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Biomedical subjects

K Meissner

Publications and source records attributed to K Meissner.

At least 55 records · Page 3Linked to original sources
PubMed1988

Arotinoid-ethylester. Effectiveness in refractory cutaneous T-cell lymphoma.

Five patients with refractory advanced cutaneous T-cell lymphoma (CTCL) (Stage IIB, two; Stage III, one; Stage IVA, two) and one patient with a refractory Stage IB CTCL (two females, four males, median age 58 years) were treated with a new polyaromatic retinoid, arotinoid-ethylester (Ro 13-6298), which has a much higher antiproliferative activity than other known retinoids. There was an objective clinical response in three of six cases [complete remission (CR) = 1, partial remission (PR) = 2]. One patient is in CR since 102 weeks currently. Mean duration of PR was 43 weeks. Two patients were withdrawn from treatment after 4 weeks because of disease progression. Two patients, one of them in PR, had to be retired from further treatment due to toxic side effects. Main side effects were mucocutaneous dryness, skin atrophy, and skin vulnerability. Skin biopsies were performed on four patients 4 weeks after the start of treatment. The epidermis and the subepidermal grenz zone were found to be clear of mononuclear clear cell infiltration in three patients. Although the number of patients is small, the results obtained suggest that arotinoid-ethylester offers a promising approach to the treatment of CTCL.

Adult↗
PubMed1988

Cutaneous T cell lymphoma: immunocytochemical study on activation/proliferation and differentiation associated antigens in lymph nodes, skin, and peripheral blood.

The expression of activation/proliferation antigens (CD 25, CD 30, Ki 67, transferrin receptor) in lymph nodes and skin were compared in nine patients with mycosis fungoides (MF) with patients with erythroderma not related to MF, and patients with reactive lymphofollicular hyperplasias (a total of 14 patients). A panel of differentiation antigens was analyzed in addition. Reactivities were revealed by the APAAP technique. Activation/proliferation antigen scores in lymph nodes were related to the clinical stages of MF in most instances (low scores in cases of MF stage I/II, high scores in 3/4 cases of MF stage III/IV). They differed markedly in cases of non-MF-erythrodermia with the exception of one patient, and in all cases of reactive lymphofollicular hyperplasia. Expression of activation/proliferation antigens in lymph nodes were different in most cases from those in skin and peripheral blood. For diagnostic use, the activation/proliferation antigen scores were superior to the cell differentiation antigen profiles. Among cellular differentiation antigens, only the extent of CD1+ cells provided some diagnostic information, since the number of these cells were markedly increased in all cases of dermatopathic lymphadenitis with/without MF when compared with reactive lymphofollicular hyperplasia. In the diagnosis of MF, immunohistochemistry of activation/proliferation or differentiation antigens cannot replace routine paraffin histology, but may provide supplement any data in equivocal cases.

Adult↗
PubMed1988

[Percutaneous layer differentiation of the colonic wall by ultrasound. Clinical case examples and experimental results].

Based on 3 case observations, the feasibility of the percutaneous sonographic objectivation of a five-layer image of the colon wall using a 5 Mhz linear transducer is reported for the first time. Sonographic stratification is promoted by means of "ultrasound windows" or contrasting borderlines. Employing stepwise dissection of autoptic specimens and ultrasonic comparison, it was possible to identify the hypodense zones 2 and 4 as mucous membrane and muscle layer, divided by the reflecting submucous layer (zone 3). The hyperdense bands 1 and 5 were found to represent borderline echos of the large bowel wall. This preliminary report is a step towards an eventual percutaneous staging of colon neoplasms.

Adolescent↗
PubMed1987

Severe clostridium infection following perforation of the uterus in a patient with an ectopic pregnancy.

Twenty-eight hours after CO2 insufflation and curettage in a 26 year old, haemolysis, jaundice and anuria developed. As an ectopic pregnancy was also suspected, a diagnostic laparoscopy was done and was followed by a hysterectomy and left salpingo-oophorectomy before Clostridium perfringens was grown on culture. The survival of the patient despite clostridial infection is probably due to immediate surgical treatment and intensive post-operative care.

Adult↗
PubMed1987

[Ultrasound study of "acute appendicitis," an elective procedure or obligation in general surgery. A prospective study].

