Biomedical subjects

B Winkler

Publications and source records attributed to B Winkler.

At least 55 records · Page 3Linked to original sources

PubMed1987

Parathyroid variants: US evaluation.

High-resolution (10-MHz) ultrasonography was performed in 181 patients with primary or secondary hyperparathyroidism during a 4-year period and evaluated retrospectively. Thirty-seven unusual-appearing parathyroid tumors were found among 235 parathyroid glands identified as abnormal. There was pathologic correlation in 36. The typical appearance of parathyroid adenoma was that of an oval hypoechoic or anechoic lesion in the neck, aligned in a craniocaudal direction and often posterior to the thyroid. Morphologic variations from the norm included giant size (n = 11) (4.6%), cystic changes in a solid tumor (n = 9) (3.8%), calcified glands (n = 6[in three patients]) (2.5%), a multilobulated configuration (n = 5) (2.1%), an inhomogeneous pattern (n = 5) (2.1%), and a parathyroid cyst (n = 1) (0.4%). Recognizing the abnormal parathyroid variants can increase the diagnostic accuracy of sonographic examination.

Adenoma↗

PubMed1987

Laryngeal papillomatosis: clinical, histopathologic and molecular studies.

The clinical course and pathology of 57 patients with laryngeal papillomatosis were reviewed. Tissues from 26 patients were analyzed for human papillomavirus (HPV) DNA by Southern blot hybridization. Histopathologic evaluation of the papillomas showed no correlation with age of onset or clinical pattern of remission and recurrence. The pathology was characterized by abnormal squamous maturation with parakeratosis, retardation of superficial cell maturation, papillomatosis, and basal hyperplasia. HPV DNA was present in all lesions, with 92% containing either HPV-6 or 11. Latent HPV DNA was detected in clinically uninvolved tissues of 11 of 14 (78.5%) patients studied. There was no correlation between HPV type, histopathology and/or clinical pattern. Despite homogeneity of pathology, the clinical expression of laryngeal HPV infection varied widely. A mechanism for the pathogenesis of laryngeal papillomatosis, based on the concept of maturational arrest, is proposed.

Adult↗

PubMed1987

Chlamydia trachomatis infection of the female genital tract. Pathogenetic and clinicopathologic correlations.

Further studies are needed to define the clinicopathologic manifestations of CT infection. Many questions remain regarding the natural history and pathogenetic mechanisms of CT and its biologic and clinical interactions with other prevalent STDs. However, it is apparent that CT is a major cause of STD in the Western world and that its incidence and prevalence have increased to epidemic proportions in young, sexually active women and men. As with other STDs, epidemiologic control of CT infection is of paramount importance. The clinician and pathologist should develop a heightened awareness of the probability of Chlamydia infection in all patients at risk for STD, and in clinical settings, only a high index of suspicion will result in timely therapeutic intervention. Although more simplified and less expensive diagnostic procedures for CT are being investigated, presently, culture isolation is the best and most accurate diagnostic method for CT genital infection and its use should be popularized and made more easily available. Immunofluorescent staining using monoclonal and heterologous antibodies to extracellular CT elementary bodies in preselected smears appears promising as a diagnostic technique and requires further study. There is no apparent role for the use of routine cyto- and histologic microscopy in the diagnosis of CT infection and the practice of diagnosing presumed chlamydial vacuoles or inclusions from cervicovaginal Pap smears should be actively discouraged. Although CT cervicitis plays a dominant role in the pathogenesis and dissemination of CT infections, it should be remembered that multiple sites of genital involvement occur commonly with CT infection and this multifocality should be considered when CT cervical cultures are negative and in post-treatment follow-up. Cultures should be obtained from sites of suspected involvement and should include scrapings or biopsy sampling of the tissue surface to insure the presence of sufficient numbers of epithelial cells. Local secretions or exudate should not be considered adequate. In the female, sampling of the urethra, rectum, and endometrium may facilitate accurate diagnosis. Scraping or sampling of the tubal epithelium by biopsy may provide diagnostic material in acute salpingitis and PID and should be considered if laparoscopy or laparotomy are performed. Routine screening by culture for CT cervicitis has been suggested in high-risk clinical groups and in antepartum patients for prophylaxis of fetal and neonatal disease and requires serious consideration because of the high prevalence of CT infection.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1986

Müllerian adenosarcoma with ovarian sex cord-like differentiation. A light- and electron-microscopic study.

A Müllerian adenosarcoma in which the sarcomatous element showed ovarian sex-cord like differentiation, occurred as a polypoid growth in the uterine cervix of a 53-year-old woman. The tumor was composed of an admixture of benign neoplastic glands and a sarcomatous stroma, the latter containing in addition to endometrial stromal sarcoma, nests of lipid-rich cells resembling ovarian sex-cord elements. This is the first report of such differentiation in Müllerian adenosarcoma. Origin from a focus of cervical endometriosis is postulated.

