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W Remmele

Publications and source records attributed to W Remmele.

At least 19 recordsLinked to original sources
PubMed2000

[Effectiveness and efficiency of ambulatory diabetes education programs. A comparison of specialty practice and general practice].

BACKGROUND AND OBJECTIVE: The increasing incidence of NIDDM requires adequate proof of the effectiveness and efficiency of out-patient programmes for diabetics. This study aimed at examining which of the two methods may promise the better results under controlled expenses--modifications of the present standardized diabetes education program in the general practice or specifically developed diabetes education programme in specialist diabetes practice. PATIENTS AND METHODS: 75 diabetics took part in the different out-patient diabetes education programmes at one special practice for diabetology or one of seven general practitioner practices, respectively. The self-developed intensive diabetes education programme of the special practice led by two specialists in diabetology and a dietician was compared with the diabetes education programme of the general practices performed by a doctor's assistant. 38 diabetics in eight training groups at the specialist for diabetology and 37 patients in seven training groups at the general practices were instructed. 32 patients in total (18 patients at the specialist practice and 14 patients at the general practices) additionally received an evaluated support programme which addressed psychosocial impediments related to the topics of a structured diabetes therapy. All patients were asked to complete a questionnaire before, right after, 3 and 6 months after the programme. Weight and glycosylated haemoglobin (HbA1c) were measured before, 3 and 6 months after the programme. RESULTS: The mean weight and glycosylated hemoglobin of all groups decreased as expected. However, the patients of the general practices achieved more lasting reduction of these objective parameters. All patients stated impairments of their quality of life, but the patients of the specialist practice felt more impaired. The motivational support programme achieved only few positive results. CONCLUSION: The standardized diabetes education programme of the general practices and the more intensive and expensive diabetes education programme achieved equally valuable results. Regarding time and expenses, the standardized diabetes education programme may be the more efficient method of NIDDM out-patient education.

Aged↗
PubMed1996

Pyloric gland type adenoma of the gallbladder with squamoid spindle cell metaplasia.

This study documents a pyloric gland type adenoma of the gallbladder with prominent spindle cell metaplasia arising in a 61 year-old woman. A pedunculated polyp, 1.5 x 1.0 x 1.0 cm, was histologically diagnosed as a tubular adenoma. Most glandular structures showed positivity for a monoclonal antibody M2 (2B5) which indicates a differentiation to pylotic gland type. The spindle cell component displayed no apparent epithelial structures but stained mostly positive for pancytokeratin and cytokeratin (CK) 18, and focally for CK 5 + 6, CKs 7 and 19, whereas CKs 8, 13, 20, and non-epithelial markers could not be demonstrated. This suggests that the spindle cells were immature epithelial cells differentiating towards squamous and/or glandular cells. Even in spindle cell areas, the nuclear atypia was mild, and proliferating cells positive for MIB-1 (Ki-67) antigen were infrequently seen. This unique phenomenon, of which only three cases have been previously reported, is considered to represent benign squamoid spindle cell metaplasia.

Adenoma↗
PubMed1996

Lipid islands in human gastric mucosa: morphological and immunohistochemical findings.

BACKGROUND & AIMS: Lipid islands are a common finding in the gastric mucosa, but their pathogenesis has not yet been established. The aim of this study was to investigate the morphology and immunophenotype of the various cells in lipid islands and to consider the possible mechanisms involved in the pathogenesis of these lesions. METHODS: Morphological and immunohistochemical investigations using antibodies against macrophages, smooth muscle cells, and lymphocytes were performed. Unfixed tissue was available for immunostaining for low-density lipoprotein (LDL) and oxidized LDL in one case. RESULTS: The lipid islands were composed of KP1-, KiM1p-, and cathepsin D-positive foam cells that were only weakly reactive for lysozyme. In cryostat sections, the foam cells were found to contain LDL and oxidized LDL. A few smooth muscle cells, plasma cells, lymphocytes, pericytes, fibroblasts, and Schwann cells that contained lipid droplets were also found. CONCLUSIONS: In gastric lipid islands, the presence of oxidized LDL, which is taken up by macrophages and smooth muscle cells via scavenger receptors, suggests that oxidized LDL is of key significance in the development and persistence of these lesions. Because the metabolism of LDL to oxidized LDL may occur by various mechanisms, various different initial conditions, including gastritis, may precede the development of lipid islands. Thus, anti-inflammatory treatment may be appropriate.

