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Biomedical subjects

H Dralle

Publications and source records attributed to H Dralle.

229 records · Page 13Linked to original sources

Tumor volume correlated serum CEA levels in nude mice after primary xenotransplantation of human colorectal carcinoma.

Six different human colorectal adenocarcinomas were xenotransplanted onto six groups of female, syngeneic BALB/c nude mice, 4 weeks of age, under standardized pathogen-free conditions, and the serum CEA levels were determined by RIA. Five tumors grew positively, yielding a tumor take of nearly 90%. One tumor showed no growth macro-or microscopically. All animals were sacrificed after 12 weeks post-transplantation. Ten untreated controls showed a mean serum CEA concentration of 0.62 +/- 0.14 ng/ml. All tumor-bearing animals, including the negative tumor take group, exhibited increased CEA levels (1.0-60.0 ng/ml), which were positively correlated to tumor volume, measured in all tumor-bearing animal groups. However, no correlation was observed between patients' serum CEA levels, measured preoperatively, and CEA concentrations in nude mice. These findings suggest that further immunohistologic studies are necessary to evaluate the difference of CEA synthesis by microscopically identical original human and transplanted tumor tissue.

Adenocarcinoma↗

Infantile periarteritis nodosa. Case report and review of the literature.

The clinical and autopsy findings of a three-month-old male infant with infantile periarteritis nodosa are described adn the literature reviewed. Different stages of the inflammatory vascular process could be seen in the iliacal, axillary, carotidal, coronary and the small periadrenal-tissue-arteries. Secondary changes were found in the axillary and coronary arteries consisting of aneurysmal dilatation and thrombosis. Fatal myocardial infarction occurred thirty-nine days following hospital admission.

Autopsy↗

Immunohistochemical analysis of thyroglobulin synthesis in thyroid carcinomas.

This immuno-histochemical description of thyroglobulin synthesis in human thyroid carcinomas is based on the analysis of 72 malignant thyroid neoplasms and about 100 cases of thyroid adenomas and other diseases of the thyroid gland. In our experience immuno-histochemistry has been an invaluable diagnostic adjunct to light microscopy for three reasons: 1) as an approach to a functional classification of thyroid carcinomas, 2) as an aid in the differential diagnosis of thyroid carcinomas of follicle cell type from tumors of other origins, 3) as an aid in the functional classification of non-cancerous thyroid tissue. In the field of metastasizing thyroid carcinoma this immuno-histochemical approach combined with a morphometrical method may enable accurate identification of patients for whom radioiodine therapy is appropriate.

Adenocarcinoma↗

Pituitary adenoma, primary parathyroid hyperplasia and papillary (non-medullary) thyroid carcinoma. A case of multiple endocrine neoplasia (MEN).

An acidophilic pituitary adenoma associated with primary nodular parathyroid hyperplasia and a small papillary thyroid carcinoma was discovered at the autopsy of a 44 year old female acromegalic. The thyroid carcinoma showed evidence of lymphatic spread. Several etiopathogenetic mechanisms for the non-medullary thyroid carcinomata associated with Multiple Endocrine Neoplasia (MEN) have been postulated, since the follicular epithelium of the thyroid does not belong to the neural ectoderm derivates unlike the C-cells of the thyroid, the adenohypophysis and probably the parathyroid glands. Apart from genetic influence, or coincidence, one has to rule out carcinogenic exposure or hormonal influence. Clinically speaking, one should always consider whether malignant thyroid disease coexists with hyperplastic or neoplastic parathyroid tissue.

Adenoma, Acidophil↗

Immunhistochemical and electron microscope analysis of adenomas of the thyroid gland. I. A comparative investigation of hot and cold nodules.

Histologic, immunhistochemical and electron microscopic changes in 8 cases of scintigraphically proven autonomous thyroid adenomas are described and compared with non-functioning adenomas. Adenomas with a light microscopic appearance suggesting autonomy show follicles which are mainly small or normal sized and lined by columnar thyroid cells with a partly vacuolated and eosinophilic cytoplasm. Immunhistochemically a high content of thyroglobulin corresponds to the amount of rough endoplasmatic reticulum. Typical ultrastructural criteria are a well developed cytocavitary network, numerous mainly apically localized lysosomes, prominent Golgi fields with sprouting vesicles and autophagic vacuoles. The cell surface is, when compared to non-functioning adenomas, enlared apically by numerous long microvilli and basally by deep infoldings. On contrast to experimentally TSH-stimulated animal thyroids, colloid droplets and pseudopodia are rare. The morphological findings are compared with recent biochemical results and the diagnostic value of electron microscopy is discussed.

Adenoma↗

"The" pheochromocytoma: a benign, intra-adrenal, hypertensive, sporadic unilateral tumor. Does it exist?

