional significance of these inclusions in normal human brain and in cerebral neuroepithelial neoplasms remains to be determined.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010000191
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  • 92
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    Systemic hypothermia following spinal cord compression injury in the rat: an immunohistochemical study on MAP 2 with special reference to dendrite changes (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 546-552 
    Details
    ISSN: 1432-0533
    Keywords: Key words Hypothermia ; Immunohistochemistry ; Microtubule-associated protein 2 (MAP2) ; Rat ; Spinal cord injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Systemic hypothermia has been shown to exert neuroprotective effects in experimental ischemic CNS models caused by vascular occlusions. The present study addresses the question as to whether systemic hypothermia has similar neuroprotective qualities following severe spinal cord compression trauma using microtubule-associated protein 2 (MAP2) immunohistochemistry combined with the avidin-biotin-peroxidase complex method as marker to identify neuronal and dendritic lesions. Fifteen rats were randomized into three equally sized groups. One group sustained thoracic laminectomy, the others severe spinal cord compression trauma of the T8-9 segment. The control group contained laminectomized animals submitted to a hypothermic procedure in which the esophageal temperature was reduced from 38 °C to 30 °C. The two trauma groups were either submitted to the same hypothermic procedure or kept normothermic during the corresponding time. All animals were sacrificed 24 h following the surgical procedure. The MAP2 immunostaining in the normothermic trauma group indicated marked reductions in MAP2 antigen in the cranial and caudal peri-injury zones (T7 and T10, respectively). This reduction was much less pronounced in the hypothermic trauma group. In fact, the MAP2 antigen was present in almost equally sized areas in both the hypothermic groups independent of previous laminectomy alone or the addition of trauma. Our study thus indicates that hypothermia has a neuroprotective effect on dendrites of rat spinal cords subjected to compression trauma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010000206
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  • 93
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    Electronic Resource
    Ectopic expression of telencephalin in brains with holoprosencephaly (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 506-512 
    Details
    ISSN: 1432-0533
    Keywords: Key words Telencephalin ; Holoprosencephaly ; Cerebral cortex ; Glomerular structure ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Telencephalin (TLN), a telencephalon-specific glycoprotein, is exclusively expressed in neurons of the mammalian telencephalon. In the normally developing human brain, TLN immunoreactivity appeared and increased from 35 gestational weeks (GW) in the temporal cortex, and reached adult level at 5 months of postnatal age, being strong in the molecular layer, and weak in the external and internal granular layers. TLN expression corresponded with the development of neuronal dendrites and synapses. In brains with holoprosencephaly TLN immunoreactivity was already strong from as early as 28 GW. Staining was weak in the molecular layer, but strong in the external sparse and middle cellular layers in most cases. Notably, TLN was abundant in the glomerular structures in the internal pyramidal and multiform layers of fetal brains with alobar holoprosencephaly, which disappeared with increasing age. These results indicate premature and ectopic development of the dendrites and synaptic network in holoprosencephaly.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010000184
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  • 94
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    Developmental expression of myotonic dystrophy protein kinase in brain and its relevance to clinical phenotype (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 513-520 
    Details
    ISSN: 1432-0533
    Keywords: Key words Myotonic dystrophy ; Myotonic dystrophy protein kinase ; Immunohistochemistry ; Human brain
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To investigate the pathophysiologic role of myotonic dystrophy protein kinase (DMPK) in the brain in myotonic dystrophy (MD), the developmental characteristics of DMPK immunoreactivity in the central nervous system and its alteration with disease were studied. Eleven patients’ brain with MD (5 congenital form, 6 adult form) were examined by immunohistochemistry using a specific antibody against synthetic DMPK peptides, anti-peptide DM1, and compared with 30 control brains, including 16 age-matched controls. In controls, DM1-immunoreactive neurons appeared in the early fetal frontal cortex and cerebellar granule cell layer, persisting through 29 weeks of gestation and then disappearing. In contrast, immunoreactive neurons continued to persist in the cerebral cortex and cerebellar granule cell layer of MD patients. When we counted DM1-immunoreactive neurons, the increase over controls was greater in the congenital form of MD than in the adult form, and was greater in the cerebrum than in the cerebellum in both forms of MD. DM1 immunostaining was predominantly nuclear, mirroring Western blotting of subcellular fractions. Differences in DM1 expression related to development and to the two forms of MD may be closely related to the pathogenesis of mental retardation in this disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010000216
