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Biomedical subjects

A Rütten

Publications and source records attributed to A Rütten.

At least 19 recordsLinked to original sources
PubMed2007

[Extrafacial granuloma eosinophilicum].

Three patients with a rare extrafacial granuloma eosinophilicum are presented. Lesions were localized on the scalp, the upper back or the upper arm. Only one patient had a typical facial granuloma eosinophilicum at the same time. Diagnosis was established by histopathology. The histopathological findings vary with the age of the lesion. Early lesions are characterized by a vasculitis with many eosinophils separated by a Grenz zone from epidermis and follicular structures. With time the inflammation changes and hyalin fibrosis takes place.

Adult↗
PubMed2006

[Physical activity and health. Evidence for the health benefits of different physical activity promotion concepts].

Recent years have been marked by increased efforts of public health to pro mote physical activity. Concepts used for the promotion of physical activity range from the prescription of exercise to advice for "active living". The article compares existing evidence for the health benefits of the concepts of physical activity, health-enhancing physical activity, exercise and the German concept of "health sport". Furthermore, existing evidence for different promotion strategies for physical activity on the individual and population level are presented and discussed. Referring to the situation in Germany, the article intends to support current discussions regarding the development of health sport programs and initiatives to promote active living.

Exercise↗
PubMed2005

Palmar atypical lipomatous tumour with spindle cell features (well-differentiated spindle cell liposarcoma): a rare neoplasm arising in an unusual anatomical location.

Lipomatous tumours, both benign and malignant, arising on the hands are uncommon. We present a rare atypical lipomatous tumour with spindle cell features (synonym: well-differentiated spindle cell liposarcoma) arising on the left palm of a 54-year-old male patient. The neoplasm presented as a long-standing, exophytic neoplasm measuring 9 x 9 cm. The well-circumscribed neoplasm was completely excised, and margins were tumour free. Histologically, the neoplasm showed features closely resembling spindle cell lipoma, being composed of mature adipocytic cells associated with bland, neuroid spindle cells staining positively for CD34. However, focally, atypia of adipocytic and stromal cells as well as scattered lipoblasts were noted, and immunohistochemical stainings showed focal overexpression of MDM 2 and CDK4. Aypical lipomatous tumour with spindle cell features may arise very rarely in palmar location and has to be distinguished from a number of benign and malignant mesenchymal neoplasms.

Diagnosis, Differential↗
PubMed2005

Cutaneous clear cell myomelanocytic tumour: a new member of the growing family of perivascular epithelioid cell tumours (PEComas). Clinicopathological and immunohistochemical analysis of seven cases.

AIMS: To analyse seven cases of cutaneous myomelanocytic tumour histologically and immunohistochemically. Perivascular epithelioid cell tumours (so-called PEComas) are rare and recently delineated neoplasms occurring in the lung, kidney, pancreas, uterus, falciform ligament, vulva, heart, prostate and soft tissues. PEComas are characterized by a perivascular location of neoplastic cells showing a broad spectrum of epithelioid and spindled cells with clear, and granular pale eosinophilic cytoplasm, and a variable expression of melanocytic and muscle markers, whereas S100 protein and cytokeratins are usually absent. METHODS AND RESULTS: We report seven cases of cutaneous myomelanocytic tumour arising on the lower (six cases) and upper (one case) extremities of female adults (age range 30-66 years). In all cases an ill-defined dermal lesion with extension into subcutaneous tissue was noted. The neoplasms contained numerous blood vessels with a lace-like pattern and slightly thickened vessel walls, and were composed of perivascular epithelioid cells containing clear or focally granular pale eosinophilic cytoplasm and round vesicular nuclei with small, sometimes slightly enlarged nucleoli. Increased proliferative activity and tumour necrosis were not seen. Immunohistochemically, tumour cells stained positively for HMB-45, microphthalmia transcription factor, and NKIC3 in all cases, whereas perivascular expression of alpha-smooth muscle actin and focal positivity for desmin were noted in one case each only. Two out of four cases tested stained focally positive for calponin. No expression of S100 protein and pancytokeratin was present. Despite incomplete/marginal excision in three cases none of the neoplasms has recurred locally so far. CONCLUSIONS: With the presented series of cutaneous myomelanocytic tumours the clinicopathological spectrum of PEComas is expanded.