This study aims to examine the frequency of the pheochromocytoma (pheo), defined as a "benign, intra-adrenal, hypertensive, sporadic, unilateral tumor." Three large series amounting to 310 subphrenic chromaffin tumors operated over periods of 17, 23, and 41 years, respectively, have been reviewed. Among those combined 310 pheos, 48 (15.5%) were malignant (i.e., metastatic) and 262 (84.5%) were benign; 42 (13.5%) were ectopic (35% of malignant tumors versus 9.5% of benign tumors); 230 (74.2%) were hypertensive (74% of benign tumors versus 73% of malignant tumors); 29 (9.4%) were bilateral, including 23 patients with a family history; 41 (13.2%) of patients had MEN II type A or B syndrome; and 20 (6.5%) occurred in a phacomatosis setting. Some of the patients had a non-MEN family history of pheo (n = 5), seemingly sporadic hyperparathyroidism (n = 4), or other associated neuroendocrine tumor (n = 9). Sometimes several of these features were combined. Finally 125 (40.3%) cases fitted the classic description of the tumor, 47.0% at the time of initial presentation and 40.3% at the end of follow-up. Late occurrence of metastases or metachronous diagnosis of familial disease make lifelong follow-up mandatory. Genetic studies may be indicated in pheochromocytoma patients.

Adrenal Gland Neoplasms↗

Prognostic significance and surgical management of locoregional lymph node metastases in papillary thyroid cancer.

We studied the records of 342 patients with papillary thyroid carcinoma out of a total of 728 thyroid cancer patients treated at the Medical School of Hannover (MHH) from 1972 through 1992. The comprehensive data-abstracting forms were designed, and the acquired information was coded, stored, maintained, and evaluated by the Clinical Cancer Registry of the MHH. A total of 160 patients (46.8%) initially had lymph node metastases (N1 status). The N status significantly influenced recurrence (p < 0.00001) and survival (p < 0.00001). Excluding other risk factors developed by univariate and multivariate analysis, such as high age (age > 45 years, p < 0.001), tumor invasion (T4 tumor, p < 0.005), and distant metastases (M1, p < 0.001), lymph node metastases remained an independent, highly significant prognostic marker for more aggressive papillary thyroid cancer. N1 status did not influence survival of patients with T4 tumor but did influence those with T1-T3 status (p < 0.001). The influence of N1 status remained significant in patients older (p < 0.001) and younger (p < 0.05) than 45 years of age. Systematic compartment-oriented dissection of lymph node metastases improved survival (p < 0.005, T1-T3) and recurrence (p < 0.00001, T1-T3) especially in patients with T1-T3 tumors. In conclusion, lymph node metastases with a significant incidence at a young age and male sex had a substantial effect on survival and recurrence especially in those with tumor status T1-T3. Systematic compartment-oriented dissection of the lymph node metastases results in better survival and a lower recurrence rate.

Adolescent↗

Sporadic unilateral adrenomedullary hyperplasia with hypertension cured by adrenalectomy.

Adrenomedullary hyperplasia (AMH) with increased urinary excretion of epinephrine is regarded as the earliest adrenal manifestation in familial pheochromocytoma; however, pathogenetic mechanisms and morphogenesis involved in the development of sporadic adrenomedullary diseases are unknown as yet. We present 4 patients with clinical, biochemical, imaging, and morphological findings of sporadic unilateral adrenomedullary hyperplasia cured by unilateral adrenalectomy. All patients were hypertensive with intermittent hypertensive crises, and with increased catecholamine concentrations in urine and serum. Correct unilateral localization was achieved by 123-I-BG-scan (planar and SPECT) (n = 2) or cavovenous blood sampling with selective catheterization of both suprarenal veins (n = 2). Histomorphometric analyses revealed diffuse adrenomedullary hyperplasia in all 4 specimens with significant increase of relative volume to 17.6% (controls, 8.7%), and of estimated medullary weight to 0.95 g (controls, 0.45 g); corticomedullary ratio (C:M) was decreased to 5.4 (controls, 11.2). DNA histograms showed euploidy in all cases. In 3 patients, DNA analysis revealed evidence of cell proliferation, but without increase to grade of malignancy indices (0.101-0.523). Adrenalectomy was performed preferentially by a translumbar approach; the operative and postoperative course was uneventful in all 4 patients. Blood pressure without antihypertensive drugs returned to normal in 3 patients, in 1 patient to the upper normal limit.

Adrenal Gland Diseases↗

Myocardial calcification after orthotopic heart transplantation.

Two cases with a remarkable similarity in their clinical and histopathologic findings are reported. Both cases involved myocardial calcification found in biopsy material obtained after orthotopic heart transplantation. Myocardial calcification after heart transplantation so far has been described in only one case in the medical literature and thus appears to be a rare entity. Its occurrence is associated with a certain constellation of clinical situations, which include repeated episodes of acute rejection, temporary uremia, periods of septicemia, alcoholism, and cyclosporine and/or steroid therapy.

Biopsy↗

Review: recent developments in adrenal surgery.

The improvements of biochemical methods and imaging techniques in the diagnosis of adrenal disorders have changed the surgical management with regard to indication for operation, surgical approach to the adrenals and the extent of resection. This study reviews recent developments in surgical strategy of adrenal disorders based on surgical treatment of 246 patients from 1975 to 1993 at the Medical School of Hannover. Today extraperitoneal incisions are used with increasing frequency in small benign tumours to minimize the surgical trauma. The indication for operation of adrenal incidentalomas should be considered in all patients with hyperfunctional lesions and suspected malignancy. Bilateral total adrenalectomy is attended with the need for life-long adrenocortical supplementation resulting in an impaired quality of life. In this respect MEN 2 patients with bilateral adrenomedullary disease benefit from unilateral or bilateral subtotal resections with preservation of adrenocortical function. In conclusion, adrenal surgery today aims at the reduction of surgical trauma, early diagnosis and treatment of adrenal malignancies, and the preservation of adrenocortical function.

Adrenal Gland Diseases↗