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B Helpap

Publications and source records attributed to B Helpap.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Suspicious acinar proliferations of the prostate].

A variety of small acinar lesions of the prostate may mimick prostate cancer. In the central and transition zone of the prostate atypical adenomatous hyperplasia (AAH) has to be differentiated from low grade carcinoma (Gleason score 2-6). In the dorso-peripheral zone high grade PIN (prostatic intraepithelial neoplasie) and ASAP (atypical small acinar proliferations) represent the most important mimicers of carcinoma. High grade PIN has to be differentiated from intraductal carcinoma, ASAP on the other hand may mimic low grade carcinoma. The significance of basal cell type cytokeratin immunhistochemistry (IHC) in the differentiation between ASAP and low grade carcinoma of the prostate is assessed by additional MIB-1 IHC. The status of the basal cell layer in ASAP was shown to be variable (complete, fragmented and partial loss). Independently from the status of the basal cell layer the mean MIB-1 proliferation index of ASAP was significantly higher than of clearly benign lesions and did not differ from that of low grade carcinoma. Taking into account the high detection rate of carcinoma in repeat biopsies, close clinical follow up of patients with ASAP should be recommended.

Biomarkers↗
PubMed1998

[A fulminant course of infection after splenectomy].

A report is given of two patients with a history of splenectomy many years previously due to traumatic rupture. No vaccination was given to either patient. From a state of good health, both patients developed fulminant, therapy-resistant sepsis with proof of Streptococcus pneumoniae in the blood culture. Autopsy findings were similar to Water-house-Friderichsen-syndrome. In conjunction with the history of splenectomy, the final pathological diagnosis was a so-called OPSI syndrome. This postsplenectomy sepsis is discussed further.

Adrenal Glands↗
PubMed1998

[Prognostic factors of prostatic carcinoma].

The histological classification or typing of prostate carcinoma combined with histological grading according to Gleason or WHO with nucleolar subgrading are the most important prognostic factors in carcinoma of the prostate. Prostatic cancer is the most common malignancy in adult males and is the second-most-common cause of cancer death in the USA. The histological Gleason grade may be reduced if only a small amount of tumor tissue is present in the core needle biopsy, in contrast to the combined histological and cytological grading according to WHO with nucleolar subgrading. When there is sufficient carcinomatous tissue in the core needle biopsy, there is no difference from that in radical prostatectomy tissue, because most cases of prostatic carcinoma are highly malignant. DNA cytometry, immunohistochemical analysis with Ki67/Mib1 or molecular pathological studies with the tumor suppressor gene p53 or apoptosis suppressing oncoprotein bcl2 and the density of blood capillaries may be helpful as additional prognostic factors, but only together with the results of the primary histological section. For comparison of grading results with the international literature both grading systems should be used according to Gleason and WHO with nucleolar subgrading.

Adult↗
PubMed1998

[Single ventricle (cor trilocular biatriatum). A case report].

Univentricular hearts represent rare complex cardial malformations. We report a case of a 34-year old male with single ventricle, two atria, tricuspid atresia, large atrial septal defect, complete transposition and pulmonary valvar stenosis. There were no signs of chronic pulmonary hypertension. Intensive clinical analysis of the cardiac malformation was first performed at the age of five years. Conclusion was that the patient would have no benefit from operation. The patient had nearly normal live conditions with a profession, family and some sportive activities like squash. He died of sudden cardiac death. The malformation was examined by sequential segmental analysis and in comparison with the embryonic development. Special features are emphasized. Clinical picture, prognosis and therapy are reported from literature. During the last years development of cardiac surgery achieved good results. Special morphologic constellations, as in our case, may be the reason that conservative therapy can be sufficient for prolonged survival with good quality of life.

Adult↗
PubMed1998

Differential diagnosis of glandular proliferations in the prostate. A conventional and immunohistochemical approach.

A variety of small acinar lesions of the prostate can mimic prostate cancer in punch biopsies and in transurethral resection material. The first part of this review deals with differential diagnostic problems of the central and transition zone, including atypical adenomatous hyperplasia of the prostate, atrophic processes, sclerosing adenosis, basal cell hyperplasia, and low-grade adenocarcinoma. The second part deals with differential diagnostic problems in the peripheral zone: prostatic intraepithelial neoplasia, postatrophic hyperplasia, Cowper's glands, seminal vesicles, and ductal and intraductal carcinoma. Finally, atypical and small acinar proliferations are described. Diagnostic perspectives are discussed. proliferations (ASAP) that cannot be integrated into any of the well-established diagnostic entities [1, 16, 22, 41]. The relevant glandular proliferations of the central, transitional and peripheral zones of the prostate are discussed here with reference to the related carcinomas.

