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J M Gokel

Publications and source records attributed to J M Gokel.

At least 37 records · Page 2Linked to original sources
PubMed1989

[The value of immunofluorescence on frozen sections and immunoperoxidase methods on paraffin sections with different types of glomerulonephritis comparative study].

171 kidney biopsies were tested with the peroxidase- antiperoxidase (PAP)-method on paraffin sections. A comparison of the PAP-results with corresponding ones for the immunofluorescence method (IMF) on frozen sections was possible in 131 of the biopsies. When results of the 2 techniques were compared, outcomes showed a very strong accordance for both methods in tissues of postinfectious and perimembraneous GN an a strong accordance in mesangioproliferative GN tissue. In membrano-proliferative GN the immunopathological findings were more readily delinated with the PAP-method than with IMF. Cases involving IgA-nephritis, focal sclerosis and lupus nephritis with smaller deposits did not show consistant reactivity in the PAP-method as compared with IMF. 40 kidney biopsies, not examined by IMF, were diagnosed as GN by light microscopy and could be shown in 29 cases to contain evidence of an immune pathogenesis with the PAP-method.

Biopsy↗
PubMed1988

New methods for noninvasive monitoring of rejection after heart transplantation.

Between August 1981 and February 1987, 67 orthotopic heart transplants and three heart-lung transplants were performed in 69 patients at the University of Munich Hospital. The immunosuppressive regimen consisted of cyclosporine A, azathioprine, and prednisone. The diagnosis of acute rejection was based on cytoimmunologic monitoring, frequency analysis of fast Fourier transformed surface electrocardiograms (FFT-ECGs), and two-dimensional echocardiography. The results of these diagnostic methods were compared to the findings provided by endomyocardial biopsies, which were performed simultaneously with the noninvasive studies. Seventy patients underwent cytoimmunologic monitoring. In 88% of all rejection episodes, this technique revealed activated lymphocytes and lymphoblasts in the mononuclear concentrate of the peripheral blood samples; the presence of such cells is known to be an extremely early sign of acute rejection. Twenty-six patients were monitored by means of FFT-ECG. In 20 of the 21 cases of rejection, this method disclosed significant changes in the frequency spectrum of the QRS complex in the 70- to 110-Hz range; in 12 cases, these changes were the earliest sign of acute rejection. Therefore, FFT-ECG had a sensitivity of 95%. All of the QRS changes were reversible with rejection therapy. Forty-five patients were subjected to two-dimensional echocardiography. In 31 of the 35 cases of rejection, the echocardiogram showed a significant increase in the left ventricular wall thickness and a decrease in the left ventricular cross-sectional area during mild rejection. Moderate or severe rejection was characterized by an increase in the diastolic area, as well as a decrease in the systolic area change and in the diastolic maximum velocity of area change. Thus, two-dimensional echocardiography had a sensitivity of 89%. In the recent cases, the diagnosis of rejection was based on noninvasive methods alone. After rejection therapy had been instituted, endomyocardial biopsies were performed to assess the effectiveness of the treatment. With noninvasive rejection monitoring, the number of endomyocardial biopsies performed during the first three postoperative months was only 2.8 per patient; in comparison with invasive rejection monitoring, noninvasive follow-up was associated with a 75% reduction in the need for biopsy.

Journal Article↗
PubMed1988

Cyclosporine-associated nephropathy in patients with heart and bone marrow transplants.

The morphology of kidneys from heart (n = 55) and bone marrow (n = 112) transplant recipients treated either with cyclosporine (CSA) or conventional immunosuppression was investigated at autopsy. The major findings were: In the bone marrow transplant recipients glomerular collapse, tubular atrophy, interstitial fibrosis, striped form, CSA-associated arteriolopathy and thrombi in glomeruli and/or arterioles were more often found in the CSA group as compared to conventional immunosuppression. In the heart transplant recipients glomerular collapse and obsolescence, tubular atrophy and intimal fibrosis in arteries were more frequent in the CSA group. Vascular interstitial toxicity known to be associated with CSA treatment from renal transplant patients was found in 54% (25% severe) of the bone marrow and 19.5% (9.7% severe) of the the heart transplant recipients. The prevalence of vascular interstitial toxicity in bone marrow versus heart transplant recipients is possibly due to higher CSA dosage and pretreatment with cytostatic drugs and irradiation. Analyses of the lesions from early stages to the full picture of vascular interstitial toxicity suggests that CSA causes a form of thrombotic microangiopathy with focal glomerular and/or arteriolar thrombosis followed by typical CSA-associated arteriolopathy which results in interstitial fibrosis with tubular atrophy.

