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Biomedical subjects

F Borchard

Publications and source records attributed to F Borchard.

At least 55 records · Page 3Linked to original sources
PubMed1997

Epidemiology of Whipple's disease in Germany. Analysis of 110 patients diagnosed in 1965-95.

BACKGROUND: The epidemiology of Whipple's disease (WD) is obscure. To obtain basic data, we performed an evaluation of WD patients in Germany. METHODS: Information was collected from 110 WD patients diagnosed during 1965-95 at 5 institutions in different regions of Germany. Four items were evaluated: 1) year in which the diagnosis was made; 2) residence and 3) age at the time of diagnosis; and 4) sex. RESULTS: WD patients originated from all parts of Germany. The incidence of new cases was relatively stable, with a mean of one to two cases per year per collecting centre. In 1995, a maximum of 13 new WD patients was diagnosed. There was a significant increase in the mean age of patients (1965-75, 48.7 years; confidence interval, +/- 3.98 years; 1976-85, 50.7 years, +/- 3.69 years; 1986-95, 57.0 years, +/- 2.80 years; P < 0.01) and an increasing proportion of women (1965-85, 4%; 1986-1995, 22%). CONCLUSIONS: Whipple's disease is not quite as rare as commonly assumed. There is no obvious geographic predominance. During the past three decades, the demography of WD patients has changed.

Adult↗
PubMed1996

Prognostic influence of p53 expression in gastric cancer.

The presence of the nuclear phosphoprotein p53 was investigated in a series of 120 consecutive gastric carcinomas. This immunohistochemical study on formalin-fixed, paraffin-embedded material found p53 expression in 43 per cent (n = 51) of carcinomas using a monoclonal antibody (DO-1), whereas no immunoreactivity for p53 was present in tumour-associated non-neoplastic gastric mucosa or tumour stroma. There was no statistically significant correlation with known prognostic parameters such as extent of tumour growth (pT state), nodal involvement (pN state), or tumour grade. The same applied for association with patient age and sex or pathological parameters such as tumour size, localization, or growth pattern according to histological classification. Kaplan-Meier analysis revealed marginal statistically significant differences in survival times between patients with p53-positive tumours with more than 35 per cent of p53-positive tumour cells and those with less than 35 per cent of p53-positive tumour cells or p53-negative tumours (P = 0.04). However, by multivariate analysis, p53 immunoreactivity did not turn out as an independent prognostic parameter. p53 expression can easily be detected in a variety of human malignancies including gastric cancer by immunohistochemical methods, but its prognostic significance and possible role as an independent marker of poor prognosis still have to be confirmed by further studies.

Biomarkers, Tumor↗
PubMed1996

Differential p53 protein expression in stomach adenomas of gastric and intestinal phenotypes: possible sequences of p53 alteration in stomach carcinogenesis.

In a comparative study, the expression of p53 protein was investigated in intestinal- and gastric-type adenomas of the stomach. The former is a conventional type, which is well known to be a premalignant lesion of the stomach, but the latter is a rare, more recently noted entity. Of 28 intestinal-type adenomas, 17 (60.7%) contained more than 5% of p53 immunoreactive cells. In these adenomas, the extent of positivity for p53 protein was significantly higher in high-grade dysplasia than in low-grade dysplasia (P < 0.05), suggesting that p53 alteration plays a part in the dysplastic progression of intestinal-type adenomas. Among 18 gastric-type adenomas in which most of the tumour cells displayed gastric-type mucin, substantial expression of p53 protein was found only in the 3 tumours with high-grade dysplasia. Thus, the incidence of p53 expression was significantly higher in intestinal-type adenomas than in gastric-type adenomas (P < 0.01). These results suggest that p53 gene alteration is an earlier event in the gastric carcinogenetic sequence with the intestinal phenotype than in that with the gastric phenotype.

Adenoma↗
PubMed1996

Pattern of gastric endocrine cells in microcarcinoidosis--an immunohistochemical study of 14 gastric biopsies.

A total of 14 gastric biopsy specimens from patients with microcarcinoidosis were analysed by immunohistochemical methods to evaluate the pattern of endocrine cell hyperplasia and dysplasia. All the patients had type A gastritis (autoimmune gastritis). Nonantral proliferations of gastric endocrine cells were classified according to Solcia et al. All 14 cases had hyperplasia and 13 (92.9%) of them, dysplasia of gastric endocrine cells; 9 (64.3%) of the 14 were found to have showed a coexisting invasive gastric carcinoid at the time of diagnosis of microcarcinoidosis. The patients with invasive carcinoids had higher degrees and more complex forms of endocrine dysplasia (precarcinoid lesions). The average size of the foci of the microcarcinoidosis in gastric biopsies was 0.14 +/- 0.09 cm in the patients without invasive carcinoid, as against to 0.5 +/- 0.24 cm in the group of patients with associated invasive carcinoid. Microcarcinoid gastric biopsies about 0.5 cm in size, are suggestive of adjacent invasive carcinoid. However, even frankly invasive ECL carcinoids seem to be clinically less dangerous than was thought until recently.

