Percutaneous antegrade electropapillotomy. Study in dogs.

Antegrade electropapillotomy using the percutaneous transcystic approach was successfully performed in 11 of 16 dogs. When the intervention was effective, the pressure gradient between common bile duct and duodenum decreased from 6 to 1.3 mm Hg on average and returned to gradients slightly below the initial values after 4 weeks, owing to reactivation of the sphincter mechanism. Ineffective cutting, however, resulted in a temporary pressure rise. In one dog a papillary stenosis developed and was relieved by antegrade electrocutting. Irrespective of the success of the papillotomy, rises in levels of serum glutamine oxaloacetic and pyruvic transaminase, alkaline phosphatase, serum amylase and …

Gegenüberstellung der Wertigkeit von Angioskopie, Angiographie und Sonographie zur Erfassung pathologischer Gefäßwandprozesse

AIMS The ability of angioscopy, angiography and sonography to evaluate arteriosclerotic vascular lesions were compared to determine if angioscopy is a valuable addition in the diagnostic armamentarium. METHODS An in-vitro study was selected to enable microscopic assessment of the arteries. Angiography was followed by sonography and endoscopy and finally the vessels were evaluated macro- and microscopically. RESULTS The configuration of the vascular stenosis (plaque-shape, semicircular-eccentric, circular-concentric) was more reliably defined with angioscopy as compared to angiography and sonography. Intense calcification of plaque was detected sonographically with a high sensitivity (90%) u…

Cytoplasmic microvesicles in chromophobe cell renal carcinoma demonstrated by freeze fracture

In the chromophobe cell type of renal carcinoma, cytoplasmic microvesicles (frequently with "inner vesicles") demonstrable by transmission electron microscopy are one of the most important diagnostic features. The present paper reports on these microvesicles in freeze fracture replicas. Their diameter is mainly between 140 and 300 micron, but smaller and very much larger vesicles may also occur. The vesicle membrane is devoid of, or contains only scanty intramembranous particles. Cytoplasmic invaginations, probably the precursors of "inner vesicles" can also be detected. Connections with the agranular endoplasmic reticulum, mitochondria or other cell components could not be documented. Larg…

Differences in Attachment and Phagocytosis of Salmonella minnesota Strains (S Form, Re Mutant) by Mouse Peritoneal Macrophages: Participation of Endogenous C1q and Bacterial Surface Components (LPS, Porins)

The virulence of bacteria in many phagocytic systems has been studied for several years and it is known that macrophages play an important role in host defence against invading microorganisms and in cooperation with cellular and humoral immune mechanisms. Pathogenic bacteria can be divided into two groups with regard to their fate within phagocytes: (a) extracellular bacteria which are promptly killed after phagocytosis and (b) facultative intracellular bacteria which are resistant to intracellular killing unless macrophages are activated. Humoral immune mechanisms (antibody, complement) deal mainly with extracellular bacteria, while cellular immune mechanisms (T cells, macrophages) deal wi…

Osteonectin Expression in Odontogenous and Non-odontogenous Tumors and Tumor-like Lesions of the Skull and Jaw Bones

The organic matrix of osseous and odontogenic tissues is formed mainly by collagen type I. In addition there is a considerable bulk of noncollagenous proteins (Prince et al. 1987) in bone among which osteonectin represents the greatest amount. This protein, first isolated by Termine et al. (1981) has a molecular weight of 29 kD and possibly is involved in the mineralization process of collagenous fibrils in bone (Romberg et al. 1985). Recently osteonectin could be demonstrated in bone tumors and normal bone and has been considered as a marker for bone tumor cells (Schulz et al. 1985; Jundt et al. 1987). The aim of the present study was to examine the expression of osteonectin in odontogenou…

