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Biomedical subjects

W Stolz

Publications and source records attributed to W Stolz.

At least 91 records · Page 5Linked to original sources
PubMed1996

Nonradioactive arbitrarily primed polymerase chain reaction: a novel technique for detecting genetic defects in skin tumors.

Initiation and progression of melanocytic and non-melanocytic skin tumors are accompanied and probably caused by a variety of genetic defects. In contrast to other human tumors, however, limited amounts of available tissue in skin cancer often hamper extensive genetic studies of native material of early lesions. Therefore, we applied a novel DNA fingerprinting technique based on polymerase chain reaction (PCR), the arbitrarily primed PCR (AP-PCR). This technique enabled us to scan large parts of the genome (about 30 kb/PCR reaction) for somatic mutations starting with minute amounts of tissue. In contrast to previous reports on AP-PCR, we were able to visualize PCR products by a rapid nonradioactive silver-staining technique using a simple device for staining of large polyacrylamide gels. In nine benign and malignant melanocytic skin tumors, the method provided a set of reproducible DNA fingerprints. Genetic defects were detected by comparing the fingerprints of tumor cells and constitutive DNA from blood leukocytes. Since nonradioactive AP-PCR fingerprinting also offers the unique capability to isolate and sequence polymorphic DNA fragments from fingerprint gels, we conclude that this technique seems to be important and practically feasible for elucidating the genetic roots of skin tumors.

Base Sequence↗
PubMed1996

Characteristic but unfamiliar--the cowpox infection, transmitted by a domestic cat.

An 11-year-old girl had been suffering from 2 recently developed reddish ulcerated nodules on the right side of her neck and, concomitantly, from a very hard swelling as well as from painless lymphadenopathy. Subsequently, thick black eschars appeared on the surface of the ulcers. Using the negative staining technique, an orthopox virus infection could be identified by electron microscopy. The patient's characteristic history as well as her close contact with a cat frequently hunting nice indicated the diagnosis of a cowpox infection, which was unequivocally confirmed by identification of both the viral culture and specific antibodies in the serum of the patient.

Animals↗
PubMed1996

[Abdominal colposuspension: a synopsis of various approaches and techniques including endoscopic modifications].

Though abdominal colposuspension is an established operative procedure in the therapeutic spectrum of female urinary stress incontinence, there is controversy concerning new access routes and fixation techniques. On the basis of a comparison between results of a "feasibility" study at our department concerning the trans- and extra-peritoneal endoscopic access as well as suspension techniques with alloplastic material and suturing vs. stapler application, and al literature survey, a synoptic concept is being evaluated. In case of critically made indication, first trends show that results of laparoscopically and retziusscopically assisted techniques are comparable to those of conventional procedures. However, the lack of long-term results as well as an initially prolonged operation time have to be considered. In the meantime an extraperitoneal transumbilical colposuspension was attempted in 2 patients, already unsuccessfully operated upon (conventional Burch) previously. Due to extensive perivesical adhesions a laparotomy had to be performed. The limits of the endoscopic approach seen to be reached in these cases.

Female↗
PubMed1995

Prognostic significance of DNA cytometry in comparison with histologic measurements in malignant melanomas.

In the present study we evaluated the prognostic impact of both DNA cytometry and quantitative histology in patients with malignant melanoma (MM). In contrast to previous investigations on sections, rapid image analysis (IA) of imprint specimens was performed to measure DNA cytometric features; 34 cases of stage I MM with low (< 1.5 mm, n = 20) and higher tumor thickness (TTH) (> 1.5 mm, n = 14) were analyzed. We found significant correlations between cytometric features and TTH, which is accepted as the most important prognostic criterion in MM. Higher TTH was closely correlated with the rate of markedly aneuploid nuclei, which is indicated by the 5c exceeding rate (5cER; r, 0.89; p < 0.001). The gain of chromatin in thicker tumors was accompanied by higher mean nuclear area (MAREA; r, 0.60; p < 0.001) and mean DNA content (MDNA; r, 0.58; p < 0.001). Additional evidence for prognostic significance of cytometry was obtained by preliminary survival analysis of 16 cases (four patients died within 2 1/2 years and 12 patients survived for at least 4 1/2 years). Applying multivariate stepwise discriminant analysis, a combination of TTH, level of invasion (LEV), 2c deviation index (2cDI), and modified standard deviation of the DNA values (SDNAM) proved to be most effective. One hundred percent of the cases were correctly classified as survivors or nonsurvivors. TTH and the 5cER were found to be the best univariate criteria for prognosis. In the U test according to Mann and Whitney, a significant discrimination of survivors and nonsurvivors was possible using either TTH or the 5cER, respectively (p < 0.02). Thus, we would like to conclude that IA of imprint specimens can be recommended as a rapid and simple additional method for grading.

