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T Schulz

Publications and source records attributed to T Schulz.

At least 91 records · Page 5Linked to original sources

Birt-Hogg-Dubé syndrome and Hornstein-Knickenberg syndrome are the same. Different sectioning technique as the cause of different histology.

The autosomal dominant inherited syndromes of Hornstein and Knickenberg (HKS), and Birt, Hogg and Dube (BHDS) are both characterized clinically by the overall spread of multiple flesh coloured papules of the skin. However, it is a matter of debate if colonic neoplasms (adenomas as well as adenocarcinomas) are associated findings in the HKS or rather in the BHDS. Furthermore, histological differences are said to exist between the skin lesions in the two syndromes: whereas perifollicular fibromas were described in the HKS, fibrofolliculomas and trichodiscomas were found in the BHDS. In the present study, we report on a father and his daughter in whom we initially diagnosed a BHDS. We then examined a greater number of the papular lesions in histologic sections cut vertically as well as horizontally to the epidermis. Our results indicate that the histologic differences between the skin lesions in the two syndromes are artificial ones, caused by interpretation of different sectioning planes, and that consequently HKS and BHDS are the same. Therefore, it is necessary to look for colonic polyps in the syndrome in question, regardless if one prefers the name HKS or BHDS for it.

Adult↗

Calculating the interindividual geometric standard deviation for use in the integrated exposure uptake biokinetic model for lead in children.

The integrated exposure uptake biokinetic (IEUBK) model, recommended for use by the U.S. Environmental Protection Agency at residential Superfund sites to predict potential risks to children from lead exposure and to establish lead remediation levels, requires an interindividual geometric standard deviation (GSDi) as an essential input parameter. The GSDi quantifies the variability of blood lead concentrations for children exposed to similar environmental concentrations of lead. Estimates of potential risks are directly related to the GSDi, and therefore the GSDi directly impacts the scope of remediation at Superfund sites. Site-specific GSDi can be calculated for sites where blood lead and environmental lead have been measured. This paper uses data from blood and environmental lead studies conducted at the Bingham Creek and Sandy, Utah, Superfund sites to calculate GSDi using regression modeling, box modeling, and structural equation modeling. GSDis were calculated using various methods for treating values below the analytical method detection and quantitation limits. Treatment of nonquantifiable blood lead concentrations affected the GSDi more than the statistical method used to calculate the GSDi. For any given treatment, the different statistical methods produced similar GSDis. Because of the uncertainties associated with data in the blood lead studies, we recommend that a range of GSDis be used when analyzing site-specific risks associated with exposure to environmental lead instead of a single estimate. Because the different statistical methods produce similar GSDis, we recommend a simple procedure to calculate site-specific GSDi from a scientifically sound blood and environmental lead study.

Algorithms↗

Diagnostic utility of the polymerase chain reaction in 2 cases of suspected Whipple disease.

We describe 2 patients with a diagnosis of Whipple disease in whom the usual antibiotic therapy failed. A polymerase chain reaction-based test was used to identify the recently described Whipple bacillus, Tropheryma whippelii. In one case, the diagnosis was confirmed, whereas in the second case, which had been histologically diagnosed as Whipple disease of the brain, the process was identified as a monocyte-derived histiocytosis. In conclusion, Whipple disease can be distinguished from other diseases with similar histological features with the use of a polymerase chain reaction-based test.

Actinobacteria↗

[Pancreas transplantation with bladder and intestinal drainage technique with systemic-venous and initial experiences with portal venous drainage. Which technique can be recommended today?].

The experience worldwide with pancreas transplantation includes more than 9000 cases. In the most popular patient group (simultaneous pancreas-kidney transplantation, SPK) the graft-function rate at 1 year now reaches more than 80%. More than 90% of all pancreas transplants were performed using the bladder-drainage technique (BD) with systemic venous anastomosis. Late problems with the BD require enteric conversion in 10-20% in the long term. In the present study we report the results of 40 SPK using the BD (n = 20) and enteric drainage (ED) techniques (n = 20). After 3 months, the patients pancreas and kidney survival rates in the BD group were 100, 95 and 100% and in the ED group 100, 100 and 100%, respectively. No anastomosis leakage occurred in either group. In two cases of the ED group the pancreas grafts were drained portal venously via the superior mesenteric vein without surgical complications. With growing experience, excellent SPK results can be reached with both the BD and ED techniques.

Adult↗

[Appearance of the resection area of brain tumors in intraoperative MRI imaging].

