Biomedical subjects

W Stolz

Publications and source records attributed to W Stolz.

At least 19 recordsLinked to original sources

PubMed1992

In situ localization of IgG in epidermolysis bullosa acquisita by immunogold technique.

BACKGROUND: Epidermolysis bullosa acquisita (EBA) is an immunologically mediated mechanobullous dermatosis. Recently, serum antibodies in patients with EBA have been reported to bind to the carboxyl terminus of type VII collagen, the disease antigen. However, the precise localization of immunoglobulins in diseased skin has not been demonstrated. OBJECTIVE: In the present study skin samples taken from a 59-year-old man with EBA were processed for immunoelectron microscopy. METHODS: A preembedding immunogold ultrastructural technique was applied. RESULTS: Gold particles, indicative of IgG binding, were deposited within the anchoring plaques and within the lamina densa in some perilesional skin sections. In a similar distribution, IgG-containing amorphous aggregates were detected within the basement membrane zone of perilesional and lesional skin. In some places these immunoglobulin deposits covered the whole region of anchoring fibrils. CONCLUSION: These results demonstrate the precise localization of IgG within the basement membrane zone of EBA skin that corresponds to the carboxyl terminus of collagen VII in normal skin.

Diagnosis, Differential↗

PubMed1992

[Initial results of a new method of sonographic diagnosis of lung maturity].

The immaturity of the foetal lung is one of the central problems in obstetrics. In this paper first results are presented to determine the maturity of the foetal lung by sonography. Using the foetal liver as a reference organ we are avoiding the known pitfalls which made it impossible in the past to standardise the foetal lung changes depending upon the age of gestation. We examined 121 patients between week 27 and week 41. In one ultrasound section cut we depicted lung and liver as well. According to the known A-mode we registered frequencies in both organs. The registered frequencies were entered digitally into a computer and checked for f mean, f max and f min. Subsequently we calculated quotients of frequencies of the foetal lung and liver. For all weeks of gestation the mean value and standard deviation were calculated. We found that the liver is an adequate reference organ, since there is no change in the reflection pattern between the different weeks of gestation. We registered significant differences in the quotients of lung and liver between the different weeks of gestation, a cutting line being week 35. A quotient of Q mean lower than 1.1 hints to lung maturity while values over 1.1 point to immaturity.

Female↗

PubMed1992

[Three-dimensional ultrasound imaging of benign and malignant breast tumors--initial clinical experiences].

Previous experimental and clinical studies showed, that three-dimensional (3-D), i.e. dynamic spatial reconstruction of 2-D ultrasound images is feasible. A rotating acoustic plane helps to visualise the cross-sections serially and in a coordinated manner. When reconstructing the 2-D ultrasound images, surface reconstruction from planar contours of each cross-section is performed (so that the organ limits are defined) and the cross-sectional pictures are reconstructed into 3-D organ images. This approach had been described by the authors on a previous occasion. Another step forward is "transparent" spatial imaging eliminates the source of error involved in contouring. It is important to emphasise, that the 3-D system now described by the authors, yields a spatial image of the organ in question, and does not just present 3 planes of the organ (some authors have been claiming, that such an imaging method is also three-dimensional). Our system enables the imaging of several cross-sectional planes cut through the spatially calculated organ. This results in cross-sections, which cannot be performed by conventional sonography, thus disclosing new perspectives and possibilities. In the present article, the authors describe a clinical pilot study in the diagnosis of carcinomas of the breast. In our opinion, 3-D imaging of the tumours enables the physician to diagnose the status of the tumours; this is demonstrated by the examples of 35 malignant and benign tumours of the breast. In 95% of the cases of malignant tumours and 80% of the benign tumours, the diagnosis proved correct. This paper describes the fundamental possibilities and limitations of the new method.

Breast Neoplasms↗

PubMed1992

Ultrastructural immunogold studies in two cases of linear IgA dermatosis. Are there two distinct types of this disease?