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  • 95
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    Electronic Resource
    Phenotypic modulation of smooth muscle cells in human cerebral aneurysmal walls (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 475-480 
    Details
    ISSN: 1432-0533
    Keywords: Key words Cerebral aneurysm ; Immunohistochemistry ; Smooth muscle cell ; Phenotypic modulation ; Myosin heavy chain isoforms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We used immunohistochemical methods to analyze the phenotypes of smooth muscle cells (SMCs) in human cerebral arteries and aneurysmal walls. Thirty-two aneurysmal walls were studied; 31 aneurysmal walls were resected at operation and 1 aneurysm was obtained at autopsy. Seven control arteries were obtained at autopsy. Semiserial sections were subjected to immunohistochemical staining with antibodies to α-smooth muscle actin (α-SMA), desmin and smooth muscle myosin heavy chain isoforms: SM1, SM2 and SMemb. In control cerebral arteries, SMCs in the media were strongly immunostained for α-SMA, desmin, SM1 and SM2; immunoreactivity for SMemb was faint or weakly positive. SMCs in both non-ruptured and ruptured aneurysmal walls showed no staining for desmin; the expression of α-SMA was well preserved. Compared with control cerebral arteries, in 4 of 11 non-ruptured aneurysmal walls, the staining intensity of SMCs for SMemb was clearly increased. In ruptured aneurysmal walls, the expression of SM2 was lower than in control cerebral arteries and non-ruptured aneurysmal walls. Our study suggests that the phenotype of SMCs in aneurysmal walls is different from the contractile type in the media of normal cerebral arteries, at least partially changing to the synthetic type in some non-ruptured aneurysms. SMCs in ruptured aneurysmal walls may have lost both phenotypes before rupture. Phenotypic modulation of SMCs in the aneurysmal walls appears to be related to a remodeling of the aneurysmal wall and to a rupture mechanism.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010000220
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  • 96
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    Long-term expression of heme oxygenase-1 (HO-1, HSP-32) following focal cerebral infarctions and traumatic brain injury in humans (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 377-384 
    Details
    ISSN: 1432-0533
    Keywords: Key words Heme oxygenase-1 ; Heat shock protein-32 ; Traumatic brain injury ; Cerebral infarction ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Extracellular heme derived from hemoglobin following hemorrhage or released from dying cells induces the expression of heme oxygenase-1 (HO-1, HSP-32) which metabolizes heme to the gaseous mediator carbon monoxide (CO), iron (Fe) and biliverdin. Biliverdin and its product bilirubin are powerful antioxidants. Thus, expression of HO-1 is considered to be a protective mechanism against oxidative stress and has been described in microglia, astrocytes and neurons following distinct experimental models of pathological alterations to the brain such as subarachnoidal hemorrhage, ischemia and traumatic brain injury (TBI) and in human neurodegenerative diseases. We have now analyzed the expression of HO-1 in human brains following TBI (n = 28; survival times: few minutes up to 6 months) and focal cerebral infarctions (FCI; n = 17; survival time: 〈 1 day up to months) by ¶immunohistochemistry. Follwing TBI, accumulation of ¶HO-1+ microglia/macrophages at the hemorrhagic lesion was detected as early as 6 h post trauma and was still pronounced after 6 months. In contrast, after FCI HO-1+ microglia/macrophages accumulated within focal hemorrhages only and were absent in non-hemorrhagic regions. Further, HO-1 was weakly expressed in astrocytes in the perifocal penumbra. In contrast to experimental data derived from rat focal ischemia, these results indicate a prolonged HO-1 expression in humans after brain injury.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010000202
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  • 97
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    Electronic Resource
    Allograft inflammatory factor-1 defines a distinct subset of infiltrating macrophages/microglial cells in rat and human gliomas (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 673-680 
    Details
    ISSN: 1432-0533
