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E Kunze

Publications and source records attributed to E Kunze.

At least 37 records · Page 2Linked to original sources
PubMed1998

Histogenesis of nonurothelial carcinomas in the human and rat urinary bladder.

The histogenesis of nonurothelial carcinomas (squamous cell carcinoma, common adenocarcinoma, clear cell adenocarcinoma, signet ring cell adenocarcinoma and undifferentiated carcinomas) of the urinary bladder is difficult to understand, since the bladder is normally lined exclusively by transitional cell epithelium and contains no otherwise specified epithelia. In the present study we analysed the morphology and development of nontransitional cell carcinomas of the human and comparatively of the rat urinary bladder in an attempt to elucidate their histogenetic derivation. There is strong evidence that the underlying histogenetic principle consists in the well-known pluripotent metaplastic potency (squamous, columnar, goblet and signet ring cell, glandular and so-called nephrogenic metaplasia) of the normal and neoplastic urothelium as well, due to the complex embryologic origin of the bladder. Our findings indicate that squamous cell carcinomas, common and clear cell adenocarcinomas, and signet ring cell adenocarcinomas mainly arise secondarily from preexisting, predominantly solid transitional cell carcinomas by focally beginning and diffusely progressing metaplastic changes of various types. The second histogenetic pathway consists in the formation from primary metaplasias of the transitional cell epithelium in situ. Undifferentiated carcinomas (small, large and sarcomatoid subtypes) develop from preexistent solid urothelial carcinomas by a cellular dedifferentiation. Recognition of transitional cell carcinomas characterised by focal metaplastic processes or cellular dedifferentiation seems to be important from a clinical point of view, because of their probably more malignant biologic behaviour compared with uniformly differentiated pure urothelial carcinomas. Our comparative morphologic analysis of nonurothelial carcinomas and their histogenesis has demonstrated that the findings in the human and rat urinary bladder are largely identical. The experimental models used permit reliable extrapolation of the results obtained to the situation in man.

Adenocarcinoma, Clear Cell↗
PubMed1997

Lack of an antitumoral effect of immunomodulatory galactoside-specific mistletoe lectin on N-methyl-N-nitrosourea-induced urinary bladder carcinogenesis in rats.

The aim of the present animal experiment was to study the effect of galactoside-specific lectin or agglutinin (VAA) from mistletoe (Viscum album L.) on chemically induced tumor development in the urinary bladder of rats. Since VAA has been shown to exert a remarkable immunomodulating effect, any change in tumor formation would indicate a lectin-triggered immune control of urothelial carcinogenesis in the used model. To produce vesical neoplasms the direct-acting urothelial carcinogen N-methyl-N-nitrosourea (MNU) was administered at a single intravesical dose (7.5 mg/kg body weight). Highly purified VAA was given subcutaneously twice a week at the immunomodulatory dose of 1 ng/kg body weight over a period of 6 months during the critical phases of tumor development. After a total experimental time of 15 months the incidence of epithelial bladder tumors was 29.3% in controls versus 27.9% in rats additionally receiving the lectin and thus not significantly different in both experimental groups. There were, moreover, no substantial differences in the histopathologic spectrum of epithelial tumors induced, their patterns of growth, grades of cellular malignancy and local extension. The frequency and histopathology of mesenchymal bladder tumors as well as the incidence and morphology of carcinomas of the ureters and renal pelves also proved to be similar in controls and in rats treated with VAA. In conclusion, the present data provide no evidence for a modifying or even inhibitory effect of the immunomodulatory galactoside-specific mistletoe lectin on experimental urothelial carcinogenesis.

Adjuvants, Immunologic↗
PubMed1996

Aggressive osteoblastoma with focal malignant transformation and development of pulmonary metastases. A case report with a review of literature.

We report the case of a 57-year-old woman with an unusually fast-growing and destructive osteoblastic tumor affecting the left humeral head. On histopathologic examination, most of the initial tumor revealed the characteristic morphologic features of a benign-appearing aggressive osteoblastoma. Based upon the presence of a few small scattered areas composed of atypical osteoblasts in abundant lace-like osteoid showing vascular permeation, the definitive diagnosis was that of an osteoblastoma with focal malignant transformation to well-differentiated osteosarcoma. Molecular biologic analysis revealed a splice mutation at the exon 5 donor site of the p53 gene, clearly indicating a malignant potential of the tumor. The proximal third of the humerus was resected en bloc and replaced by an uncemented modular endoprosthesis. Five months after surgery, an extensive local soft tissue recurrence occurred. Eight months postoperatively, a further massive recurrent tumor had developed an multiple pulmonary metastases became evident. Chemotherapy caused a marked decrease in the size of the soft tissue recurrences and the lung metastases showed no further increase of their number and size. Osteoblastomas with conversion to osteosarcoma should be considered a separate clinicopathologic tumor entity to be distinguished from genuine osteosarcoma. All cases of malignantly transformed conventional and aggressive osteoblastomas reported to date have shown a conversion to low- or high-grade osteosarcomas only in recurrent tumors. The present case supports the concept that osteoblastomas may primarily undergo early malignant transformation. Osteoblastomas with conversion to osteosarcoma require an aggressive surgical approach followed by chemotherapy in the hope of prolonging life expectancy or obtaining a cure.