It has been suggested that patients with homogeneous linear IgA deposits at the basement membrane zone constitute a distinct bullous disorder called linear IgA dermatosis (LAD) of adults or children. The results of the present ultrastructural immunogold study in two patients with LAD suggest that LAD is not a single disease entity. LAD in a 10-year-old girl was found to be ultrastructurally similar to an IgA-type pemphigoid. IgA was detected in the uppermost lamina lucida underlying the basal cell plasma membrane. In a second patient, an 86-year-old man, IgA deposits were present within the lamina densa and the anchoring plaques. The distribution of IgA in this patient was ultrastructurally identical with that of IgG in epidermolysis bullosa acquisita skin and with that of the non-collagenous globular terminus of collagen VII within the basement membrane zone of normal skin. By using the immunogold technique, we could distinguish two distinct types of LAD according to the IgA binding sites in the diseased skin. We suggest that different labelling patterns may correspond to different clinical pictures.

Aged↗

PubMed1992

Replication of parvovirus B19 in hematopoietic progenitor cells generated in vitro from normal human peripheral blood.

Erythroid progenitor cells generated in vitro from peripheral human blood in the presence of interleukin-3 and erythropoietin were infected with human parvovirus B19. B19 virus DNA replication was highest 48 to 72 h after infection, and maximum levels of B19 virus proteins were detected in culture supernatants at 72 to 96 h after infection. B19 virus propagated in vitro was infectious. This cell culture system with peripheral blood cells facilitates studies in vitro of B19 virus replication.

Blood↗

PubMed1992

Ultrastructural binding sites of endomysium antibodies from sera of patients with dermatitis herpetiformis and coeliac disease.

The ultrastructural binding sites of endomysium antibodies, specific serological markers of gluten sensitive enteropathy, were investigated in the rabbit oesophagus using the immunogold technique. Endomysium antibodies from sera of patients with dermatitis herpetiformis and with coeliac disease bound in an identical manner in a non-fibrillar material closely associated with fine collagenous-reticulin fibrils and also with similar fibrils connecting smooth muscle cells and elastic tissue in the endomysial connective tissue. These observations suggest that IgA antibodies in sera from patients with dermatitis herpetiformis and coeliac disease recognise a common antigen in an amorphous component associated with the reticular connective tissue of oesophageal lamina muscularis mucosae and thus confirm the probable identity of IgA class endomysium and jejunal antibodies.

Animals↗

PubMed1992

Mineralocorticoids and mineralocorticoid receptors in mononuclear leukocytes in patients with pregnancy-induced hypertension.

To examine the role of mineralocorticoids in the pathophysiology of pregnancy-induced hypertension (PIH), we studied plasma aldosterone and 18-hydroxycorticosterone levels in 25 women with PIH and 25 normal pregnant women, as controls. Furthermore, we evaluated the mineralocorticoid receptor (MR) status in mononuclear leukocytes in the 2 groups. MR count was significantly (P less than 0.0005) decreased in the PIH group (148 +/- 9 binding sites/cell) compared with the control group (300 +/- 17 binding sites/cell; mean +/- SEM). Plasma aldosterone in women with PIH was 281 +/- 61 pmol/L; in normal pregnant women it was 697 +/- 172 pmol/L (P less than 0.025). Plasma 18-hydroxycorticosterone was also significantly (P less than 0.025) lower (PIH, 1071 +/- 149 pmol/L; controls, 1907 +/- 318 pmol/L). These values were determined at the onset of clinical symptoms of PIH. These results cannot be explained by receptor down-regulation due to higher levels of mineralocorticoids in PIH; a hitherto unknown mineralocorticoid may, thus, be responsible for the hypertension and altered MR status.

18-Hydroxycorticosterone↗

PubMed1992

[Ultrasound diagnosis of fetal lung maturity--a new method].