Algorithms↗
PubMed1995

[Necrobiotic xanthogranuloma with eye involvement. Overview and case report].

Necrobiotic xanthogranuloma is a rare disease marked by yellowish-brown plaques with destructive growth and a tendency to ulceration, which shows a characteristic histopathological pattern of palisading granuloma with foam cells, Touton's and foreign-body giant cells, bizarre multinuclear giant cells, cholesterol clefts and marked necrobiosis of the connective tissue. Necrobiotic xanthogranuloma is associated with IgG paraproteinaemia, and occasionally with an IgA paraproteinaemia. Ocular symptoms and visceral involvement are common. We report a case of a 53-year-old woman with periorbital necrobiotic xanthogranuloma, ocular involvement and IgG paraproteinaemia, who had undergone argon-laser treatment to no avail following a diagnosis of xanthelasma. Periorbital xanthelasma-like lesions with a tendency to ulceration in combination with unexplained ocular symptoms consisting of keratitis, scleritis, episcleritis or uveitis should suggest the diagnosis of necrobiotic xanthogranuloma, especially if they are associated with paraproteinaemia.

Diagnosis, Differential↗
PubMed1995

[Clinical and electron microscopy study of sudden deafness treatment with the 10% HES 200/0.5 and pentoxifylline combination].

The incidence of sudden hearing loss has increased. The pathogenetic mechanisms are still unknown, but viral infections and vascular phenomena with acute impairment of microvascular perfusion are thought to play a major role. Infusion of hydroxyethyl starch (HES) is used as a regimen to treat sudden hearing loss. In our clinic, anaphylactic reactions due to HES have not been observed so far. However, the use of HES is still discussed controversially due to long-term storage of HES molecules in tissue and due to high incidence of long-lasting pruritus. In a retrospective analysis of 118 patients treated with HES for sudden hearing loss, we observed pruritus starting in 64% of patients one to three weeks after therapy. This symptom with a duration between two weeks and four months was refractory to medical interventions. During therapy with HES improvement of hearing was observed in 75% of patients, in 62% improvement of hearing persisted still at the end of the observation period (7 months post infusionem). Light and electron microscopic assessment of human skin biopsies of one patient after treatment with HES showed storage of HES especially within dermal macrophages. Pathogenetically a pathway independent of histamin seems responsible for the induction of pruritus. Accordingly, classic antihistaminic drugs had no therapeutic effect in our patients. Dextran is used as an alternative to hydroxyethyl starch. In contrast to HES, the often mentioned higher incidence of severe anaphylactic reactions due to dextran has dramatically decreased with hapten inhibition (after preinjection of monovalent haptendextran Promit).(ABSTRACT TRUNCATED AT 250 WORDS)

Auditory Threshold↗
PubMed1995

Interaction of liposomes with human epidermis reconstructed in vitro.

Upon topical application of liposomes of the large unilamellar vesicle type to human epidermis reconstructed in vitro, there is a dose-dependent alteration of the morphology of both the stratum corneum and the living part of the epidermis. In particular, shrunken lipid droplets are found between corneocytes and keratinocytes. Sometimes, corneocytes show inclusions reminiscent of 'cholesterol crystals'. Corneocytes, moreover, show a decreased density. Both corneocytes of the various layers of the stratum corneum and keratinocytes belonging to the uppermost layer of the living epidermis show particularly osmophilic membranes, indicating lipid transfer. Intact liposomes or their remnants can sometimes be seen between corneocytes of the upper strata. The presence of liposomal lipid within the stratum corneum is supported by the presence of gold particles used as a marker. There is, however, no evidence for the uptake of intact liposomes by the living epidermis, or their passage through this compartment of the skin.

Culture Techniques↗
PubMed1995

Localized cicatricial pemphigoid of the Brunsting-Perry type with transition into disseminated cicatricial pemphigoid. Report of a case proved by preembedding immunogold electron microscopy.

BACKGROUND: In 1979, Provost described two patients with the clinical features of disseminated cicatricial pemphigoid for the first time. Until now, only four additional cases of disseminated cicatricial pemphigoid have been described. Existence of diagnosis of disseminated cicatricial pemphigoid has been discussed controversially because in four cases investigated by electron microscopy the blister formation was found below the lamina densa, which is indicative of an epidermolysis bullosa acquisita. OBSERVATION: A 78-year-old woman is presented with a generalized eruption of blisters leaving behind scars that developed after a 7-year-long history of mild circumscribed recurrent blisters and scarring eruptions that had been diagnosed previously as Brunsting-Perry type of cicatricial pemphigoid. Immunofluorescence antigen mapping disclosed the blister formation above the lamina densa. Electron and immunoelectron microscopy using a preembedding immunogold technique revealed blister formation and antibody binding within the lamina lucida, predominantly below the subbasal dense plate. CONCLUSIONS: The clinical features of disseminated blistering followed by scarring, the immunofluorescence antigen mapping, and the electron and immunoelectron microscopic findings in our case for the first time clearly prove the existence of a disseminated cicatricial pemphigoid.