Human chromophobe cell renal carcinoma

Twelve renal cell carcinomas composed of "chromophobe" cells are described. This is the first report of renal chromophobe cell tumors in humans neoplasms of this cell type having been described previously only in experimentally induced adenomas in animals. By light microscopy chromophobe cells have slightly opaque or finely reticular cytoplasm when stained with haematoxylin and eosin. They may be distinguished from the clear cells of hypernephroid renal cell carcinomas by the strongly positive reaction of their cytoplasm with Hale's (1946) colloidal iron method and the weaker positive reaction with alcian blue. Vesicular structures, often containing internal vesicles, and possibly derived f…

Klassifikation der Nierenzellkarzinome/Tumoren und ihre Beziehung zum Nephron-Sammelrohrsystem

After a controversial phase of nomenclature (including--among others--the terms "hypernephroma" and "hypernephroid carcinoma") a cytomorphologically defined subtyping of renal cell tumours (adenomas, carcinomas, oncocytomas) is offered, based on new electron microscopical and histochemical observations. These data are in part supported by cytogenetical findings reported in the literature. Phenotypical/histogenetical relations to different parts or cell types, respectively, of the nephron-collecting duct system could be demonstrated. Chromophobe cell carcinoma and oncocytoma exhibit features of the intercalated cells.

Parenchyma-sparing surgery for renal tumors

Between 1969 und 1989 conservative surgery for kidney tumors was performed in 123 patients. In 49 patients there was an imperative indication for a parenchyma-sparing operation because nephrectomy would have made dialysis obligatory. Thirty-five of these 49 patients show no signs of tumor progression after a mean follow-up of 4.5 years. Known metastases were present in 3 of 6 patients who died as a result of their tumors. In two patients there was a recurrence after 1 and 5 years, respectively, requiring a second organ-preserving operation. In one further patient we suspect that multiple small tumor lesions may be present 2 years after the first operation. In 74 patients with a healthy cont…

Bioactive Glass-Ceramics in Middle Ear Surgery An 8-Year Review

An 8-year follow-up of Ceravital middle ear prostheses showed there was extremely good tolerance in the middle ear space. Incompatibility phenomena were not observed, and inflammatory reactions were neither caused nor supported by the implants. The tympanoplasties were always performed without interposition of cartilage between the tympanic membrane or the tympanic membrane graft and the disk-shaped portion of the implant, and extrusions were never observed. Long-lasting inflammatory processes appeared to destroy implants the same way they destroy ossicles. Transient inflammatory periods (such as episodes of purulent otitis media, which occurred soon after the prostheses were implanted) did…

Molekulargenetische Diagnostik und Histo- pathologie epithelialer Nierentumoren

Parosteal osteosarcoma of the talus.

A case of parosteal osteosarcoma in the very rare location of the talus is presented. The radiological, pathological, and clinical characteristics of parosteal osteosarcoma are described and the differential diagnosis discussed.

Conservative Surgery of Renal Tumors: Operative Technique, Complications, Results, DNA Cytometry

Until now radical nephrectomy has been regarded as the standard therapy for nonmetastasized renal cell carcinoma. This operation has been accepted because of the theoretical advantage of a more complete resection. A parenchyma-sparing operation was only performed in patients in whom radical nephrectomy would result in renal failure requiring hemodialysis (imperative indication), such as patients with single kidney, bilateral tumors, dysfunctional contralateral kidney, or chronic renal failure. However, the widely used partial nephrectomy in these instances may in certain cases result in insufficient residual renal parenchyma. Simple enucleation of the tumor with a small surrounding margin o…

Cytomorphological typing of renal cell carcinoma--a new approach.

