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Biomedical subjects

M Stolte

Publications and source records attributed to M Stolte.

At least 307 records · Page 17Linked to original sources
PubMed1996

A comparative ultrastructural study of the parotid gland acinar cells of nine wild ruminant species (mammalia, artiodactyla).

The ultrastructural similarities and differences of the parotid gland acinar cells of nine wild ruminants (roe deer, nyala, tahr, Eld's deer, red deer, Pere David's deer, European mouflon, African buffalo, sable antelope) representing three feeding types i.e. concentrate selectors (CS), grass and roughage eaters (GR) and intermediate feeders (IM) were compared. The parotid acinar cells of the CS contained more granular endoplasmic reticulum, Golgi-complexes and secretory granules than those of the GR. The acinar cells of the latter were characterized by numerous mitochondria, folded plasma membranes and intercellular secretory canaliculi. The ultrastructure of the secretory granules varied in different species but their morphology was not related to feeding type. An unusual feature of the parotid acinar cells of all feeding types was the evidence of an apocrine-like mode of secretion. A typical morphological change of some parotid acinar cells was the compression of the nucleus by large vacuoles. No distinctive differences were found in the ultrastructure of the parotid gland of wild and captive ruminants.

Animals↗
PubMed1996

Cure of gastric ulcer disease after cure of Helicobacter pylori infection--German Gastric Ulcer Study.

BACKGROUND: Helicobacter pylori infection is associated with gastric ulcer disease in about 75% of cases. OBJECTIVE: The aim of this study was to determine whether H. pylori eradication reduces gastric ulcer relapse rates. DESIGN: The study was randomized, controlled, multicentric and investigator blinded, and was conducted at three university hospitals, two teaching hospitals, and by six practising gastroenterologists. METHODS: During a period of 1 year 152 patients with gastric ulcers were randomly assigned to one of two treatment regimens: omeprazole 20 mg daily in the morning for 8 weeks (74 patients), or bismuth subsalicylate 600 mg three times daily for 8 weeks combined with 500 mg amoxicillin twice daily and 1000 mg tinidazole twice daily for the first 10 days (triple therapy) (78 patients). Follow-up examinations were performed 6, 12 and 18 months after treatment and whenever ulcer symptoms occurred. RESULTS: Of the 152 randomized patients five were excluded because of gastric cancer, 10 missed follow-up examinations and seven receiving triple therapy terminated treatment because of side effects. Of the remaining 130 patients, five of 69 (7.2%) in the omeprazole and six of 61 (9.8%) in the triple group were H. pylori negative. After 8 weeks' therapy, the gastric ulcer was healed in 85.9% (omeprazole) and in 81.8% triple) in H. pylori-positive patients, and in 80% (omeprazole) and 16.7% (triple) in H. pylori-negatives. H. pylori was eradicated in 8.1% of the patients who received omeprazole monotherapy and in 78.2% receiving triple therapy, and in 8.1% and 69.4% in an intention-to-treat analysis. The subsequent relapse rates during a follow-up period of 12 months were 50% in the omeprazole group and 4% in the triple group. Gastric ulcer relapse was observed in 49% of patients who were H. pylori positive and in 2% who were H. pylori negative after treatment. CONCLUSION: The data show that the presence of H. pylori is an important predictor of gastric ulcer relapse and that eradication of H. pylori may heal gastric ulcer disease.

Adult↗
PubMed1996

Helicobacter pylori reinfection is rare in peptic ulcer patients cured by antimicrobial therapy.

BACKGROUND: Cure of H. pylori infection in peptic ulcer patients significantly reduces the risk of ulcer recurrence. Since data on the rate of H. pylori reinfection in patients undergoing successful anti-H. pylori therapy are sparse, this study was conducted with the aim of determining the H. pylori reinfection rate in peptic ulcer patients receiving antibacterial treatment to heal their ulcer and cure H. pylori infection. METHODS: A total of 217 patients with H. pylori-associated duodenal or gastric ulcer were followed up after treatment with various antibacterial regimens resulting in histologically documented cure of H. pylori infection. Endoscopic and histological examinations were performed 4 weeks after completion of treatment and after 1, 2 and 5 years, or whenever dyspeptic symptoms occurred. To assess the H. pylori status two antral and two corpus biopsies were obtained for histological examination. RESULTS: Out of 217 patients with initially cured H. pylori infection 175 were available for endoscopic follow-up. At the time of analysis, 44 patients were re-examined after 1 year, 113 patients after 2 years and 18 patients after 5 years, giving a total of 360 patient years of follow-up. The mean duration of follow-up was 24.7 months. H. pylori reinfection was confirmed histologically in eight patients, three of whom becoming H. pylori-positive again within the first year of follow-up. Six of the eight patients with H. pylori reinfection also suffered an ulcer relapse. Eight cases of reinfection in 360 patient years represents an overall reinfection rate of 2.2%. Within the first 2 years of follow-up the reinfection rate was 0.8% per year. CONCLUSION: Our data suggest that H. pylori reinfection is rare in peptic ulcer patients receiving successful anti-H. pylori therapy. H. pylori reinfection frequently coincides with ulcer recurrence. Cure of H. pylori infection results in cure of peptic ulcer disease, provided H. pylori reinfection does not occur.

