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J Smolle

Publications and source records attributed to J Smolle.

At least 181 records · Page 10Linked to original sources
PubMed1989

Surface microscopy. A new approach to the diagnosis of cutaneous pigmented tumors.

Clinical guidelines for the diagnosis of pigmented lesions of the skin are not always reliable. Surface microscopy (SM) represents an interesting approach to this problem. For this in vivo investigation, a stereomicroscope, a glass slide, and immersion oil are used. In the present study, the various criteria of SM that cannot be discerned by the naked eye are correlated with the histopathological structures in step-sectioned specimens. Characteristic SM features such as the pigment network, "black dots," or "irregular extensions" were found to correspond to particular histological findings. SM opens a new dimension of clinical morphology for the diagnosis and differential diagnosis of malignant melanomas, dysplastic nevi, or nonmelanocytic pigmented neoplasms, and facilitates a more reliable preoperative assessment of these lesions.

Dermatitis, Seborrheic↗
PubMed1989

[Permeability of the alveolocapillary membrane during unilateral lung lavage. An experimental study].

Experimental unilateral continuous lung lavage in a nonregenerating system containing 3000 ml isotonic crystalloid was performed in 12 pigs to determine the permeability of the alveolocapillary membrane under these conditions. The maximum time of lavage was 270 min. The concentrations of ions in both serum and fluid were determined at defined intervals. Exponential functions adjusted to the electrolyte changes in the fluid suggest different types of kinetics: sodium and urea adapted rapidly to serum concentrations. The half-time of the exponential function was short, the permeability constant high. Calcium, phosphate, and creatinine increased significantly, the permeability constant being lower than for urea. Potassium showed a linear increase, possibly due to influx from intracellular compartments. Total protein and albumin increased only initially, levelling far below the serum values. The low permeability constants of protein and albumin indicate an almost total lack of permeation, the initial increase possibly being due to washout of the epithelial lining fluid compartment. There was only a minimal loss of lavage fluid into the organism.

Animals↗
PubMed1988

[Statistical relations between blood and cerebrospinal fluid serology in patients with syphilis].

In any case of latent syphilis without conclusive history, an examination of the cerebrospinal fluid (CSF) is generally recommended. The present paper deals with the question whether particular findings obtained by serologic tests on the blood can supply sufficient proof to rule out any specific involvement of the central nervous system in an individual patient. Serologic investigation on 148 blood-CSF sample pairs revealed striking correlations between several blood and CSF parameters on a high level of statistical significance. Based on blood serology data alone, a multi-dimensional, non-parametric statistical test (the k-nearest-neighbor method) was able to rule out specific involvement of the CSF in more than one third of the patients. We consider our approach useful in certain cases where CSF examination should rather be avoided, especially in patients with impaired general condition due to other diseases. Yet, in any case of neurological irregularity, CSF examination should generally be carried out regardless of the results of blood serology.

Adult↗
PubMed1988

Nuclear parameters in the superficial and deep portion of melanocytic lesions--a morphometrical investigation.

Morphometric techniques in diagnostic pathology of pigmented skin lesions are not yet well established. The so-called maturation of melanocytes (nevus cells) with progressive descent into the dermis is one important criterion to differentiate benign from malignant melanocytic lesions in conventional histology. We therefore examined morphometrically the nuclear parameters of melanocytes (nevus cells) in the superficial and deep portion of 120 pigmented skin tumors (40 cases each of malignant melanoma. Spitz's nevus and benign dermal nevus) with special emphasis on the "maturation to the depth". A "maturation parameter" (MP) was assessed in each individual case, calculating the ratio of the nuclear area in the deep portion and in the superficial portion. The mean values of MP were 0.720 +/- 0.11 for dermal nevi, 0.725 +/- 0.10 for Spitz's nevi and 1.125 +/- 0.11 for malignant melanoma. The difference between malignant melanoma and both groups of benign nevi was statistically significant (p less than or equal to 0.01). The efficiency of the maturation parameter was 0.95 for the distinction of dermal nevi and malignant melanomas, and 0.97 for the distinction of Spitz's nevi and malignant melanoma. Measurements of the superficial portion only revealed comparatively low efficiency values (0.70 and 0.56, respectively). Our results indicate that morphometric evaluations of the nuclear area of melanocytes (nevus cells) in the deep portion of the infiltrate are more discriminative than those in the superficial portions. The establishment of the MP allows a better differentiation between benign and malignant melanocytic lesions and therefore morphometric methods may obviously be a helpful tool in the diagnosis of melanocytic skin tumors.

