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Biomedical subjects

M Stolte

Publications and source records attributed to M Stolte.

At least 325 records · Page 18Linked to original sources
PubMed1996

[Autoimmune gastritis in its various stages].

Based on 196 consecutively diagnosed cases of autoimmune gastritis the histological spectrum of this disease was examined with special regard to the so called active autoimmune gastritis. The analysis revealed statistically significant differences. The chronic atrophic type showed more often microglandular hyperplasia of endocrine cells (p < 0.005) and revealed less often colonisation of the body mucosa by Helicobacter pylori (p < 0.001) than the active form. The inflammatory reaction of the antral mucosa, however, showed no differences. In addition immunohistochemical stainings were performed in 25 patients in whom parietal cell antibodies had been detected. In cases with active autoimmune gastritis T cells were found not only in the lamina propria but as well within the oxyntic glands as contrasted with the atrophic form. Only in the former group of patients furthermore B cells could be identified in the lamina propria. We conclude that especially with respect to the active form further knowledge of the progression of the autoimmune process might be gained.

Aged↗
PubMed1996

[Carcinoid tumors of the stomach in atrophic autoimmune gastritis: classification, differential diagnosis and prognosis].

With the aim of evaluating the prognosis of neuroendocrine tumours of the stomach we studied 255 patients with these tumours to gain informations about the different biological behaviour of these tumours. We examined subtypes on the basis of the type of gastritis according to RINDI et al. 1993. A classification was made on the basis of tumour size, depth of invasion, angio invasion, functioning or non functioning, metastatic or non metastatic according to CAPELLA et al. 1994 to estimate benign and low or high grade malignant behaviour. 191 carcinoid tumours in autoimmune gastritis were in 86.4% classified as benign tumours (88% not more than 1 cm in diameter, 1 case with lymph node metastasis, no carcinoid tumour related death). 12 carcinoids associated with ZES-MEN I showed a benign or low grade malignant behaviour (60% more than 1 cm in diameter, 2 cases with lymph node metastasis, 1 with distant metastasis, 1 carcinoid related death). 36 sporadic carcinoid tumours were in 42% low grade malignant (36% 1-2 cm size, 25% more than 2 cm in diameter, 3 cases with lymph node metastasis, 2 with distant, 6 with lymph node and distant, 7 carcinoid related death). 13 neuroendocrine carcinoma were high grade malignant (1.5-7 cm size, 6 cases with lymph node metastasis, 2 with distant, 4 with lymph node and distant, 8 carcinoma related death). Therefore we conclude that in the classifications compared carcinoid tumours in A-gastritis are-in contrast to the other types of neuroendocrine tumours of the stomach-benign tumours with a good prognosis. The type of gastritis is for the prognosis of gastric neuroendocrine tumours besides tumour size and metastasis the most important parameter.

Adolescent↗
PubMed1996

Antelopes (Bovidae) kept in European zoological gardens as intermediate hosts of Sarcocystis species.

Four different forms of sarcocysts from the zoo-kept antelopes Addax nasomaculatus. Antilope cervicapra, Taurotragus oryx and Boselaphus tragocamelus (Bovidae) were investigated by light and transmission electron microscopy, in special consideration of the cyst wall. The sarcocysts found in Addax (born in a zoo) were not distinguishable from Sarcocystis medusiformis of Australasian sheep by their morphology and would be the first indication for the occurrence of this species in Europe. Sarcocysts from Antilope (born in a zoo) resembled the tenella/capracanis type of sheep/goats and were, therefore, designated as Sarcocystis sp. (? cf. capracanis) in this paper. Sarcocysts from Taurotragus were similar to a zoonotic species of cattle and hence provisionally designated as S. sp. (? cf. hominis). A sarcocyst form with hair-like villar protrusions of the cyst wall was found in Taurotragus. Boselaphus and Antilope and compared with a common species of cattle: S (? cf. cruzi).

Animals↗
PubMed1995

Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection. MALT Lymphoma Study Group.

