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Biomedical subjects

W Hartschuh

Publications and source records attributed to W Hartschuh.

At least 37 records · Page 2Linked to original sources

Analysis of losses of heterozygosity of the candidate tumour suppressor gene DMBT1 in melanoma resection specimens.

Deleted in malignant brain tumours 1 (DMBT1), a candidate tumour suppressor gene located on chromosome 10q25.3-q26.1, has recently been identified and found to be deleted in several different types of human tumours. In melanomas, the chromosomal region 10q22-qter is commonly affected by losses, hence we screened primary melanoma samples for losses of heterozygosity (LOH), and acquired melanocytic naevi and melanomas for transcription of DMBT1 and protein expression. Of 38 informative melanomas, 1 nodular melanoma and 2 subcutaneous metastases showed LOH of both microsatellites flanking the gene, suggesting loss of 1 DMBT1 allele. Three further melanomas showed LOH at 1 informative locus but were heterozygous for the second marker. Applying reverse-transcription polymerase chain reaction (RT-PCR), DMBT1 transcription was not found in melanomas. However, DMBT1 transcription was also absent from the majority of naevi from which melanomas frequently arise, making down-regulation of gene transcription during transformation from naevus to melanoma unlikely. Immunohistochemistry showed nerves, sweat glands and the stratum spinosum of the epidermis to be DMBT1 protein positive, whereas the naevi and melanoma cells themselves were negative. All considered, the candidate tumour suppressor gene DMBT1 does not appear to be a major inactivation target in the development of melanomas.

Agglutinins↗

[Merkel cell carcinoma: a diagnostic and therapeutic challenge].

Merkel cell carcinoma (cutaneous neuroendocrine carcinoma) is a highly malignant, neuroendocrine skin tumor. It mostly occurs in elderly patients in the sun-exposed skin of the head and neck and the extremities. Merkel cell carcinomas develop as fast-growing dermal tumors. They are characterized by a high frequency of lymph-node metastases (50%) and local recurrences (25-77%). The 5-year survival rate is 30-74%. Histology reveals uniform, round cells with a small cytoplasmic rim expressing cytokeratin 20, neurofilament, synaptophysin, chromogranin, and neuron-specific enolase. Ultrastructurally, 100-200 nm electron dense granules are typical findings. Wide surgical excision, followed by radiotherapy, is the treatment of choice. Regional lymph-node metastases should be treated by radical lymph-node excision and radiotherapy. In advanced metastatic Merkel cell carcinoma, a remission can be achieved by different chemotherapy schedules or the somatostatin analogue octreotide. However, the prognosis remains poor. The current knowledge about this disease and guidelines for effective diagnosis and treatment are given.

Biomarkers, Tumor↗

[Benign melanosis of the lip. Treatment with the Q-switched ruby laser].

BACKGROUND AND OBJECTIVE: Benign melanosis of the lip represents a cosmetic problem for many of those who are afflicted. It responds well to therapy with Q-switched lasers. The value of previous studies has been limited by small numbers of cases or short follow-up times. PATIENTS/METHODS: In a retrospective study 9 patients were treated by the Q-switched ruby laser (694 nm, pulse duration 25-40 ns, spot size 4 mm, energy density 10 J/cm2) in the period from 5/94 to 10/99. The benignity of the lip melanosis was determined dermatoscopically. In one case, the diagnosis was also confirmed histologically by a punch biopsy. The follow-up time was between 6 months and 5 1/2 years. RESULTS: In 3 cases a complete clearance of the melanosis was achieved after one session, while in 6 patients a second treatment was required. There were no recurrences. Scars or pigment alterations were likewise not observed. CONCLUSIONS: The treatment of benign melanosis of the lip with the Q-switched ruby laser is an elegant and safe method with excellent cosmetic results.

Adult↗

Koebner phenomenon due to scratch test in scleromyxoedema.