During MRI-controlled resection of brain tumors using an open MRI system, operation-induced alterations may occur, especially enhancement of the resection cavity wall. This may simulate tumor areas, resulting in false assessment of the resection or resection of non-tumorous areas. Based on 42 MRI- and biopsy-controlled brain tumor resections in an 0.5 T open MRI (Signa SP, GE), the appearance and origin of operation-induced reactions are analyzed. In our opinion, there is a superposition of preformed peritumoral reactions by operation-induced microcontusions. The beginning of the cavity wall enhancement needs at least 10-15 min. MRI-controlled analysis of the intraoperative steps by the neurosurgeon and neuroradiologist allows discrimination of operation-induced reactions from tumor areas and leads to safe operation.

Astrocytoma↗

The trichofolliculoma undergoes changes corresponding to the regressing normal hair follicle in its cycle.

The trichofolliculoma is a follicularly differentiated hamartoma, usually described as showing many vellus follicles, spreading from a central infundibular cyst. In spite of the well known regressive changes of normal hair follicles during catagen and telogen, the possibility of corresponding changes in the trichofolliculoma has not yet been discussed in the literature. By examining a total of 31 cases of trichofolliculoma it is demonstrated that this hamartoma undergoes an evolutionary process with great morphological changes, which can be attributed to the anagen, catagen, and telogen phase of the follicular cycle.

Adolescent↗

Folliculo-sebaceous cystic hamartoma is a trichofolliculoma at its very late stage.

Folliculo-sebaceous cystic hamartoma (FCH) was described as an entity recently and was defined as an adnexal hamartoma, showing above all an infundibular cystic structure linked to many sebaceous lobules. Differentiation toward the inferior segment of the hair follicle also occurs, although to a markedly lesser degree. Signs of regression and rest corresponding to the normal follicular cycle are often apparent in these follicular proliferations. Therefore so-called FCH has much in common with the newly described late stage of trichofolliculoma, which also exhibits an infundibular cyst and sebaceous and follicular differentiation with various signs of catagen and telogen. Comparing our 8 cases of FCH and 31 cases of trichofolliculoma, we came to the conclusion that FCH is the very late stage of trichofolliculoma. This stage could be characterized by a nearly complete regression of the transient follicular epithelium, whereas concurrent growth and maturation of sebaceous elements appear.

Adolescent↗

Molecular genetics of root gravitropism and waving in Arabidopsis thaliana.

When Arabidopsis thaliana seedlings grow embedded in an agar-based medium, their roots grow vertically downward. This reflects their ability to sense the gravity vector and to position their tip parallel to it (gravitropism). We have isolated a number of mutations affecting root gravitropism in Arabidopsis thaliana. One of these mutations, named arg1, affects root and hypocotyl gravitropism without promoting defects in starch content or in the ability of seedlings' organs to respond to plant hormones. The ARG1 gene was cloned and shown to code for a protein with a J domain at its amino terminus and a second sequence motif found in several cytoskeleton binding proteins. Mutations in the AGR1 locus promote a strong defect in root gravitropism. Some alleles also confer an increased root resistance to exogenous ethylene and an increased sensitivity to auxin. AGR1 was cloned and found to encode a putative transmembrane protein which might be involved in polar auxin transport, or in regulating the differential growth response to gravistimulation. When Arabidopsis seedlings grow on the surface of agar-based media tilted backward, their roots wave. That wavy pattern of root growth derives from a combined response to gravity, touch and other surface-derived stimuli. It is accompanied by a reversible rotation of the root tip about its axis. A number of mutations affect the presence or the shape of root waves on tilted agar-based surfaces. One of them, wvc1, promotes the formation of compressed root waves under these conditions. The physiological and molecular analyses of this mutant suggest that a tryptophan-derived molecule other than IAA might be an important regulator of the curvature responsible for root waving.

Arabidopsis↗

[Splenic abscess. Diagnosis and treatment].

A diagnosis of hospital discharges shows splenic abscess to be a rare condition, with one case per 10,000 discharges. Haematogenous seeding to the spleen from an infection at a distant site, most often endocarditis, has been the most common predisposing condition but an increase has been observed in immuno-suppressed patients too. Fever, leukocytosis and left upper quadrant pain are suggestive, but the signs and symptoms of splenic abscesses are often non-specific. Ultrasound and computed tomography are reliable diagnostic tools. Splenectomy and antibiotics have been the treatments of choice, with increasing use of percutaneous drainage as an alternative, in order to preserve splenic function. We describe a patient with a salmonella splenic abscess that was treated with percutaneous drainage and ciprofloxacin.

Abscess↗

Expression and immunogenicity in rats of recombinant adenovirus 5 DNA plasmids and vaccinia virus containing the HTLV-I env gene.