Lymphoma of gastric-mucosa-associated lymphatic tissue (MALT) type has been linked to infection with Helicobacter pylori. We investigated the effect on MALT lymphoma of eradicating H pylori infection. 33 patients with primary gastric low-grade MALT lymphoma associated with H pylori gastritis were treated with omeprazole (120 mg daily) and amoxycillin (2.25 g daily) for 14 days to eradicate H pylori. In addition to histology, PCR was used to examine proliferation of monoclonal B cells before treatment and during follow-up. All patients had at least two post-treatment examinations, and all became negative for H pylori, 2 after a second treatment course. On histology, 23 (70%) patients showed complete regression and 4 (12%) partial regression of lymphoma. 6 (18%) patients had no change after cure of H pylori infection. 1 was treated with chemotherapy. Of 5 treated surgically, 4 were found to have high-grade B-cell lymphoma on histology of the resected stomach and 1 a high-grade T-cell lymphoma. PCR showed complete disappearance of monoclonal B cells after cure of H pylori infection in 13 of 16 patients investigated. During median follow-up of 1 year no relapse of MALT lymphoma occurred. Low-grade primary gastric MALT lymphoma can completely regress after eradication of H pylori infection. However, longer follow-up is needed to clarify whether the remission is lasting.

Adult↗
PubMed1995

[Analysis of inflammatory reaction and epithelial proliferation in corpus mucosa of the stomach. A contribution to carcinogenesis].

To elucidate conflicting evidence concerning the role of Helicobacter pylori (HP) in the evolution of gastric carcinoma, a retrospective analysis was performed on the corpus mucosa of gastric surgical specimens removed from patients with gastric carcinoma (n = 53) and pancreatic carcinoma (n = 45). Prevalence, activity and degree of chronic active gastritis (CAG) were investigated. Furthermore, proliferative activity was determined by the expression of the Ki67 antigen in epithelial cells of the neck region and the foveolae using immunohistochemistry. CAG and intestinal metaplasia were significantly more prevalent in patients with gastric than with pancreatic neoplasms. Degree and activity of CAG were higher in the group of patients with gastric carcinomas. Numbers of Ki67-positive nuclei were significantly higher in pronounced than in mild CAG. Our data are in keeping with the assumption that HP-associated CAG contributes to the development of gastric adenocarcinoma. As possible pathomechanism, it may be assumed that a conspicuously expressed inflammatory reaction triggers epithelial proliferation, with resulting higher vulnerability to mutagenic effects.

Adenocarcinoma↗
PubMed1995

Cutaneous mast cell tumours in a lion (Panthera leo): a light and transmission electron microscopical study.

Cutaneous mast cell tumours of a 16-year-old female Indian lion (Panthera leo) were studied histologically and ultrastructurally. The proliferation index detected with an antibody against the nuclear antigen Ki-67 was 16.5%. A cytochemical test for chymase activity was negative. Mast cell tumours are well known in domestic animals and in cats are of two distinct histological types. The present paper is the first report of poorly differentiated cutaneous mast cell tumours in a lion. In their histological and ultrastructural appearance, and in their lack of chymase activity, the neoplastic mast cells resembled tumour mast cells in cats.

Animals↗
PubMed1995

Differentiation of focal foveolar hyperplasia from hyperplastic polyps in gastric biopsy material.

Our objective was to investigate the question as to whether focal foveolar hyperplasia and hyperplastic polyp can be differentiated in forceps biopsy material from the stomach. Morphometric determination of the height of the epithelium layer in forceps biopsy specimens was obtained from 35 hyperplastic polyps, and forceps biopsy material was obtained from 25 focal foveolar hyperplasias. The diagnosis of hyperplastic polyp was confirmed by subsequent polypectomy. The medians and scatter range of the epithelial layer height were calculated. Using the t-test for independent samples the question was examined as to whether there is any statistically significant difference between hyperplastic polyps and focal foveolar hyperplasia in terms of the parameter "height of the foveolar epithelial layer." The measurements revealed that the average height of foveolar epithelial cells in hyperplastic polyps is 37.70 microns +/- 7.41 microns. In the case of focal foveolar hyperplasia, the corresponding figure was only 24.26 microns +/- 5.11 microns. This difference was statistically highly significant (p < 0.0001). In conclusion, focal foveolar hyperplasia and hyperplastic polyp of the gastric mucosa can readily be differentiated on the basis of architectural and cytological criteria, even in forceps biopsy material. Since the hyperplastic polyp very probably does not evolve from focal foveolar hyperplasia, and the latter is not a pre-neoplastic condition or lesion, it is proposed that focal foveolar hyperplasia should no longer be referred to as "gastric polyp," which would avoid unnecessary follow-up examinations and possibly even surgery.

