Biomedical subjects
Publications and source records attributed to S Witte.
Flow cytometric analysis of cytologic samples from four different organs shows that nuclear DNA content of malignant cell populations depends to a large extent on organ of origin of the tumor. This fact must be considered in planning screening systems.
In every case of duodenal endoscopy we collect cell material from the papilla of Vater by means of a guided brush technique. The microscopic techniques used include phase contrast study of unfixed material and Papanicolaou stained smears. Normal epithelial cells of the papillary region differ from those of the duodenal epithelium and the epithelial cells of the common bile or pancreatic ducts collected by retrograde cannulation. A striking feature in the cytology of the papilla is the marked tendency for cellular atypias. Mostly these atypias have no correlation to histologic biopsy specimens although they persist in such cases during repeated examinations. Tumour cells from carcinoma of the papilla are found very regularly and consequently the cytodiagnosis of these tumours became of great practical value. Polypoid lesions of the papilla give also, a characteristic cell picture. From a cytological point of view the papillary region, where different kinds of epithelia come together, is of special pathogenetic importance.
The techniques for cell collection are well established. Cells in good quality and sufficient quantities are obtained. The preparation of the sediment depends on the microscopic techniques to be used. The cytological tumor criteria are well established. The diagnostic efficiency is more than 90% of cases with proved malignancies. In comparison with the endoscopic biopsy the brush cytology has the following advantages: A stenosis can be reached by the brush much easier than by the forceps. The tumor detection is improved by cytology under optimal conditions for 10% of the cases. Quantitative microscopic techniques can be adapted. The most important perspective for a further improvement of gastric cytology lies in the development of methods for automation in tumor cell recognition. The present status of such techniques is presented.
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This report is based on own practical experiences with the Hematrak during seven months of daily use in the hematologic routine in a general hospital. We describe briefly the operation of the instrument. The importance of the preparation of the slides is stressed. In this respect a device for automatic smear preparation is mentioned. To test the reliability of the instrument the differential counts of the instrument were compared with manual results and regression values calculated. The reproducibility was checked and calculated. The next point of interest was the number and kind of cells determined as "suspect" by the instrument. Finally we tested how pathologic cells were detected and determined by the instrument.
The extravascular protein contents in the perivascular connective tissue of a rat's mesenterial plate was measured ultramicrospectrophotometrically in situ and in vivo after changing the hydrostatic and colloidosmotic pressures of the blood. We analized the perivascular area of the different microcirculatory vessels, arterioles, capillaries and venules. The perivascular protein contents, which corresponds besides arterioles to 40% and besides venules to 59% in comparison to the intravascular blood plasma, decreased in a comparison group under the osmotic influence of the perfusion liquid on the mesenterial plate. An injection of an isotonic saline solution is followed only by small fluctuations of the perivascular protein contents during one hour. After blood loss a transitional increase of extravascular protein at the perivenular area was observed indicating the mobilisation of protein depots. Around arterioles the extravascular protein contents did not change significantly. An intravenous injection of albumin solution was followed by a short-termed increase of tissue protein around the arterioles. Around the venules after 50 minutes the extravascular protein contents increased significantly. Within one hour after the changes of the permeability conditions the maximal induceable protein movements in the perivascular space were calculated as +/- 1.35 g% plasma protein concentration corresponding to a maximun protein exchange of +/- 3.1 mg ml(-1) tissue.
Gastric mucosa was obtained from 126 patients by endoscopic biopsy and subsequent cell brushing for histological, cytological and DNA cytophotometric studies. 23 cases were carcinomatous. DNA histogram evaluation for each case was carried out with special consideration of the position of the DNA stem line and the scatter of the measured DNA values. Additionally, DNA distribution characteristics were established for clinical or cytological diagnostic groups. By ascertaining relative mean ploidy values (U values) and relative frequency of euploid and polyploid values (Z values) in the sample populations, cell nuclear DNA determination was used as a criteria for differentiating between benign and malignant alterations of the stomach. The results allow optimistic prognosis concerning the use of cell nuclear DNA content as a significant, though not as the only measuring factor in automated diagnostic procedures.
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The cytology of the stomach aims at detecting the carcinoma. For the obtaining of cell material today mainly endoscopically well-aimed techniques are applied. In other words: The diagnostic results decisively depend on the abilities of the endoscopist who has to discover a suspect region in the stomach and to take off the material in a well-aimed way. Under these aspects and prerequisites, in fact, any type of stomach cancer can be cytologically diagnosed. For the differentiation between tumourous cells and non-tumorous cells the changes of the gastric mucosa with non-malignant diseases are important (chronic gastritis, ulcer, erosion) for the cytologist. Often, with stomach cancer the stomach cell findings resemble those arrived at with non-malignant stomach diseases. Characteristic cytological findings with gastritis, ulcer and erosions are demonstrated. The clinical diagnostics of these diseases is the task of endoscopy and biopsy. The problem of the so-called false positive cell findings is discussed. Ways towards a quantitative diagnostics are being opened by cytophotometric methods. The author states first experience of his own gathered by applying the DNA-determination in individual cells and in the flow-through method.
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The technique spontaneously or siphoned after cholecystokinin stimulation. Our technique of cell collection within the region of the duodenum, the pancreas and the bile-ducts have been optimal performed by duodenoscopical methods. From the papilla of Vater, the cell brush abrasion is used. Pancreatic secretions are obtained by praepapillary drainage with a catheter after secretin stimulation or siphoned after canulation of the ductus Wirsungianus. Bile is obtained wth the same technique of material collection and processing is described. Characteristical tumor cell findings of the papilla of Vater, of the pancreas and the bile ducts are demonstrated and the cytodiagnostic's position within the tumor recognition in this area is discussed. We think the tumor cell search with the described duodenoscopical techniques as indicated in following cases: 1. suspicion of carcinoma of papilla of Vater, 2.obstructve jaundice, 3. in search of carcinoma of the pancreas.
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