Bone Neoplasms↗
PubMed1995

[Exulcerating cystadenolymphoma of the parotid gland. A case report].

A recurrent adenolymphoma of the left parotid gland occurring in a 79-year-old woman is reported having caused an extensive ulceration of the epidermis, clinically suggestive of a malignant tumour. The ulcerative tumour process cannot be explained by a particular pattern of growth or a malignant transformation of the adenolymphoma. It is assumed that residual tumour cells of the initially incompletely removed adenolymphoma spread via a long-standing postoperative fistula to the epidermis leading to the uncommon ulceration.

Adenolymphoma↗
PubMed1995

Mobilization of CD34-positive tumour cells in a patient with testicular mixed germ cell tumour.

Tumour cells from a patient with recurrent testicular germ cell cancer and bone marrow infiltration were found to express CD33 and CD34 in the absence of other haemopoiesis-associated antigens. After myelosuppression and treatment with G-CSF for stem cell mobilization, CD34-positive tumour cells were detected in the peripheral blood in addition to normal haemopoietic progenitor cells. The tumour cells were decreased in the leukapheresis product. Retrospectively, the appearance of tumour cells in the peripheral blood after stem cell mobilization was the first indication of impending relapse.

Adult↗
PubMed1994

Primary mesenchymal tumors of the urinary bladder. A histological and immunohistochemical study of 30 cases.

The light microscopic and immunohistochemical features of 30 primary mesenchymal neoplasms of the urinary bladder are reported. Half of the cases represented smooth and striated muscle tumors (five leiomyomas, seven leiomyosarcomas including epithelioid and myxoid subtypes, one rhabdomyoma, one embryonal rhabdomyosarcoma and one alveolar rhabdomyosarcoma). One third of the tumors were of fibrohistiocytic origin (one fibrous histiocytoma and eight malignant fibrous histiocytomas including fascicular and storiform, inflammatory and pleomorphic subtypes). In addition, a malignant epithelioid schwannoma, a round cell liposarcoma, two hemangiomas and two mixed mesodermal tumors were observed. The morphology of the vesical mesenchymal tumors was identical to that of their counterparts known to occur in other sites, particularly in the soft tissue. Muscle-specific actin, alpha-1-antichymotrypsin, S-100-protein and neuron-specific enolase proved to be useful and reliable immunomarkers for differential diagnosis of poorly differentiated leio- and rhabdomyosarcomas, malignant fibrous histiocytomas and malignant schwannomas. Since some tumors coexpressed several classes of intermediate filaments, diagnostic immunocytochemistry should only be used considering a larger panel of antibodies and in close correlation with the histological and cytological features of the neoplasms.

Adolescent↗
PubMed1994

Incidence and morphology of concurrent primary carcinomas of the urinary bladder and prostate in transurethral resection specimens.

A retrospective morphologic investigation was conducted to determine the incidence of concurrent primary carcinomas of the urinary bladder and prostate gland and to identify their patho-histologic features using transurethral resection specimens. The study was based upon 1281 cases with the initial diagnosis of a benign or malignant epithelial or mesenchymal tumor of the bladder. In 294 of the patients (23.0%), transurethral resection specimens were also available from the prostate. The incidence of double carcinomas (n = 52) was found to be 4.2% of all vesical carcinomas reviewed (n = 1228) and 17.7% of only those cases with biopsies available from both organs. Of the coexisting bladder carcinomas, 81% represented papillary transitional cell carcinomas grades 1 and 2. These were associated in 78.6% of the cases with well and moderately differentiated carcinomas (grades 1 and 2) of the prostate gland, showing either a uniform glandular or a pluriform glandular and cribriform pattern of growth. Half of the concurrent cancers of the bladder were noninvasive and 19.2% had infiltrated only the lamina propria. Thus, the great majority of coincidental vesical and prostatic carcinomas proved to be well and moderately differentiated and by far the majority of the bladder carcinomas exhibited a low stage. Since there was no typical association of particular histologic carcinoma types coexisting with each other and because the extent of local spread was unremarkable, it is impossible to predict the occurrence of double carcinomas of the urinary bladder and prostate on morphologic grounds.

Adenocarcinoma↗
PubMed1993

Tubulo-papillary adenoma (so-called nephrogenic adenoma) arising in the renal pelvis. Report of a case with a critical consideration of histogenesis and terminology.