The role of osteonectin in human tooth development: An immunohistological study

We investigated immunohistologically 160 teeth and dental germs in various stages of tooth development taken from human individuals (13th week of pregnancy to the 24th year of life) to study the osteonectin expression in dental hard tissue. In the course of dentinogenesis, the predentin, the odontoblasts, and their cell processes show a positive osteonectin staining reaction. During cementogenesis, osteonectin is synthesized by cement-producing fibroblasts, cementoblasts, and cementocytes. The expression of osteonectin during dentinogenesis and cementogenesis is closely related to the development of the respective calcified tissue. All cells of the inner and outer enamel epithelium, the cel…

Factors influencing survival after resection of pancreatic cancer. A DNA analysis and a histomorphologic study

BACKGROUND The influence of DNA content on prognosis in stomach cancer has been investigated rarely, and the results are controversial. METHOD The prognostic relevance of the DNA content and histomorphologic parameters was evaluated in 41 patients after resection of pancreatic cancer. RESULTS In the univariate analysis, the DNA content, tumor size, lymph node status, tumor stage, nuclear grade, and type of resection had a statistically significant influence on the prognosis. No association was found between the DNA content and the histomorphologic features. Apart from the operative procedure, the DNA content was the strongest indicator of prognosis in the multivariate analysis. CONCLUSIONS …

HER-2/neu is expressed in human renal cell carcinoma at heterogeneous levels independently of tumor grading and staging and can be recognized by HLA-A2.1-restricted cytotoxic T lymphocytes.

The HER-2/neu oncoprotein, a 185 kDa membrane-associated tyrosine kinase with extensive homology to the epidermal growth factor receptor (EGF-R), is overexpressed in breast and ovarian carcinomas. Its overexpression is closely associated with poor prognosis in the course of disease. Here we demonstrate HER-2/neu overexpression in both established cell lines and biopsy material obtained from renal epithelial tumors. Immunohistochemical analysis of human kidney tumor lesions using 2 HER-2/neu-specific antibodies revealed HER-2/neu expression in more than 40% of primary epithelial renal tumors and more than 30% of primary renal cell carcinoma (RCC) specimens. A distinctive HER-2/neu expression…

Modulation of type II collagen-induced arthritis in DBA/1 mice by intravenous application of a peptide from the C1q-A chain.

In this report we are able to show that intravenous (i.v.) application (day 0) of a nonapeptide (residues 26-34) from the human C1q A-chain (designated peptide A-C1q) prior to intradermal (i.d.) administration of chicken type II collagen (CII) in arthritis-susceptible DBA/1 mice (H2q), leads to abrogation of polymorphonuclear neutrophil (PMN) invasion into the joints. This nonapeptide exhibits epitope characteristics and high homology to residues 137-147 of CB11 (a cyanogen bromide fragment of chicken CII, known to contain both arthritis inducing and suppressing determinants). Arthritis index was lowest in animals pretreated i.v. with CII (as internal control), though animals pretreated i.v…

Gefäßrekanalisation mit einem elektrischen Thermokauter-Katheter -In-vitro-Erfahrungen mit einem neuen Kathetersystem

Recanalisation of arteriosclerotic occlusions by means of laser angioplasty, Kensey catheter and the "hot tip" catheter is undergoing early, successful clinical trials. The thermo-cautery catheter described in this paper uses the well known technique of cutting with high frequency electric currents in order to achieve vascular recanalisation. Seven attempts were made to recanalise occlusions at post mortem; four were successful, but perforation occurred in three. Histologically we found a narrow rim of carbonisation of tissues surrounded by a zone of homogenisation and a transitional zone.

Successful adenovirus-mediated wild-type p53 gene transfer in patients with bladder cancer by intravesical vector instillation.

PURPOSE: To study safety, feasibility, and biologic activity of adenovirus-mediated p53 gene transfer in patients with bladder cancer. PATIENTS AND METHODS: Twelve patients with histologically confirmed bladder cancer scheduled for cystectomy were treated on day 1 with a single intratumoral injection of SCH 58500 (rAd/p53) at cystoscopy at one dose level (7.5 × 1011 particles) or a single intravesical instillation of SCH 58500 with a transduction-enhancing agent (Big CHAP) at three dose levels (7.5 × 1011 to 7.5 × 1013 particles). Cystectomies were performed in 11 patients on day 3, and transgene expression, vector distribution, and biologic markers of transgene activity were assessed by m…

