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Biomedical subjects

M Mengel

Publications and source records attributed to M Mengel.

30 records · Page 2Linked to original sources

MEN I gene mutations in sporadic adrenal adenomas.

Loss of heterozygosity (LOH) on chromosome 11q13 occurs in about 20% of sporadic adrenal neoplasms. Adrenal lesions, mostly benign, occur in up to 40% of patients from MEN I kindreds. The MEN I gene, positioned on 11q13, has been considered a primary candidate gene in these lesions. We studied a group of 15 patients with sporadic adrenal adenoma, and 1 patient with multinodular hyperplasia. Of the 16 patients, 4 had incidentally discovered masses, 5 had Conn's syndrome, 6 suffered from Cushing's syndrome, and 9 had high sex hormone production. Studies with the markers D11S480, PYGM, D11S449, and D11S987 in 13 patients (12 of whom were from our group of 16) revealed 4 losses of heterozygosity on D11 S480 on 11q13, but the deletion did not affect the MEN I gene in any case. We present complete direct DNA sequencing data of the menin gene in 14 sporadic adrenal adenomas and one with adrenal hyperplasia. We identified one heterozygous missense mutation, T552S, in a hormonally inactive adrenal adenoma. One base exchange was identified close to the intron-exon boundary in intron 9 of a nodular adrenal hyperplasia. mRNA expression studies found that MEN I was transcribed in all 13 samples analyzed. In summary, our study identified the second patient with sporadic benign adrenal tumor presenting a menin gene mutation. Our complete direct sequencing approach adds evidence that menin gene mutations may account only for a minority of benign adrenal tumors if at all. Another tumor-suppressor gene inactivated in sporadic adrenal neoplasms may be located on chromosome 11q13.

Adenoma↗

Concentration dependent and adverse effects in immunohistochemistry using the tyramine amplification technique.

Although the tyramine amplification technique to enhance sensitivity in immunohistochemistry has been described in numerous methodological papers, it has not yet gained access to diagnostic immunohistochemistry. This is mainly due to problems and pitfalls occurring in adaptation of this method to routine application. In this study a monoclonal antibody and a polyclonal antiserum (pan-cytokeratin and anti-myoglobin) were tested in tissues with different amounts of epitopes, using a checkerboard table and testing a total of 133 different dilution combinations of both the tyramide solution and the primary antibodies. The specific tissue investigated, i.e. the amount of accessible epitope to be detected and the applied concentration of the tyramide solution mainly influenced the staining reaction. Several pitfalls such as an uneven distribution of the staining or dramatic overstaining (paradoxical overstaining) must be considered to achieve optimal results. In conclusion, our data confirm methodological studies that the tyramine amplification technique is a powerful method to enhance immunohistochemical sensitivity. However, for reliable daily practice several pitfalls of the technique have to be circumvented.

Antibodies, Monoclonal↗

New Infrared Transitions in Solid Parahydrogen in the MIR and NIR/VIS Regions

We have studied the infrared spectrum of solid parahydrogen at different orthohydrogen impurity levels in the mid-infrared (MIR) region between 600-2000 cm-1 and in the near infrared/visible (NIR/VIS) region between 10 000-16 500 cm-1. The most important new observations in the MIR region, obtained with a single pass through an absorption cell 4.75 cm in length, are the U0(0) + S0(0) double transition around 1520 cm-1, broadened to about 20 cm-1 by roton delocalization, and the single orthohydrogen transition U0(1) at 1619.12 cm-1, which was previously observed only in normal hydrogen. For the NIR/VIS measurements an internal multireflection cell with 14-cm absorption path length was used. Of particular interest here is the second overtone band of solid hydrogen including double transitions of the type Q2(J) + Q1(J') (J = 0, 1; J' = 0, 1). At 10 241.07 cm-1 the new single transition W2(0) could be observed. For several double transitions in the NIR/VIS region a fine structure is observed, which can be explained by anisotropic interaction in rotationally excited pairs of molecules. The treatment of the fine structure of the Q2(0) + S1(0) transition leads to the prediction of a considerable intensity of the triple transition Q2(0) + Q1(0) + S0(0). Stimulated by this result we have found the triple transitions Q1(0) + Q1(0) + S0(0) at 8660 cm-1 and S1(0) + Q1(0) + S0(0) at 8990 cm-1 in the first overtone region. At 12 788 cm-1 we detected an absorption feature that we have assigned to the triple transition S1(0) + Q1(0) + Q1(0). We explain the infrared activity of this transition in terms of a three-body process, a dipole moment induced within a triplet of hydrogen molecules by successive pairwise induction. Copyright 1998 Academic Press.

