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Biomedical subjects

A Böcking

Publications and source records attributed to A Böcking.

At least 19 recordsLinked to original sources
PubMed1992

[CT-guided Tru Cut biopsy of solid pelvic space-occupying lesions. The indications, technic and results].

Solid lesions in different localisations of the pelvis were biopsied with a large-bore Tru-Cut cannula (G 14) in 88 patients under computed tomographic guidance. Special techniques for safe access to pelvic lesions are described. Indications for biopsy were suspected extraluminal tumour recurrence (n = 49), masses outside the pelvic organs in the absence of a known pelvic primary (n = 21) and in the presence of a known pelvic primary (n = 10). In 8 cases, lesions situated within pelvic organs were punctured. Without any repeat biopsy, accuracy reached 96.6%, sensitivity was 95.2% and specificity was 100%. In comparison to the results of FNA reported in the literature diagnostic accuracy can be improved upon by using large-bore biopsy. No complications occurred.

Anesthesia, Local↗
PubMed1992

[Percutaneous CT-controlled cutting-needle biopsy of diffuse interstitial and alveolar lung diseases--the technic and results].

Twenty-three patients underwent CT-guided large-bore biopsy of diffuse lung disease of clinically and radiologically indeterminate etiology. The procedure was preceded by negative transbronchial biopsy in 20 cases. CT-guided biopsies were performed with a 14-gauge Trucut-needle. Obtaining at least 3 specimens of different parts of the diseased area, a correct histologic diagnosis was achieved in all cases. The size of the histologic specimens (mean: 5-6 mm) exceeded that of the specimens obtained by transbronchial biopsy as reported in the literature. Two major complications occurred and included a rapidly developing tension pneumothorax treated by a small-bore catheter and one self-limited hemoptysis. Major advantages of percutaneous CT-guided biopsy are the nonsuperimposed and very sensitive imaging of lung alterations in diffuse lung diseases that allows evidence of adjacent less and more involved areas accessible by one biopsy approach. CT-guided large-bore biopsy with a cutting needle seems to be a very promising, accurate method in the pathomorphologic work-up of diffuse lung diseases rendering open biopsy unnecessary in many cases.

Adult↗
PubMed1992

[CT-guided large-bore biopsy of solid non-organ-bound space-occupying lesions in the retroperitoneum].

Seventy-eight solid, non-organic retroperitoneal tumours were biopsied with a 14-gauge Tru-Cut needle in 73 consecutive patients with the exception of one. Adequate material was not obtained in only one patient with the primary known (1.3%). In the adequate material (98.7%), the dignity of all lesions was accurately determined and 93.1% of lesions were accurately classified. Typing accuracy reached 100% in histologically known primaries (n = 31) and 87.8% in histologically unknown primaries (n = 41). A hypertensive crisis and a small haematoma following biopsy of an inadvertent extra-adrenal phaeochromocytoma was the single complication found in this series. An arterial bleeding following biopsy was prophylactically embolised through the biopsy needle. CT-guided large-bore biopsy of solid non-organic retroperitoneal tumours is a safe, non-invasive procedure with a high diagnostic yield that obviates the need for open diagnostic procedures in a large number of cases.

Adolescent↗
PubMed1992

Prediction of recurrence in giant cell bone tumors by DNA cytometry.

The most interesting therapeutic aspect of giant cell bone tumors is which patients can be cured without a risk of recurrence by intralesional surgery (curettage). To find out the suitability of some DNA cytometric and morphometric parameters for showing differences between this group of patients (n = 9) and those with recurrence (n = 12), the parameters mean ploidy, 2cDI (mean square deviation of the tumor cell DNA content from the normal 2c value), mean nuclear area and its variability were calculated from cytologic specimens prepared by a cell separation technique from formalin-fixed, paraffin-embedded tissues, measuring the values of 100 stromal cells per case by a TV image analysis system. Further measurements were performed on 19 cases of different diseases of the bone and on an additional 17 cases of giant cell tumors without follow-up. The 2cDI allowed us to distinguish the two groups of patients, with and without recurrence, without overlap; even the lowest value for patients with recurrence was higher than the highest value for cured ones. Mean ploidy analysis resulted in a less convincing discrimination of the patients. Mean nuclear area and its variability failed to predict recurrence. Single-cell DNA cytometry provided a parameter, 2cDI, that was able to predict recurrence in patients with giant cell bone tumors with high sensitivity.

Adult↗
PubMed1991

[CT-guided course-punch biopsy of the adrenals. The indications, technic and results].