Inverse regulation of vascular endothelial growth factor and VHL tumor suppressor gene in sporadic renal cell carcinomas is correlated with vascular growth: an in vivo study on 29 tumors

Tumors associated with the VHL (von Hippel-Lindau) disease, such as hemangioblastomas and renal carcinomas and their sporadic counterparts, are cystic and well vascularized. Mutations of the VHL tumor-suppressor gene and elevated levels of vascular endothelial growth factor (VEGF) have been described in these tumors. The upregulation of VEGF has been shown in vitro as a consequence of alteration of the VHL gene. No comprehensive in vivo analysis has yet been carried out of the factors affecting tumor growth, vascularization, VEGF, and VHL expression. We performed immunohistochemistry and mRNA studies on primary sporadic renal carcinomas and matching normal renal tissue. We semiquantitativel…

Intercalated cells as a probable source for the development of renal oncocytoma

Renal oncocytoma is a distinct type of epithelial tumor said to arise from the collecting duct system. Here we show that in nine of ten oncocytomas the tumor cells expressed an analog of the erythrocyte anion exchanger band 3. In the normal kidney band 3 is confined to the basolateral surface of the majority of intercalated cells which comprise up to 50% of the cortical collecting duct epithelium. Carbonic anhydrase c is another protein abundant in intercalated cells, and this was also expressed in six of the ten oncocytomas investigated. Immunoreactivity specific for band 3 and carbonic anhydrase c was not detected in any of the 20 renal cell carcinomas examined. At favourable section plan…

Loss of heterozygosity at the short arm of chromosome 3 in renal‐cell cancer correlates with the cytological tumour type

A majority of renal-cell tumours retain heterozygosity at the short arm of chromosome 3. To investigate possible histopathological differences between tumours with and without such losses, we compared loss of heterozygosity data from 51 tumours with 1 histological and 2 different cytological classifications of renal-cell tumour. Using the cytological classification of Thoenes et al., we only found tumours with loss of heterozygosity in these authors' clear-cell category. Possibly, only these tumours arise by a mechanism of double loss of a tumour-suppressor gene on 3p, non-clear-cell renal tumours having a different genetic background. Alternatively, deletions may occur in all subtypes, in …

Cellular immune response to human renal-cell carcinomas: Definition of a common antigen recognized by HLA-A2-restricted cytotoxic T-Lymphocyte (CTL) clones

Cytotoxic T lymphocyte (CTL) clones directed against autologous renal-cell carcinoma (RCC) cell lines were generated by mixed lymphocyte/tumor-cell culture (MLTC) using peripheral blood lymphocytes (PBL). A CD8+, CD4- CTL clone MZ1257-CTL 5/30 with high cytolytic activity for the autologous tumor cell line MZ1257-RCC was established. No lysis of the autologous EBV-transformed B lymphocytes (EBV-B) or K562 cells was observed. A panel of HLA-A2-matched allogeneic RCC lines was recognized by CTL 5/30. Further specificity analysis showed a cross-reactivity with HLA-A2-matched allogeneic tumor cells of various origins, especially melanoma. CTL 5/30 was also cross-reactive with several HLA-A2-pos…

Das Onkozytom der Niere

The angiographic findings in ten patients with renal oncocytoma are described. Characteristic features include: absence of encasement, vascular occlusions, arterio-venous shunts and contrast lakes (8/10). Spoke-wheel arrangement of tumor vessels (8/10). Homogeneous tumour contrast during the capillary phase (7/10). Sharp demarcation from the kidney and surroundings (9/10) and a peritumoral halo (4/10). If the suspicion of an oncocytoma is raised by CT examination of a space-occupying lesion (part I), angiography should be performed to confirm the diagnosis and help in planning surgical treatment.