Journal Article↗

Tyramine amplification technique in routine immunohistochemistry.

Signal amplification in immunohistochemistry via binding of biotinylated tyramine to proteins near the site of peroxidase-labeled antibodies is a promising new technique, but studies investigating a wide range of markers are lacking. The tyramine amplification technique (TAT) was investigated on 85 antibodies using a simple and fast protocol, and TAT results were compared to those obtained with conventional immunohistochemistry. Using TAT, most of the markers could be 5- to 50-fold further diluted and still showed identical staining results compared with standard stainings (maximal 500-fold). However, the variable reactivity of the different markers with TAT underlines the need for individual testing of every antibody to determine the optimal dilution. Some antibodies against cell adhesion molecules could be demonstrated for the first time in archival, formalin-fixed tissue sections. TAT, if carefully evaluated, offers a revolutionary improvement for modern immunostaining, either to increase sensitivity or primary antibody dilutions (cost reduction). From a methodological point of view, immunohistochemistry has not reached its limits by far and TAT is an important progressive step in this developmental process.

Antibodies, Monoclonal↗

Classical Hodgkin's disease. Clinical impact of the immunophenotype.

Antibodies against CD15, -30, and -20 are often used to support morphological diagnosis of Hodgkin's Disease (HD). The classical HD, i.e., the non-lymphocyte-predominance types, are CD15+, CD30+, and CD20- in general. However, the results for CD15 are less clear-cut in many studies, showing up to 40% of classical HD that lack positivity for this maker. Little is currently known about the relevance of antigen expression in relation to clinical outcome in HD. Therefore, the three markers were analyzed in 1751 cases from the German Hodgkin Study Group, using micro-wave epitope retrieval to optimize staining sensitivity. Eighty-three percent of the cases showed a classical immunophenotype (CD15+, CD30+, CD20-), twelve percent lacked CD15 positivity (CD15-, CD30+, CD20-), and five percent showed other combinations. For 1286 cases, clinical follow-up was available, which revealed significant differences for freedom from treatment failure (P = 0.0022) and overall survival (P = 0.0001) between cases with classical immunophenotype and CD15 negativity (CD30+, CD20-). Multivariate Cox regression using the three markers, age, sex, histology, stage, B-symptoms (fever, sweats, weight loss > 10% of body weight), hemoglobin, and erythrocyte sedimentation rate as factors showed that lack of CD15 expression in classical HD is an independent negative prognostic factor for relapses (P = 0.022) and survival (P = 0.0035). In conclusion, immunohistochemistry is able to identify classical HD cases with unfavorable clinical outcome.

Adolescent↗

Use of dermagraft, a cultured human dermis, to treat diabetic foot ulcers.

