Biomedical subjects

J Oertel

Publications and source records attributed to J Oertel.

At least 37 records · Page 2Linked to original sources

PubMed1995

Tumorous manifestation of hairy cell leukemia after long-term treatment with interferon alpha.

Tumorous-manifestation of hairy cell leukemia in a patient treated with IFN alpha for 7 years is described. After this time, while the patient still was in hematological remission, a tumorous involvement of the lung by hairy cells developed and was successfully treated by surgery. No differences in the phenotype of hairy cells in the lung tumor, in the bone marrow, or in the blood could be detected.

Bone Marrow↗

PubMed1994

CD 34 immunotyping of blasts in myelodysplasia.

We studied the expression of the hematopoietic progenitor cell antigen CD 34 in six patients with refractory anemia with excess of blasts (RAEB), five patients with RAEB in transformation (RAEB-T), and seven patients with chronic myelomonocytic leukemia (CMML). Immunocytochemical labeling of bone marrow cells was performed by an indirect immunoperoxidase method with preservation of morphological details. The cells were stained with May-Grünwald-Giemsa, photographed, destained, and immunolabeled by the immunoperoxidase technique. We found 1.5 +/- 0.5% blasts and 0.8 +/- 0.4% CD 34+ blasts in normal bone marrow. The CD 34 positivity of blasts was 53 +/- 9%. The patients with RAEB showed 1.7 +/- 1.4% CD 34+ blasts. The CD 34 positivity of blasts (11.8 +/- 5.6%) was lower than in normal bone marrow. The patients with RAEB-T had a higher percentage of CD 34+ blasts (7.3 +/- 3.4) and a higher CD 34 positivity of blasts (28.2 +/- 14.6%) than patients with RAEB. The CMML patients showed a percentage of CD 34+ blasts and a CD 34 positivity of blasts in the range of RAEB. We found an increase of promonocytes (PMC) in 5/7 patients. In some patients the PMC were CD 34 positive. Our results indicate that the increase of blasts in REAB is related to CD 34-negative blasts. With progression to RAEB-T the percentage of CD 34-positive blasts increased. Some of the CMML patients also showed a population of CD 34-positive PMC. A clone of undifferentiated CD 34-positive cells is characteristic for patients with these types of myelodysplasia.

Anemia, Refractory, with Excess of Blasts↗

PubMed1994

CD34 immunophenotyping of blasts in myelodysplasia.

Immunological analysis of bone marrow cells in myelodysplasia using immunofluorescence did not allow accurate morphological identification of blast cells. However, improvement of the immunoperoxidase technique allows one to realize the diagnostic potential of immunocytochemistry. CD34 immunotyping of blasts in normal human bone marrow showed 0.8 +/- 0.4% CD34 positive blasts and these cells had the morphology of type 1 blasts. The increase of bone marrow blasts in RAEB patients is related to CD34 negative type II and III blasts. A clone of undifferentiated CD34 positive blasts is characteristic of RAEB-T and acute myeloid leukaemia evolving from myelodysplasia. The detection of CD34 positive bone marrow blasts allows a better discrimination between RAEB and RAEB-T.

Antigens, CD↗

PubMed1994

Demonstration of cytomegalovirus after bone marrow transplantation by polymerase chain reaction, virus culture and antigen detection in buffy coat leukocytes.

We prospectively monitored buffy coat leukocytes of 47 patients after 50 marrow transplantations (autologous n = 18, allogeneic n = 32) by polymerase chain reaction (PCR) for the presence of cytomegalovirus (CMV). None of the 18 autologous graft recipients (9 seropositive, 9 seronegative) had positive PCR results or CMV disease throughout the post-transplantation course. Six of 32 allograft recipients (19 seropositive, 13 seronegative) became PCR positive, four of whom developed CMV disease. PCR positive patients were found more often (5 of 10) in the group with acute GVHD grade II-IV compared with 1 of 22 in the group without or with grade I acute GVHD (p = 0.002). Comparison of PCR with antigen assay and virus culture showed an agreement in 90 of 96 (94%) samples. Discordant results were due to a higher sensitivity of the PCR compared with antigen assay (n = 4) and virus culture (n = 6). In conclusion, PCR helps to identify those patients who will not develop CMV disease and narrows down the number of patients who eventually will suffer symptomatic CMV infection. Furthermore, PCR is a useful tool for following the post-transplantation course with respect to CMV and for judging the effect of antiviral treatment.