The Koebner phenomenon or isomorphic response was originally described in psoriasis and has subsequently been observed in various other diseases. We report a patient with isomorphic response in scleromyxoedema, a variant of papular mucinosis with diffuse infiltration of the skin. The Koebner phenomenon was due to a scratch test performed 4 weeks before the appearance of streaky, lichenoid infiltrations on the forearms.

Cyclophosphamide↗

Malignant transformation of multiple dermal cylindromas.

Cylindromas are benign tumours arising as small, solitary, slow-growing nodules on the head and neck. Multiple cylindromas may form a 'turban tumour' in the autosomal dominant Brooke-Spiegler syndrome. We report two unusual cases of multiple cylindromas with transformation into cylindrocarcinomas. The first patient, a 63-year-old white woman, developed a cylindrocarcinoma on pre-existing multiple cylindromas on her right shoulder. Eight months after resection she developed a lymph node metastasis in the right axilla. The second patient, a 68-year-old white woman, presented with multiple cylindromas of the scalp. One of these transformed into a cylindrocarcinoma, infiltrating the dura mater, with local recurrence 2 years after incomplete resection and postoperative radiation.

Aged↗

Localized Birt-Hogg-Dubé syndrome with prominent perivascular fibromas.

The autosomal dominant Birt-Hogg-Dubé syndrome is a cutaneo-intestinal condition that manifests on the skin in the form of multiple, skin-colored small papules that, histologically, prove to be mantleomas (fibrofolliculomas and trichodiscomas). These cutaneous lesions usually appear in the region of the head, neck, and upper part of the trunk. To date, only a single report in the literature describes the localized occurrence of this syndrome. We now describe a localized form of the Birt-Hogg-Dubé syndrome in a man with multiple mantleomas that were confined to the left half of the face, and which, in part, were arranged in the form of plaques. Another striking finding in this patient was a conspicuous vascular component in the lesions, characterized by a pronounced, well-demarcated fibrosis in the region of cutaneous blood vessel proliferations. Because perivascular fibromas have already been observed in other patients with Birt-Hogg-Dubé-syndrome, the perivascular fibroma, with fibrofolliculoma and trichodiscoma, must be included within this syndrome's spectrum of skin changes.

Adult↗

Cytokeratins as markers of follicular differentiation: an immunohistochemical study of trichoblastoma and basal cell carcinoma.

Trichoblastoma(s) (TB) are benign neoplasms of follicular differentiation frequently found in nevus sebaceus. Many morphologic features are shared with nodular basal cell carcinoma(s) (BCC), sometimes rendering the differential diagnosis difficult. Because both neoplasms can simulate components of mature hair follicles histologically, we attempted to corroborate this by immunohistochemical examination of cytokeratins and hair keratins differentially expressed in the hair follicle. Trichoblastoma(s) and BCC showed homogenous expression of CK14 and CK17. The innermost cells of the tumor nodules in all TB and in 72% of BCC were positive for CK6hf. Using a specific CK15 antibody, 38% of TB showed a focal labeling and all BCC remained negative; 70% of TB and 22% of BCC expressed CK19. CK8 was expressed by numerous Merkel cells present in all TB but in none of the BCC examined. All type I and II hair keratins tested, (especially hHa1, hHa5, and hHa8) remained negative in all tumors examined. Trichoblastoma(s) and BCC show consistent expression of CK6hf, CK14, and CK17; variable expression of CK15 and CK19; and absence of hair keratins. This indicates a differentiation toward the outer root sheath epithelium or the companion layer and not toward the inner root sheath, matrix, or cortex.

Biomarkers, Tumor↗

[Interstitial granulomatous dermatitis with arthritis].

Interstitial granulomatous dermatitis with arthritis is a rare dermatologic disorder seen in patients suffering from diseases in which circulating immune complexes occur. The typical cutaneous signs are linear cords usually located on the lateral aspect of the trunk. The characteristic, although not specific, histology reveals a dense diffuse infiltrate composed mostly of histiocytes, accompanied by neutrophils and eosinophils, and degenerated collagen surrounded by palisades of histiocytes. We discuss this disorder and its differential diagnosis.