First results are presented to determine the maturity of fetal lung by sonography. Using the fetal liver as a reference-organ we are avoiding the known pitfalls which made it impossible in the past to standardize the fetal lung changes depending on the age of gestation. We examined 104 patients between week 27 and week 41. In one ultrasound section cut we depicted as well lung and liver. According to the known A-mode we registered frequencies in both organs. The registered frequencies were entered digitally into a computer and checked for f(mean), f(max) and f(min). Afterwards the frequencies of the lung were divided by those of the liver. Of all weeks of gestation the mean value and standard deviation were calculated. We found the liver as an adequate reference-organ, since there is no change of the reflection pattern between the different weeks of gestation, while there are significant changes to be registered in the fetal lung, a cutting line being week 35. A quotient of f(mean) lower than 1.1 hints to lung maturity while values over 1.1 point to immaturity. This was confirmed by several cases of analysis of amniotic fluid (L/S-ratio). Further comparisons with amniotic fluid results will have to validate these findings.

Amniocentesis↗

PubMed1992

[Doppler ultrasound study of breast tumors using color Doppler ultrasound, duplex ultrasound and the CW Doppler ultrasound].

The preoperative examinations by doppler-sonography of 83 patients with tumors of the breast are presented. The examinations are done with newest technique: duplex-sonography in slow-flow-technique (AI 3200, Dornier); colour-sonography in MEM-technique (AI 5200, Dornier) and synchronical colour-doppler++ (Quantum 2000, Siemens) and CW-doppler-sonography (Vasocope 3, Kranzbühler). There is a markable difference between the side of carcinoma and the normal side as well as pre- and postmenopausal patients. No difference is shown in cases of benign tumors and the normal side. The increasing blood flow of a malignant tumor is showed in changing the doppler parameters (A/B-ratio and resistance-index) and in the doppler wave form. The number of vessels found in or around a tumor is not a good criteria to find malignant diseases, the best criteria is the difference between sides of the mamma.

Blood Flow Velocity↗

PubMed1991

Prognostic significance of DNA cytometry in cutaneous malignant lymphomas.

The current classification of cutaneous malignant lymphomas (ML) into low-grade and high-grade lymphomas was found to be of limited reproducibility and permitted only a rough prediction about outcome. With this in mind, the relationship between nuclear DNA content and both prognosis and histologic grading according to the Kiel classification was evaluated on Feulgen-stained imprint specimens. In all, 49 cases of malignant non-Hodgkin's lymphoma, primary of the skin or with an involvement of the skin as one of the first symptoms, were studied using a computerized high-resolution image analysis system. The 2c deviation index (2cDI), which reflects the variation of the nuclear DNA values around the normal diploid peak, was found to be the best prognostically relevant criterion. Using the 2cDI, a significant discrimination (P less than 0.001 in the U test) between low-grade and high-grade ML was achieved. The prognostic benefit of the 2cDI was well documented by a significant inverse correlation between the 2cDI and the period of time until the patients progressed at least into one higher stage or died of lymphoma (r equals -0.63, P less than 0.05). In addition, the 2cDI enabled prognosis of the course of disease. In the group with low 2cDI values (2cDI, less than 0.5), no progression of the disease was observed after 1 year. In the groups presenting with a 2cDI between 0.5 and 1.0 and higher than 1.0, a progression was found in 57% and 64% of the cases studied, respectively. In conclusion, these measurements indicate that the determination of DNA distribution patterns in imprint specimens allows a precise and objective prognostic evaluation of cutaneous ML.

Adult↗

PubMed1991

Removal of parvovirus B19 from contaminated factor VIII during fractionation.

A solution of pooled cryo-precipitate for preparing factor VIII (F VIII) by the solvent/detergent method was contaminated experimentally with parvovirus B19-positive plasma to evaluate virus reduction achieved by the final steps of the F VIII production process. Virus reduction was at least 2 logs of the total amount of B19 virus added to the pooled cryo-precipitate. The major amount of B19 virus was detected in the solution used to regenerate the F VIII-selective anion exchange chromatography column. A few viral particles were detected in the final F VIII concentrate before filtration but these were aggregates and were removed by filtration, and in the solution used to regenerate the anion exchange resin. It is not known whether the residual viral DNA present in the final product represents infectious or inactivated particles.