Adenocarcinoma, Clear Cell↗
PubMed2004

Factors influencing long-term survival in mesothelioma patients--results of the German mesothelioma register.

Between 1987 and 2000, the German mesothelioma register recorded a total of 4,455 patients with malignant mesotheliomas. Survival times for 498 (11.2%) patients were available; 155 patients (study group, 3.5% of the total group) survived for more than 2 years and 343 patients (control group, 7.7% of the total group) survived for fewer than 24 months. Male patients were over-represented in both groups, with 13% of women in the study and 4.4% in the control group. The proportion of pleural mesotheliomas was more than 90% in both groups, with peritoneal cases comprising 6.5% in the study group and 3.2% in the control group. Histologically, the epithelioid subtype was represented in 58% of the study group, whereas the biphasic subtype predominated (67.6%) in the control group. Only 7% of tumours were of the sarcomatoid subtype. The average age of patients in the study group was 57.4 years, thus lower than in the control group (62.8 years). Lung dust analysis showed an increased pulmonary asbestos burden in 94% of all patients; significant differences between the study and control group were not observed. In the majority of the total group pleural effusions were the first symptoms. Therapeutic data were available in fewer than 40% of all cases. Surgical interventions were performed, partly in combination with radiation and chemotherapy and as alternative treatments. Significant deviations in survival time dependent on therapy applied could not be proved. By multivariate analysis (Cox proportional hazards regression model) favourable prognostic factors for long-term survival were epithelioid tumour subtype, comparatively young age (<60 years), and female gender ( P<0.05).

Aged↗
PubMed2004

[Circumscribed acral hypokeratosis].

Circumscribed acral hypokeratosis is a rare chronic disorder of cornification that occurs predominantly in women. Lesions are solitary and do not respond to any local conservative treatment. They have to be differentiated by biopsy from other non-healing lesions and tumors in acral skin. Clinically lesions appear as sharply circumscribed reddish macules. The histologic hallmark is a circumscribed loss of the entire stratum corneum, which can be best demonstrated at the border of the lesion as a contrast to the perilesional broad stratum corneum typical for acral sites.

Aged↗
PubMed2003

Physical activity monitoring in Europe. The European Physical Activity Surveillance System (EUPASS) approach and indicator testing.

OBJECTIVES: The main objective of this paper is to describe the approach and specific findings of the European Physical Activity Surveillance System (EUPASS) research project. In particular, the analysis presented aims at testing the reliability, comparability and predictive power of different sets of physical activity (PA) indicators. DESIGN: First, a panel study based on computer-aided telephone interview (CATI) was designed to report PA data of a representative, selected group of about 100 persons per country at three points in time. Second, a CATI time series survey was carried out with the goal of realising about 100 interviews per month over six consecutive months. SETTING: The project was carried out in eight European countries to support the development of the European Union's (EU) Health Monitoring Programme. SUBJECTS: Random population samples (subjects aged 18 years and older) were drawn from each participating country. RESULTS: While many PA indicators used in EU countries to date as well as the psychosocial and environmental measures tested in the present study had acceptable to good reliability coefficients, the test-retest reliability scores of the International Physical Activity Questionnaire (IPAQ) version tested (the short (last 7 days) telephone interview IPAQ; IPAQ-S7T) were rather low. The comparability between extant national PA items and the IPAQ-S7T was low for all countries. The strongest predictors of perceived health were the psychosocial and environmental PA indicators. CONCLUSIONS: According to the results of the present study, more research is needed to further investigate and improve the quality of the IPAQ. In addition, the specific predictive power of the tested psychosocial and environmental PA indicators on perceived health should be of particular interest for designing health surveillance activities in the future.