Amoxicillin↗
PubMed1996

Different expression of Helicobacter pylori gastritis in children: evidence for a specific pediatric disease?

BACKGROUND: Infection with Helicobacter pylori causes active chronic gastritis. Once the infection is acquired, gastritis will persist for almost the rest of one's life. To date, very few data are available on H. pylori gastritis in relation to age. Therefore, we attempted to investigate whether H. pylori gastritis in children exhibits features different from H. pylori gastritis in adults of two different age groups. MATERIALS AND METHODS: Fifty consecutive children with a median age of 11 years (range, 3-18 years) were compared with two groups of 50 adult patients, one group with a median age of 43 (range, 19-56 years) and another group with a median age of 70 years (range, 59-86 years). All patients had H. pylori gastritis unrelated to active peptic ulcer disease. Two biopsy specimens were taken from the antrum and two from the corpus, and the following gastritis parameters were evaluated: degree and activity of gastritis, H, pylori colonization, replacement of foveolar epithelium by regenerative epithelium, mucous depletion, presence of atrophic gastritis with intestinal metaplasia, and presence of lymphoid follicles. RESULTS: Degree and activity of gastritis, extent of H. pylori colonization, degree of replacement by regenerative epithelium, extent of mucous depletion, degree of atrophic gastritis with intestinal metaplasia, and the presence of lymphoid follicles in the antrum, as well as the presence of lymphoid follicles in the corpus differed significantly (chi-square test: p < .05). All these differences--except the once frequent occurrence of atrophic gastritis with intestinal metaplasia in adults--were attributable to a higher expression of these gastritis parameters in children. CONCLUSIONS: We conclude that H. pylori gastritis, particularly in the antrum, is more severely expressed in childhood. One reason for this might be a child-specific immune response to an infection with H. pylori. Alternatively, infection may represent a pediatric disease characterized by a nonatrophic, highly expressed form of gastritis, which changes its appearance once the host becomes adapted over time.

Adolescent↗
PubMed1996

Characterization of lymphocytic infiltrates in Helicobacter pylori-associated gastritis.

BACKGROUND: This study evaluated the specific subset composition of lymphocytes present in Helicobacter pylori-associated gastritis (HAG), since reports so far have led to inconclusive and conflicting results. METHODS: Endoscopic biopsy specimens from 56 patients were studied by quantitative immunohistochemistry using monoclonal antibodies against the lymphocyte markers CD3, CD22, CD4, CD8, CD45RO, CD1O3, TCR alpha/beta, and TCR gamma/delta. Lamina propria and intraepithelial compartments were evaluated separately. Grade, activity, and density of bacterial colonisation were assessed histologically and with Warthin-Starry stain. RESULTS: Evaluation showed a significant increase in CD4+, CD45RO+, TCR alpha/beta+ activated lamina propria lymphocytes in HAG which correlated with grade and activity of gastritis and degree of bacterial colonisation, whereas subsets of intraepithelial lymphocytes did not change significantly. TCR gamma/delta+ T cells were not found to be increased in HAG. CONCLUSIONS: Selective expansion of CD4+, CD45RO+ memory-type T cells could reflect an antigen-specific and/or chemokine-mediated effect in HAG. Locally produced CC chemokines such as RANTES have been detected in HAG.

Adult↗
PubMed1996

Adenoma-carcinoma sequence in the papilla of Vater.