Chromosomal changes in renal oncocytomas Evidence that t(5;11)(q35;q13) may characterize a second subgroup of oncocytomas

Many of the reported oncocytomas have different chromosome abnormalities, indicating that they comprise a cytogenetically heterogenous group of tumors consisting of potentially cytogenetic subgroups. We have performed cytogenetic studies on nine renal oncocytomas. Clonal abnormalities were present in eight tumors. The findings most observed were the loss of the Y chromosome, and abnormalities of chromosomes 1 and 22. We also observed telomeric associations (tas) in two tumors and structural aberrations of chromosomes 9p and 19q, as well as monosomy 10. In two cases we found a similar reciprocal t(5;11)(q35;q13) in two cases. Review of the literature disclosed one other oncocytoma with a t(5…

Autosomal dominant polycystic kidney disease—in vitro culture of cyst-lining epithelial cells

The major form of autosomal dominant polycystic kidney disease (ADPKD) in humans is linked to the PKD1 gene on chromosome 16p. The identity of the gene and the underlying pathogenetic mechanisms are not yet defined. Cyst-lining epithelial cells derived from a polycystic kidney were successfully grown in culture and designated MZ-PKD-1 cells. By linkage analysis, the related pedigree of the nephrectomized patient could be linked to the PKD1 gene on chromosome 16p. Thus, these cells exhibit the genotype of a mutated PKD1 gene and represent an in vitro culture model for ADPKD involving chromosome 16p. The antigenic phenotype was characterized immunohistologically by epithelial differentiation …

Interleukin-7 or Interleukin-15 Enhances Survival ofMycobacterium tuberculosis-Infected Mice

ABSTRACTBoth antigen-presenting cells and immune effector cells are required to effectively eradicate or containMycobacterium tuberculosis-infected cells. A variety of cytokines are involved to ensure productive “cross talk” between macrophages and T lymphocytes. For instance, infection of macrophages with mycobacteria leads to effective interleukin-7 (IL-7) and IL-15 secretion, and both cytokines are able to maintain strong cellular immune responses of α/β and γ/δ T cells. Here we show that either cytokine is able to enhance survival ofM. tuberculosis-infected BALB/c mice significantly compared to application of IL-2, IL-4, or phosphate-buffered saline (as a control). Enhanced survival cou…

Histopathology and Classification of Renal Cell Tumors (Adenomas, Oncocytomas and Carcinomas)

The term renal cell tumors (adenomas and carcinomas) subsumes the tumors deriving from the uriniferous tubule epithelium of the kidney. Precise analysis shows that the renal cell tumors display different cell types which build up the individual tumor alone or in combination with each other. Three categories of basic elements are distinguished in the characterization of renal cell tumors: Cytological elements = tumor cell types: Clear, chromophobe, chromophilic (basophilic, eosinophilic), oncocytic, spindle-shaped/pleomorphic. Histological elements = growth patterns: Compact, acinar (nest-like), tubulopapillary (tubular, papillary), cystic. Cytological grading of malignancy: G I, G II, G III…

The human chromophobe cell renal carcinoma: its probable relation to intercalated cells of the collecting duct.

In the present study we have examined ten cases of the chromophobe type renal cell carcinoma. This type of tumor is distinguished from the other carcinomas of the kidney with light cytoplasm (formerly called “hypernephroid”) by (a) a positive Hale’s iron colloid stain of the cytoplasm, (b) the occurrence of numerous invaginated vesicles within the cytoplasm that resemble the invaginated vesicles of intercalated cells of the collecting duct system, and (c) a positive immunoreaction of both the plasma membrane and the cytoplasm with antibodies to the epithelial membrane antigen (EMA) and carbonic anhydrase C (CAC), respectively. Unlike oncocytomas, which also express CAC and EMA, the chromoph…

Cytogenetic analysis of epithelial renal-cell tumors: Relationship with a new histopathological classification

Renal-cell carcinomas (RCC) are clinically, histologically and cytogenetically very heterogeneous. The present histological WHO classification shows no clear correlation between histologic subtypes and specific chromosomal abnormalities. In 1986, a new classification was proposed by Thoenes and Storkel based on the cell type from which the tumor arises. They distinguish S cell types: clear-cell, chromophilic, chromophobic, ductus Bellini and oncocytic. Results of 105 primary tumors show that, in this new classification, there is a correlation between different subtypes of renal-cell tumor and specific chromosomal abnormalities at a microscopic and/or molecular level. The clear-cell compact …

DNA image cytometry. A prognostic tool in squamous cell carcinoma of the esophagus?