Cell Nucleus↗
PubMed1988

Solitary coin lesion in patients with malignant melanoma: an indication for thoracotomy?

In five patients solitary pulmonary lesions were detected radiographically during routine follow up after malignant melanoma. Surgical removal was done in each case under the tentative diagnosis of metastases. Histologically, two lesions turned out as benign chondroma, one as organized pulmonary infarction and one as bronchogenic carcinoma. Only in one patient was a melanoma metastasis present. The findings underline the usefulness also in malignant melanoma of a surgical approach in suspected solitary pulmonary metastases.

Adult↗
PubMed1988

Mononuclear cell patterns in the skin. An immunohistological and morphometrical analysis.

A large variety of skin diseases is characterized by the presence of mononuclear cell infiltrates in the dermis and to some extent in the epidermis. We have investigated frozen material of 566 lesions of benign and malignant skin diseases by immunohistological methods with a panel of 20 monoclonal antibodies; quantitative studies using computer-assisted image analysis were additionally performed in 80 specimens. In all reactive lesions, mononuclear cells were arranged in distinct compartments simulating the architecture of normal lymphatic tissue. A qualitatively uniform T cell compartment (mainly helper-inducer T lymphocytes, suppressor-cytotoxic T lymphocytes, Langerhans' cells) with slight quantitative differences was found in all inflammatory skin diseases, in peritumoral infiltrates, and also in normal skin. The B cell compartment (B lymphocytes, few T lymphocytes and monocytes) is only rarely seen (some B cell lymphomas and pseudolymphomas). The monocyte compartment (monocytes, few T lymphocytes) associated with a T cell compartment is typical for granulomatous skin lesions. The epidermis forms a separate functional region, which might evolve into a lymphoepithelial compartment in diseased skin. Low-grade malignant lymphomas of the skin display similar architectural patterns as reactive lesions, whereas high-grade malignant lymphomas do not. Obviously the mononuclear cells in the skin are usually arranged in compartments and form a limited number of distinct patterns. As similar patterns are found in diseases that are completely different with respect to clinical appearance, histological features, cause, and outcome, the patterns are not disease specific but reflect general anatomical-functional relationships of inflammatory cells and the skin.

Antibodies, Monoclonal↗
PubMed1988

HLA-DR-positive keratinocytes are associated with suppressor lymphocyte epidermotropism. A biomathematical study.

The expression of HLA-DR antigen on keratinocytes has recently been described as a frequent finding in various dermatologic disorders without restriction to a particular entity or a peculiar histologic reaction pattern, except for the association with a mononuclear dermal infiltrate. To determine the relationship of HLA-DR+ keratinocytes and T lymphocyte epidermotropism in human disease in vivo, 82 skin specimens were investigated by immunohistologic and stereologic methods and by two- and three-dimensional linear regression analysis. In randomly selected cases of various dermatoses, HLA-DR+ keratinocytes were associated with T lymphocyte epidermotropism. Furthermore, HLA-DR+ keratinocytes correlated particularly with the proportion of epidermotropic suppressor/cytotoxic cells. Our findings demonstrate that HLA-DR+ keratinocytes are associated with a particular pattern of epidermotropism, which may suggest an interaction of keratinocytes and T suppressor/cytotoxic cells in vivo.

Antibodies, Monoclonal↗
PubMed1988

Asthma caused by bromelain: an occupational allergy.

Bromelains consist of a group of proteolytic enzymes of Bromeliaceae. They are commonly used in pharmaceutical industries, food production and in diagnostic laboratories. Bromelains are known to cause IgE-mediated reactions of both the immediate type and the 'late phase reaction of immediate type reaction' with predominantly respiratory symptoms. We report four cases of occupational allergy to bromelain in workers of a blood grouping laboratory. These observations prompted us to investigate the sensitization rate to bromelain in all workers of the particular diagnostic laboratory who had contact with bromelain. These results were compared with those obtained from healthy, randomly selected individuals without evident bromelain exposure. Our findings indicate that (i) bromelain is a strong sensitizer, (ii) sensitization usually occurs due to inhalation and not to ingestion, (iii) bromelain allergy is occupationally acquired, and adequate precautions are necessary. We can further state that (iv) skin testing with relatively pure allergens such as isolated proteases like bromelain may induce systemic reactions, even at very high dilutions.

Administration, Inhalation↗
PubMed1988

Pulmonary exchange of solutes during experimental lung lavage in pigs.