Adolescent↗

PubMed1993

Immunotyping of blasts in refractory anaemia with excess of blasts.

A study of immunological markers was performed in 16 patients with newly diagnosed refractory anaemia with excess of blasts (RAEB) and RAEB in transformation (RAEB-T) and in 12 other patients with acute myeloid leukaemia evolving from RAEB or RAEB-T. Immunocytochemical investigation of bone marrow blasts was done using a modified indirect immunoperoxidase technique. This method permitted accurate morphological identification of blasts and other cells in bone marrow. The monoclonal antibodies used in RAEB and RAEB-T samples were anti-CD34, -c-kit, -HLA-DR and -CD13. The range of CD34 expression of blasts in RAEB samples was 1-14% (mean 6.2%) and in RAEB-T samples 29-48% (mean 35.5%). CD34 positivity was detected in 3-94% (mean 47.4%) of the bone marrow blasts in acute myeloid leukaemia evolving from RAEB and RAEB-T. Expression of c-kit was demonstrated only in a low percentage of blast cells in RAEB, RAEB-T and acute myeloid leukaemia following myelodysplasia. A high percentage (> 30%) of blasts in most patients with RAEB, RAEB-T and acute myeloid leukaemia was HLA-DR and CD13 positive. We observed the transformation from RAEB to acute myeloid leukaemia in three patients. The proportion of CD34 positive blasts increased to 25% and 32% in two patients. The third patient showed an unchanged percentage of CD34 positivity of blasts. These findings indicate that the CD34 positivity of blasts increases with the progression of myelodysplasia to RAEB-T and acute myeloid leukaemia demonstrating the instability of the clonal defect in myelodysplasia.

Acute Disease↗

PubMed1993

Altered expression of the retinoblastoma susceptibility gene in chronic lymphocytic leukaemia.

The pathogenesis of chronic lymphocytic leukaemia (CLL) is unknown. One of the most frequent cytogenetic abnormalities in CLL is a deletion within the long arm of chromosome 13, the region to which the retinoblastoma (Rb) gene has been mapped. Lack of Rb expression has been linked to the carcinogenic process in many human tumours. We therefore sought to investigate the role of Rb gene inactivation in CLL using differential polymerase chain reaction on reverse transcribed RNA. The result of the PCR was quantitated using HPLC. 5/39 patients revealed a lack or significantly impaired expression of the Rb gene upon differential PCR analysis. In addition, immunocytochemical studies were performed using the Rb-specific monoclonal antibody PMG245. 10/56 patients showed a weak or absent expression upon immunocytochemical analysis compared to monocytes or granulocytes. The samples lacking Rb were from both early and late stage CLL. Our results indicate that inactivation of the Rb protein occurs in a fraction of CLL cases and can be found in early and late stages of the disease.

Aged↗

PubMed1992

Treatment of neutropenia in Felty's syndrome with granulocyte-macrophage colony-stimulating factor--hematological response accompanied by pulmonary complications with lethal outcome.

We report on a 67-year-old man with Felty's syndrome (FS) complicated by recurrent pneumonia and an infected wound, which was not healing in spite of maximal antibiotic and local therapy. Encouraged by previous experience, we treated him with granulocyte-macrophage colony-stimulating factor (GM-CSF). His total leukocyte count rose, but the patient's pneumonia deteriorated. In addition, a previously known chronic obstructive lung disease (COLD) was exacerbated acutely. These complications finally led to his death. Postmortem examination revealed widespread pneumonia with invasive aspergillosis and a peripheral adenocarcinoma in his left lung.

Adenocarcinoma↗

PubMed1992

Acute parvovirus B19 infection mimicking myelodysplastic syndrome of the bone marrow.

A 36-year-old, previously healthy woman was referred to our institution with pancytopenia and splenomegaly for suspected acute leukemia. Bone marrow aspiration showed marked dysplastic changes, excess of blasts, and only spurious red blood cell precursors. Action was taken to prepare allogeneic bone marrow transplantation from an HLA identical sibling for myelodysplastic syndrome. Repeat cytological examination of the bone marrow revealed striking hyperplasia of the red cell line with presence of abnormal giant proerythroblasts. Acute parvovirus B19 infection was suspected and confirmed by detection of anti-B19 IgM and B19 DNA. The underlying disease for this transient aplastic crisis was a formerly unknown hereditary spherocytosis.