The complete human T-cell leukemia virus type I (HTLV-I) env gene was inserted into an expression cassette containing the adenovirus 5 major late promoter (Ad5-MLP). Recombinant Ad5-HTLV-I-env was obtained by homologous recombination in 293 cells simultaneously transfected by the expression cassette and the genomic DNA of Ad5. In vitro expression of the HTLV-I-env gene in the recombinant vector was detected by immunofluorescence and Western blotting. Functional expression of HTLV-I-env was confirmed by syncitium formation specifically in HeLa cells infected with Ad5-HTLV-I-env. Two immunization regimens against HTLV-I were tested in WKY and Fischer F-344 rats. The first involved WKY rats primed with Ad5-HTLV-I-env or naked DNA plasmids containing the HTLV-I-env gene and boosted with Ad5 containing the HTLV-I-env gp46 gene or with baculovirus-derived recombinant gp46. No antibody against HTLV-I was detected, while HTLV-I-specific cytotoxic T lymphocytes were recovered from all immunized groups but not from controls. The second approach involved Fischer F-344 rats primed and boosted with recombinant vaccinia virus containing the HTLV-I-env gene. Such rats developed antibodies against the HTLV-I env gp21 and gp46 (non-neutralizing). After challenge with human HTLV-I-producing cells (MT-2), both immunization regimens were found to induce partial protection.

Adenoviridae↗

Simultaneous pancreas-/kidney transplantation--the Bochum experience.

Since the introduction of the bladder drainage technique, the number of pancreas transplants performed has now reached 1,000 per year worldwide. Most of these transplants have been performed in the United States. In contrast, the number of pancreas transplants performed in the Eurotransplant community has remained at a low level for several years. The results of a consecutive series of 40 simultaneous pancreas/kidney transplantations (SPK) performed between June 1994 and July 1996 demonstrate that high 1-year graft function rates of 87.1% for pancreas and 94.8% for kidney grafts can be achieved. Therefore, SPK can be recommended as a standard procedure for patients with insulin-dependent diabetes mellitus and end-stage renal disease in Germany, too.

Adult↗

Merkel cells are absent in basal cell carcinomas but frequently found in trichoblastomas. An immunohistochemical study.

The possibility of a neuroendocrine differentiation in basal cell carcinomas (BCCs) has been a matter of debate for many years. In the present immunohistochemical study, applying the cytokeratins 8, 18 and 20 as the most established markers for Merkel cells (MCs), we did not find elevated numbers of MCs in any of 205 BCCs. This speaks against a neuroendocrine line of differentiation in BCCs. In contrast, we found various amounts of MCs in 15 of 36 trichoblastomas, which are the main benign differential diagnosis of BCC. In 4 trichoblastomas abundant MCs were spread over the whole epithelial tumor area. Additionally, the trichoblastomas' overlying epidermis exhibited significantly much higher numbers of MCs than the uninvolved adjacent skin or the epidermis overlying the BCCs. These findings might be an additional aid in the distinction between trichoblastomas and BCCs. Furthermore, concerning the recent discussion about the role of MC in growth and development of follicular germ, our observations are another sign of regulative influences of the MC, also in follicular germ under pathological conditions. Trichoblastomas with high numbers of MCs could be characterized as showing advanced differentiation toward the neuroendocrine component of the hair follicle, i.e., the MCs.

Basal Cell Carcinoma↗

Merkel cell hyperplasia in chronic radiation-damaged skin: its possible relationship to fibroepithelioma of Pinkus.

Moderate hyperplasia of Merkel cells (MC) in chronic sun-damaged skin and hypertrophic actinic keratoses is well known. In the present study we investigated the number of MC in 24 samples of chronic radiation dermatitis and 19 cases of fibroepithelioma of Pinkus (FP), which is known to arise preferably in radiation-damaged skin. Using antibodies against the low molecular weight cytokeratins 8, 18, and 20 and chromogranin A to visualize MC, we found hyperplasia of MC in chronic radiation dermatitis. Additionally, in all FPs we could detect many MC, especially in areas with a pronounced fenestrated pattern. Recently, regulative functions of MC on the growth of follicular epithelium under various conditions were discussed. Thus, MC hyperplasia suggests a causal role also in the development of FP. In this context, hyperplasia of MC in chronic radiation dermatitis could explain the frequent occurrence of FP due to radiation exposure. As we recently found MC also in trichoblastomas but not in basal-cell carcinomas, the MC in FP may indicate its relationship to the benign trichoblastoma rather than to the basal-cell carcinoma. It is possible that regulative influences of the MC are important for the clinically rather benign course of FP.

Aged↗