Adenocarcinoma↗
PubMed1998

[Uterine leiomyosarcoma with subsequent pregnancy].

Leiomyosarcoma are malignant tumors showing smooth muscle differentiation, they are rare, representing only about 25 percent of all uterine sarcomas and mixed malignant tumors and slightly more than 1 percent of all corporeal malignant tumors. Usually they arise in postmenopausal women and are not known to be related to the known risk factors for endometrial carcinoma (nulliparity, obesity, diabetes mellitus, hypertension, etc.) or carcinosarcoma (prior radiation therapy). They may occur in uteri that also bear typical benign leiomyomas, but leiomyosarcoma rarely can be proven to have arisen in or from benign leiomyomas. We report on two premenopausal women with leiomyosarcoma--out of totally 31 cases in our clinic from 1975-1995 who got pregnant after surgical treatment preserving the uterus. The patients are alive without evidence of disease 3 and 6 years after surgical resection.

Abortion, Incomplete↗
PubMed1997

[Fulminant infection outcome after splenectomy].

A report is given of two patients with a history of splenectomy many years previously due to traumatic rupture. No vaccination was given to either patient. From a state of good health, both patients developed fulminant, therapy-resistant sepsis with proof of Streptococcus pneumonlae in the blood culture. Autopsy findings were similar to Waterhouse-Friderichsen-syndrome. In conjunction with the history of splenectomy, the final pathological diagnosis was a so-called OPSI syndrome. This postsplenectomy sepsis is discussed further.

Adrenal Glands↗
PubMed1997

Osteoclast-like giant cell tumour of the pancreas presenting as a pseudocyst-like lesion.

A 57-year-old male patient presented with a cystic lesion in the tail of the pancreas, which was considered to be a pseudocyst. He was treated by cystojejunostomy but one year later a tumour was found to have invaded the stomach and jejunum. This was an osteoclast-like giant cell tumour containing a small area of typical ductal adenocarcinoma. Immunohistochemical staining revealed that the pleomorphic tumour cells were positive for cytokeratin, epithelial membrane antigen, vimentin and the proliferation marker MIB-1. The osteoclast-like giant cells and some small histiocytic cells stained for leukocyte common antigen and histiocytic markers and were negative for MIB-1. At autopsy, tumour rests were found in the pancreas but there were no metastases. Osteoclast-like giant cell tumours of the pancreas may present as cystic lesions and should be included in the differential diagnosis of pseudocysts.

Antigens, Nuclear↗
PubMed1997

Enzyme activities in tissue of human benign prostatic hyperplasia after three months' treatment with the Sabal serrulata extract IDS 89 (Strogen) or placebo.

OBJECTIVE: The mechanism of action of plant extracts used for the medical treatment of human benign prostatic hyperplasia (BPH) is still unknown. In this prospective, randomized, double-blind trial, we investigated the possible influence of the Sabal serrulata extract IDS 89 (Strogen) on epithelial and stromal enzyme activities of BPH tissue. METHODS: 18 patients with BPH were randomly assigned to receive 3 x 2 capsules Strogen uno (320 mg/capsule) (n = 8) or placebo (n = 10) daily for 3 months. The activity (Vmax and Km) of 5 alpha-reductase. 3 alpha-HSORred, 3 beta-HSORred, and creatine kinase was determined in mechanically separated epithelium and stroma of human BPH. RESULTS: The multivariate correlation analysis revealed a positive correlation between therapy and the following enzyme alterations: (1) In epithelium, the substrate affinity of the 5 alpha-reductase decreased slightly (increase of Km value). (2) In stroma, the Vmax value of the 3 alpha-HSORred increased statistically distinctly, leading to a moderate increase of Vmax/Km. (3) In stroma, the Vmax value of the 3 beta-HSORred increased moderately, but not statistically significant. (4) In stroma, the Vmax value of creatine kinase increased significantly, leading to a statistically distinct increase of Vmax/Km. CONCLUSION: This double-blind, placebo-controlled clinical trial with the S. serrulata extract IDS 89 revealed significant biochemical changes at the cellular level of BPH tissue. However, the alterations are merely moderate, their biochemical causes and consequences regarding the pathophysiology of BPH rather uncertain. Therefore, more studies are needed before plant extracts like IDS 89 become valid candidates likewise synthetic substances already used for medical treatment of human BPH.

3-Hydroxysteroid Dehydrogenases↗
PubMed1997

Lethal complications in a case of sigmoid diverticulitis. A case report.