Adolescent↗
PubMed2003

Using different physical activity measurements in eight European countries. Results of the European Physical Activity Surveillance System (EUPASS) time series survey.

OBJECTIVES: The European Physical Activity Surveillance System (EUPASS) research project compared several physical activity (PA) measures (including the International Physical Activity Questionnaire (IPAQ)) in a time series survey in eight countries of the European Union. The present paper describes first results provided by the different instruments regarding PA participation, frequency and duration, both at the European and national levels. The purpose of the present study is to explore and compare the specific quality and usefulness of different indicators rather than to provide valid and reliable prevalence data. Thus, the main focus is on discussion of the methodological implications of the results presented. METHODS: A time series survey based on computer-aided telephone interviewing (CATI) was carried out in eight European countries over a six-month period. The study provided for about 100 realised interviews per month in each country (i.e. approximately 600 per country). Descriptive statistical analysis was used to: (1) report IPAQ results on vigorous, moderate and light PA and sitting, as well as on the overall measure of calories expenditure (MET min-1), in the different countries; (2) compare these results with national PA indicators tested in EUPASS; and (3) compare IPAQ results with other European studies. RESULTS: First, the scores for the different PA categories as well as for the overall measure of calories expenditure provided by the IPAQ appeared rather high compared with previous studies and public health recommendations. Second, the different PA measurements used in EUPASS provided completely different results. For example, national indicators used in Germany and The Netherlands to date neither corresponded in absolute values (e.g. means of PA or sitting) nor correlated with the IPAQ in any significant way. Third, comparing EU countries, the ranking for vigorous, moderate and light activities by use of the IPAQ differed from that of other European studies. For example, in the present analysis, German respondents generally showed higher scores for PA than the Finns and the Dutch, while, in contrast, findings from other studies ranked Finland before The Netherlands and Germany. CONCLUSIONS: The present analysis highlights some methodological implications of the IPAQ instrument. Among other things, differences in overall scores for PA as well as in the ranking of nations between the present results using IPAQ and other measures and studies may partly be due to the concepts of PA behind the measurements. Further analysis should investigate if the range of PA-related categories provided by the IPAQ is fully appropriate to measure all relevant daily activities; it may also consider the public health implications of mixing up different contexts of PA (e.g. work, leisure-time, transportation) in the IPAQ short version.

Adult↗
PubMed2002

[Eccrine sweat gland carcinoma of the skin].

Sweat gland carcinomas represent a group of morphological heterogeneous tumors with clear differences regarding clinical course and prognosis. The most relevant and accepted entities are described clinically and histopathologically with special reference to the differentiation from benign adnexal tumors. Carcinomas arising from preexisting benign adnexal tumors such as spiradenocarcinoma, cylindrocarcinoma, malignant mixed tumors of the skin are easily recognized. To establish the diagnosis of microcystic adnexal carcinoma or aggressive digital papillary adenocarcinoma can be more difficult, because these carcinomas do not show cytological criteria for malignancy and may therefore resemble benign adnexal tumors especially in small specimens.

Adenocarcinoma↗
PubMed2002

Differentiation between malignant and benign follicular adnexal tumours of the skin by DNA image cytometry.