Adrenal lesions exceeding 1.5 cm diameter were biopsied with a Tru-Cut needle (G 14) under CT guidance for histologic evaluation in 61 patients. Using CT for guidance, special techniques for safe access to the adrenals are described. Large-bore biopsy yielded a sensitivity of 100% and a specificity of 97.4%. Diagnostic accuracy was 98.3%. No significant complications occurred. In comparison to the results of FNA reported in the literature, large-bore biopsy of adrenal lesions improves the rate of adequate material and the histopathologic differentiation without increase of complications.

Adrenal Gland Neoplasms↗
PubMed1991

Monitoring DNA cytometric parameters during the course of chronic myelogenous leukemia.

The prognostic value of three DNA cytometric parameters--stemline ploidy (STL), stemline shoulder fraction (SSF) and "proliferative" fraction (PRF)--for the prediction of disease transformation and survival was examined for 20 patients with chronic myelogenous leukemia (CML) during the course of their disease and compared with two commonly used hematologic parameters (degree of leukocytosis and percentage of circulating leukemic progenitor cells). With disease progression, STL and SSF increased significantly, whereas PRF showed a steady decrease from diagnosis to blast crisis. The most significant part of these changes took place during the chronic phase, before the clinical onset of disease transformation. Hematologic parameters, in comparison, revealed significant changes later, shortly before blast crisis. The remaining duration of the chronic phase diminished from 25.5 months at the time of diagnosis, when the median STL was 2.0c, to 19.6 months for patients showing an STL of 2.1c, to 15.0 months with an STL of 2.2c and to 1.0 months for those with an STL of greater than or equal to 2.3c. Prognostically relevant limits for SSF and PRF were at 20%. When the SSF passed this limit or the PRF fell below it, the mean remaining chronic phase of these patients amounted to only 14.1 and 10.1 months. Interactive cytometry allows analysis of the DNA cytometric equivalent of changes in leukemic progenitor cells, which are well known from cytogenetic and cell kinetic studies. These three DNA cytometric parameters reflect the "natural history" of CML with the development of a cytogenetically hyperdiploid clone during disease progression in most patients and a simultaneous loss of proliferative potential on the level of myelobasts.(ABSTRACT TRUNCATED AT 250 WORDS)

Blast Crisis↗
PubMed1991

DNA-cytometric detection of euploid polyploidization in oral lichen ruber planus.

The DNA distribution was analyzed in 29 cases of oral lichen ruber planus that were negative for human papillomavirus and not suspected of being precancerous. Monolayer smears prepared from formalin-fixed, paraffin-embedded tissues were automatically Feulgen stained and used for rapid interactive DNA cytometry via a TV-based image analysis system combined with an automated microscope. Nuclei with DNA contents greater than 4c were found in 25 cases (86%). DNA contents greater than 8c were seen in five cases (17%), and small peaks at 8c were found in three cases. These increased DNA values in nonprecancerous lesions must be interpreted as euploid polyploidization and have to be taken into account if DNA measurements are performed for diagnostic purposes in lichen ruber planus lesions that are suspected of having malignant transformation.

DNA↗
PubMed1990

[Importance of DNA-cytometric parameters in the prediction of blast crisis in the course of chronic myelogenous leukemia].

In a retrospective study the DNA-cytometric parameters stemline ploidy, stemline shoulder fraction and proliferative fraction were followed during the course of the disease in 20 patients with chronic myelogenous leukemia. Stemline ploidy and stemline shoulder fraction significantly increased whereas the proliferative fraction steadily decreased during the disease most of these changes taking place during chronic phase before the clinical onset of blast crisis. Prognostically relevant cutpoints indicating disease transformation during the next 12 months could be defined.

Blast Crisis↗
PubMed1990

[DNA cytometry and automation in clinical diagnostics].

The biological basis for DNA-cytometric assistance in the diagnostic evaluation of dysplasias and borderline lesions is "chromosomal aneuploidy" as a marker for neoplasia. The detection of its equivalent in DNA-cytometry ("DNA-aneuploidy") may be taken as a marker for neoplastic transformation. Examples for the DNA-cytometric detection of prospective malignancy are reported for cervical dysplasias, myelodysplasias and borderline cystadenomas of the ovary. Further examples are given for diagnostic assistance in the cytological detection of malignant cells in touch preparations from soft tissue and bone tumours and in urine samples. The basis for "DNA-grading" of malignancy is the fact that the modal chromosomal aneuploidy and its variability in many tumours correlate with the patients prognosis. The prognostic validity of their DNA-cytometric equivalents (modal DNA-ploidy = stemline-ploidy and 2c Deviation Index resp.) are demonstrated for chronic myelogenous leukemias and urinary bladder cancers. Other DNA-cytometric parameters may also be prognostically valid. Data, concerning the prognostic relevance of DNA-cytometry are known for at least 18 different tumour sites. The reproducibility of "DNA-grading" of malignancy is high as compared with subjective morphological grading systems. Modern technological equipment for Feulgen-staining and interactive DNA-measurements for diagnostic purposes is described.