A 61-year-old female complaining of arthralgia was repeatedly treated with antibiotics and also with prednisolone. A chronic polyarthritis was assumed. In hospital, leukocytosis of 21.000 was found one day before death as well as moderate anemia. Colonoscopy was rejected by the patient. A computer tomography revealed destructive arthritis of the symphysis, vertebral osteochondrosis L5/S1, and sigmoid diverticulosis. The patient died with clinical signs of central dysregulation. At autopsy, a covered perforation of a sigmoid diverticulum with purulent peridiverticulitis was found. The 5th lumbal vertebra and the symphysis showed hematogenic abscesses. Microabscedating pneumonia, purulent meningitis and hypophysitis, and mycotic aneurysm of the basilar artery with lethal rupture were further results of hematogenic spread. Death was caused by massive subarachnoidal hemorrhage. This history is not untypical for elder patients with complicated diverticular disease. The intestinal perforation is often clinically occult due to only few and unspecific symptoms which cannot be exactly attributed to the colon. In the last ten years, we have found lethal complications of sigmoid diverticulitis at a frequency of 0.32% (5 cases in 1.557 subsequent autopsies). The clinical differential diagnosis included diverticulitis in none of the cases. This underlines the importance of autopsies for quality control in medicine, because modern diagnostic methods such as computer tomography were not able to give the correct diagnosis in these cases.

Aneurysm, Ruptured↗
PubMed1997

Relationship between atypical adenomatous hyperplasia (AAH), prostatic intraepithelial neoplasia (PIN) and prostatic adenocarcinoma.

Two histopathologic lesions are considered putative precursors of prostate cancer, but the supportive evidence for one (prostatic intraepithelial neoplasia, or PIN) is much greater than the other (atypical adenomatous hyperplasia, or AAH). High grade PIN is the most likely precursor of carcinoma, arising in the peripheral zone, but probably does not account for well-differentiated cancer arising in the transition zone. The biological significance of atypical adenomatous hyperplasia of the prostate (AAH) is inconclusive at the time. The histological and cytological features of AAH are intermediate between BPH and low grade carcinoma, suggesting that AAH may be a precursor of well differentiated transition; zone carcinoma. In the recent time new findings on morphogenetic aspects of normal and abnormal prostatic growth i.e. stem cell models are discussed and topics about grading and proliferative activities, frequency and histological changes associated with aging as well as clinical relevance of PIN and AAH. This paper reviews the results and discussion at the second international consultation meeting on PIN in Mayo Clinic, Rochester, Nov. 3-4 th. 1995, following the first international consultation meeting of AAH and PIN and origin of the prostatic carcinoma in Ancona, Sept. 11-12 th 1994.

Adenocarcinoma↗
PubMed1996

[Experiences from consultation in prostatic diseases].

With the introduction of the terms atypical adenomatous hyperplasia (AAH) and prostatic intraepithelial neoplasia (PIN), the spectrum of prostatic diseases has been distinctly enlarged. With more sophisticated diagnostics, however, diagnostic and differential diagnostic problems grow more important. At the institute of pathology in Singen, this issue is reflected by the increasing use of the uropathologic consultation service since 1989. The purpose of this paper is to demonstrate typical diagnostic and differential diagnostic problems in the pathology of the prostate on the basis of this consultation service. 573 submitted prostatic cases were evaluated and the final diagnoses were compared to the preliminary diagnoses by the primary pathologist. Frequent differences could be detected in the 3 following groups: 1. Differentiation of sclerosing adenosis versus well differentiated adenocarcinoma 2. Differentiation of AAH versus well differentiated adenocarcinoma 3. Differentiation of high grade PIN versus poorly differentiated adenocarcinoma 4. Differentiation of glandular G II a versus G II b carcinomas. Possible decision guidelines are presented.

Biopsy, Needle↗
PubMed1995

Effects of the selective metabotropic glutamate receptor agonist, L-CCG-I, on acquisition of a Morris task by rats.

L-Glutamate, a major excitatory neurotransmitter in the central nervous system, plays an important role in a variety of neuronal events associated with learning and memory, neuronal plasticity, neurotoxicity, and neurodegeneration. We assessed the effects of L-CCG-I ((2S,3S,4S)-alpha-(carboxycyclopropyl)glycine), a conformationally restricted glutamate analogue, in a standard Morris water escape task with young adult rats. L-CCG-I is considered to be a selective agonist of the metabotropic glutamate receptor. Vehicle, 5, 50, or 500 nmol L-CCG-I was injected intra-cerebroventricularly (i.c.v.) into the right lateral ventricle 30 min before the start of each of five daily acquisition sessions. The data indicate that L-CCG-I had a centrally mediated mode of action; rats treated with 500 nmol L-CCG-I were clearly impaired in acquiring the standard Morris water escape task. The no-effect dose was 5 nmol.