Arthritis, Rheumatoid↗

[Presentation of pyoderma gangraenosum in a dermatologic atlas of the early 19th century].

Pyoderma gangrenosum was first described in 1930 by Brunsting, Goeckermann and O'Leary. Nevertheless we found some illustrations in an atlas on dermatology, published by Marie-Nicolas Devergie in the first half of the 19th century, which appear to be pyoderma gangrenosum. In addition to discussions of typical syphilitic affections of the skin, Devergie's "Clinique de la Maladie Syphilitique" includes illustrations of gangrenous ulcers, which appeared unexpectedly after local and systemic therapy with mercury. Devergie interpreted those enlarging ulcers as a side effect of mercury therapy. Thus we were able to find evidence of pyoderma gangrenosum more than 100 years before first description in 1930. The etiology of this clinical picture is still unsettled. The favorite postulate has been a bacterial genesis which was the subject of numerous publications until the 1960s.

Atlases as Topic↗

[Biker's nodule"--perineal nodular induration of the cyclist].

The "biker's nodule" is a rarely appearing perineal nodular induration of the cyclist. Repeated microtrauma to the subcutaneous fatty tissue or collageneous tissue, caused by pressure or vibration which the bicycle's saddle exerts on the perineal region, leads to collagenous degeneration, myxoid alteration and pseudocyst formation. Because of the painful subcutaneous nodules the patient is often forced to reduce or even give up his training. Therapy of the "biker's nodule" consists in avoiding the pathogenetic factors, i.e. giving up training for a temporary period of time and reducing pressure on the perineal region. Intralesional injection of either hyaluronidase or corticosteroids may also be helpful.

Adipose Tissue↗

[Ultrasound imaging of the sentinel lymph node in malignant melanoma].

BACKGROUND AND OBJECTIVE: In the therapy of malignant melanoma sentinel lymph node(SLN) excision has assumed increased importance. The localization of the sentinel node is possible by lymphoscintigraphy and gamma probe guidance. Aim of the study was to prove whether SLN can be identified sonographically. PATIENTS/METHODS: 23 patients (16 women, 7 men; average age 42.7 years) with malignant melanoma required SLN excision. Before the patient underwent lymphoscintigraphy, sonography of the regional lymph nodes was performed. The position of lymph nodes (LN) with asymmetrical extension of the cortical substance was marked cutaneously according to the probe position in two axis (M1). During lymphoscintigraphy the gamma probe position orthograd to the skin with the highest count rate was marked (M2). Then a second sonography of the region was performed. RESULTS: In all patients M1 and M2 marked the same point. During the operation the sonographically documented position of the SLN could be confirmed in all cases. The second sonography after the lymphoscintigraphy showed a more blurred distinction between the cortical substance and the center of the lymph nodes. CONCLUSIONS: Our results show that sonography allows an identification of SLN. We think that the preoperative sonography of the SLN is an important supplementary method in addition to lymphoscintigraphy.

Adult↗

Transient complete remission of metastasized Merkel cell carcinoma by high-dose polychemotherapy and autologous peripheral blood stem cell transplantation.

Merkel cell carcinoma (MCC) is a rare cutaneous tumour with neuroendocrine differentiation. Metastasis occurs preferentially to regional lymph nodes but distant and multiple visceral metastases may occur. Chemotherapy has been performed with a variety of protocols based largely on agents active in small-cell lung cancer. Owing to the rarity of MCC, there is no standard protocol for the treatment of metastatic disease. We report a 59-year-old patient with systemic metastatic MCC. After diagnosis of distant metastases, first-line polychemotherapy (cisplatin 80 mg m(-2), doxorubicin 50 mg m(-2), etoposide 300 mg m(-2) and bleomycin 30 mg) was administered four times at 3-weekly intervals and resulted in partial remission of metastases. Subsequently, high-dose chemotherapy according to the PEI regimen (ifosfamide 12 g m(-2), carboplatin 900 mg m(-2) and etoposide 1500 mg m(-2)) was applied, followed by autologous blood stem cell transplantation (ABSCT). This protocol resulted in a complete remission that lasted for 6 months. This is the first report on a complete remission of metastatic MCC after high-dose polychemotherapy and ABSCT. High-dose chemotherapy might be a therapeutic option in chemosensitive metastatic MCC, and further evaluation is warranted.