Adult↗
PubMed1996

Sebaceous gland metaplasia in cardiac-type mucosa of the oesophago-gastric junction.

The first case of sebaceous gland metaplasia arising in cardiac-type mucosa of the oesophago-gastric junction of 71-year-old man is reported. Within cardiac glands, small nests composed of clear cells closely resembling sebaceous glands of the skin were found. Immunohistochemically, the cell nests stained positively for a monoclonal antibody 115D8 against milk-fat globule membrane (MAM-6). These cells were sometimes covered by cylindrical cells positive for foveolar-type mucin of the stomach (MI), and basal marginal cells of these nests expressed high molecular weight cytokeratins (34BE12). This study documents a new type of metaplasia of the gastric mucosa.

Aged↗
PubMed1996

Pyloric gland type adenoma of the gallbladder with squamoid spindle cell metaplasia.

This study documents a pyloric gland type adenoma of the gallbladder with prominent spindle cell metaplasia arising in a 61 year-old woman. A pedunculated polyp, 1.5 x 1.0 x 1.0 cm, was histologically diagnosed as a tubular adenoma. Most glandular structures showed positivity for a monoclonal antibody M2 (2B5) which indicates a differentiation to pylotic gland type. The spindle cell component displayed no apparent epithelial structures but stained mostly positive for pancytokeratin and cytokeratin (CK) 18, and focally for CK 5 + 6, CKs 7 and 19, whereas CKs 8, 13, 20, and non-epithelial markers could not be demonstrated. This suggests that the spindle cells were immature epithelial cells differentiating towards squamous and/or glandular cells. Even in spindle cell areas, the nuclear atypia was mild, and proliferating cells positive for MIB-1 (Ki-67) antigen were infrequently seen. This unique phenomenon, of which only three cases have been previously reported, is considered to represent benign squamoid spindle cell metaplasia.

Adenoma↗
PubMed1996

Differentiation towards gastric foveolar, mucopeptic and intestinal goblet cells in gallbladder adenocarcinomas.

Cellular differentiation in 22 surgically removed adenocarcinomas of the gallbladder was immunohistochemically studied with antibodies specific to mucins of gastric foveolar cells (M1), (pseudo)pyloric cells (M2) and intestinal goblet cells (M3), and also with antibodies against pepsinogen II and chromogranin A. More than 70% of tumours (16 of 22 cases) displayed gastric- and/or intestinal-type differentiation, most of which (12 of 16 cases) showed both types of differentiation. Two tumours showed an organoid growth pattern similar to the normal gastric mucosa. The presence of endocrine cells positive for chromogranin A was closely related to that of gastric- and/or intestinal-type cells. The present findings clearly indicate the multidirectional differentiation of gallbladder adenocarcinomas and suggest that most gallbladder adenocarcinomas develop and progress under induction of gastric and intestinal differentiation.

Adenocarcinoma↗
PubMed1996

[Inflammatory esophageal diseases caused by herpes simplex virus infections--overview and report of 15 personal cases].

Frequency of herpes simplex virus(HSV)-induced esophagitis was reported to range from 0.5% to 6% in non-selected patients according to autopsy and clinical studies. In case of gastrointestinal involvement, affinity of herpes simplex virus to squamous epithelia predisposes the esophagus to be affected. Typically, patients complain about acute onset of odynophagia, retrosternal pain, or symptoms of gastrointestinal blood loss, while systemic signs of inflammation are often absent. Endoscopic examination usually reveals disseminated, roundish mucosal defects with distinct borders preferably in the distal part of the esophagus. If suspected clinically and by endoscopy, a histological and/or cytological diagnosis should be achieved by carefully taking multiple biopsies from the edge of the suspicious lesions. Antiviral therapy is not obligatory, since HSV esophagitis often resolves spontaneously. In the presence of preexisting immunodeficiency, marked clinical symptoms, or complicated course, however, the guanosine analogue aciclovir is the treatment of choice. In view of a comparably low sensitivity of macroscopic assessment and an expected increase in incidence of this viral infection, a high index of suspicion for this disorder appears to be necessary for all clinicians working in the field of endoscopy. Based on 15 personal observations recorded from 1983 to 1995, epidemiological, pathogenetic, morphological, and clinical features of HSV esophagitis will be summarized and discussed in the light of the pending literature on this subject.

Adolescent↗
PubMed1996

[Snow white small intestinal villi in hypobetalipoproteinemia].