Cell Differentiation↗

PubMed1986

Squamous metaplasia in the trachea: the tracheotomized rabbit as an experimental model and implications in recurrent papillomatosis.

Squamous metaplasia following tracheotomy has been well documented. Most studies have dealt primarily with changes at--or adjacent to--the cuff site and have failed to evaluate its effect in the distal trachea. We have used rabbits as experimental models for the induction of tracheal squamous metaplasia, using uncuffed tracheotomy tubes. Rabbits were routinely killed 24, 36, 48, 72, 120, and 168 hours posttracheotomy, and the entire larynx, trachea, and main-stem bronchi were step-sectioned for histologic examination. Patchy areas of squamous metaplasia were found in all rabbits with tracheotomy equal to or longer than 48 hours. The metaplasia appeared to increase with time of intubation. Induction of squamous metaplasia (following tracheotomy as a contributing factor to the spread of laryngeal papillomatosis) is discussed.

Animals↗

PubMed1986

Oxytocin increases extrapancreatic glucagon secretion and glucose production in pancreatectomized dogs.

Infusion of oxytocin into normal dogs increases plasma levels of insulin and glucagon and glucose production and uptake. To determine whether infused oxytocin also increases glucagon secretion from extrapancreatic sites, pancreatectomized dogs, off insulin for 18 hr, were infused with oxytocin and plasma glucagon, and glucose production and uptake were measured using the [6-3H]glucose primer-infusion technique. The diabetic dogs, in the control period, had elevated plasma glucose and glucagon levels, an increased rate of glucose production, and a relative decrease in glucose uptake (decreased clearance). Infusion of oxytocin (500 microU/kg/min) caused a rise in plasma glucagon and glucose levels, increased glucose production, and further decreased glucose clearance. It is concluded that oxytocin can stimulate secretion of extrapancreatic glucagon, which contributes to the increased glucose production.

Animals↗

PubMed1986

Presence of human papillomavirus type 16 related sequences in verrucous carcinoma of the larynx.

Verrucous carcinoma of the larynx clinically resembles laryngeal papilloma in that both are wart-like masses on the vocal cords and may be characterized by multifocality and recurrence. Human papillomavirus (HPV) infection is an etiological factor in laryngeal papilloma, and recent evidence implicates HPV in squamous neoplasias. To determine whether HPV is also associated with verrucous carcinoma of the larynx, we analyzed tissue specimens from six patients with verrucous carcinoma of the larynx by Southern and DNA dot blot hybridization for HPV DNA. From three patients, specimens of normal laryngeal epithelium were also studied. All tissues showed evidence of HPV sequences related but not identical to HPV-16. They were negative for HPV-11. In contrast, four squamous cell carcinomas of the larynx and three normal laryngeal tissues were negative for HPV DNA. Histological sections of the six verrucous lesions were found to contain koilocytosis. Immunoperoxidase staining for HPV capsid antigens was negative in all these cases. The consistent and specific association of HPV with the verrucous carcinomas in this report suggests the possibility of a pathogenic involvement.

Antigens, Viral↗

PubMed1985

Immunoperoxidase localization of chlamydial antigens in acute salpingitis.

Seventy surgically excised fallopian tubes in which there was originally a diagnosis of acute salpingitis were reviewed histologically and screened for chlamydial antigens by the immunoperoxidase technique. Chlamydial antigens were localized within tubal epithelial cells in two of the 70 cases (3%). Endometrial specimens from these two patients were also positive for chlamydial antigens. There was no definite correlation between the histologic features of the salpingitis and chlamydial immunoperoxidase positivity.

Acute Disease↗

PubMed1985

Mucoepidermoid carcinoma arising in an intraparotid lymph node.

A well-differentiated mucoepidermoid carcinoma that was confined to, and apparently arose within, an intraparotid lymph node is reported. Salivary gland ducts and acini often are found within intraparotid lymph nodes, and occasionally within extraparotid nodes. Salivary gland tumors, both benign and malignant, can develop within this ectopic salivary tissue. When a malignant salivary-gland-type neoplasm is found within an intraparotid or periparotid lymph node, the possibility exists that the tumor has arisen within the node and does not necessarily represent a metastasis from some other occult site.

Adult↗

PubMed1985

Human papillomavirus infection of the esophagus. A clinicopathologic study with demonstration of papillomavirus antigen by the immunoperoxidase technique.