BACKGROUND: Our aims were to investigate the question as to whether the adenoma-carcinoma sequence also applies to the papilla of Vater and to determine the frequency with which a tumour of the papilla of Vater, diagnosed histologically as containing portions of an adenoma, already contains adenocarcinoma elsewhere. METHODS: A retrospective analysis was carried out of the forceps, snare biopsy, and excised specimens obtained from the papilla of Vater in 559 patients, including 210 patients with the primary diagnosis of carcinoma and 110 patients with the diagnosis of 'portions of an adenoma'. Comparisons were made of the age distribution of patients with adenoma and those with carcinoma, and the frequency of residual adenoma in a carcinoma as a function of degree of malignancy, T stage, and UICC stage. A follow-up examination of the patients with the primary diagnosis 'parts of an adenoma of the papilla of Vater' was performed. RESULTS: The average age of the patients with the final diagnosis adenoma was 65.2 years, and that of the carcinoma patients 73.0 years. Residual adenoma was found in 54.9% of the 51 surgical specimens and in 31.7% of the 159 biopsy specimens obtained from carcinomas. The frequency of residual adenoma in carcinomas decreased statistically significantly with increasing T stage and degree of malignancy. The follow-up examination of the 110 patients with the primary biopsy diagnosis parts of an adenoma of the papilla of Vater showed unequivocal results in 80 cases. Only in 39.7% of these cases was the primary diagnosis adenoma confirmed, whereas in 60.25%, further histologic examination showed a carcinoma. CONCLUSIONS: An analysis of our results, together with those reported in the literature, indicates that the adenoma-carcinoma sequence also applies to the papilla of Vater and that, in a high percentage of patients with the histologic diagnosis 'parts of an adenoma, other regions of the tumour already contain a carcinoma.

Adenoma↗
PubMed1996

Intragastric pH during treatment with omeprazole: role of Helicobacter pylori and H. pylori-associated gastritis.

BACKGROUND: Omeprazole treatment produces lower intragastric pH values 4 weeks after cure of Helicobacter pylori infection than before. We therefore investigated the effect of healing H. pylori-associated gastritis on intragastric pH in the presence and in the absence of omeprazole therapy. METHODS: Before and on day 8 of omeprazole, 20 mg once daily, 24-h intragastric pH-recordings were performed in 14 subjects with H. pylori infection and repeated 4 and 52 weeks after cure of infection. Gastritis severity in corpus and antrum was graded by using a modified Sydney system. RESULTS: In the absence of omeprazole administration, median 24-h pH values before cure did not differ from those 4 and 52 weeks after cure. On day 8 of omeprazole administration, 24-h pH values were much higher before cure (median, 5.15; 95% confidence interval (CI), 4.3-6.0) than 4 weeks (3.6; 2.1-4.4; P < 0.001) and 52 weeks after cure (3.0; 2.1-4.4; P < 0.001). The activity of corpus and antral gastritis was not associated with the magnitude of H+ change induced by omeprazole. CONCLUSION: The increased pH produced by omeprazole during H. pylori infection is likely to be due to neutralizing substances produced by H. pylori and not to H. pylori-induced gastritis.

Adult↗
PubMed1996

Severity of Helicobacter pylori gastritis predicts duodenal ulcer recurrence.

BACKGROUND: Helicobacter pylori gastritis is suggested to be the underlying condition leading to duodenal ulcer disease. The aim of the study was to investigate the relationship between chronic active H. pylori gastritis and the risk of duodenal ulcer (DU) recurrence. METHODS: One hundred and eighty-eight patients were followed up with regard to the evolution of their H. pylori gastritis after they had received antibacterial or acid-suppressing treatment for their DU. Four weeks, 1 year, and 2 years after treatment and in the case of DU recurrence several morphologic indicators of gastritis were studied histologically in the antrum and corpus. RESULTS: In patients who were cured of H. pylori infection a significant and long-lasting regression of all gastritis variables were observed. patients with persistent H. pylori infection after antibacterial treatment showed only a temporary regression of all gastritis variables. In the overall group of patients who received acid-suppressive therapy there was no change in gastritis. However, in the subgroup of patients who received omeprazole monotherapy, no change in the antrum but a statistically significant increase of gastritis in the corpus was observed. The grade of antral gastritis at the end of treatment was significantly and positively correlated with the risk of DU recurrence and was independent of the kind of pretreatment (18.5% recurrences in grade-2 versus 86% in grade-4 gastritis). CONCLUSIONS: The data show that the grade of gastritis is an important risk factor for duodenal ulcer recurrence. Cure of H. pylori infection is associated with healing of chronic H. pylori-associated gastritis. These data lend considerable support to the hypothesis that H. pylori gastritis is the most important factor among those leading to duodenal ulcer disease.

Chronic Disease↗
PubMed1996

European brown hare syndrome in free-ranging hares in Poland.