In contrast to the severe clinical picture of abetalipoproteinemia patients with hypobetalipoproteinemia are often asymptomatic. We demonstrate a 52-years-old female patient with a white mucosa of the small intestine casually observed by endoscopy. The white appearance of the mucosa was limited to the villi. As demonstrated by light and transmission electron microscopy this was caused by fat loaded enterocytes similar to the picture of abetalipoproteinemia. Fasting serum lipids and apolipoproteins were only if the lower norm level for some parameters, but no increase of the serum lipids was observed after an oral fat load. Because of the missing symptoms, the typical histomorphology and laboratory findings the snow white mucosa of the small intestine is due by the hetocygote form of the autosomal dominant hypobetalipoproteinemia with fat loaded enterocytes.

Apolipoproteins↗
PubMed1996

[Lymphocytic gastritis: autoimmune disease or variant of Helicobacter gastritis?].

Lymphocytic gastritis is characterized by the accumulation of small lymphocytes within the surface and foveolar epithelium, however its cause has not been proven. As compared with chronic active gastritis, the local immunoreaction of lymphocytic gastritis was immunohistochemically studied. Although many organisms of Helicobacter pylori (H. pylori) were immunohistochemically detected in all cases with chronic active gastritis, a few organisms were scattered only in 4 cases (28.6%) with lymphocytic gastritis. The extent of HLA-DR-expression in the foveolar epithelium was significantly higher in H. pylori-gastritis than in lymphocytic gastritis, and that of beta 2-microglobulin-expression in the surface epithelium was higher in lymphocytic gastritis than in H. pylori-gastritis. Numerous intraepithelial lymphocytes in lymphocytic gastritis were proved to be CD8-positive cytotoxic/suppressor T-lymphocytes. Our findings suggest that MHC-class I-expression is closely related to the pathogenesis of lymphocytic gastritis. Therefore, some intracellular autoantigens, molecularly mimicking viral antigens, may play a role in its pathogenesis. These autoantigens might occur probably associated not only indirectly with H. pylori-infection but also with unknown viral infection, food intake, bile reflux or stomach tumor.

Adult↗
PubMed1995

Incidence and prognostic significance of vascular and neural invasion in squamous cell carcinomas of the esophagus.

The prognostic influence of blood-vessel invasion (BVI), lymphatic-vessel invasion (LVI) and neural invasion (NI) was evaluated retrospectively in a series of 161 patients with squamous cell carcinoma (SCC) of the esophagus who underwent esophageal resection. Evidence of BVI, LVI and NI was found in 32.9%, 48.5% and 26.1%, respectively. Incidence of BVI, LVI and NI was significantly higher in high pT categories (pT3 and pT4) than in low pT categories (pT1 and pT2) and in patients with distant metastases than in patients without distant metastases. Incidence of LVI and NI in lymph-node-positive patients was significantly higher than in lymph-node-negative patients. The 5-year survival rate was significantly lower in patients with BVI or LVI than in patients without BVI or LVI. Patients with evidence of NI showed no significant differences in 5-year survival from patients without evidence of NI. By stepwise multivariate Cox regression analysis, BVI and LVI were shown to be independent prognostic factors. A search for vascular invasion may therefore provide additional prognostic precision in SCC of the esophagus.

Carcinoma, Squamous Cell↗
PubMed1995

[Prognostic factors in curative resection of stomach carcinoma. A uni- and multivariate analysis].

The TNM system, including tumor infiltration (T category), lymph node infiltration (N category) and metastasis (M category), is a well-established system of prognostic factors. To evaluate the prognostic importance of patient characteristics and tumor parameters 5 clinical and 13 pathological factors were analyzed. Data on 200 consecutive patients with histologically verified stomach cancer were prospectively recorded using a standardized form. In the subgroup with curative resection (R0, n = 108) a uni- and multivariate analysis was performed with respect to 5-year survival. In the univariate analysis statistical significance was demonstrated for the following factors: tumor size, tumor localization, T category, N category, number of infiltrated lymph nodes infiltrated, lymph node compartments, tumor stage, lymph node ratio: infiltrated/inspected. Multivariate analysis, taking into consideration the interaction between prognostic factors, revealed only two factors as statistically significant: number of infiltrated lymph nodes and tumor size. Our results and those in the literature indicate that the infiltration of lymph nodes is the most relevant prognostic factor. In addition to the TNM system the number of infiltrated lymph nodes seems to be of prognostic importance.

Adult↗
PubMed1995

[Primary seminoma. A rare mediastinal tumor].

This is a report on three patients with primary mediastinal seminoma. Two patients had no symptoms, and one had had thoracic pain for the last few years. The preoperative diagnosis was thymoma in all cases, and in one patient the radiologist had suspected a seminoma. We removed the tumor after performing median sternotomy (n = 2) and anterolateral left thoracotomy (n = 1). The presence of a primary gonadal seminoma was excluded with a urological and ultrasound examination. All patients are still alive following adjuvant chemotherapy (n = 2; 120 and 8 months) and radiotherapy (n = 1; 84 months). Chemotherapy consisted of four cycles of cisplatin, etoposide and ifosfamide or combination therapy with cisplatin, bleomycin and velbe.

