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G Dhom

Publications and source records attributed to G Dhom.

At least 19 recordsLinked to original sources
PubMed2003

[Rudolf Virchow's influence on medicine after 100 years].

100 years after Rudolf Virchow's death, we find it necessary to demonstrate the mark his work has left on present day medicine. Curt Froboese wrote 50 years ago: "To come to know Rudolf Virchow well, it is sufficient to read him". Therefore the present collection of literal quotations from Virchow tries to show how valid many statements of Virchow still are. His definition of "health" precedes the well-known formulation of the World Health Organization. Virchow had a presentiment of molecular pathology, without defining this word, when he ascribed molecular forces to the cell and particularly to the cellular nucleus. As a terminologist he played a guiding role. His linguistic sense enabled him to prematurely find out "barbarisms" in medical terminology. At the same time, he also supported an international understanding. In particular the surgeons came to know through Virchow that malignant tumors are also primarily local events to be surgically treated preferably in the early stage. Therefore he requested a population-based statistical survey as developed by the cancer registries today. The legend that Virchow fought against bacteriology is not true. He did not stop in his efforts to differentiate between etiology, germs and the course of infection which presupposes knowledge of the respective cellular phenomena. Summing up it can be said that Virchow still plays an important role in our medical world.

Germany↗
PubMed2002

Patient delay and stage of diagnosis among breast cancer patients in Germany -- a population based study.

Early diagnosis is a tenet in oncology and should enable early treatment with the expectation of improved outcome. Extent and determinants of patient delay of diagnosis in breast cancer patients and its impact on stage of disease were examined in a population based study among female breast cancer patients in Germany. Two hundred and eighty-seven women, aged 18 to 80 years with newly diagnosed invasive symptomatic breast cancer, were interviewed with respect to the diagnostic process. Patient delay was defined as time from onset of first symptoms to first consultation of a doctor. Median patient delay was 16 days among symptomatic patients. Eighteen per cent of all breast cancer patients waited longer than 3 months before consulting a physician. Long patient delay was associated with old age, history of a benign mastopathy, obesity, and indices of health behaviour such as not knowing a gynaecologist for out-patient care and non-participation in general health screening examinations. A strong association between patient delay and stage at diagnosis was observed for poorly differentiated tumours. These results suggest that at risk groups for delaying consultation can be identified and that a substantial proportion of late stage diagnoses of poorly differentiated breast cancer cases could be avoided if all patients with breast cancer symptoms would present to a doctor within 1 month.

Adolescent↗
PubMed2001

Long-lasting reduction of risk of colorectal cancer following screening endoscopy.

Several studies have suggested that incidence and mortality of colorectal cancer (CRC) may be strongly reduced for up to 10 years by endoscopic screening with removal of precancerous lesions, but so far there are no data on risk reduction beyond this period. We assessed long-term reduction of CRC risk following screening endoscopy in a statewide population-based case-control study in Saarland, Germany. Lifetime history of screening endoscopy was compared between 320 cases with CRC aged 45-80 and 263 controls with other forms of cancer recruited from the same population. Potential confounding factors were controlled for by multiple logistic regression. 11% of cases compared to 27% of controls had a history of endoscopy for screening purposes (adjusted odds ratio (OR) = 0.28, 95% confidence interval (CI): 0.16-0.48). This strong risk reduction was also seen (OR = 0.41, 95% CI: 0.19-0.89) in subjects who had their last screening endoscopy more than 10 years ago (median: 18.9 years). Long term (> 10 years since last screening) risk reduction appeared to be particularly strong for advanced (Dukes C or D) CRC (OR = 0.19, 95% CI: 0.06-0.64). We conclude that risk reduction by screening endoscopy is long lasting, in particular with respect to advanced CRC.

Aged↗
PubMed2001

Socio-demographic factors, health behavior and late-stage diagnosis of breast cancer in Germany: a population-based study.