Unilateral continuous lung lavage in a nonregenerating system (3,000 ml isotonic cristalloid) was done in 12 pigs for 270 min. The concentration of substances in serum and fluid was measured. Half-time (t1/2) of exchange and permeability constants (P) were determined. In the fluid Na+ decreased significantly (t1/2 = 107 min, P = 7.8 x 10(-7]. Urea increased significantly, reaching serum level after 270 min (t1/2 = 109.1 min, P = 6.18 x 10(-6]. Ca2+ (t1/2 = 36.7 min, P = 4.1 x 10(-7] PO4 = (t1/2 = 173.3 min, P = 1.1 x 10(-7], and creatinine (t1/2 = 55.2 min, P = 6.2 x 10(-7] also increased markedly but did not reach serum level. The adjustment to serum concentration may be prevented by interaction between diffusion, active transport or Donnan's equilibria. K+ increased almost linearly, documented by the long half-time (t1/2 = 7,835.2 min, P = 7.7 x 10(-7] and did not reach serum level. The calculated limit value was higher than the serum level. Active transport systems or influx of K+ from cellular compartments rather than from the serum might be involved in its linear kinetics. Total protein (t1/2 = 61.5 min, P = 2.06 x 10(-9] and albumin (t1/2 = 58.8 min, P = 1.7 x 10(-9] increased initially but levelled far below the serum value. The low P indicates a lack of significant permeation. Initial increase may be due to washout of the epithelial lining fluid compartment. There was minimal transfer of lavage fluid into the organism (10-20 ml/30 min). Serum concentrations were not affected by the lavage.

Animals↗
PubMed1988

[Direct light microscopy of pigment tumors of the skin].

Clinical guidelines for the diagnosis of pigmented skin lesions are not always reliable. Incident light microscopy provides an interesting approach to solving this problem. For this investigation a stereomicroscope, a glass slide and immersion oil are used. The various in vivo criteria of this method, which go beyond the changes discernible by the naked eye, are correlated with the histopathological structures. Incident light microscopy opens up a new dimension of clinical morphology for the diagnosis and differential diagnosis of malignant melanoma, dysplastic nevi or non-melanocytic pigmented neoplasms and facilitates a more precise preoperative assessment of these lesions.

Diagnosis, Differential↗
PubMed1987

[Remarks on contact eczemas--etiopathogenetic considerations based on immunohistochemical studies].

Functionally defined inflammatory cells can be selectively labeled in tissue sections by immunohistochemical methods. We investigated the cellular infiltrate in acute toxic contact dermatitis and various forms of contact eczema and other inflammatory dermatoses. In all cases, the so-called "superficial T-cell pattern" was evident, which comprised T-lymphocytes, predominantly helper/inducer cells, as well as Langerhans cells/indeterminate cells. The numerical density of these cell types, which represent the cellular prerequisites for delayed hypersensitivity reactions, turned out to be markedly increased in affected skin. Compared with normal skin, therefore, lesional skin provides a different immunological microenvironment. We conclude that a negative patch test reaction in normal skin does not exclude the possibility that the same allergen may provoke and enhance immunological reactions in eczematous skin. Eczema is regarded as an abnormal reaction of the organism towards exogenous factors; the abnormal reaction may be confined to sites with a considerable infiltrate. This might explain the pronounced chronicity of contact eczemas, even after withdrawal of the presumed cause, and the existence of chronic allergic contact eczemas without positive patch test results. The inflammatory infiltrate may be interpreted as a major predisposing factor for further immunological reactions at the same site.

Antibodies, Monoclonal↗
PubMed1987

Simultaneous localization of calcitonin mRNA and peptide in a medullary thyroid carcinoma.

We report the visualization of calcitonin gene expression products at the mRNA and peptide levels on the same section of a medullary thyroid carcinoma by combined in situ hybridization and immunohistochemistry. mRNA detection was accomplished by hybridization with radioactively labeled antisense RNA probes followed by autoradiography and immunohistochemically using the avidin-biotin complex method. Best results were obtained when in situ hybridization preceded immunohistochemistry, as determined by quantitative analysis of the autoradiographs. When immunohistochemistry was performed prior to in situ hybridization, the RNase inhibitor heparin had to be added to the antibodies to retain hybridizable mRNA. The intensity of the two reactions varied in individual cells, indicating a functional heterogeneity of tumor cells with regard to calcitonin mRNA content and storage of the related immunoreactive peptide. These results, in combination with elevated serum calcitonin levels, suggest significant differences in the rate of secretion of individual tumor cells. Simultaneous localization of mRNA and its peptide within the same cell may, therefore, provide further insight into gene expression and secretory activity at the single cell level.