Adult↗

PubMed1992

PCR-determined expression of the MDR1 gene in chronic lymphocytic leukemia.

To determine the role the multiple drug-resistance (MDR 1) gene plays in chronic lymphocytic leukemia (CLL), we measured the expression of the MDR 1 gene in 30 patients with this disease. A rapid, highly sensitive, and nonradioactive technique based on the polymerase chain reaction (PCR) was used for that purpose. In this technique, called differential PCR, the target (MDR 1) and a reference gene (beta 2-microglobulin) are co-amplified by PCR from random hexamer-primed cDNA in the same reaction vessel. The level of target gene expression is reflected in the ratio between the intensities of the two resulting PCR product bands, as measured by high-performance liquid chromatography (HPLC). MDR 1 gene expression was detectable in 29/30 (97%) patients with CLL, with a median expression level of 0.36 U (human placenta = 1 U). There was no correlation between expression of the MDR 1 gene and clinical stage, time from diagnosis, absolute lymphocyte count, several lymphocyte surface markers, or prior treatment in the patients analyzed. Immunocytochemical studies of the same material using the monoclonal antibody C219 showed a very low or undetectable expression of the P-glycoprotein in the lymphocytes of all patients studied, whereas granulocytes were significantly more immunoreactive. We conclude that the level of expression of the MDR 1 gene in CLL is generally low, that the removal of granulocytes is important in studies of expression of MDR 1 mRNA in CLL, and that differential PCR provides a rapid and reliable method for quantifying the amount of a specific mRNA, even in very small samples of total RNA.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed1992

Analysis of chronic lymphoid leukaemias according to FAB.

We have studied the immunophenotypic features in patients with chronic lymphoid leukaemia and investigated the suitability of classification according to guidelines of the French-American-British (FAB) group. Immunophenotyping was carried out on cytocentrifuge preparations of mononuclear blood leukocytes using the alkaline phosphatase-antialkaline phosphatase (APAAP) method. The 114 leukaemias, including 58 cases of B-chronic lymphocytic leukaemia (B-CLL), 3 Waldenström's macroglobulinaemia, 6 prolymphocytic leukaemia (B-PL), 13 B-CLL/PL, 4 B-CLL of mixed cell type, 8 splenic lymphoma with villous lymphocytes (SLVL), 8 hairy cell leukaemia (HCL), two HCL variant, three leukaemic phase of follicular lymphoma, two leukaemic phase of intermediate lymphoma, two plasma cell leukaemia and two chronic T-cell leukaemia, were investigated. The 111 of 112 B-chronic lymphoid leukaemias (B-CLL + B-PL + B-CLL/PL + SLVL + HCL etc.) showed monotypic light chains. The antibody HML1 was highly specific for HCL. The antibodies CD11c and CD25 were positive in all HCL cases, but were not specific for this disease. CD5 positivity and CD22s negativity were found in most patients with B-CLL, B-CLL/PL and B-CLL of mixed type. This marker type has a limited value for differentiation from the other chronic lymphoid leukaemias. We also studied three patients with chronic lymphoid leukaemia which were not described by the FAB classification. We conclude that a study of the morphology of the leukaemic cells was the most useful basis for the diagnosis of these leukaemias, whereas immunotyping was apparently valuable only in individual cases.

Antigens, CD↗

PubMed1992

[Magnetic resonance tomographic screening studies of the bone marrow with gradient-echo sequences. II. Gadolinium-DTPA-supported studies of plasmocytoma patients].

MR imaging was performed in 19 patients with proven multiple myeloma. Both plain and Gd-DTPA enhanced in-phase and opposed-phase gradient-echo techniques were used (0.1 mmol Magnevist/kg body weight). Plain, opposed-phase imaging demonstrated more lesions than plain in-phase imaging (35 vs. 16); enhanced opposed-phase imaging demonstrated more lesions than plain opposed-phase and enhanced in-phase imaging (47 vs. 35 and 17 lesions). These results suggest that enhanced opposed-phase images which have a high contrast between normal and infiltrated bone marrow are especially suited for MR screening in multiple myeloma.