    Keywords: Key words Cell culture ; Cell line ; Glioma ; Calcium-binding proteins ; Microglia enzymology ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Allograft inflammatory factor-1 (AIF-1) is a Ca2+-binding peptide that constitutes a potential modulator of macrophage activation and function during the immune response of the brain. Peptides termed microglia response factor-1 or ionized calcium-binding adaptor molecule-1 have been reported to be identical with AIF-1. We have investigated the expression of AIF-1 in the rat C6 glioblastoma and 9L gliosarcoma tumor models and additionally assessed AIF-1 expression in a diverse range of human astrocytomas by immunohistochemistry. AIF-1 was expressed by activated microglial cells and a subset of infiltrating macrophages in areas of infiltrative tumor growth and in compact tumor areas in both rat and human gliomas. Double-labeling experiments in rats and humans characterized the nature and the functional status of AIF-1+ cells. AIF-1 expression was detected in cells expressing major histocompatibility complex class II molecules and in a subset of activated macrophages/microglial cells. All MRP-8+ cells coexpressed AIF-1. In humans, there was a strong correlation of AIF-1-expressing activated macrophages/microglial cells with tumor malignancy (P 〈 0.0001). These results suggest that AIF-1 defines a distinct subset of tumor-associated activated macrophages/ microglial cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010000233
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  • 98
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    Electronic Resource
    Amyloid in a multiple sclerosis lesion is clearly of Aλ type (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 709-711 
    Details
    ISSN: 1432-0533
    Keywords: Key words Multiple sclerosis ; Aλ amyloid ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In rare multiple sclerosis cases amyloid is deposited in demyelinated plaques. In one such case amyloid was examined immunohistochemically with a panel of antibodies directed against different amyloid types. The amyloid was classified as the Aλ type produced by a local monoclonal B cell population.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010000244
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  • 99
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    Electronic Resource
    Heterotopia in microcephaly induced by cytosine arabinoside: hippocampus in the neocortex (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 403-408 
    Details
    ISSN: 1432-0533
    Keywords: Key words Cytosine arabinoside ; Heterotopia ; Microcephaly ; Hippocampus ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pregnant mice were injected intraperitoneally with cytosine arabinoside (Ara-C) on days 13.5 and 14.5 of pregnancy. The brains of their offspring were studied histologically and histochemically. In addition to dysgenic microcephaly, nodular structures consisting of cells with a relatively homogeneous morphology were observed in the depths of the cerebral cortex. The cell clusters were first seen around postnatal day 4, and had a cellular continuity with the disarrayed pyramidal cell layer in the CA1 region of the hippocampus. Golgi-Cox staining showed a number of pyramidal-shaped cells in the clusters. Morphologically, they resembled the pyramidal neurons of the hippocampus. Immunohistochemical examination, using anti-serotonin or anti-tyrosine hydroxylase antibodies, also indicated similarities between the cell clusters and the pyramidal cell layer. It is, therefore, proposed that the cell clusters consisted of heterotopic pyramidal cells of the hippocampus. A few synaptic structures could already be detected in the heterotopic cell clusters on postnatal day 3 by electron microscopy. This early establishment of synaptic contact with related neurons may have caused the heterotopic localization of the pyramidal cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010000205
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  • 100
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    Ubiquitin-immunoreactive skein-like inclusions in the neostriatum are not restricted to amyotrophic lateral sclerosis, but are rather aging-related structures (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 43-49 
    Details
    ISSN: 1432-0533
    Keywords: Key words Aging ; Immunohistochemistry ; Inclusion body ; Neostriatum ; Ubiquitin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We examined the presence of ubiquitin-immunoreactive skein-like inclusions (SLI) in the neostriatum and spinal cord in normal individuals and patients with different neurodegenerative diseases. Ubiquitin-immunoreactive SLI in the neostriatum were observed both in the normal individuals and in the patients with a variety of neurodegenerative diseases. In particular, SLI were frequently seen in normal aged subjects and certain neurodegenerative diseases, such as progressive supranuclear palsy and myotonic dystrophy. In contrast, the occurrence rate of SLI in cases with Pick’s disease and multiple system atrophy tended to decrease. On the other hand, SLI in the spinal anterior horn were detected in cases of amyotrophic lateral sclerosis, but not in any cases with other neurodegenerative diseases. SLI in the neostriatum were also identifiable using phosphotungstic acid-hematoxylin and Gomori trichrome staining. Ubiquitin immunoelectron microscopy demonstrated that the SLI in the neostriatum corresponded to bundles of filaments. These features of SLI in the neostriatum were quite similar to those of intracytoplasmic rod-like inclusions (RLI) in the large neurons of caudate nucleus, which were first described by Kojima and Ogawa in 1974. Our findings indicate that SLI in the neostriatum are ubiquitin-related structures whose occurrence increases by aging, and less frequently accompany several neurodegenerative diseases, and are identical to at least some RLI.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010051191
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