Autoanalysis↗
PubMed1990

[Methodological requirements for precise measurements using DNA single cell cytometry].

Methodological aspects on DNA single cell cytometry were investigated. Specimens can be homogeneously Feulgen-stained if a high constancy of temperature is realized in the staining cuvette during acid hydrolysis. For the TV image analysis system under investigation (TAS-plus, Leitz) a linear correlation (r greater than 0.99) between physically defined optical transmission values and resulting electronic signals was found. Shading effects can be controlled by using a narrow mask width (VQ less than 1.5%). As an internal standard blood cells or epithelial cells can be used if a correction factor, that was found to be mainly constant, is calculated.

Cytodiagnosis↗
PubMed1990

Performance of a TV image analysis system as a microdensitometer.

The performance of a TV image analysis system combined with an automated microscope (the Leitz TAS plus) as a microdensitometer and morphometric device was investigated. There was a strict linear correlation (r greater than .99) between the physically defined optical transmission values and the resulting electronic signals from the plumbicon TV camera for the whole area displayed on the monitor. The shading of the optoelectronic system had a coefficient of variation (CV) of 1.42% for measurements in the center of the displayed area, but a CV of 3.55% for measurements over the whole monitor area. Densitometric measurements remained stable 15 minutes after putting the microscope lamp into operation (T less than 0.075%, remeasuring every two minutes). The geometric distortion, measured as different ferret diameters of ideally round latex particles, ranged from +/- 0.5% to +/- 1.0% deviation over the entire displayed area. These results indicate that densitometric and morphometric measurements with this equipment are sufficiently precise and reproducible when performed in the center of the area displayed on the monitor.

Densitometry↗
PubMed1989

DNA grading of oral squamous carcinomas. A preliminary report.

The prognostic validity of the DNA-malignancy-grade (DNA-MG), ranging on a continuous scale from 0.00 to 3.00 was tested in a preliminary study on 7 patients with oral squamous cell carcinomas. Monolayer smears were prepared after a cell separation procedure from paraffin-embedded surgical tumor specimens. Feulgen staining was performed automatically in a modified Shandon staining machine. A TV image analysis system with an automatic microscope (TAS plus, Leitz, FRG) was used for DNA measurements. The DNA-MG revealed a strong correlation with the patients prognosis. 3 patients who died after having a tumor relapse (mean survival = 10 months) had DNA grades greater than 1.40, whereas patients who survived without having a tumor relapse (mean survival = 53 months) revealed DNA grades below 1.00. Additionally, the DNA-malignancy-grade was closely correlated with the histopathologic malignancy grades.

Adult↗
PubMed1989

Automated Feulgen staining with a temperature-controlled staining machine.

A Shandon Varistain 24-3 staining machine was modified in order to run automated DNA Feulgen staining. Initial studies showed a strict dependence of the staining intensity (integrated optical density [IOD]) on the temperature of the DNA hydrolysis in 4 N HCl: a difference of 0.5 degrees C around the optimum hydrolysis temperature of 27.5 degrees C resulted in IOD differences of up to 7.8% in epithelial cells and up to 12.0% in lymphocytes. A temperature-controlled stainless steel cuvette, covered with a 4 N HCl-resistant material, was developed and integrated into the machine. Temperature measurements were performed at different positions in the cuvette and on glass slides with copper-constantan electrodes fixed on them; no temperature gradient could be detected within the cuvette. The adjusted temperature of 27.5 degrees C remained constant over 24 hours. The coefficient of variation (CV) of the staining intensity in lymphocytes between different areas on the same slide and between different slides of the same staining cycle was less than 0.6%. The CV between different staining cycles was 5.9%. This system for automated Feulgen staining thus gives reproducible and reliable results and may be introduced into routine diagnostic procedures.

Coloring Agents↗
PubMed1989

Bowenoid papulosis. Classification as a low-grade in situ carcinoma of the epidermis on the basis of histomorphologic and DNA ploidy studies.