In 45 patients who underwent an esophagus resection due to a squamous cell carcinoma, in addition to the TNM classification and usual morphologic criteria, the paraffin-embedded material underwent deparaffinization, was rehydrated, and was mechanically and enzymatically processed into a single-cell solution. For evaluating the DNA histogram this was analyzed with the help of automatic single-cell cytophotometric study. The method, contrary to that of flow cytometric study, allows for the selective analysis of tumor cells due to the electronically, previously given selection criteria, whereas artifacts, stroma, and infection cells remain excluded from analysis. The multivariate analysis show…

Tumorspecific Antigens in Human Renal Cell Carcinoma: Ultrastructural Localization of the Antigen by Immune-Electron-Microscopy

In clinical oncology, tumor markers are a valuable tool in therapy monitoring of tumor patients as well as for primary diagnosis. In renal cell carcinoma a number of tumor associated antigens were described which may also be expressed in normal kidney epithelium (Bander et al. 1983; Bander 1984; Moon et al. 1982; Oosterwijk et al. 1987a, b; Ueda 1981). Only occasionally are antigens described which do not react in normal kidney tissue. The here described antigen is restricted to well differentiated human renal cell carcinoma (RCC) and does not show any expression in the normal kidney or other human organs (Table 1). The antibodies produced by hybridoma-technology are highly specific for the…

Characterization of conservatively resected renal tumors using automated image analysis DNA cytometry

The DNA histograms of 57 conservatively resected renal tumors were studied using automated image analysis DNA cytometry (Leytas II). Forty-nine of the analyzed tumors were renal cell carcinomas, six were oncocytomas, one was an angiomyolipoma, and one was a renal cell adenoma. On the basis of their DNA histograms, diploid, tetraploid, and aneuploid tumors could be distinguished. Aneuploid tumors could be subtyped further according to the DNA content of the stem cell line as hyperdiploid, hypertriploid, or hypertetraploid. Eight of the tumors were characterized by a combination of diploid and hypertriploid stem cell lines. During a mean follow-up of 5 years, only the two patients with a pure…

Chromophobe cell renal carcinoma and its variants--a report on 32 cases.

This paper reports on 32 chromophobe cell renal carcinomas observed in 697 renal cell cancers (RCC) of adults (peak in the sixth decade of life). The chromophobe cell-type differs from other types of RCC macroscopically, the cut-surface being predominantly of grey-beige colour. Histologically, there are two variants: one is the typical (light) variant (n = 22) and the other is eosinophilic (n = 10). Both variants have in common (a) reaction of the cytoplasm with Hale's acid iron colloid; (b) electron microscopic detection of cytoplasmic microvesicles (150-300 nm), frequently with 'inner vesicles', and (c) low glycogen content in comparison with the clear cell carcinoma. Immunocytochemical i…

Posttransfusional, LKM-1-autoantibody-positive hepatitis C virus infection, cryoglobulinemia, and aplastic anemia.

Aplastic anemia is occasionally caused by viral hepatitis, hepatitis C virus being the most important factor. Pathogenetically, decreased bone marrow function, abnormalities of the bone marrow microenvironment, and immune-mediated suppression of hematopoiesis are important. Hepatitis C virus infection is associated with a variety of extrahepatic manifestations including autoimmune features like cryoglobulinemia, Sjogren's syndrome, and autoimmune hepatitis. Here we report the case of a 42-year-old man with aplastic anemia due to posttransfusional hepatitis C virus infection associated with cryoglobulinemia and LKM-1 autoantibodies. Following a triple immunosuppressive therapy, there was a c…