Papillomaviruses are known to be oncogenic in animals. In humans they are associated with benign squamous tumors (verruca, condylomata acuminata, and papillomas) in a variety of body sites. Human papillomavirus (HPV) infection of the esophagus, however, has not previously been documented. Recent reports of condylomatous changes in esophageal epithelium adjacent to esophageal carcinoma and the sporadic descriptions of esophageal papillomas in the literature for many years, lend credence to the assumption that HPV may affect the squamous mucous membrane of the esophagus. In the current study 75 cases, including 2 papillomas and 73 focal epithelial hyperplasia of the esophagus, were examined for histologic evidence of HPV infection as characterized by the presence of koilocytosis, giant and multinucleated cells, dyskeratosis, hyperkeratosis, acanthosis, papillomatosis, and anisonucleosis. Thirteen of the cases--the 2 papillomas and 11 of the focal epithelial hyperplasias--contained distinctive histologic evidence of HPV infection. The presence of HPV antigens was demonstrated by immunoperoxidase (IMPO) in the 4 of the 13 cases (31%). In the remaining cases the IMPO was equivocal in two and negative in seven.

Adult↗

PubMed1985

Verrucous carcinoma of the larynx. Possible human papillomavirus etiology.

Verrucous carcinoma of the larynx is a distinct and uncommon variant of well-differentiated squamous cell carcinoma. By DNA hybridization techniques, we clearly demonstrated human papillomavirus (HPV-16-related) sequences in five patients with this neoplasm. In addition, HPV-16-related sequences were found in adjacent normal tissues. The DNAs from squamous cell carcinomas of the larynx were negative when hybridized to HPV-6, -11, or -16. Postirradiation anaplastic transformation of verrucous carcinoma has been described. We believe that radiotherapy should not be given unless the potential consequences are fully explained because of its potential to activate or alter HPV-16-related sequences.

Base Sequence↗

PubMed1985

Occlusion of inner ear vessels by magnetic forces applied to circulating metallic iron particles.

We describe a method for the photometric assay of the content of carbonyl iron powder in the blood and discuss a process comparing the in vitro effects of bar magnets on flowing carbonyl iron powder suspensions. We have used this method experimentally on laboratory animals and have induced thrombosis of inner ear vessels with magnetic forces following injections of the carbonyl iron powder.

Animals↗

PubMed1985

[Measurements of blood supply of freely transplanted rib and iliac crest grafts by the tracer microsphere method].

The actual blood perfusion of bone grafts in the lapse of time of their implantation is demonstrable by the tracer microsphere-method. The transplanted rib bone graft turns out to be almost equal to the cortico-spongiose pelvis bone graft concerning the blood perfusion. The long distance bridging rib bone graft shows the blood perfusion of the starting point after six weeks.

Animals↗

PubMed1985

Adenocarcinoid of the appendix presenting as bilateral Krukenberg's tumor of the ovaries. Immunohistochemical and ultrastructural studies and literature review.

A patient with an adenocarcinoid of the appendix presented with bilateral Krukenberg's tumors of the ovaries. Immunohistochemical and ultrastructural studies revealed a selective ability of the mucinous (goblet cell) component of the appendiceal neoplasm to metastasize. A review of the literature has revealed nine previously published cases of appendiceal adenocarcinoid metastatic to the ovaries. All showed involvement of both ovaries, but none provided unequivocal evidence of a metastatic proliferating carcinoid element. As the appendiceal lesion is often grossly inconspicuous, it may be overlooked in cases presenting initially with ovarian tumors. Routine appendectomy is therefore recommended in such patients where no grossly obvious primary tumor is evident.

Adenocarcinoma↗

PubMed1984

Koilocytotic lesions of the cervix. The relationship of mitotic abnormalities to the presence of papillomavirus antigens and nuclear DNA content.

It has been reported that abnormal mitotic figures (AMFs) occur principally in aneuploid lesions and that aneuploidy is a diagnostic feature of non-endocrine-dependent epithelial cancer precursors and cancers. Recently, AMFs have been reported in cervical lesions interpreted as flat condylomata, and it has been suggested by several authors that AMFs may not be diagnostic or aneuploidy or neoplasia, particularly in human papillomavirus-(HPV)-induced lesions. Although it is conceivable that AMFs may be a regular feature of HPV infection, their association with cytologic atypia and their presence in higher grades of cervical intraepithelial neoplasia (CIN) suggests that AMFs may herald the presence of a different lesion than the pure flat condyloma. In the current study, koilocytotic cervical lesions thought to be HPV-induced were examined microscopically for the presence of AMFs, and the findings were correlated with the presence of HPV as determined by immunoperoxidase and nuclear DNA distribution patterns as measured by Feulgen microspectrophotometry. In unselected lesions originally diagnosed as flat cervical condylomata, AMFs were surprisingly common (22.6%), and did not correlate with the extent of koilocytosis. Immunoperoxidase (IMPO) stains were performed in 35 cases with AMFs, and were negative for HPV in 74.3% and positive in 22.8%. However, among the cases evaluated by IMPO, there was an inverse relationship between the presence of mitotic abnormalities and the expression of HPV antigen. Nine of 11 (81.8%) lesions containing AMFs were aneuploid, and 2 of 11 (18.2%) were polyploid. Abnormal mitotic figures have a range of morphology and frequency in koilocytotic cervical lesions. Although the biology of these lesions is not well-defined, the presence of AMFs may identify a subgroup of HPV-induced cervical atypias which represent a transition between flat cervical conylomata and CIN.