Adult↗
PubMed1995

Achalasia-associated squamous cell carcinoma of the esophagus: flow-cytometric and histological evaluation.

Although the risk of cancer is increased in patients with achalasia, biomarkers of an increased cancer risk have not been evaluated. In an esophagectomy specimen of a patient with achalasia-associated squamous cell carcinoma, normal mucosal and carcinomatous samples were systematically taken for flow cytometry and histology. The distribution of DNA aneuploidy and dysplasia was mapped within the resected specimen. Four of 10 tumor samples and 4 of 16 normal mucosal samples of the esophagus showed additional aneuploid stem lines. Gastric mucosa only showed diploid DNA histograms. S-phase fraction in normal esophageal samples (7.8% +/- 1.1%) was lower than in dysplastic and carcinomatous samples (8.8% +/- 2.4%; P = NS). Areas of mild to moderate dysplasia were detected in the esophageal mucosa adjacent to the neoplasm. This report shows the potential applicability of flow cytometry in the surveillance of patients with achalasia. However, prospective endoscopic studies with long follow-up periods are required before flow cytometric and histological parameters can be used as biomarkers of an increased cancer risk in achalasia.

Carcinoma, Squamous Cell↗
PubMed1995

Schönlein-Henoch purpura associated with gastric Helicobacter pylori infection.

Schönlein-Henoch purpura is characterized by palpable purpura, colicky abdominal pain, gastrointestinal hemorrhage, arthralgias, and renal involvement. Bacterial and viral infections, as well as drugs and diseases associated with immune complexes, are thought to be responsible. We describe the case of a 21-year-old woman with Schönlein-Henoch purpura and chronic active gastritis with erosions. Helicobacter pylori was found in gastric mucosa using the newly introduced, nontoxic, noninvasive 13C-urea breath test; infection was confirmed by gastric mucosal biopsy. After eradication of H. pylori with omeprazole and amoxicillin, the skin changes, gastric complaints, and proteinuria disappeared. Ten months later, Schönlein-Henoch purpura recurred. H. pylori was again detected. After therapy, H. pylori was eradicated and the clinical manifestations faded. To our knowledge, H. pylori has not previously been described as a cause of Schönlein-Henoch purpura.

Adult↗
PubMed1995

Mycobacteria of Runyon groups I, II and IV do not play an aetiological role in Crohn's disease.

OBJECTIVE: In addition to Mycobacterium paratuberculosis, other slow-growing as well as rapid-growing mycobacteria were isolated from mucosa or full thickness samples of intestine from patients with Crohn's disease. The meaning of these data remained unclear. To investigate the possible aetiological role of these rapid- and slow-growing mycobacteria, serosa and mesenteric lymph nodes were also cultivated in the present study. DESIGN AND METHODS: Mucosa, lymph nodes and serosa of 23 patients with Crohn's disease and 23 patients with other intestinal afflictions were incubated at 37 degrees C on Löwenstein-Jensen medium and Herrold egg yolk medium. These methods allow the cultivation of most atypical mycobacteria, including Mycobacterium paratuberculosis. In addition, full thickness samples of some of these patients were analysed for mycobacterial DNA using polymerase chain reaction. RESULTS: Despite lack of decontamination of 60% of lymph nodes and serosa, no mycobacterial growth was observed over a long incubation period (an average of 718 days in Crohn's disease and 552 days in controls) on Löwenstein-Jensen medium. Polymerase chain reaction was based on the amplification of 16S ribosomal DNA sequences specific for mycobacteria of tissues derived from four patients with Crohn's disease and one control was negative. CONCLUSIONS: These findings suggest that mycobacteria, such as M. fortuitum and M. chelonei, which are widespread in the environment, are not involved in the aetiology of Crohn's disease but, rather, should be considered as environmental opportunists.

Adolescent↗
PubMed1995

Colitis ulcerosa complicated by malignant lymphoma: case report and analysis of published works.

A 51 year old woman with a two year history of ulcerative colitis developed a wide spread gastrointestinal non-Hodgkin's lymphoma of low grade malignancy (MALT-lymphoma) involving upper and lower gastrointestinal tract, spleen, and bone marrow. After chemotherapy, clinical symptoms improved and lymphocytic infiltrates disappeared. Thirty nine cases of ulcerative colitis and 22 cases of Crohn's disease complicated by gastrointestinal lymphomas reported in published works are reviewed. In inflammatory bowel diseases any dense lymphocytic infiltrates seen in biopsy specimens obtained from ulcerative colitis or Crohn's disease should be assessed to exclude gastrointestinal lymphoma.

Antineoplastic Combined Chemotherapy Protocols↗