Amino Acids, Dicarboxylic↗
PubMed1995

Nucleolar organizer regions in low- and high-grade carcinomas of the prostate.

The number of silver-stained nucleolar organizer regions (AgNORs) and the status of nucleoli were studied in biopsies from 10 cases of normoglandular prostatic tissue and the findings were compared with the results obtained for 10 cases of hyperplastic prostatic tissue (BPH) and 74 cases of prostatic carcinoma of various grades of malignancy. There was an increase in the number of AgNORs detected between the grade of malignancy found in highly versus poorly differentiated carcinomas of the prostate. Furthermore AgNOR values differed significantly among the groups compared (P < 0.001). The nucleolar status confirmed these differences. In addition, the significantly different survival of patients suffering from prostatic carcinomas support our idea of subdividing GII carcinomas into group IIa (low risk) and group IIb (high risk). This subgrading implies the possibility of preoperatively identifying patients with a prostate carcinoma of high malignancy within the GII carcinoma group.

Carcinoma↗
PubMed1995

Nucleolar and AgNOR-analysis of prostatic intraepithelial neoplasia (PIN), atypical adenomatous hyperplasia (AAH) and prostatic carcinoma.

Atypical glandular proliferations of the prostate are found in combination with prostate carcinomas but also with benign prostatic hyperplasia (BPH). These atypical glandular lesions that mimic glandular carcinoma within the anterocentral part of the prostate (transition zone) are named "atypical adenomatous hyperplasia (AAH)." The term for atypical ductal and acinar mainly papillary and/or cribriform proliferations in the peripheral zone is "prostatic intraepithelial neoplasia (PIN)." In this study the significance of the status of nucleoli and the number of silver-stained nucleolar organizing regions (AgNOR) as a method for measuring proliferative activity was investigated in biopsies of AAH, PIN and carcinomas of different grades of malignancy. The aim was to prove whether there are relationships of AAH to low grade carcinomas on the one hand and of PIN to high grade carcinomas on the other hand. The frequency of nuclei with small nucleoli was low in BPH (0.6%). The values increased to 8.3% in AAH, and 28.7% in PIN. The frequency of nuclei with prominent nucleoli in low grade carcinomas was 41.7% and in high grade carcinomas 81.1%. Usually, one single nucleolus was found per nucleus. Multiple prominent nucleoli were found in high grade carcinomas and in some cases of high grade PIN only. The result of AgNOR-analysis was similar: low numbers in BPH, low to moderate values in AAH, moderate values in low grade carcinomas and high values in PIN, as well as high grade carcinomas. Besides correlation between topography, histology and cytology, the similarities of nucleolar and AgNOR-analysis between PIN and high grade carcinomas support the idea that PIN is the precursor of the peripheral prostatic carcinoma. The histological, cytological and cell kinetical features of AAH are intermediate between BPH and low grade carcinoma of the prostate. Therefore, the findings to date are inconclusive and further follow up studies are necessary to prove if AAH may be a precursor of transition zone carcinoma of the prostate.

Adenocarcinoma↗
PubMed1995

Working standards in prostatic intraepithelial neoplasia and atypical adenomatous hyperplasia.

All participants agreed with the use of the terms low and high grade PIN, without treatment in the case of an isolated PIN lesion. The term, definitions and biology of atypical adenomatous hyperplasia (AAH) was discussed without reaching a consent among American and European participants. As a compromise, the designation of AAH-Adenosis was accepted as a working formulation that needs further research.

Humans↗
PubMed1995

Cell kinetic studies on prostatic intraepithelial neoplasia (PIN) and atypical adenomatous hyperplasia (AAH) of the prostate.

To investigate possible cell kinetic relations between benign prostatic hyperplasia (BPH), atypical adenomatous hyperplasia (AAH), prostatic intraepithelial neoplasia (PIN) and carcinoma, cell kinetic analyses were performed using radiolabelled DNA-precursors (3H-thymidine autoradiography), immunohistochemistry (proliferation marker Ki67/MIB1 and/or PCNA) and silver staining of nucleolar organizer regions (AgNOR). All methods yielded the lowest values for BPH and AAH, while maximal values were found in carcinoma of high malignancy. PIN was equal to GII-carcinomas, while AAH was between BPH and carcinoma of low malignancy. This investigation ranks BPH, AAH, low grade carcinoma, PIN and high grade carcinoma in order using different methods of cell kinetic analysis. The preneoplastic character of PIN is apparent whereas the character of AAH remains uncertain.

Carcinoma↗