Foam Cells↗
PubMed1995

Estimation of the proliferative activity of human breast cancer tissue by means of the Ki-67 and MIB-1 antibodies--comparative studies on frozen and paraffin sections.

The estimation of the Ki-67 index in human breast cancer tissue has been proven to be a useful prognostic tool. The examination can be performed, however, only on frozen sections (FS). The development of an antibody directed against parts of the Ki-67 antigen (MIB-1) has opened a new route to determine the proliferative activity on paraffin sections (PS). MIB-1 immunohistochemistry is used instead of Ki-67 immunohistochemistry if a tumour is delivered to the pathologist after formalin fixation or if that part of the tissue suspicious for breast cancer must be totally embedded in order to confirm the diagnosis. The present study compares the findings of Ki-67 (FS) and MIB-1 (FS and PS) immunohistochemistry in a total of 544 cases of human breast cancer. The findings confirm a good statistical correlation between the Ki-67 and the MIB-1 findings. The MIB-1 results are 2-2.5 times higher in FS than in PS. Good agreement exists between the Ki-67 indices determined on FS and the MIB-1 indices determined on PS. If the cut-off value for the separation of Ki-67 negative and positive cases is defined as 10%-20%, a MIB-1 index in PS of 10% permits the correct prediction of a negative Ki-67 index in 97% of the cases, and a MIB-1 index of 30% or more correctly predicts a positive Ki-67 index in 90% or more of the cases. Hence, the determination of the MIB-1 index on PS may replace the determination of the Ki-67 index on FS with a high degree of probability.

Adult↗
PubMed1993

Comparative biochemical and immunohistochemical studies on the cathepsin D content of human breast cancer.

Cathepsin D (CD) has been introduced as a predictor of prognosis in patients with breast cancer due to its mitogenic effect and its role in tumour metastasis. Commonly, the CD content of tumours is examined by means of a biochemical method based upon the use of monoclonal antibodies, and immunohistochemical visualization of CD has not been used extensively. The present study compares the biochemical and immunohistochemical findings in 216 cases of human breast cancer. CD may occur in tumour cells and/or macrophages. Correlation of immunohistochemically determined CD content and biochemical CD content is better in tumour cells than in macrophages. The possible causes of this observation are briefly discussed. Although a statistical correlation between the biochemical and the immunohistochemical CD findings exists, the results in individual cases vary within a wide range. Hence, the results of biochemical and immunohistochemical CD assay in an individual tumour cannot be compared directly.

Breast Neoplasms↗
PubMed1993

Relation of elastosis to biochemical and immunohistochemical steroid receptor findings, Ki-67 and epidermal growth factor receptor (EGFR) immunostaining in invasive ductal breast cancer.

We studied 1073 cases of invasive ductal breast cancer, NOS for their elastic content (DEL, ductal+periductal elastosis; TEL, tumour elastosis) and compared the findings with the results of biochemical and immunohistochemical steroid hormone receptor examination. Tumours of patients up to 50 years of age and older were examined separately. In a number of tumours elastosis was also examined in relation to Ki-67 and epidermal growth factor receptor (EGFR) immunostaining. Sensitivity and specificity of DEL and TEL for predicting the receptor, Ki-67 and EGFR findings were estimated. Sensitivity of DEL and TEL for oestrogen and progesterone receptors is dependent on the degree of tumour differentiation and the degree of elastosis, increasing from DEL 1 degree and TEL 1 degree to DEL 3 degrees and TEL 3 degrees. It was more evident in grade 1 (G1) and G2 than in G3 carcinomas. Elastosis is a useful predictor of positive receptor findings particularly in G1 and G2 tumours with moderate and high-grade elastosis. It is a similarly useful predictor of negative receptor values in G3 carcinomas. The predictive value of DEL and TEL for the results of Ki-67 and EGFR immunostaining gradually decreases with increasing elastosis, consistent with the assumption that Ki-67 and EGFR identify the degree of tumour proliferation and invasion, while elastosis correlates with the degree of differentiation of breast cancer. Elastosis is a poor predictor of Ki-67 and EGFR findings in any individual breast cancer. Moderate and high-grade elastosis points to positive steroid hormone receptor assays in G1 and G2 carcinomas. In contrast, the lack of elastosis in G3 carcinomas may indicate a negative receptor assay. Both findings have a high degree of reliability.