Bone Marrow↗

PubMed1991

Detection of light chain restriction in chronic B-lymphoid leukaemia and B-non-Hodgkin's lymphoma.

The determination of immunoglobulin light chain restriction using monoclonal and polyclonal antibodies is a rapid method for the detection of a neoplastic B-cell-population. Cytocentrifuge preparates of mononuclear blood cells from 42 patients with chronic B-lymphoid leukaemia and of lymph node aspirates from 24 patients with B-non-Hodgkin's lymphoma were examined using the alkaline phosphatase-antialkaline phosphatase (APAAP) method. Monoclonal antibodies from different commercial sources and rabbit polyclonal antibodies were used in this study. Staining with polyclonal antibodies demonstrated light chain restriction in 65 cases. The leukaemic cells of a patient with hairy cell leukaemia did not express light chain immunoglobulins. Monoclonal antibodies from two manufacturers demonstrated monotypic staining for light chains in all cases with light chain immunoglobulins. Monoclonal antibodies from four manufactures failed to show monotypic light chains in 5, 21, 25 and 28 of the 65 cases. All investigated antibodies detected a similar percentage of light chain-positive lymphocytes in 10 healthy persons. We conclude that not all investigated monoclonal antibodies are suitable for detection of light chain restriction in B-non-Hodgkin's lymphomas and chronic B-lymphoid leukaemias. However, using selected monoclonal antibodies or rabbit polyclonal antibodies the APAAP method is very sensitive for detection of light chain restriction in these disorders.

Antibodies↗

PubMed1990

Immunocytochemical analysis of lymph node aspirates in patients with human immunodeficiency virus infection.

Thirty four patients positive for human immunodeficiency virus (HIV) who had lymphadenopathy were investigated using fine needle aspiration. Cytological analysis included immunocytochemical investigation with the alkaline phosphatase-antialkaline phosphatase (APAAP) method. All patients had confirmation of cytological diagnosis by lymph node biopsy. Fifteen aspirates with follicular hyperplasia were evaluated. Eleven patients showed B cell predominance. The B cell population did not show light chain restriction. Ten patients with B cell non-Hodgkin's lymphoma (five with Burkitt's lymphoma and five with B cell immunoblastic lymphoma) were investigated. Nine out of 10 cases were monoclonal with respect to their light chain determinants; only one case with Burkitt's lymphoma with partial lymph node metastasis did not show light chain restriction. The cytological diagnosis included two mycobacterial infections and four cystic lesions. Histological investigation was necessary to diagnose the extent of lymph node disease caused by Kaposi's sarcoma. These findings indicate that the immunocytological investigation of lymph node aspirates is useful for evaluating lymphadenopathy in HIV positive patients.

AIDS-Related Complex↗

PubMed1988

The value of immunocytochemical staining of lymph node aspirates in diagnostic cytology.

This study investigates the applicability of immunocytochemical techniques towards improving the cytological diagnosis of lymph node disorders. Cytocentrifuge preparations of fine needle aspirates were examined using an indirect immunoperoxidase method and the alkaline phosphatase-antialkaline phosphatase method. 36 reactive lymph nodes were evaluated. 23 patients showed T cell predominance as assessed by the presence of CD3+ cells. 13 patients showed an excess of CD24+ cells over CD3+ cells. In all patients the B cell population showed no light chain class restriction. 48 aspirates from patients with B-non-Hodgkin's lymphoma of low malignancy were investigated. The majority of the cells in each of these cases expressed CD24 and 47 cases were monoclonal with respect to their light chain determinants. In 37/48 cases the antibody OKT9 reacted with less than 15% of cells. 18 aspirates were obtained from patients with B-non-Hodgkin's lymphoma of high malignancy. 17 patients showed light chain class restriction and a high percentage of CD24+ (greater than 80%) and OKT9+ (greater than 40%) cells. 8 malignancies were considered to be of T-cell origin. A low percentage (less than 15%) of Ig+CD24+ cells with a high number of CD3+ and/or CD4+ cells suggests a T-cell lymphoma. The majority of neoplastic cells in peripheral T-cell lymphomas (excluding mycosis fungoides) expressed OKT9 and CD3 expression was found to be variable. In 15 cases of Hodgkin's disease, there were 11 correct cytologic diagnoses. A significant number of BerH2 (CD30)+ cells having the morphology of Sternberg-Reed cells supports this diagnosis. 25 aspirates were obtained from patients with metastatic malignant tumours. Marker studies in eight cases helped in distinguishing metastatic malignant tumours from malignant lymphomas. Our findings indicate that the immunocytochemical technique is applicable to cytological material and that the simplicity of the procedure merits application to routine diagnostic cytology.