BACKGROUND: We have demonstrated in previous studies that DNA image cytometry (DNA ICM) can be helpful in detecting malignancy in sebaceous tumours of the Muir-Torre syndrome and sweat gland tumours. However, little is known about DNA ICM in cutaneous adnexal tumours with follicular differentiation. OBJECTIVES: To study a larger series of benign and malignant follicular adnexal tumours with DNA ICM. METHODS: We studied 13 malignant follicular tumours (seven trichilemmal carcinomas, five malignant proliferating pilar tumours, one pilomatrix carcinoma) and 55 benign follicular tumours (four tumours of the follicular infundibulum, seven Winer's pores, eight trichilemmomas, two trichofolliculomas, 16 trichoepitheliomas, 13 pilomatrixomas, five trichoblastomas) by DNA ICM. All cases were clear-cut as malignant or benign, respectively, on histopathological criteria. The stemline interpretation according to Böcking et al. (DNA distribution in gastric cancer and dysplasia. In: Precancerous Conditions and Lesions of the Stomach, Zhang YC, Kawai K, eds. Berlin: Springer-Verlag, 1993: 103-20) was performed in all cases. In addition, 5[c]-exceeding events (5cEE) and the 2[c] deviation index (2cDI) were calculated, except in one histopathologically benign tumour, which revealed euploid polyploidization, as the analysis of 5cEE and 2cDI is not valid in that case. RESULTS: A 2cDI threshold of 0.24 proved to be the most reliable marker for the distinction between malignant and benign follicular tumours. On the basis of this feature, all malignant and benign tumours were correctly classified. A specificity of 100% was achieved by all three interpretation methods, but the sensitivity of 2cDI for the detection of malignant tumours was superior to the analysis of 5cEE (sensitivity 77%) and to the stemline interpretation (sensitivity 23%). CONCLUSIONS: DNA ICM may be helpful in distinguishing between malignant and benign follicular tumours.

Aneuploidy↗
PubMed2002

Trichogerminoma: a rare cutaneous adnexal tumor with differentiation toward the hair germ epithelium.

In 1992, Sau and colleagues described 14 cases of a rare cutaneous adnexal tumor with differentiation toward the hair germ epithelium. All cases in their study displayed a unique constellation of histological features which allowed the authors to consider the neoplasm to be a distinct entity and to designate it as 'trichogerminoma' (TG). We present a case of an adnexal tumor identical to that described as TG and report the immunophenotypical features of this neoplasm for the first time. A biopsy from a 41-year-old man revealed a well-demarcated epithelial tumor composed of multiple lobules located in the deep dermis without connection to the overlying epidermis and surrounded by a fibrous pseudocapsule. The tumorous lobules were composed of uniform basophilic cells with vesicular nuclei, dispersed chromatin and prominent nucleoli showing no prominent peripheral palisading. Some of the lobules had the appearance of densely packed 'cell balls' with peripheral condensation of the tumor cells. The stroma showed a moderate number of fibroblasts and mast cells. Reticulum staining revealed fine reticulum fibers surrounding the tumor aggregates with accentuation of the 'cell balls'. Immunohistochemically, the tumor cells expressed AE1/AE3, CK5/8, CK5/6, CAM5.2 and stained negatively for CK20, CK7, calretinin, Lu-5 and Thomsen- Friedensreich antigen. There was no increase in the numbers of CK20-positive Merkel cells in the epidermis overlying the tumor; however, a few Merkel cells were scattered in some tumor lobules. In addition, we stained 6 trichoblastomas (TBs) and found a particular pattern of calretinin expression in this tumor which was not observed in our case of TG. We conclude that pathological features allow the delineation of TG as a distinct adnexal neoplasm. Histological differential diagnosis includes basal-cell carcinoma (pilar type), large nodular TB, trichoblastic fibroma, trichoepithelioma, tricholemmoma, pilomatricoma and matrical carcinoma.

Adult↗
PubMed2001

[Health promotion by sports and physical activity: politics, behavior and infrastructures in a European comparison].

OBJECTIVES: The focus of physical activity promotion is moving from measures to increase health-enhancing physical activity on the individual level to higher-level strategies including policy and environmental approaches. Scientific evidence, traditionally related to individual-based strategies, calls for adaptation and refinement when environmental and policy changes become more relevant. METHODS: This paper investigates differences in physical activity promotion and public policy among six European countries. Data from a European study on public health promotion policy and health behaviours (MAREPS) is analysed to study behaviour, community-based opportunities for physical activity, and populations' perception of the effectiveness of their national policies in promoting physical activity. RESULTS: Analyses show significant differences in both involvement in and perceived opportunities for physical activity among the investigated countries. Populations in Finland, Switzerland, and The Netherlands show comparably higher participation and, at the same time, perceive better opportunities for physical activity within the residential environment than people in East Germany, Belgium, and Spain. Moreover, respondents from the former group of nations report considerably greater contribution of health policy in their country to the promotion of physical activity than respondents from the latter group. CONCLUSIONS: In conclusion, the results provide empirical support for the significance of environmental and policy approaches with regard to physical activity. Opportunities created by implementing such approaches may enable populations to develop more active lifestyles conducive to health. Further research employing longitudinal designs could be especially helpful to explore the causalities of the relationship between policy, environment and physical activity.