Breast Neoplasms↗
PubMed1993

Immunohistochemical determination of estrogen and progesterone receptor content in human breast cancer. Computer-assisted image analysis (QIC score) vs. subjective grading (IRS).

Immunohistochemistry of Estrogen Receptor (ER) and Progesterone Receptor (PR) has been performed in 687 cases of human breast cancer. The staining results have been compared by (1) computer-assisted image analysis (QIC Score) and (2) subjective grading of the cryostat sections ("German" IRS). Tumors without or with only weak ER or PR content may be distinguished by both methods from tumors with a high receptor content. The QIC Score values belonging to the intermediate IRS grades are distributed over a wide range, but no negative cases were found in these categories. It is concluded from our results that subjective grading of the slides is a simple, rapid and useful method for the determination of the tissue receptor content and must not be replaced by the expensive and time-consuming computer-assisted image analysis in daily practice.

Breast Neoplasms↗
PubMed1992

Serous papillary cystic tumor of borderline malignancy with focal carcinoma arising in testis: case report with immunohistochemical and ultrastructural observations.

A 59-year-old white man presented with painless scrotal swelling, a symptom he stated he had had for "several decades." Pathologic examination (conventional stainings, immunohistochemistry, and electron microscopy) revealed a cystic papillary tumor that was classified as a serous papillary cystadenoma, ovarian type, of borderline malignancy, with focal transition into invasive cancer. This appears to be the ninth reported case of testicular tumors of the serous or mucinous ovarian type and the first reported case with development of a circumscribed carcinoma from serous cystadenoma of borderline malignancy.

Cystadenoma↗
PubMed1990

Clinical and morphological characteristics of early gastric cancer. A case-control study.

We investigated whether previously reported differences between the frequency and survival of patients with early gastric cancer in Europe and Japan represent a selection phenomenon or differences in tumor biology. Within a 10-year period, early gastric cancer was diagnosed in 51 outpatients and advanced gastric cancer in 190 patients, amounting to a 21.2% incidence of early gastric cancer. Patients with early gastric cancer had an age distribution and clinical presentation similar to those of patients with benign gastric ulcers (589) but markedly different from those in patients with advanced cancer. Histological types and tumor locations were comparable in patients with early and advanced gastric cancer, indicating a close relationship between the two neoplasms. Patients with early gastric cancer had markedly higher 5-yr survival rates (83.4%) than those with advanced gastric cancer (14.5%) and did not differ in this regard from patients with benign gastric ulcers (82.9%). None of the 51 patients with early gastric cancer died of disseminated cancer. If survival rates were estimated for matched pairs with comparable age, sex, and length of follow-up, these data remained essentially unchanged (early gastric cancer: 83.4%, 95% confidence interval 73.2%-93.4%; gastric ulcer: 87.8%, 95% confidence interval 74.7%-94.3%). We conclude that early gastric cancer in European patients is comparable to early gastric cancer in Japan with regard to its morphology, clinical presentation, and curability. Early investigation of patients with significant gastrointestinal symptoms may improve the prognoses of patients with gastric cancer.

Age Factors↗
PubMed1989

Three other types of duodenal polyps: mucosal cysts, focal foveolar hyperplasia, and hyperplastic polyp originating from islands of gastric mucosa.

