Search PubMed⌕ Search

Biomedical subjects

W Stolz

Publications and source records attributed to W Stolz.

At least 109 records · Page 6Linked to original sources
PubMed1994

[Development of Doppler parameters in fetal and maternal blood vessels 10 days before to 10 days after the calculated due date].

Doppler sonography can help to assess a foetal risk situation prospectively. This procedure is therefore well suited for the screening of risk pregnancies in the 3rd trimenon. The role of Doppler ultrasound at delivery is still controversial, since, on the one hand, no data on the behaviour of Doppler parameters directly at the onset of delivery are available, and on the other hand the obstetric consequences from pathological findings are not clear. For this reason, we observed 45 normal pregnancies from the 10th day prior to the date of confinement till the 10th day post partum. In 20 patients we registered Doppler parameters from 4 days before until the onset of true labour. In all these cases, a reduction of the end-diastolic blood flow in the foetal aorta was found, which became evident by the increase of the resistance index to pathological values. Concomitant decrease of the resistance index in the foetal carotid artery was typical for a circulatory system. Since foetal outcome was normal in all newborn, this change in Doppler parameters directly at the beginning of labour must be considered as physiological. The findings suggest a physiological placental insufficiency. Since however, parameters in the uterine vessels did not show any changes, the insufficiency has its probable origin in the placenta. From these findings, one might speculate, that the supply deficiency is the labour inducing factor. No clinical consequence can thus result from pathological Doppler data found in patients directly prior and after delivery. Cardiotocographic screening is necessary.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Successful treatment of hydroxyethyl starch-induced pruritus with topical capsaicin.

We report a case of recalcitrant pruritus after infusion therapy with hydroxyethyl starch (HES) for sudden deafness. The diagnosis was confirmed by detection of typical HES storage vacuoles within dermal macrophages and perineural cells. Treatment with antihistamines and antipruritic agents, UVB irradiation, and neuroleptic drugs, was ineffective. Topical capsaicin (0.05%) twice daily produced excellent symptomatic relief, without side-effects.

Administration, Topical↗
PubMed1994

Differentiation between malignant melanomas and benign melanocytic nevi by computerized DNA cytometry of imprint specimens.

Recently image analysis (IA) and DNA-cytophotometry (CP) have proved to be useful for the differentiation between benign and malignant melanocytic lesions on paraffin sections. Since, on sections, these procedures are very time-consuming, we tested in the present study whether IA of imprint specimens, which can be evaluated in less than 30 minutes, might also be sufficient. In 39 malignant melanomas (MM), 18 melanocytic nevi (MN), and 6 dysplastic nevi (DN), 12 different morphometric and DNA cytometric features were determined in 100 randomly selected nuclei. In univariate analysis, 5 features were found to be significantly different between the benign and malignant groups (p < 0.0001): mean value (MAREA) and standard deviation (SAREA) of nuclear area and the 80th, 90th, and 95th percentiles of DNA distribution. Using SAREA, the best univariate feature, 82.5% of the cases could be correctly separated. In multivariate analysis with a combination of three features--standard deviation of nuclear area (SAREA), mean DNA value (MDNA), and 95th percentile of DNA distribution (PERC95)--a correct diagnosis was achieved in 89.5% of the cases. Results obtained in the cases of DN indicated an increased proliferation, but did not allow the separation of DN from MM and MN. Since our technique allows a rapid analysis without loss of tissue, which might be important for histological analysis, and the classification rates are equal or still higher than reported in studies on sections, imprints of melanocytic lesions seem to be most appropriate for the calculation of DNA cytometric features as helpful diagnostic criteria in equivocal melanocytic lesions.

Adult↗
PubMed1994

Papular elastorrhexis: a variant of dermatofibrosis lenticularis disseminata (Buschke-Ollendorff syndrome)?