Antineoplastic Combined Chemotherapy Protocols↗

Angiogenic switch occurs late in squamous cell carcinomas of human skin.

Angiogenesis is a crucial event in carcinogenesis and its onset has been associated with premalignant tumour stages. In order to elucidate the significance of angiogenesis in different stages of epithelial skin tumours, we analysed the vessel density in ten normal skin samples, 14 actinic keratosis (AK), 12 hypertrophic AKs, and in nine early- and 16 late-stage squamous cell carcinomas (SCCs). Mean vascular density was quantitated by counting the number of CD 31-immunostained blood vessels and by morphometric assessment of stained vessel area by computer-assisted image analysis. The results from both methods were well correlated. Mean vascular density was similar in normal dermis and in AK, and only slightly elevated in hypertrophic AKs and early SCC stages (tumour thickness < 2 mm). Only late-stage SCCs infiltrating the subcutis exhibited a significant increase in vascularization. Vessel density was independent of tumour localization, degree of proliferation and inflammatory cell infiltration. Furthermore, tumour vascularization was not correlated with the expression of vascular endothelial growth factor, a major angiogenic factor, as revealed by in situ hybridization and immunohistochemistry. The restriction of enhanced vascularization to increased tumour thickness may be a major reason for the rather low metastatic spread of cutaneous SCCs.

Carcinoma, Squamous Cell↗

Localization of xenin-immunoreactive cells in the duodenal mucosa of humans and various mammals.

Xenin is a 25-amino-acid peptide extractable from mammalian tissue. This peptide is biologically active. It stimulates exocrine pancreatic secretion and intestinal motility and inhibits gastric secretion of acid and food intake. Xenin circulates in the human plasma after meals. In this study, the cellular origin of xenin in the gastro-entero-pancreatic system of humans, Rhesus monkeys, and dogs was investigated by immunohistochemistry and immunoelectron microscopy. Sequence-specific antibodies against xenin detected specific endocrine cells in the duodenal and jejunal mucosa of all three species. These xenin-immunoreactive cells were distinct from enterochromaffin, somatostatin, motilin, cholecystokinin, neurotensin, and secretin cells, and comprised 8.8% of the chromogranin A-positive cells in the dog duodenum and 4.6% of the chromogranin A-positive cells in human duodenum. In all three species, co-localization of xenin was found with a subpopulation of gastric inhibitory polypeptide (GIP)-immunoreactive cells. Immunoelectron microscopy in the canine duodenal mucosa demonstrated accumulation of gold particles in round, homogeneous, and osmiophilic secretory granules with a closely adhering membrane of 187 +/- 19 nm diameter (mean +/- SEM). This cell type was found to be identical to the previously described canine GIP cell. Immunocytochemical expression of the peptide xenin in a subpopulation of chromogranin A-positive cells as well as the localization of xenin immunoreactivity in ultrastructurally characterized secretory granules permitted the identification of a novel endocrine cell type as the cellular source of circulating xenin.

Amino Acid Sequence↗

[Extragenital lichen sclerosus et atrophicus - treatment with pulsed dye laser].

A 17-year old female patient with extragenital lichen sclerosus et atrophicus was treated with the pulsed dye laser. Local and systemic therapy before treatment showed no effect. The lesions were removed completely with four treatment sessions. As for side effects, no pigment changes and no visible scarring was observed. The patient experienced no recurrence within a follow-up time of 7 months. The mechanism whereby lichen sclerosus et atrophicus is altered by the pulsed dye laser is unknown.

Adolescent↗