The nature of bowenoid papulosis was investigated by a comparative investigation of 12 biopsy specimens of this lesion, 19 biopsy specimens of Bowen's disease, 14 biopsy specimens of squamous cell carcinoma and 10 biopsy specimens of seborrheic keratosis. In addition to conventional histomorphologic and cytomorphologic studies, nuclear DNA measurements on single cells isolated from tissue blocks were performed using a TV image analysis system combined with an automatic microscope. Two parameters, the "5c exceeding rate" (5cER) and the "2c deviation index" (2cDI), were computed from the single-cell DNA values to arrive at a "DNA diagnosis" and a "DNA malignancy grade" (DNA-MG). All specimens of bowenoid papulosis and Bowen's disease were morphologically diagnosed as in situ carcinomas of the epidermis; a DNA diagnosis of malignant was rendered in all of these specimens due to the detection of aneuploid nuclei (5cER greater than or equal to 1). DNA diagnoses of malignant were also rendered on all specimens of squamous cell carcinoma (100% sensitivity) while DNA diagnoses of benign were rendered in all specimens of seborrheic keratosis (100% specificity). The mean DNA-MG for bowenoid papulosis (0.69) was significantly lower than that for Bowen's disease (1.04) and squamous cell carcinoma (1.15). The mean morphologic (Broder's) grade of malignancy was also lower for bowenoid papulosis than for Bowen's disease and squamous cell carcinoma. HPV 16 DNA was detected in 10 of 12 specimens of bowenoid papulosis. Thus, the results of DNA image cytometry and morphologic investigation suggest that bowenoid papulosis is a low-grade carcinoma in situ of the epidermis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Representativity and reproducibility of DNA malignancy grading in different carcinomas.

The reproducibility of the determination of the "DNA malignancy grade" (DNA-MG) was tested in 56 carcinomas of the colon, breast and lung while its representativity was tested on 195 slides from 65 tumors of the colon, breast and lung. DNA measurements were performed on Feulgen-stained smears with the TAS Plus TV-based image analysis system combined with an automated microscope. The variance of the DNA values of tumor cells around the 2c peak, the "2c deviation index" (2cDI), was taken as a basis for the computation of the DNA-MG, which ranges on a continuous scale from 0.01 to 3.00. The representativity, analyzed by comparison of the DNA-MGs measured in three different areas of the same tumor greater than or equal to 1.5 cm apart from each other, yielded an 81% agreement. No significant differences between DNA-MGs of these areas were found. The intraobserver and interobserver reproducibilities of the DNA grading system, investigated by repeated DNA measurements, were 83.9% and 82.2%, respectively. In comparison, histopathologic grading of the 27 breast cancers studied yielded 65% intraobserver and 57% interobserver reproducibilities and 66% representativity.

Breast Neoplasms↗
PubMed1989

Diagnostic and prognostic value of DNA cytometry in gynecologic cytology.

A survey of the diagnostic and prognostic value of DNA cytometric measurements in gynecologic tumors is given. In slight-to-moderate epithelial dysplasias of the uterine cervix, morphologic studies alone cannot make a definite distinction between benignity and malignancy, nor can they identify all precancerous lesions. DNA cytometry may help in these cases to detect prospective malignancy. Cytologic and histologic grading of malignancy often does not provide correct information about the prospective behavior of an individual tumor; its reliability is hampered by low interobserver reproducibilities. DNA cytometry may supplement subjective morphologic grading by providing objective and reproducible prognostic indices. The advantages and disadvantages of TV-based image cytometry and flow cytometry for application in routine gynecologic pathology and the different attempts at diagnostic DNA interpretation are discussed.

Breast Neoplasms↗
PubMed1989

DNA grading of malignancy in breast cancer. Prognostic validity, reproducibility and comparison with other classifications.

The prognostic significance of the "DNA malignancy grade" (DNA-MG) was tested in a series of 104 breast cancer patients in comparison with TNM staging, histomorphologic grading according to Bloom and Richardson, mean nuclear area (MNA) and DNA-histogram classification according to Auer. The reproducibility and representativity of the grading systems were investigated, and their results in primary tumors and lymph node metastases were compared. The scalar DNA-MG was assessed on monolayer smears prepared from paraffin-embedded tissues; the smears were automatically Feulgen stained and used for rapid interactive DNA cytometric evaluation by an automated microscope and a TV image-analysis system. TNM staging showed the highest correlation with survival, followed by histomorphologic grading and DNA-MG; MNA and the DNA-histogram classification failed to give statistically significant prognostic information. Both histomorphologic grading and DNA-MG were identified as parameters adding independent prognostic information to the TNM staging. However, only DNA-MG demonstrated an acceptable reliability, with small 95% ranges between repeated measurements within the primary tumor (+/- 0.3 DNA-MG) and a strong correlation between the results in the primary tumor and its lymph node metastases. These findings show that the DNA-MG is a valid and reliable prognostic index that adds significant prognostic information to TNM staging.

Aged↗