BACKGROUND: Buschke-Ollendorff syndrome is an autosomal dominant disorder clinically characterized by the appearance of disseminated white papules and osteopoikilosis. Histologically most cases show normal collagen and increased elastic tissue. Abortive forms of Buschke-Ollendorff syndrome are described, which show characteristic skin involvement, absence of skeletal changes and decreased elastic tissue. Papular elastorrhexis is characterized by nonfollicular, white papules, decreased elastic tissue, no genetic inheritance and no osteopoikilosis. OBJECTIVE: Is papular elastorrhexis a new entity or an abortive form of Buschke-Ollendorff syndrome? METHODS: We examined three members of one family (brother, sister and mother) presenting with nonfollicular, distributed, white papules on the trunk and extremities. Skin biopsies were examined by histological and electron-microscopic methods. RESULTS: The histological and electron-microscopic examinations of skin biopsies showed decreased, fragmented elastic fibers and normal collagen. By X-ray examination, no osteopoikilosis was found. The family presented here supports a genetic background of the disease. CONCLUSION: The clinical appearance with the absence of osteopoikilosis and the histological findings of our cases suggest the diagnosis of papular elastorrhexis. Papular elastorrhexis however was reported to be nonfamilial. Because of the genetic background found here we believe that papular elastorrhexis is an abortive form of Buschke-Ollendorff syndrome. Summarizing our data and reviewing the literature, we suggest that connective tissue nevi with the most prominent alterations in the elastic tissue should be classified under the term elastic tissue nevi.

Adolescent↗
PubMed1994

[Fetal enlarged flaccid intestinal loops and pathologic Doppler findings--criteria for fetal distress].

In pregnancies with signs of placental insufficiency relatively often flaccid and enlarged intestinal convolutions were detected, which differed markedly from hyperperistaltically distended convolutions as in the case of bowel obstructions. In order to show a correlation between placental insufficiency i.e. a deficiency in supply--and the typical flaccid bowels, we performed a prospective study on 258 pregnant women with placental insufficiency and a control group of 151 normal pregnancies. The examinations were performed with a color duplex system. As criterium we registered detection of flaccid bowel convolutions-characterized by rich echoes-which could be well distinguished from the bowel which appears as homogeneous. It could also be well differentiated from the mostly echo-free aspect of obstructed bowels, associated by hyperperistaltics. Flaccid and enlarged bowel convolutions were found in 67 patients in the collective with placental insufficiency (26%) and in 8 patients in the control group (5%). In all fetuses the aorta as well as the carotic artery were examined by Doppler sonography. In the group with placental insufficiency markedly increased values were noted from the resistance index (RI) in the aorta as compared to the controls. The values in the carotis, however, were lower. This must be considered as a sign for a higher degree of centralization in these fetuses with supply deficiency. In those fetuses with enlarged bowel convolutions the doppler parameters were even more pathologic. Their post partal condition was also clearly worse. In 28 fetuses of this group in almost all cases no diastolic flow could be detected in the arteria mesenterica superior, whereas such a flow was found in all other cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Classification, diagnosis and differential diagnosis of malignant melanoma].

Due to the recent increase of incidence of malignant melanoma and due to the significance of early detection for a definite cure from the disease, diagnosis and differential diagnosis of malignant melanoma are very important. At first glance the malignant potential of a pigmented mole can be evaluated by the macroscopical ABCD rule (Asymmetry, irregular Border, different Colors, and Diameter larger than 6 mm). In addition, also the history of the patient might be helpful. Thus a malignant melanoma should be considered when a patient reports a new rapidly growing pigmented lesion or a change in an existing mole in color, size, shape, and surface. Itching or burning should also arouse the suspicion of malignant change. Risk factors for the development of a malignant melanmoma are a high number of benign melanocytic nevi, large congenital melanocytic nevi, fair skin types with a tendency to sunburns and a malignant melanoma in the family of the patient. With dermatoscopy, which is skin surface microscopy at 10x magnification, the difficult macroscopical differential diagnosis is facilitated, because this technique opens a new dimension between macroscopy and microscopy.

Adolescent↗
PubMed1993

Analytic morphology in clinical and experimental dermatology.

During the past several years, quantitative morphology has gained increasing attention in diagnostic pathology and in certain research applications. In the field of dermatopathology, quantitative morphology has been applied to numerous problems, ranging from the interactive measurement of nuclear contours to fully automated, high-resolution image analysis of ultrastructural micrographs. Dermatologic applications are reviewed, and potential developments in the future are briefly outlined.

Animals↗
PubMed1993

Adherence of Escherichia coli to sperm: a mannose mediated phenomenon leading to agglutination of sperm and E. coli.