Seven cases are reported that initially presented on endoscopic examination as duodenal polyps originating from islands of gastric mucosa within the duodenal bulb. Microscopic examination revealed mucosal cysts (MC), focal foveolar hyperplasia (FFH), and hyperplastic polyp (HPP). These lesions must be added to the list of neoplastic and tumorlike lesions of the duodenum that may endoscopically present as polyps.

Aged↗
PubMed1988

Follow-up of patients with colonic polyps containing severe atypia and invasive carcinoma. Compliance, recurrence, and survival.

Between January 1975 and December 1984 1769 polyps were endoscopically removed from 1219 patients. Eight percent of these patients had polyps containing severe atypia and 5.0% had polyps containing invasive cancer. A close postoperative surveillance program was followed by only a few patients, but compliance improved with longer follow-up intervals. Metachronous polyps were observed with similar frequency in patients with benign polyps (34.8%) and those with polyps containing severe atypia (23.8%) or cancer (41.7%). Patients in whom malignant polyps were endoscopically removed had a 5-year survival rate of 84.3% that did not differ from that of patients' whose polyps contained severe atypia (79.0%). It was concluded that endoscopic removal of malignant polyps with favorable histologic conditions does not impair survival. The follow-up program of these patients should be adapted to that of patients with benign polyps, a procedure that may even improve patient compliance.

Actuarial Analysis↗
PubMed1988

Primary signet-ring cell carcinoma of the prostate.

The occurrence of signet-ring cells within a mucinous prostatic carcinoma is an extremely rare finding. This cancer is characterized by both intracellular retention and extracellular secretion of mucinous material. We report a case of primary signet-ring cell carcinoma of the prostate that was confirmed by autopsy. The results of gross, microscopic, and immunohistochemical examinations are described.

Adenocarcinoma, Mucinous↗
PubMed1988

Multiple lipid islands of the colonic mucosa. A light and electron microscopic study.

Light and electron microscopic findings in a case of multiple lipid islands of the sigmoid mucosa are described. The patient apparently represents the second case with these lesions published in the medical literature. Lipid droplets were found in histiocytes, pericytes, smooth muscle cells, and Schwann cells. Pathological alterations of the nervous system in lipid islands have not been described before. The accumulation of lipids in different cell types of the colonic mucosa and the alterations of nervous elements are probably due to toxic factors reaching the cells either from the intestinal lumen or from the blood stream. The term "lipid proctitis (colitis)" does not appear to be useful because the lipid islands are obviously no disease sui generis but an epiphenomenon of other pathological processes. Pathological differential diagnosis and clinico-pathological correlation of colorectal lipid islands are briefly discussed.

Colon, Sigmoid↗
PubMed1988

Primary mesenteritis, mesenteric fibrosis and mesenteric fibromatosis. Report of four cases, pathology, and classification.

Primary mesenteritis is a rare disease. Two cases and two additional patients with mesenteric fibrosis/fibromatosis are reported. A classification of primary and secondary mesenteritis is suggested in order to replace the confusing variety of terms used for the same disease process. Differential diagnosis of mesenteric fibrosis versus mesenteric fibromatosis may be difficult, and some criteria for the separation of these two entities are discussed. Among the clinical symptoms, transmission of aortic pulsations to the anterior abdominal wall is a rare but important aid for diagnosis. Associated diseases are malignant lymphoma, colonic adenomatosis (Gardner's syndrome) and retroperitoneal fibrosis. Microscopically, mesenteric lipomatosis and Whipple's disease must be ruled out. Usually, surgical treatment is not necessary. Prednisone and azathioprine may be helpful in severe cases. Fatal outcome of primary mesenteritis is extremely rare.

Adult↗
PubMed1988

[Heterotopic cartilage tissue in the uterus. Report of 2 cases and review of the literature].

The occurrence of heterotopic cartilage islands (HKI) in the uterus wall is a rare event. So far, less than 50 cases have been reported. The present paper describes two additional cases and renders a review of the pertinent literature. The following topics are discussed: epidemiology, localization, morphology, clinical findings, etiology and pathogenesis. The vast majority of the HKI will result from displacement and retention of fetal tissues in the uterine wall. In exceptional cases, a development of HKI due to metaplasia may be discussed.

Adult↗