Antibodies, Monoclonal↗

PubMed1988

[Schoenlein-Henoch purpura in chronic HBsAG-positive hepatitis].

We report about a 40-year-old male patient suffering from a recurrent vasculitis with purpura since the age of 18. In 1983, a HBsAg-positive chronic active hepatitis with circulating immune complexes which contained HBsAg, immunoglobulin M and G as well as complement (C) was diagnosed. Serum and liver tissue were negative for HBcAg, HBeAg and hepatitis B virus (HBV) DNA; there was no evidence for HBV replication. HBsAg, IgM and C3 were demonstrable in the arteriolar walls of the skin. The results support the concept that complement activating immune complexes containing HBsAg and IgM anti HBs play a role in the pathogenesis of vasculitis as described here.

Adult↗

PubMed1985

The relevance of alpha-naphthyl acetate esterases to various monocyte functions.

Human monocytes contain a series of alpha-naphthyl acetate (alpha NA) esterases which are not present in other blood cells and which can be specifically inhibited by bis(4-nitrophenyl)-phosphate (BNPP). This inhibitor is non-toxic at the concentration used and thus enabled studies on the possible significance of this enzyme towards various monocyte functions. BNPP has no noticeable influence on adhesion and spreading of monocytes on glass surfaces, nor does it inhibit the phagocytosis of IgG-coated latex particles. BNPP does, however, diminish the spontaneous cytotoxicity of freshly isolated monocytes towards the erythroleukaemic cell line K562. In the single cell assay in agarose, BNPP treatment of monocytes leads to a decrease in the number of lytic and non-lytic effector-target cell conjugates. In contrast, the antibody-dependent cell-mediated cytotoxicity (ADCC) of monocytes as well as the natural cytotoxicity of lymphocytes towards K562 cells are not influenced by BNPP. The present investigations show that monocyte specific alpha NA esterases are involved in the spontaneous cytotoxicity of monocytes toward tumour cells.

Cell Adhesion↗

PubMed1984

Two-dimensional separation of alpha-naphthyl acetate esterases in human leucocytes and platelets.

Normal human leucocytes and platelets contain esterases which hydrolyse alpha-naphthyl acetate (alpha NA). Purified preparations from these cells were investigated by isoelectric focusing and subsequent polyacrylamide gradient gel electrophoresis at pH 9.0. Extractable alpha NA esterases were separated according to isoelectric point (pI) and molecular weight (MW). Monocytes, lymphocytes, granulocytes and platelets contain a unique pattern of alpha NA esterases, most of which can be inhibited by diisopropyl fluorophosphate (DFP; 0.1 mM). Their activity, however, is not affected by eserine (0.1 mM) or p-hydroxymercuribenzoate (1 mM). No protease activity of these enzymes was detected; it is likely that the majority constitute carboxylesterases (EC 3.1.1.1). Monocytes contain five alpha NA esterases which are additionally inhibited by bis(4-nitrophenyl)-phosphate (0.1 mM) and sodium fluoride (40 mM). PIs are in the range 5.7-6.2 and MWs are 145 000, 155 000, 250 000, 290 000 and 340 000. These enzymes are specific for monocytes. Platelets are characterized by a group of alpha NA esterases having pIs between 6.5 and 8.0, these corresponding to MWs ranging from 15 000 to 400 000.

Blood Platelets↗

PubMed1984

Assessment of daily iron doses administered to patients with chronic blood loss.

In chronically bleeding patients the hemoglobin concentration in blood (Hb) increases after iron therapy. The iron dose necessary for the maintenance of Hb is proportional to blood loss. A simple method for determining blood loss in chronically bleeding patients is introduced. The amount of iron necessary for an increase of Hb is needed for determination of the daily blood loss. A good correlation between calculated and required iron dosage was found for 14 out of 16 chronically bleeding patients. The calculated dose determined for one patient was below the required value; for the other patient only a slight difference was noted.

Anemia, Hypochromic↗