Late-stage diagnosis of breast cancer is associated with poor survival. Identification of individuals at high risk of late-stage diagnosis could be an effective step to reduce breast cancer mortality. We examined the association of socio-demographic factors and health behavior with breast cancer stage in a population-based sample of 380 female breast cancer patients in Saarland, Germany. Overall, 182 women (47.9%) were diagnosed with late-stage (regional or distant) breast cancer. After control for potential confounding by multivariate logistic regression, an increased risk of late-stage diagnosis was observed for older age (OR = 1.8; 95% CI 1.0-3.2), foreign nationality (OR = 3.9; 95% CI 0.7-20.8), living in large households (OR = 1.7; 95% CI 1.0-2.9), non-participation in general health check-up (OR = 1.5; 95% CI 0.9-2.4) and low interest in health care (OR = 1.6; 95% CI 1.0-2.7). The proportion of late-stage cancer was clearly decreased when tumors were detected by screening (OR = 0.4; 95% CI 0.2-0.8). Certain socio-demographic factors and characteristics of health behavior seem to represent independent risk indicators of late-stage diagnosis.

Adult↗
PubMed2000

Individual and joint contribution of family history and Helicobacter pylori infection to the risk of gastric carcinoma.

BACKGROUND: Helicobacter pylori infection and a positive family history of gastric carcinoma have been identified as risk factors for the disease. It is unclear, however, to what degree their impact on the risk of gastric carcinoma is independent, because H. pylori also clusters within families. METHODS: The authors carried out a population-based, statewide case-control study in Saarland, Germany, to assess the individual and joint contributions of family history and H. pylori infection to the risk of gastric carcinoma. Cases included 68 patients with histologically verified gastric carcinoma. Controls included 239 patients with colorectal carcinoma who were matched to the cases by age and gender. Information on family history (defined as gastric carcinoma in at least one first-degree relative) and potential confounders was collected by standardized interviews. Immunoglobulin G antibodies against H. pylori were measured by enzyme-linked immunosorbent assay. In addition, antibodies against the CagA antigen were determined by Western blot analysis. RESULTS: H. pylori infection and family history were positively related, and both risk factors were more common among cases than among controls. Although the association between family history and gastric carcinoma was somewhat reduced by control for H. pylori infection, both risk factors still showed strong independent relations with gastric carcinoma after control for each other. Compared with uninfected subjects who had no family history, subjects with both a positive family history and infection with a CagA positive H. pylori strain had a more than 8-fold total risk of gastric carcinoma (adjusted odds ratio [OR], 8.2; 95% confidence interval [CI], 2.2-30.4) and a 16-fold risk of noncardia gastric carcinoma (OR, 16.0; 95% CI, 3.9-66.4). CONCLUSIONS: Infection with CagA positive H. pylori strains and a positive family history appear to be strong independent risk factors for gastric carcinoma. They may be useful markers for identifying subjects at high risk for the disease and for targeting efforts of prevention and early detection.

Adult↗
PubMed1997

[100 years of the German Society of Pathology (1897-1997)].

The German Society of Pathology emerged from the Society of German Scientists and Physicians. Founded in Braunschweig in 1897, the first scientific meeting was held in Düsseldorf in 1898. Rudolf Virchow was the first chairman up to this death in 1902. From the beginning the Society with its former name of German Pathological Society till the 2nd world war, was an association of German-speaking countries including Austrian and Swiss pathologists who also regularly presided at the meetings. Alternately the meetings were held in Germany, Austria, or Switzerland. The 100-year-history of the Society has been documented in 80 volumes of the meetings so far. Since 1903 these are published by Gustav Fischer, Jena-Stuttgart. The scientific results of the annual meetings show not only the growth and development of Pathology, but also the lectures and papers to the main subjects contribute considerably to the history of medical basic research in the 20th century. The chairmen's speeches combine to a history of problems in the subject of Pathology. Rudolf Virchow began it with his opening address in 1898. A special chapter covers the period of national socialism and German partition after the 2nd world war. The German Pathological Society suffered great losses by dismissal and emigration after 1933. Institutes rich in tradition got lost in East Germany. The partition of Germany, especially after construction of the wall, excluded the East German colleagues for Society life. An attempt has been made to record the losses in numbers by evaluation of the member lists of the meeting volumes. At the end of the century and after overcoming of the German partition, the German Society of Pathology has got a chance for revival.