Diagnosis, Differential↗
PubMed1995

Clinical consequences of the endoscopic diagnosis of gastric polyps.

The procedure following endoscopic detection of a gastric polyp depends on the findings on histological examination of the lesion, for which forceps biopsy material usually suffices. If Elster's polyps are present, the recommendation is merely a search for epithelial tumors in the colorectum, which occur statistically more frequently in these patients. In the case of hyperplastic polyps, the recommended procedure is endoscopic polypectomy, typing of gastritis and regular follow-up examinations. Carcinoid tumors, which usually arise in type A gastritis, require only follow-up, while sporadic carcinoid tumors should be treated surgically. Irrespective of the type and grade of dysplasia, adenomas of the gastric mucosa should always be removed in toto. Polypoid type I or type IIa early carcinomas of the stomach initially only need to be removed endoscopically. If histological examination then reveals well or moderately differentiated adenocarcinoma limited to the mucosa, surgery is not necessary, but regular follow-up is essential.

Adenocarcinoma↗
PubMed1995

Colorectal mini-de novo carcinoma: a reality in Germany too.

BACKGROUND AND STUDY AIMS: Based on Japanese case studies, we examined whether colorectal mini-de novo carcinoma also occurs outside Japan. We defined mini-de novo carcinomas as carcinomas infiltrating the submucosa, with a maximum diameter of 10 mm, and with no evidence of precursive adenomatous tissue. PATIENTS AND METHODS: Between 1988 and 1994, we diagnosed carcinomas of this type in polypectomy and surgical resection specimens from 155 patients. These mini-de novo carcinomas did not differ from carcinomas arising from adenomas in terms of patient age (median 67.1 years), sex distribution (men: women 0.96:1), or location--they occurred primarily in the sigmoid (53%) and rectum (27.3%). RESULTS: Most of the mini-de novo carcinomas were macroscopically of the polypoid type (59.4%); flat, elevated carcinomas were also relatively frequent, including those with a central concave depression (21.9%) and those without a depression (12.3%). Histologically, all of the lesions without exception were adenocarcinomas (grade 1: 28.4%, grade 2: 65.8%, grade 3: 5.8%). There was carcinomatous invasion of submucosal lymphatic or blood vessels in 20%. CONCLUSIONS: Our analysis shows that colorectal mini-de novo carcinoma is not a purely Japanese phenomenon, and that these carcinomas are being diagnosed with increasing frequency as the awareness of their existence and macroscopic growth characteristics increases.

Adult↗
PubMed1995

Oesophageal ulceration by tuberculosis: a rare cause of dysphagia.

We report on a 58-year old female patient from Afghanistan, who developed a dysphagia within 3 weeks of arrival. On the basis of radiological and endoscopic examination, an oesophageal ulcer was regarded as a malignant tumour, but because of weight loss, fever and night sweats (B symptoms) the question of tuberculosis was also considered by the pathologist. Histological assessment of biopsies produced proof of epithelioid cell granulomas with marginally polygonal giant cells of Langhans-type, as of acid-fast bacilli. In a bacteriological test, three different types of mycobacteria were found. With adequate anti-tuberculosis therapy, the oesophageal ulcer and the mediastinal lymph nodes visible in the computed tomograph soon disappeared, and the patient became free of symptoms. The clinical picture was interpreted as a primary oesophageal tuberculosis with mediastinal lymph nodes as the primary complex. In cases of oesophageal ulcer or dysphagia, tuberculosis should be included in the differential diagnosis, particularly in patients from Asia.