Blood Preservation↗

PubMed1991

Ultrastructural basis for antigen mapping using sodium chloride-separated skin.

In many cases of autoimmune blistering skin diseases indirect immunofluorescence with serum of patients on 1 M NaCl-separated skin represents a rapid diagnostic tool before the use of more complicated immunoelectron microscopy. The present study demonstrates that in skin samples from five adults, separated using 1 M NaCl, 0.15 M NaCl and 0.01 M phosphate buffered saline (PBS), the split formed within the lamina lucida at an identical ultrastructural level. The sub-basal dense plate (SDP) with a wreath of anchoring filaments remained on the epidermal side of the split adjacent to the hemidesmosomal part of the plasma membrane of basal keratinocytes. The base of the split blister was constituted from the lamina densa, with a remote possibility of some anchoring filaments attached. We demonstrate that antigens on the roof of the NaCl- or PBS-split blister may be associated, beside intracellular hemidesmosomal structures, with the SDP and basement membrane components between the SDP and the basal keratinocytes as well as with anchoring filaments attached to the SDP. The observations reported here allow a more precise mapping of antigen determinants in blistering skin diseases.

Animals↗

PubMed1991

[Differences in blood flow in maternal blood vessels in normal pregnancies and gestosis].

Clinical studies showed a lower blood flow in renal und uterine vessels in gestotic pregnancies. A comparison was therefore made between three maternal vessels (uterine, renal und thyroideal vessels) in normal and gestotic pregnant and non-pregnant women to show if the higher vessel resistance in gestotic pregnancies is a local or systemic event. There was a significant difference between the collectives in the blood flow of renal and uterine vessels, but no difference between the resistance in thyroideal vessels. The difference in the blood flow of renal vessels was higher than the difference in uterine vessels in the pregnant women. The increasing resistance, therefore, seems to be a local event at the beginning of the gestotic pattern of signs and symptoms. The higher resistance in the renal vessels allows, the conclusion that the kidney might be the important organ in the origin of the gestotic pattern of signs and symptoms.

Adult↗

PubMed1991

[Three-dimensional ultrasonic diagnosis in gynecology and obstetrics].

Three-dimensional reconstruction of an organ requires a coordinated sequence of cross-sectional scans. In ultrasound this can be solved by rotating the scan plane horizontally or vertically. Two scan heads have been built, one to rotate the plane around a horizontal, the second around a vertical axis. There are two ways to reconstruct the scans taken by ultrasound into a three-dimensional image: --to contour the surface of the organ in each scan and to reconstruct these contours to a ring-shaped structure. This procedure needs a lot of time; moreover, contouring must be performed via cursor on the screen. --calculate a transparent image of the organ. To obtain the best spatial image by the "transparent method", the image must be moved on the screen. Both methods of reconstruction are shown and compared in this paper. First experiences show that they can be applied in tumour diagnostic and in the diagnosis of malformations in early pregnancy. Further clinical studies will have to prove this.

Breast Neoplasms↗

PubMed1991

Extracellular binding sites of IgA anti-jejunal antibodies on normal small bowel detected by indirect immunoelectronmicroscopy.

Patients with dermatitis herpetiformis (DH) have IgA deposition in the papillary dermis and in the lamina propria of the small bowel. In addition, most of DH patients' sera contain IgA class anti-reticulin antibodies, anti-endomysium antibodies (EMA), and anti-jejunal antibodies (JAB) during times of gluten intake. In previous studies, JAB and EMA seemed to be identical and related to the group of anti-reticulin antibodies. In the present study, pre-embedding en bloc immunoelectronmicroscopic methods were applied for analysis of the ultrastructural binding sites of JAB on monkey and rabbit small bowels. These substrates were incubated with sera from DH patients strongly positive for JAB. Simultaneous investigations with the PAP technique and with 5 nm gold-labeled protein A or second antibodies visualized the bound IgA identically: it was associated with collagen fibrils underlying the epithelial and cryptal basement membranes and with collagen fibrils around capillaries. Staining was also detected along the endomysial collagen fibrils of smooth muscle layers, around elastica and smooth muscle cells of blood vessel walls, and along collagen fibrils near smooth muscle cells in the lamina propria. Neither the peroxidase product nor gold deposition was detected directly on the fibers, but was associated with amorphous material surrounding collagen fibers of different diameters. The distribution of JAB-stained structures corresponded to the localization of reticulin network of the small bowel. Our data indicate that JAB recognize an antigen or antigens associated with an amorphous component of the reticulin-collagen structure of jejunum and may have identical binding sites, as anti-reticulin antibodies and EMA.