Adult↗
PubMed1988

[Operability of primary inoperable pelvic tumors by preoperative regional hyperthermia in combination with systemic chemotherapy exemplified by Ewing's sarcoma].

Failure of local tumor control is of critical importance in the clinical management of large pelvic tumors. For bulky sarcomas of the pelvis a new treatment strategy could be of importance in the future using preoperative regional hyperthermia combined with systemic chemotherapy. In our case history of a patient with unresectable Ewing sarcoma of the pelvis no tumor response could be observed during multi-drug chemotherapy alone. However, after treatment with regional hyperthermia combined with systemic chemotherapy, the tumor mass became resectable and was separated from the adjacent tissue by a fibrotic pseudocapsule. Histological evaluation of the tumor tissue showed a complete change of the pattern.

Adolescent↗
PubMed1987

Systemic angioendotheliomatosis of the lung.

Systemic angioendotheliomatosis is a very rare malignant disease characterized by intravascular neoplastic proliferation of reticuloendothelial cells. According to the clinical features three different types of prognostic value can be distinguished: Exclusive skin involvement; Progressive skin lesions disseminating to internal organs; Aggressive and lethal type affecting primarily internal organs. Until now about 60 cases of systemic angioendotheliomatosis have been reported in the literature. Here we describe the first well-documented case with almost isolated lung involvement. The presentation of morphologic and clinical signs and differential-diagnostic considerations are followed by a critical review of the literature.

Aged↗
PubMed1986

The epithelial cell surface antigen 17-1A, a target for antibody-mediated tumor therapy: its biochemical nature, tissue distribution and recognition by different monoclonal antibodies.

The antigen defined by MAb 17-1A, raised against colorectal cancer cells and currently used in immunotherapy trials, is a 37 kDa protein containing N-linked glycans as demonstrated by inhibition of glycosylation with tunicamycin. The 17-1A antigen (17-1A Ag) is broadly distributed in normal epithelial tissues and is also found in various types of carcinoma. Quantitative differences in expression between normal and malignant tissues were only apparent in gastric carcinomas. After immunizing mice with fresh colon carcinoma tissue, 4 MAbs were obtained that showed the same tissue reaction pattern as MAb 17-1A and recognized the 17-1A Ag as judged from precipitation and immunoblotting experiments. MAbs M72 and M74 reacted with an anti-idiotypic serum directed against the original MAb 17-1A and were able to block 17-1A binding. In contrast, M77 and M79 are directed against a different epitope. This makes them potentially interesting for passive immunotherapy in regimens involving a combination of MAbs.

Antibodies, Monoclonal↗
PubMed1986

Fatal mitochondrial cardiomyopathy in Kearns-Sayre syndrome.

The clinical and postmortem findings in a 26 year old man with Kearns-Sayre syndrome are described. In the last years of his life he suffered from cardiac arrhythmias and a congestive cardiomyopathy, dying of cardiac pump failure. The heart was enlarged, especially the left ventricle which was fibrotic and excessively dilated. Histological and fine structural investigation revealed an excessive loss of myofibrils and an increase of enlarged mitochondria with lamellar and atypically tubular cristae in widespread heart muscle cells. Mitochondrial anomalies were also observed in some cells of the conductive system. This patient thus suffered not only from a mitochondrial myopathy with ragged red fibers but also from a fatal mitochondrial cardiomyopathy. The anomalies observed in the mitochondria of the conductive system cells suggest that the well-known conductive abnormalities in patients with Kearns-Sayre syndrome might be at least partly caused by disturbed function of these mitochondria.

Adult↗