576 patients admitted for suspected acute appendicitis were prospectively assessed by sonography following physical examination. The collective comprised - as proven by operation - 156 patients with acute appendicitis, 178 patients with chronic appendicitis or mesenteric lymphadenitis, as proven by observation, 186 patients suffering from gastroenteritis. 56 patients suffered from other diseases and 21 of them required urgent surgery. Based on clinical symptoms, correct diagnosis had been made in 433 patients (75%): gastroenteritis n = 186, chronic appendicitis or lymphadenitis n = 111 and acute appendicitis n = 136 (87%). In 123 patients the diagnosis was false positive, in 20 patients false negative. Based on sonographic assessment, 537 patients (93%) were correctly diagnosed; thus, in 129 patients (83%) an inflamed appendix was confirmed, in 56 patients; diagnosis of unrelated entities requiring urgent surgery correct in 21 cases. In 12 patients with mesenteric lymphadenitis - as proven by operation-a false positive, in another 27 patients with acute appendicitis a false negative diagnosis was made. The combination of clinical assessment and sonographic diagnosis yielded a correct diagnosis in 97% (560/576) comprising 414 true negative and 146 true positive results (94%) in respect of acute appendicitis.

Adolescent↗
PubMed1987

Ileus and intestinal obstruction--ultrasonographic findings as a guideline to therapy.

Between September 1, 1982 and January 31, 1986, a study was undertaken in a total of 111 patients to assess the efficacy of ultrasonography in diagnosing intestinal obstruction and ileus. In 109 cases (98%), ultrasonography provided the correct diagnosis. In one case, obstruction was correctly suspected. In another case, the diagnosis was false negative. In 51 cases (46%), ultrasonography yielded the causative diagnosis. Ultrasonography was especially rewarding in the diagnosis of X-ray-negative intestinal obstruction, very high obstruction, clinically concealed incarcerated femoral hernias and in the differentiation of intestinal obstruction and ileus in the postoperative course. Ultrasonographic differential diagnosis was a reliable guideline for adequate treatment modalities in pertinent cases, thus contributing to therapeutic success.

Adolescent↗
PubMed1986

Quantitative analysis of T6-positive Langerhans cells in human skin cancers.

Epidermal Langerhans cells (LC) are required for antigen-presentation and for stimulating antigen-specific T cell activation. Similar functions may be important in the immune response to malignant skin tumours. Monoclonal anti-T6 antibody was used to examine LC population in basal and squamous cell carcinomas. Positive control labeling was performed with monoclonal anti-HLA-DR antibody. The number of T6-positive LC per mm2 of section was significantly decreased (p less than 0.01) in the tumour group in comparison with a sex and age-matched control group. The number of sun-exposed and covered regions was taken into consideration in each respective group. Within the tumours, LC were found more frequently in the tumour periphery and in most differentiated tumour areas (horn pearls) than in the rest of the tumour mass. T6-positive LC were rarely found in the dermis. Moreover, LC exhibited morphological changes in specimens from tumours. Staining with anti-HLA-DR antibody revealed less numerous positive cells within tumour nests than labeling with OKT6. A relationship between T6-positive LC quantities and extent of HLA-DR-positive infiltrates around tumours could not be established. These results suggest that immunological surveillance of neoantigen-bearing tumour cells may be impaired in skin cancer. A reason for the reduced LC number may be an altered microenvironment in tumour tissue.

Aged↗
PubMed1986

[Clinical relevance of sonography in acute diagnosis of perforated gastroduodenal ulcers].

In a prospective unselected series of 22 patients with perforated gastroduodenal ulcers the diagnostic efficacy of clinical and radiologic data was modest. In eight patients only (approximately 36%), clinical data yielded sufficient evidence; in 16 patients (approximately 73%), plain X-ray demonstrated subphrenic gas. Sonography was proven to be a major advance, especially rewarding in the diagnosis of perforations with negative plain X-ray. Gastric distention and stomach wall edema are unspecific sonographic criteria, whereas objectivation of a pathologic stomach "cockade" in the presence of free gas, extraluminary ingesta or echofree fluid in the peritoneal cavity are pathognomonic data. These criteria yielded a definite diagnosis in 16 patients (approximately 73%) including four patients with negative X-ray. The combined analysis of radiologic and sonographic findings yielded an immediate correct diagnosis in 20 patients (approximately 91%).

Adult↗
PubMed1986

[Sonographic diagnosis of complicated peptic ulcer].