A study of European brown hare syndrome (EBHS) was conducted in Poland (Czempin). From April 1993 until February 1994, 100 blood and 78 spleen samples of European brown hares (Lepus europaeus) were tested for prevalence of EBHS and rabbit hemorrhagic disease (RHDV) antibodies and EBHS virus antigen with two enzyme-linked immunosorbent assay (ELISA) test kits. Thirty-eight of 100 serum samples were positive for EBHS, and six (7.6%) of 78 of the spleen materials were-antigen positive for EBHS virus. Three (3%) of the sera were positive against RHDV, whereas two of these also were seropositive for EBHSV. European brown hare syndrome virus seropositive hares were most frequently found from April to September. Based on negative staining electron microscopy investigations of liver and spleen homogenates of all antigen-positive hares, we observed caliciviruses in only one animal. For histopathological investigations organ specimens were available from 98 hares. Histopathological findings corresponded with the clinical picture of chronic EBHS. A pathohistological picture consistent with EBHS was found in 22 (22%) of investigated hares and corresponded in 50% of the animals which reacted positively in the EBHSV antigen-ELISA and in 29% of the animals which reacted positively in the EBHSV antibody-ELISA. These results from western Poland are the first that caliciviruses are present in European brown hare population in Eastern Europe and may be one of the causes for increased mortality in the Polish hare population over the past 10 years.

Animals↗
PubMed1996

The Mongolian gazelle (Procapra gutturosa, Bovidae) as an intermediate host of three Sarcocystis species in Mongolia.

The sarcocysts of three Sarcocystis species (Sporozoa: Coccidia: Sarcocystidae) found in the Mongolian gazelle are described using light and transmission electron microscopy. The host-parasite interface and the ultrastructure of the cyst wall are represented for the first time in the macrocysts of Sarcocystis mongolica Machul'skii, 1947, localised in connective tissue cells. The cyst wall is attributed to type 1 of the classification by Dubey et al. (1989). Two other species are described for the first time from Procapra gutturosa in Mongolia: S. sp. with hair-like villar protrusions (type 7) and S. danzani n. sp. with villar protrusions possessing a structure hitherto unknown, characterised by a hollow.

Animals↗
PubMed1996

Evidence that intestinal intraepithelial lymphocytes are activated cytotoxic T cells in celiac disease but not in giardiasis.

To further define intraepithelial lymphocytes (IELs) in celiac disease (CD) and giardiasis, IELs were probed for the presence of cytolytic granules containing granzyme B (GrB) and T-cell-restricted intracellular antigen (TIA)-1. The expression of TIA-1, GrB, CD3 (T-cell-receptor-associated complex), and Leu-7 (subset of natural killer cells) was studied by a sensitive three-step immunoperoxidase technique. Stained IELs were determined quantitatively, and results were expressed as number of stained IELs per 100 epithelial cells (ECs). The relative content in labeled lamina propria lymphocytes was determined and expressed as the percentage of all lamina propria cells counted. When compared with controls, CD3+ and GrB+ IELs were significantly increased (P < 0.0004) in CD paralleled by an increase in TIA-1+ IELs (P < 0.0004). In CD, the highest numbers of IELs containing GrB were found in subjects with a flat mucosa (median, 38 IELs/100 ECs, P < 0.0004), followed by cases with shortened and blunted villi (median, 8 IELs/100 ECs, P < 0.0004) and, finally, CD patients with an intact villous architecture (median, 0.5 IELs/100 ECs, P < 0.02). Except for cases with giardiasis, Leu-7+ IELs were virtually absent in all groups as were GrB+ IELs in the controls and in subjects with giardiasis. In the lamina propria of CD subjects, GrB+ lymphocytes were also significantly increased (P < 0.001), whereas controls and cases with giardiasis were essentially free of GrB+ cytotoxic T lymphocytes. The percentage of CD3+ lamina propria lymphocytes was nearly equal in all groups. In humans and mice, extensive studies revealed a GrB expression to be absolutely restricted to activated cytotoxic T lymphocytes and natural killer cells. TIA-1, on the other hand, is considered a marker of resting T lymphocytes possessing cytolytic potential. We therefore conclude that IELs are cytotoxic T cells that are in a resting state in the normal small bowel and in giardiasis. In CD, they become activated as suggested by the GrB positivity of their granules.

Adolescent↗
PubMed1996

[Prevalence of Helicobacter pylori infection in stomach carcinoma].