Aged↗
PubMed1994

[The interdisciplinary aspects of notalgia paraesthetica].

For 3 years a 75-year-old man with type II diabetes had been suffering from paroxysmal pruritus in a circumscribed area of brown discoloration of the skin over the left should blade. This condition, also known as notalgia paraesthetica, is a rare, but perhaps underdiagnosed, neurocutaneous entity, a largely sensory neuropathy due to a muscular compression phenomenon. In this case histological examination of a biopsy specimen showed focal acanthosis, obvious basal hyperpigmentation and discrete perivascular lymphocytic infiltration with numerous melanophages. At first, glucocorticoids were administered unsuccessfully against the distressing pruritus. Purely symptomatic local capsaicin treatment decreased the pruritus temporarily. Endocrinological diagnosis failed to demonstrate multiple endocrine neoplasia (MEN) syndrome 2A, which has been frequently described in association with notalgia paraesthetica.

Aged↗
PubMed1994

The ABCD rule of dermatoscopy. High prospective value in the diagnosis of doubtful melanocytic skin lesions.

BACKGROUND: The difficulties in accurately assessing pigmented skin lesions are ever present in practice. The recently described ABCD rule of dermatoscopy (skin surface microscopy at x10 magnification), based on the criteria asymmetry (A), border (B), color (C), and differential structure (D), improved diagnostic accuracy when applied retrospectively to clinical slides. OBJECTIVE: A study was designed to evaluate the prospective value of the ABCD rule of dermatoscopy in melanocytic lesions. METHODS: In 172 melanocytic pigmented skin lesions, the criteria of the ABCD rule of dermatoscopy were analyzed with a semiquantitative scoring system before excision. RESULTS: According to the retrospectively determined threshold, tumors with a score higher than 5.45 (64/69 melanomas [92.8%]) were classified as malignant, whereas lesions with a lower score were considered as benign (93/103 melanocytic nevi [90.3%]). Negative predictive value for melanoma (True-Negative divided by [True-Negative+False-Negative]) was 95.8%, whereas positive predictive value (True-Positive divided by [True-Positive+False-Positive]) was 85.3%. Diagnostic accuracy for melanoma (True-Positive divided by [True-Positive+False-Positive+False-Negative]) was 80.0%, compared with 64.4% by the naked eye. Melanoma showed a mean final dermatoscopy score of 6.79 (SD, +/- 0.92), significantly differing from melanocytic nevi (mean score, 4.27 +/- 0.99; p < 0.01, U test). CONCLUSION: The ABCD rule can be easily learned and rapidly calculated, and has proven to be reliable. It should be routinely applied to all equivocal pigmented skin lesions to reach a more objective and reproducible diagnosis and to obtain this assessment preoperatively.

Dermatology↗
PubMed1994

Evaluation of different image acquisition techniques for a computer vision system in the diagnosis of malignant melanoma.

BACKGROUND: Digital image analysis was found to be a useful technique for improved accuracy of preoperative diagnosis of melanocytic lesions. In previous studies digitized color slides were used as input for digital image analysis. New technologies and smaller video cameras made it possible to develop a camera system that allows the digitization of skin lesions directly from the patient. OBJECTIVE: We investigated whether conventional color slides or directly digitized images should be used for a reliable recognition of malignant melanoma. METHODS: Computer features describing characteristics of the lesions were computed for 404 digitized color slides and for 309 directly acquired lesions. Statistical analysis and classifier construction was performed by the commercial statistical classification program CART. RESULTS: With the data set derived either from the color slides or from the directly digitized lesions a sensitivity of about 90% for the recognition of malignant melanoma could be obtained. CONCLUSION: Both image acquisition techniques allow a reliable detection of malignant melanoma and both are appropriate as input for an image analysis system regarding its efficiency as a diagnostic tool. However, none of the classifiers can be applied with reasonable significance to both techniques.

Diagnosis, Computer-Assisted↗
PubMed1994

[Incontinence operation by "Retzius-scopy"? An endoscopic modification of the Marshall-Marchetti-Krantz operation].

The operative treatment of stress incontinence with the Marshall-Marchetti-Krantz procedure has proved effective. A new, endoscopic modification of this procedure is presented here, based on the principle of vesico-urethral suspension with fibrin glueing. Open abdominal surgery is replaced by retziusscopy and a minimal invasive endoscopic intervention in the Retzius' cavity.

Female↗