Adolescent↗
PubMed2001

[Familial dyskeratotic comedones. A rare entity].

Familial dyskeratotic comedones is a rare autosomal dominant genodermatosis. In childhood or adolescence disseminated keratotic papules develop and gradually increase in number with time. The isolated papules show a central keratotic plug which tends to recur after extraction. Pruritus and occasional inflammation are the only symptoms. The lesions appear on the extremities, and less frequently on the trunk and the face. About half of the patients have a history of acne vulgaris. The histologic picture is highly characteristic and shows a deep invagination of an acantholytic and dyskeratotic epidermis with prominent cornification. Familial dyskeratotic comedones are generally refractory to any therapy. We report on two sisters with familial dyskeratotic comedones successfully treated by CO2-laser therapy.

Adult↗
PubMed2001

[Occult dermal primary melanoma in congenital nevus-cell nevus].

Malignant melanomas normally arise at the dermoepidermal junction. Development of these tumours in deeper layers of the dermis without having contact with the junction is rare. A small congenital melanocytic nevus localized in the region of the waist band was excised because of mechanical irritation; it had not shown any changes over years. A thorough examination of the whole body did not give any clue to a malignant melanoma. Histologically a compound nevus with the typical architecture of a congenital melanocytic nevus was found. In the deeper dermis there was an isolated nodule of extremely atypical melanocytes with minimal pigmentation of melanin. S100 antigen could be demonstrated throughout the whole tumour whereas HMB45 was only found at the dermoepidermal junction. There was no marking of the tumour cells with a pancytokeratin antibody. A histological relationship between the new tumour and a mixed tumour of the left testicle, which had been excised 3 years ago, could be excluded. We did not find any metastases neither by image-aided methods nor by sentinel lymph node biopsy.

Adult↗
PubMed2001

The importance of the social environment for physically active lifestyle--results from an international study.

Physically active lifestyles are regularly associated with improved health and quality of life. Differences in lifestyles in society can partly be understood through the differences in the social and physical environment. This study examines the relationships between reported physical activity, and the extent of perceived support for physical activity in the physical and policy environment (e.g. facilities, programmes and other opportunities), and in the social environment. The data for the study come from a cross-cultural health policy study called MAREPS. In total, 3342 adults, 18 years or older, from six countries (Belgium, Finland, Germany, The Netherlands, Spain, Switzerland) were interviewed via telephone. Respondents were categorised as active or inactive according to self-reported physical activity. Social environmental factors and physical and policy environmental factors were also assessed. The analysis of the data was informed by social cognitive theory, although the study was not originally designed for this purpose. Sixty-eight percent of females and 70% of males were active. The proportions of active and inactive varied by countries to a great extent. The strongest independent predictor of being physically active was social environment. Those who perceived low social support from their personal environment (i.e. family, friends, school and workplace) were more than twice as likely to be sedentary compared to those who reported high social support from their personal environment. Specific knowledge of the programmes and actions for physical activity and sport was also a strong predictor of being active. A supportive physical and policy environment was not associated with participation in physical activity as strongly as had been anticipated. The variation between countries was stronger predictor of being active than the physical and policy environment variables. This study generates the hypotheses and raises the questions that in a preliminary way, there appears to be some relationships between aspects of physical and social environment and physical activity participation. However, future research is needed to refine and clarify this.

Adolescent↗