The sensitivity of sonography was assessed in an unselected series of 56 patients suffering from complicated gastric (20) or duodenal (36) ulcers. Evidence of ingested material and/or free gas in the peritoneal cavity associated with a pathologic gastroduodenal cockade proves perforation. Ulcer penetration is visible as eccentric "tumour" extension into hepatoduodenal ligament, liver or pancreas, whereas callous ulcer is recognisable as pathologic noninfiltrating cockade, and duodenal obstruction from stomach distention in spite of fasting. Based on these criteria, immediate diagnosis was feasible in 42/56 patients (approximately 75%). Ulcer perforation was confirmed in 20/26 (approximately 77%), including plain x-ray negative cases, which comprised approximately 31% of the perforations in this series. Ulcer penetration and - obstruction and chronic callous ulcers were diagnosed in 22/30 (approximately 73%) patients. Thus, sonography was proven to be highly contributive to immediate diagnostic fact finding and therapy.

Adult↗
PubMed1986

GP37 expression in normal and diseased human epidermis: a marker for keratinocyte differentiation.

An antiserum prepared against a glycoprotein (GP37) extracted from the upper epidermal layers, was used to stain frozen sections of human oral mucosa, normal and abnormal skin by an indirect immunofluorescence technique. On normal human epidermis, this antiserum mainly reacted with the cytoplasm of granular cells, whereas on buccal mucosa the recognized antigen was observed as scattered dots limited to the upper epithelial layers. In epidermal diseases, alterations in the staining pattern were observed. In psoriasis, the labelling was markedly diminished; in contrast, in lichen planus it was intense and present on the 3-6 uppermost cellular layers. Basal cell epitheliomas were almost negative, except around horn cysts. In Bowen's disease dyskeratotic cells were strongly labelled. In squamous cell carcinomas a clear-cut staining was observed in squamous nests. On cultures, GP37 expression could be induced by growing epidermal cells in vitamin A-depleted medium. The biological significance of the observed staining patterns remains to be precised. Nevertheless, GP37 represents a sensitive marker of epidermal differentiation and may be useful in skin pathology and in in vitro studies.

Animals↗
PubMed1986

[Hematoma of the rectal sheath: clinical report of experiences with special reference to ultrasound diagnosis].

Rectus sheath hematomas are rare sequelae of direct or indirect trauma to the abdominal wall, with or without muscle rupture or laceration of epigastric vessels. "Spontaneous" hemorrhage may occur in patients receiving anticoagulant therapy. The diagnosis remains frequently unrecognized prior to ill advised laparotomies performed for suspected abdominal emergencies. Nine patients suffering from rectus sheath hematoma are reported, typical etiological factors, clinical and radiological findings and diagnostic difficulties outlined. Ultrasonography has proven to be the procedure of choice, yielding immediate diagnosis and trend observation.

Adult↗
PubMed1985

[Sonographic differential diagnosis of intestinal obstruction--results of a prospective study of 48 patients].

Based on a routine ultrasonic screening program of patients suffering from acute abdominal disorders, the efficacy of ultrasonic diagnosis of intestinal obstruction was assessed prospectively in a series of 48 patients. In the entire series proven to suffer from ileus, all were correctly diagnosed prior to further procedures. In cases with marked gaseous distention, typical ultrasonic patterns were objectivated using a side position of the patients. The assessment of specific mucosal structures permitted the identification of the obstruction site in mechanical ileus. Sonographic observation in real time motion yielded a differential diagnosis of cases with persisting peristalsis and cases with complete paralysis. In 6 cases, causative diagnosis of ileus was achieved by sonography alone, in 12 cases by combination of clinical and sonographic findings.

Adolescent↗
PubMed1985

[Value of sonographic ileus diagnosis].

Patients in an early state of mechanical bowel obstruction, with unspecific clinical symptoms, negative laboratory findings and no evidence of ileus in plain abdominal X-ray, are a pitfall for diagnosis and therapeutic decisions. In a partly retrospective, partly prospective study 11% (n = 13) of ileus patients admitted to our hospital met these criteria of "early state" bowel obstruction. Using conventional methods of diagnosis, in 6% (n = 7) false negative diagnosis was obtained; 4% (n = 5) were primarily admitted to the internal medical department. In all these cases, abdominal sonography yielded a correct diagnosis by demonstrating specific criteria of bowel obstruction even at onset of disease. The correct diagnosis was uniformly confirmed by early operation.

Adolescent↗