Germany↗
PubMed1994

The pathology of the adrenal glands in sudden infant death syndrome (SIDS)

The sudden infant death syndrome (SIDS) is at present based on unknown pathogenetical mechanisms but in industrial nations is the most common cause of death in infancy after the perinatal period. Studies of a large number of adrenal glands in this syndrome have not been reported. Therefore, we evaluated 146 SIDS cases (85 males, 61 females, aged 14-465 days) and 24 control cases (17 males, 7 females, aged 18-623 days) by light microscopy, morphometry and immunocytochemistry (anti-chromogranin A and anti-S100 protein). Our data revealed a normal maturation of the adrenal glands in SIDS cases. Necroses, extensive hemorrhages or inflammation were not found. A focal lipid depletion of the zona fasciculata was seen in 92% of the adrenal glands of the SIDS and control cases. We found a siderosis (in 33% of the SIDS cases and 4% of the control cases) and calcium deposits (13% and 12% respectively) due to hyperemic involution of the fetal zone. The medulla, including the sustentacular cells (S 100 protein-positive cells) and chromaffin cells (chromogranin A-positive cells) was unchanged. Our results indicate that the few morphological alterations of the adrenal glands in SIDS cases are the effect of the underlying disease and not the cause of the sudden death.

Adrenal Cortex↗
PubMed1994

[The cancer cell and the connective tissue. A historical retrospect].

Since the introduction of microscopic examination of tumours, many researchers have dealt with the relationship between cancer cells and connective tissue. Rudolf Virchow's opinion that carcinomas derive from connective tissue was soon disproved by the studies of Cornil, Thiersch, and Waldeyer, but no clue was provided to the reason for the invasion of the epithelium. Julius Cohnheim and particularly Hugo Ribbert were of the opinion that invasion of the epithelium was only possible in the case of a primarily altered connective tissue. Ultimately the stroma determines malignant growth. From 1902, Max Borst finally formulated the views on tumour-stroma-relationship that are still valid today and postulated interrelations which can only be proved and confirmed by modern molecular biological methods.

Cell Transformation, Neoplastic↗
PubMed1993

Effectiveness of colorectal cancer screening: results from a population-based case-control evaluation in Saarland, Germany.

In order to evaluate the effectiveness of colorectal cancer screening by the faecal occult blood test (FOBT) in Germany a population-based case-control study was conducted in Saarland, a southwestern state of Germany. As cases, we identified 522 persons (244 males, 278 females) who died of colorectal cancer between 1983 and 1986 between the ages of 55 and 75 years. For 163 male cases complete screening histories were retrieved together with up to five age-matched controls who had not died of colorectal cancer identified from the files of the case's referring general practitioner (GP). For 209 female cases screening histories were retrieved from their GPs and gynaecologists as well as for age-matched controls. Individual screening histories were established with emphasis on identifying whether FOBTs were carried out asymptomatically or symptomatically. In the time period 6-36 months prior to diagnosis 13% of the male cases and 14% of the male controls had at least one asymptomatic FOBT with a corresponding matched odds ratio of 0.92 (95% CI: 0.61, 1.75). For the same prediagnostic period 16% of the female cases and 29% of the female controls had at least one asymptomatic FOBT leading to an odds ratio of 0.43 (95% CI: 0.27, 0.68). Thus, for males where participation rates are generally low, no protective effect could be seen but for females where participation rates are higher a clear protective effect is seen. Possibilities for bias need to be taken into consideration when interpreting these results. Organizational measures ensuring a high penetrance of a mass screening programme are seen as a way to elevate efficacy.

Aged↗
PubMed1992

Distribution of basement membranes in primary and metastatic carcinomas of the prostate.