Calcitonin↗
PubMed1987

Malignant fibrous histiocytoma of the lung: prognosis and therapy of a rare disease. Report of two cases and review of the literature.

On the basis of 2 own patients and 18 cases reported in the literature, clinicopathological features of primary malignant fibrous histiocytoma of the lung are reviewed. Of the 20 patients (age-range: 14-75 yrs; 13 male, 7 female), 14 underwent resection. Recurrences were noted in 7 of them. 8 patients were free of disease at least 8 months postoperatively, one having undergone successful pulmonary metastasectomy. Postresection disease-free survival ranged from 8 months to 10 years. Adjuvant chemotherapy or irradiation (3/14) did not influence postoperative outcome. After chemotherapy, irradiation or conservative measures alone (6/20) survival did not exceed 12 months; remissions were not reported. The course was fatal within 12 months in 9/20 cases due to distant metastasis or local growth. 1 patient died of tumour-associated hypoglycemia. Age, sex, localization of the tumor and histologic subtype did not influence prognosis. Small tumors, asymtomatic at time of detection probably carry a better prognosis than larger ones.

Aged↗
PubMed1987

NK cell density in malignant skin tumours--a stereological study.

We determined the density of natural killer (NK) cells in frozen sections of malignant melanoma (nine cases), squamous cell carcinoma (six cases) and non-neoplastic tonsil (five cases) by immunohistological and stereological methods. The mean density of NK cells in malignant melanoma (5.0 +/- 1.5 X 10(3)/mm3) and in squamous cell carcinoma (5.1 +/- 2.7 X 10(3)/mm3) was significantly lower than in germinal centres of normal human tonsils (5.0 +/- 0.8 X 10(4)/mm3). The NK cell/tumour cell ratio (0.03 +/- 0.015 in malignant melanoma and 0.02 +/- 0.015 in squamous cell carcinoma) is 10(2)-10(4) times lower than that commonly used for in vitro assays. The possible role of NK cells in malignant skin tumours should be viewed with caution.

Biopsy↗
PubMed1987

Transferrin receptor expression in normal skin and in various cutaneous tumors.

In the majority of human cells the transferrin receptor (TFR) plays an important role by mediating the cellular iron uptake. The TFR is especially expressed by proliferating cells and has been found in high amounts in malignant tumors. The distribution of the TFR in frozen sections of 89 skin biopsies of normal skin and of various cutaneous tumors was investigated using an anti-TFR monoclonal antibody (OKT9) and a 3-step immunoperoxidase method. Our results indicate that in normal human skin the TFR shows a characteristic microanatomical distribution in the basal cell layer correlated to the architectural pattern of the dermal-epidermal interface. In cutaneous lymphomas of high grade malignancy the TFR was expressed in virtually all cells compared to only 25-75% in low grade lymphomas. Malignant melanomas were strongly positive in the whole tumor tissue, whereas benign melanocytic nevi were largely negative. Obviously the immunohistochemical demonstration of the TFR may serve as prognostic indicator or diagnostic aid, respectively.

Antibodies, Monoclonal↗
PubMed1987

[Immunohistochemical classification of cutaneous lymphomas and pseudolymphomas].

We investigated 46 cases of cutaneous lymphoma and pseudolymphoma by immunohistochemical methods using a panel of monoclonal antibodies. Of the cutaneous T cell lymphomas, 2 did not show the classic helper phenotype but revealed a predominance of suppressor cells in one case and of immature thymocytes in the other. Cutaneous B cell lymphomas of low-grade malignancy were characterized by the presence of completely developed T zones between the B cell areas. B cell lymphomas of high-grade malignancy revealed an immunohistologically homogeneous infiltrate. Cutaneous pseudolymphomas can be classified in T cell pseudolymphomas (lymphocytic infiltration, lymphomatoid papulosis) and B cell pseudolymphomas. Lymphadenosis cutis benigna with germinal center cell differentiation was clearly distinguishable from other B cell pseudolymphomas, which are considered to comprise mainly peripheral B lymphocytes. Immunohistological methods are obviously useful in the classification of lymphoproliferative diseases of the skin and can make a contribution to increasing our understanding of them.

Antibodies, Monoclonal↗