Deglutition Disorders↗
PubMed1995

Intragastric acidity as a predictor of the success of Helicobacter pylori eradication: a study in peptic ulcer patients with omeprazole and amoxicillin.

Omeprazole plus amoxicillin cures Helicobacter pylori infection. The hypothesis was tested that low acidity is a predictor of outcome. Fifty patients with relapsing or complicated, or both H pylori positive duodenal (n = 25) or gastric ulcer (n = 25) were randomly treated with either omeprazole 20 mg twice daily plus amoxicillin 1 g twice daily or with omeprazole 40 mg twice daily plus amoxicillin 1 g twice daily over two weeks. After one week of combined treatment, a 24 hour gastric pH measurement was performed in all patients. H pylori cure rate was 67%. Patients who later turned out to be cured had higher pH values during night time and after meals (p < 0.05). In an explorative analysis drug compliance, smoking, location of the ulcer (duodenum versus stomach), age, and grade of body gastritis were additional predictors of the outcome. Smoking (p = 0.006), compliance (p = 0.037), duodenal ulcer disease (p = 0.065), and young age (p = 0.021) were related to high acidity. In conclusion, the success of eradication treatment with omeprazole and amoxicillin in ulcer patients infected with H pylori depends on intragastric pH. Drug compliance, smoking habits, location of ulcer, age, and activity of body gastritis are other predictors and in part related to intragastric acidity.

Adult↗
PubMed1995

Effect of curing Helicobacter pylori infection on intragastric pH during treatment with omeprazole.

It has been shown that omeprazole treatment produces higher intragastric pH values in Helicobacter pylori positive subjects than in H pylori negative subjects. This study aimed to investigate the effect of curing H pylori on the intragastric pH in both the presence and absence of omeprazole therapy. Twenty four hour intragastric pH recordings were performed before and after a one week course of omeprazole (20 mg once daily) in 18 H pylori positive subjects and were repeated after the infection had been cured. In the absence of omeprazole, the total 24 hour pH values before cure did not differ from those afterwards. During omeprazole treatment the 24 hour pH values were much higher before (median (95% CI) 5.4: 4.3, 6.0), than after cure of infection (3.6: 2.1, 4.4; p < 0.001). The omeprazole induced fall in H+ activity before cure of H pylori did not, however, differ from that afterwards. It is concluded that the apparently greater antisecretory effect of omeprazole during H pylori infection may be a result of the production of acid neutralising compounds by the H pylori. Although a direct interaction between H pylori and omeprazole cannot be excluded, it seems unlikely.

Adult↗
PubMed1995

High-dose omeprazole plus amoxicillin or clarithromycin cures Helicobacter pylori infection in duodenal ulcer disease.

Treatment with omeprazole plus amoxicillin or clarithromycin resulted in encouraging Helicobacter pylori cure rates in pilot and controlled studies. The present prospective, randomized study was designed to compared the efficacy and safety of amoxicillin and clarithromycin as constituents of omeprazole-enhanced antibiotic therapy of H. pylori infection. Fifty patients with active duodenal ulcer disease and histologically and/or culturally confirmed H. pylori colonization of the gastric mucosa were treated with omeprazole (day 1-14: 40 mg twice daily, day 15-42: 20 mg once in the morning). The patients were randomly assigned to receive either amoxicillin (1 g twice daily; group I: n = 25) or clarithromycin (500 mg twice daily; group II: n = 25) during the first 2 weeks of treatment. The patients of group I and II had comparable demographic and clinical characteristics. One patient of group I was lost to follow-up. H. pylori infection was cured in 87.5% of group I and 84.0% of group II (p = 1.00). All ulcers had healed after 6 weeks of omeprazole treatment. Pain relief occurred within the first day of treatment in the majority of patients of both groups (p = 0.89). Minor side effects were recorded in 6 patients of group I and in 4 patients of group II (25 vs. 16%; p = 0.50). In 1 female patient amoxicillin had to be withdrawn after 3 days because of nausea and emesis. In conclusion, 2 weeks of treatment with omeprazole plus amoxicillin or clarithromycin are highly and equally effective regimens to cure H. pylori infection in patients with duodenal ulcer disease.

Amoxicillin↗