The presence of periacinar and pericellular basement membranes (BMs) has been reported recently in common prostatic adenocarcinomas. In this study we extended our investigations of BMs on lymph node and hematogenous metastases, primary prostatic cancer with unusual histologic features, and posttreatment tumors. In contrast to prostatic malignancies that derive from the transitional epithelium (squamous cell carcinoma, prostatic transitional cell carcinoma) and prostatic involvement by bladder cancer, inconspicuous stromal changes and distinct BM formations at the site of tumor invasion were observed in carcinomas deriving from the secretory epithelium (papillary ductal carcinoma) and from the basal cell (basal cell carcinoma). Even highly malignant anaplastic and small cell carcinomas, as well as irradiated and/or hormonally treated tumors, showed distinct BM formations in contact with the stroma. The same observations could be made in lymphatic and hematogenous metastases of different anatomic sites. These findings indicate that prostatic malignancies may retain BMs even in high-grade lesions, metastases, posttreatment tumors, and variants of prostatic adenocarcinoma.

Basement Membrane↗
PubMed1992

[Adrenal cortex carcinoma. A rare cause of a Conn syndrome in childhood].

A 2 1/3 year old girl presented classical Conn-Syndrome as diagnostic feature of an adrenocortical carcinoma. Sonographic diagnosis was confirmed by CT-scan, typical hormonal pattern and subsequent surgical procedure. Without further therapy there has been no relapse with a follow-up of 3 years.

Adrenal Cortex Hormones↗
PubMed1991

Relation of endocrine-paracrine cells to cell proliferation in normal, hyperplastic, and neoplastic human prostate.

The relative distribution pattern of the pan-endocrine marker Chromogranin A (Chr A) and the proliferation-associated Ki-67 antigen was investigated in 20 prospectively sampled prostatectomy specimens. In cryostat sections, the Chr A immunoreactivity showed evidence of endocrine differentiation in all 15 prostatic adenocarcinomas. Nine tumors displayed a weak, 5 a moderate, and 1 adenocarcinoma a strong endocrine differentiation. These findings highlight the importance of endocrine differentiation in prostate malignancy that histologically resembles ordinary adenocarcinomas. The simultaneous demonstration of Ki-67 and Chr A revealed that in normal, hyperplastic, and neoplastic prostate tissue Chr A-positive cells were preferentially situated in proximity to Ki-67-labeled cells. This relative distribution pattern of both markers may indicate that endocrine cells are involved in controlling cell proliferation through a paracrine hormonal mechanism. However, an obvious correlation was not found between the degree of endocrine differentiation and proliferative activity in prostatic adenocarcinomas. Furthermore, a coexpression of Ki-67 and Chr A in the same (tumor) cells was not observed suggesting that the endocrine phenotype is only expressed in the G0 phase of the cell cycle as well as in normal, hyperplastic, and neoplastic conditions.

Adenocarcinoma↗
PubMed1991

Basement membranes in fetal, adult normal, hyperplastic and neoplastic human prostate.

The distribution of the various basement membrane (BM) components (type IV collagen, laminin and heparan sulphate proteoglycan) was studied in fetal, adult normal, hyperplastic and neoplastic prostates in formalin- and ethanol-fixed paraffin-embedded specimens. Stromal, epithelial and neoplastic BMs expressed differential susceptibility to pepsin treatment, suggesting conformational differences in the expression of epitopes on BM proteins in distinct anatomical structures and various lesions of the human prostate. In fetal prostate the acinar BM was regular and continuous in contrast to normal adult prostate and various hyperplastic conditions where the acinar BM was locally thickened or unreactive to the anti-BM antibodies. The localization pattern of BM components in grade I and grade II phases of prostatic cancer did not differ essentially from those found in various hyperplastic lesions. Regardless of the histopathological grade of malignancy, prostatic carcinoma cells were surrounded by distinct pericellular and periacinar membranes which were present even at points of contact with the stroma. This suggests that stroma invasion is invariably associated with neoplastic BM formations. Immunohistochemical evidence of the stromal or epithelial origin of neoplastic BMs could not be found. However, the consistent extracellular distribution of neoplastic BM components in contact with the stroma indicates that the elaboration of BM material requires a stromal influence.

Adenocarcinoma↗