OBJECTIVE: To investigate the mechanism of adherence between Escherichia coli and sperm. DESIGN: Experimental study performed with donor sperm and male genital tract-derived E. coli. SETTING: Andrology unit of a university hospital. PATIENTS: None. INTERVENTIONS: Monitoring of sperm-E. coli agglutination; addition of sugars to block adherence; electron microscopy. MAIN OUTCOME MEASURE: Sperm-E. coli agglutination. RESULTS: Escherichia coli readily adhered to and agglutinated sperm. The phenomenon was observed at E. coli to sperm ratios as low as 1:20; maximum sperm agglutination involving approximately 90% of spermatozoa was seen with ratios of 1:5 or higher. By transmission electron microscopy, E. coli adherence was observed both on sperm heads and tails. Heteroagglutination could be blocked by D-mannose and alpha-methyl-mannopyranoside but not by other sugars. Preincubation of sperm or E. coli with mannose resulted in block of agglutination, indicating mannose-binding structures both on sperm and E. coli. CONCLUSIONS: Adherence of E. coli to sperm is mediated by mannose and mannose-binding structures present on both cell types. Agglutination of sperm by E. coli may be relevant in male and female infertility.

Bacterial Adhesion↗
PubMed1993

Bacteriophages induced by ciprofloxacin in a Borrelia burgdorferi skin isolate.

Two types of tailed bacteriophages were detected by electron microscopy in a Borrelia burgdorferi strain which had been isolated from infected human skin and exposed to the gyrase inhibitor ciprofloxacin. One of these phages displayed an isometric 30 nm head, a neck and a contractile tail 50-64 nm in length with a baseplate, according to an A-1 morphology. The other phage showing a B-1 morphology had a 30 nm isometric head as well and a long non-contractile straight tail 115-130 nm in length without neck and baseplate. Both types of phages could be found together within one plasmolysed spirochetal cell. We conclude that we are dealing with a lysogenic strain of Borrelia burgdorferi carrying at least two different prophages inducible by ciprofloxacin.

Adult↗
PubMed1993

Squamous cell carcinoma in localized scleroderma following immunosuppressive therapy with azathioprine.

A 40-year-old man presented with an ulcerated tumour in a fibrotic plaque on the dorsum of his left foot. Due to severe localized scleroderma, the patient had been treated with azathioprine 10 years earlier. Histopathology of the excised tumour revealed an anaplastic squamous cell carcinoma within a scar of localized scleroderma. The case demonstrates that not only patients with tense scar tissue following burning, congelation, chronic radiodermatitis, lupus vulgaris or lupus erythematosus but also patients who have had localized scleroderma may run a greater risk of developing squamous cell carcinoma. Immunosuppressive therapy has to be discussed as an additional risk factor in our patient. Therefore, narrow clinical follow-up was recommended for early detection of relapse.

Adult↗
PubMed1993

[Interferon-gamma. Therapy of recurrent furunculosis in HIV infections].

Four HIV-antibody-positive patients in stages CDC II to CDC IV C2 with furuncles that had so far proved refractory to treatment were successfully treated with systemic application of recombined gamma-interferon, 50 micrograms s.c. on days 1, 2 and 3 of the first week with a new cycle after 3 weeks. A significant clinical improvement was seen in all patients after three to five cycles. Side-effects of therapy with gamma-interferon were similar to the symptoms of influenza and improved during therapy. No changes in immunological parameters and white blood cells counts were observed. The general condition of the patients improved or remained unchanged. A few weeks after discontinuation of therapy two patients relapsed, but they were again successfully treated with gamma-interferon.

AIDS-Related Opportunistic Infections↗
PubMed1993

[Historical development of skin surface microscopy].

Within the last decade, skin surface microscopy has been rediscovered as an useful technique for preoperative diagnosis of pigmented skin lesions. This method was originally developed early this century as one component of "functional diagnosis" in constitutional pathology.

Europe↗
PubMed1993

Classification of melanocytic lesions with color and texture analysis using digital image processing.

The incidence of malignant melanoma, the most dangerous skin cancer, has increased rapidly during the last decade, and the figures are still rising. Since well-trained and experienced dermatologists are able to reach only a diagnostic accuracy of about 75% in visual preoperative classification, the discriminating ability of digital image analysis was evaluated in more than 350 malignant melanoma and benign melanocytic lesions that had all been confirmed histologically. Color slides of melanocytic lesions were scanned and digitized. Computer algorithms were programmed in FORTRAN on a DECstation 5000/200. A feature set was calculated describing the texture, color and their distributions as well as asymmetry, size and border of each lesion. These features, together with the histologic diagnosis, were the input in a commercial statistical classification program. In contrast to the accuracy of 75% achievable by the human eye, a correct classification rate of about 92% was reached with the mathematical classifier as compared with the histologic diagnosis.

Algorithms↗
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↗