Animals↗

PubMed1984

Chlamydial cervicitis and cervical intraepithelial neoplasia: an immunohistochemical analysis.

Studies using serological and culture techniques indicate that chlamydial infection is frequently associated with cervical intraepithelial neoplasia (CIN). This relationship was investigated by examining a series of biopsies containing normal epithelium, non-neoplastic condylomatous epithelium, and neoplastic epithelium (CIN). In each case the degree of inflammation and the presence of reparative atypia were recorded from an examination of the hematoxylin and eosin stained sections and serial sections were stained for chlamydial antigens using a polyclonal antichlamydial antibody and the immunoperoxidase technique. Overall, staining for chlamydia was positive in 0, 2, and 16% of biopsies with mild, moderate, and severe inflammation, respectively. In cases of severe inflammation positive staining was present in 20, 25, and 8% of biopsies containing non-neoplastic, condylomatous, and neoplastic epithelium, respectively. In all positive cases the staining was most prevalent in areas of the most intense inflammation. A spectrum of squamous epithelial changes was found in the infected biopsies and their distinction from CIN is discussed. This study suggests that tissue staining for chlamydia is related more to the extent of the coexisting inflammation than the presence or absence of CIN. Chlamydial infection, however, was frequently associated with inflammation-related squamous atypia in the transformation zone, which may be confused histologically with CIN.

Antigens, Bacterial↗

PubMed1984

Localizing chlamydial infection in cervical biopsies with the immunoperoxidase technique.

One hundred and two cervical biopsy specimens containing varying degrees of chronic inflammation were stained for chlamydial antigens with the immunoperoxidase technique. Seven cases (6.9%) were positive. Histologically, six (84%) of the Chlamydia-positive cases contained severe chronic inflammation, all contained reparative atypia, and two (28%), follicular cervicitis. When evaluated separately, 22% (six of 27) of the specimens with severe inflammation were positive in contrast to 0% (0 of 45) of cases with mild inflammation. Positively staining cells were located primarily in columnar epithelium and reparative atypia and occasionally in areas of immature squamous metaplasia. The cytological finding which correlated with positive staining was cytoplasmic vacuolation; however, cytoplasmic vacuoles were common in cells which did not stain positively, and it was impossible to predict on histological grounds which cells/specimens would stain positively by immunoperoxidase. Because of these findings, the presence of chlamydial infection should be strongly suspected whenever the cervical biopsy specimen contains severe inflammation and repair. Although tissue staining may not be as sensitive as culture for diagnostic purposes, it can be performed rapidly and simply and may be a useful special stain in cases where the diagnosis of chlamydial infection is not suspected clinically or cultures are not immediately available.

Biopsy↗

PubMed1984

Human papillomavirus infection and cervical intraepithelial neoplasia: histopathology and DNA content.

To evaluate the reliability of diagnostic criteria for separating intraepithelial squamous lesions into low- and high-risk categories, 25 lesions of the cervix were diagnosed as flat condyloma, atypical immature metaplasia, or cervical intra-epithelial neoplasia with koilocytosis based on well-defined histologic criteria. The presumption was that flat condyloma and atypical immature metaplasia would be diploid/polyploid as compared to low-grade cervical intraepithelial neoplasia, which should be aneuploid. Using the major histologic parameter of the presence or absence of abnormal mitoses to distinguish the low- and high-risk lesions, it was found that all of five typical flat condylomas were diploid/polyploid and seven of eight atypical immature metaplastic lesions were diploid/polyploid; 11 of 13 cervical intraepithelial neoplasms with koilocytosis, however, were aneuploid. An additional histologic parameter of anisocytosis (variation in nuclear size) appeared much less reliable for segregating these lesions than the nature of the mitoses. Lesions for which ploidy values were particularly difficult to predict were extremely well-differentiated koilocytotic lesions with occasional abnormal mitoses. Whether these are true polyploid lesions in which the abnormal mitoses are a response to the virus, or whether they are very early aneuploid lesions that cannot be confirmed by microspectrophotometry, remains to be determined.

Aneuploidy↗