OBJECTIVE: To assess the effect of a tissue-engineered human dermis (Dermagraft) in healing diabetic foot ulcers. RESEARCH DESIGN AND METHODS: This controlled prospective multicenter randomized single-blinded pilot study evaluated healing over a 12-week period in 50 patients with diabetic foot ulcers. These patients were randomized into four groups (three different dosage regimens of Dermagraft and one control group). All patients received identical care except for the use of Dermagraft tissue. Ulcer healing was assessed by percentage of wounds achieving complete or 50% closure, time to complete or 50% closure, and volume and area measurements. RESULTS: Ulcers treated with the highest dosage of Dermagraft, one piece applied weekly for 8 weeks (group A), healed significantly more often than those treated with conventional wound closure methods; 50% (6 of 12) of the Dermagraft-treated and 8% (1 of 13) of the control ulcers healed completely (P = 0.03). The percentage of wounds achieving 50% closure was also significantly higher (75 vs. 23%; P = 0.018), and the time to complete or 50% closure was faster (P = 0.056). The group A regimen was more effective than other treatment regimens. All three were better than the control, however, and a dose-response was observed. There were no safety concerns. After a mean of 14 months of follow-up (range 11-22 months), there were no recurrences in the Dermagraft-healed ulcers. CONCLUSIONS: Dermagraft was associated with more complete and rapid healing in diabetic foot ulcers. The recurrence data may indicate an improved quality of wound healing.

Aged↗

Psychosocial and psychopathologic influences on management and control of insulin-dependent diabetes.

The objective of this research was to explore the relationship of psychosocial variables to management and control of insulin-dependent diabetes, as measured by a scale of reported behavioral adherence and by glycosylated hemoglobin, respectively. The method includes a relatively large sample (127 subjects) drawn from a clinic, a broad range of psychosocial variables (depression, anxiety, family process, health locus of control), and documented reliability and validity of psychosocial measurement (alpha coefficients ranging from .63 to .95). The results show that both anxiety and depression have weak positive correlations with blood sugar. Family process variables also are weakly correlated with blood sugar. The measure of behavioral adherence is moderately correlated with blood sugar. The life stage of the diabetic appears to affect these relationships markedly. The conclusion is that there is no broad strong association of psychosocial variables with blood sugar but that there may be subgroups of diabetics, especially adolescents with recent onset, for whom the relationships may be more powerful.

Adolescent↗

The use of the family APGAR in screening for family dysfunction in a family practice center.

The Family APGAR questionnaire was used to determine the prevalence of self-reported family dysfunction present in patients who attended a family practice center, to determine whether knowledge of the Family APGAR score increased the frequency with which family physicians evaluated family functioning and diagnosed family dysfunction, and to determine whether certain psychosomatic complaints associated with family dysfunction were more common in a group of patients with a Family APGAR score of less than 6. To achieve these purposes, all patients entering the center were asked to fill out a Family APGAR questionnaire during the month of March 1984. Physicians learned of the results in a randomly selected one half of all cases. A chart review was conducted one month later. Twenty-four percent of patients reported family dysfunction (APGAR less than 6). Knowledge of the APGAR score did not increase the frequency with which physicians evaluated family function (20 percent known vs 17 percent unknown) or diagnosed family dysfunction (6.3 percent known vs 6.4 percent unknown). Patients with self-reported family dysfunction as defined by the Family APGAR did not have more psychosomatic complaints noted in their charts than patients without self-reported family dysfunction. Family dysfunction is a common problem in family practice patients, it is recorded infrequently in patients' charts, and knowledge of the results of a screening device does not increase the frequency with which family dysfunction is noticed.

False Negative Reactions↗

The use of the cytocentrifuge in the diagnosis of meningitis.

A retrospective case-control records review was conducted to determine the usefulness of the cerebrospinal fluid (CSF) cytocentrifuge in the diagnosis of meningitis. Over a two-year period, 7,114 records were reviewed, from which 53 cases of aseptic meningitis (AM) and 22 cases of bacterial meningitis (BM) were obtained. Twenty-four cases, judged to be free of meningeal disease, obtained during a three-week period in July 1982, were used as controls. The mean percent polymorphonuclear leukocytes by cytocentrifuge was 14.5% +/- 25.4% in controls, 34.2% +/- 29.6% in AM patients, and 86.4% +/- 13.3% in BM patients. Statistically significant differences existed between the means of each group when compared overall (P less than 0.001) and when each group's mean was compared pair-wise to the two other group means in the study (P less than 0.01 to P less than 0.001). Knowledge of the percent PMNs by cytocentrifuge may be useful in distinguishing patients with meningitis, particularly bacterial, from those free of meningeal disease.

Adolescent↗