Animals↗

PubMed1991

Ultrastructural discrimination between malignant melanomas and benign nevocytic nevi using high-resolution image and multivariate analyses.

Prompted by the well-known difficulties of reliable and objective histologic differentiation between initial malignant melanoma (MM) and benign nevocytic nevi (NN), ultrastructural high-resolution image and multivariate analyses were evaluated for their diagnostic efficiency. Thirty-seven different features describing morphometry (area, circumference, and shape factor), amount of heterochromatin and euchromatin, chromatin homogeneity, and presence of smaller dark chromatin aggregations were determined by a MICROVAX 3500 computer in each of 1840 intraepidermal melanocytic nuclei of 17 MM and 20 NN. A strategy for the classification of cases based on the identification of markedly atypical melanocytic cells (MACS) was developed. MACS, selected in multivariate analysis with a linear combination of the eight most important features for cell classification, were found in 39.4% of the melanoma cells, but only in 0.3% of nevocytic nevus cells. The presence of MACS allowed a clear differentiation between MM and NN. All cases of MM had more than four MACS, whereas 17 cases of nevocytic nevi were MACS negative, and in each of the remaining three cases only one MAC was present. The percentage of MACS detected within intraepidermal parts of MM by using computerized high-resolution image analysis was found to be a highly efficient diagnostic marker. The new classification strategy has the potential of saving considerable time in subsequent studies, because preselected sampling and the calculation of only a few criteria have proven sufficient for correct classification of malignant melanomas.

Chromatin↗

PubMed1991

Herpes gestationis: ultrastructural identification of the extracellular antigenic sites in diseased skin using immunogold techniques.

Using a direct immunogold technique, we studied the level of immunological events in the skin basement membrane in a patient with herpes gestationis during blister formation. Within the lamina lucida, IgG and C3 were localized beneath the basement membrane of basal keratinocytes, 30-40 nm above the lamina densa. In many areas of blister formation sub-basal dense plates, but probably also the upper parts of the hemidesmosomes were separated from the roof of the blister. In the perilesional lamina lucida and in the blister, IgG and C3 containing amorphous grains, most probably immunocomplex aggregates, were detected. They covered the basement membrane of keratinocytes and left free a 30-40 nm band above the lamina densa. Our study indicates that in herpes gestationis the cleavage, accompanied by IgG, C3 and immunocomplex deposition, occurs at the level of the sub-basal dense plate. However, cleavage through upper hemidesmosomal structures can occur in parallel. These data further support the involvement of hemidesmosomes in the pathogenesis of the disease and therefore in its relationship to bullous pemphigoid.

Acute Disease↗

PubMed1991

Urodynamic assessment and lateral urethrocystography. A comparison of two diagnostic procedures for female urinary incontinence.

We compared urodynamic findings and results of lateral urethrocystography in 84 case. The aim of the study was to establish a possible correlation between anatomic findings and functional results. Clinically, a significantly greater increase in the normal axis of urethral inclination was noted in patients with a urodynamic diagnosis of stress incontinence than in patients with urge incontinence or for normal urodynamic findings. Lateral urethrocystography vis-à-vis urodynamic assessment proved to be a method having high sensitivity (91%) but low specificity. These two methods supply different but complementary data. Together with the patients' medical history, the assessment of their complaints, clinical vaginal examination, and clinical stress test, they offer valuable information for an efficient therapeutic concept.

Adult↗