This report outlines the results of the first prospective case-controlled study performed within a defined geographic area of southern Germany showing a significant association between Helicobacter pylori infection and gastric carcinoma (odds ratio = 2.18, 95% confidence interval 1.04-4.56). Furthermore, it can be clearly demonstrated that no association exists between carcinoma of the gastric cardia and H. pylori infection. There is no difference in prevalence of H. pylori infection between intestinal and diffuse-type carcinoma (Lauren classification). H. pylori status determination and strain typing may be useful in identifying patient groups at risk for developing gastric carcinoma.

Adolescent↗
PubMed1996

Screening for gastrointestinal neoplasia: efficacy and cost of two different approaches in a clinical rehabilitation centre.

Mortality from colorectal cancer (CRC) can be reduced by screening of asymptomatic individuals and by removal of colorectal adenomas (CRA). It is still under debate which screening method should be used. In a clinical rehabilitation centre we compared two widely different approaches: faecal occult blood testing (FOBT) with subsequent endoscopy of test-positives in an unselected patient group, and primary sigmoidoscopy of asymptomatic persons between 50 and 60 years of age. Between January 1988 and October 1991 a FOBT was offered to all--symptomatic and asymptomatic--6,500 in-patients of a clinical rehabilitation centre and lower/upper GI-endoscopy was suggested to test-positives (study A). In the latter half of this period 1,166 persons without bowel symptoms and/or disease and aged 50-60 years were invited to a screening sigmoidoscopy (study B). In study A 95% of the patients (n = 6,234) returned a complete FOBT, which was positive in 186 (2.98%). 126 of these 186 patients (68%) accepted further investigation, and a total of 78 sigmoidoscopies, 78 colonoscopies and 47 gastroscopies were performed. Six patients in whom a malignancy was detected (1 gastric, 1 rectal and 4 colonic; all in a curable stage) underwent surgery. In 28 patients CRA were identified and removed by snare excision. In study B 658/1,166 asymptomatic in-patients accepted the screening sigmoidoscopy (56%). Rectosigmoid adenomas were identified in 153 (23%). One rectal cancer was found. Of these cases, 116 underwent an additional colonoscopy, disclosing proximal adenomas in 39 patients (33.6%). The cost of identifying one CRA-bearer was $1,436 in study A and $271 in study B (assuming: FOBT = $3.00; sigmoidoscopy = $63.00; colonoscopy = $135; gastroscopy = $108). In study A, the cost of identifying one patient with cancer would have been $5,435, if the cost of identifying one CRA-bearer was set to $271 as in study B. Screening for CRC was well-accepted in the health-orientated environment of a rehabilitation centre. The cost of identifying a CRA-bearer with screening sigmoidoscopy was about one-fifth of that using preselection with a FOBT. However, with FOBT a higher number of cancers was found. For the discovery of CRA, mass-screening with sigmoidoscopy of persons above the age of 50 years can be advised. For the detection of both CRA and CRC, screening with FOBT and subsequent endoscopy is an acceptable and cost-effective method.

Adenoma↗
PubMed1996

Helicobacter pylori and the evolution of gastritis.

Following the isolation of Helicobacter pylori from the stomachs of patients with peptic ulcer in 1982, intensive research has examined the relationship between this organism and gastritis. H. pylori affects the grade and activity of gastritis, the quality of surface epithelial cells, and the nature of mucus production. Gastritis results from a direct action, involving bacterial cytotoxins and enzymes, and also in an indirect way through the effect of monocyte and granulocyte infiltration. Eradication of H. pylori leads to the long-term healing of gastritis. H. pylori is also associated with intestinal metaplasia and the development of mucosa-associated lymphoid tissue (MALT). Regression of MALT lymphomas has been reported after H. pylori eradication treatment.

Gastric Mucosa↗
PubMed1996

[Eosinophilic gastroenteritis in food allergy].

A 23-year-old woman suffered from chronic abdominal pain, nausea and diarrhea. The clinical symptoms particularly increased after ingestion of several foods. Laboratory investigation revealed a moderate eosinophilia in peripheral blood, elevated serum IgE-level and specific IgE against food allergens in radioallergosorbent testing. The patient exhibited exsudative ascites with eosinophiles. CT scan revealed a thickened wall of the small bowel. There was no evidence of a parasitic or extraintestinal disease. Endoscopically, the gastrointestinal tract appeared normal. Histological examinations of biopsies of the gastrointestinal tract led to the diagnosis of eosinophilic gastroenteritis. Under an elimination diet the patient is symptom-free since 16 months without ascites.

Adult↗