This is the first detailed clinical and histopathologic report of a tubulo-papillary adenoma (so-called nephrogenic adenoma) arising in the renal pelvis of a 35-year-old woman. The tumor showed a polypoid exophytic growth and consisted of closely packed tubular formations lined by cuboidal to low columnar cells with an admixture of delicate papillary structures. Its benign nature was indicated by the lack of cellular atypias, the extremely low proliferative activity and the absence of invasiveness. We favor the metaplastic theory of origin rather than an embryologic (dysontogenetic) derivation from mesonephric remnants as the underlying histogenetic principle. The descriptive term "tubulo-papillary adenoma" seems more appropriate than the designation "nephrogenic adenoma". True tumors of this type should clearly be distinguished from metaplastic tubular, papillary or tubulo-papillary cuboidal hyperplasias of the urothelium (so-called nephrogenic metaplasia) which are considered preneoplastic and assumed to be immediate precursors of adenomas of the lower urinary tract.

Adenoma↗
PubMed1993

[Incidence and morphology of coexisting carcinomas of the urinary bladder and prostate].

The objective of the present study was to determine the incidence of coexisting carcinomas of the urinary bladder and prostate using biopsy material obtained by transurethral resection and to identify the histologic tumor types including grading and staging. The incidence of double carcinomas was found to be 4.2% referring to all bladder carcinomas studied (n = 1228) and 17.7%, respectively, considering only those cases for which biopsies were available from both organs (n = 294). The overwhelming majority (81%) of the bladder carcinomas represented well and moderately differentiated papillary transitional cell carcinomas (grades 1 and 2) showing a low staging. Accordingly, most of the prostatic carcinomas (78.6) were well and moderately differentiated uniform glandular and pluriform glandular-cribriform types of a low staging.

Carcinoma, Papillary↗
PubMed1993

[Etiology, pathogenesis and epidemiology or urothelial tumors].

A hospital-based case-control study of 531 male and 144 female matched pairs was conducted to analyse the role of nonoccupational and occupational risk factors in the etiology of tumors of the lower urinary tract. Smoking of cigarettes was associated with an increased risk and showed a significant dose- and time-response for both sexes. Heavy pipe smoking also significantly increased the risk. Controlling for smoking, a significantly twofold or more increase in risk was found for heavy consumption of coffee in both sexes and for heavy intake of beer in males. Increasing levels of total fluid intake were associated with increasing, smoking-adjusted risks in men. Significant associations were found for chronic infection of the lower urinary tract, familial history of bladder cancer, and frequent consumption of high fat meals among men and for frequent consumption of canned food in both sexes. With regard to occupational history, significantly elevated risks were found for ever-employment in the printing, plastics and synthetics, rubber, mining and dyestuffs industries, for exposure to spray paints, zinc, chromium/chromate, oils, petroleum and metal dust/fume, and for occupation as mining worker and truck driver among men. Multivariate logistic regression analysis showed-with the exception of fluid intake-significant contribution of the above-mentioned risks factors to the risk of bladder cancer.

Beer↗
PubMed1992

Life style and occupational risk factors for bladder cancer in Germany. A case-control study.

A hospital-based, case-control study of 531 male and 144 female matched pairs was conducted in Germany to analyze the role of nonoccupational and occupational risk factors in the etiology of tumors of the lower urinary tract (bladder cancer). Smoking of cigarettes was associated with an odds ratio (OR) of 3.6 for men and 3.2 for women, compared with not smoking and showed a significant dose- and time-response relationship for both sexes. Heavy pipe smoking significantly increased the risk (OR = 1.9 in men), and smoking of cigars did not alter the risk of bladder cancer. Controlling for smoking, a significantly twofold or more increase in risk was found for heavy consumption of coffee in both sexes and for heavy intake of beer in males. Increasing levels of total fluid intake were associated with increasing, smoking-adjusted risks in men. Significant associations were found for chronic infection of the lower urinary tract (OR = 1.8), familial history of bladder cancer (OR = 2.5), and frequent consumption of high fat meals (OR = 1.4) among men and for frequent consumption of canned food in both sexes (OR = 1.7 for males, 2.4 for females). With regard to occupational history, significantly elevated odds ratios were found for ever-employment in the printing (5.0), plastics and synthetics (2.6), rubber (2.5), mining (2.0), and dyestuffs (1.9) industries, for exposure to spray paints (2.9), zinc (2.3), chromium/chromate (2.2), oils (1.5), petroleum (1.4), stone dust (1.4) and metal dust/fumes (1.3), and for occupation as mining worker (2.0) and truck driver (1.8) among men. Multivariate logistic regression analysis showed significant contribution of coffee and beer drinking, ingestion of canned food, and familial occurrence of urothelial tumors to the risk of bladder cancer in men after accounting for the effects of tobacco smoking, occupational exposures, and a history of bladder infection. These other variables did not influence the risk attributable to occupational exposures.

Aged↗
PubMed1991

Undetected fatal acute pancreatitis: why is the disease so frequently overlooked?

An analysis of postmortem investigations between 1980 and 1985 revealed 43 patients with acute pancreatitis. In 13 (30.2%) of them, the diagnosis was first established at autopsy. In eight of the latter patients, the diagnosis could have been present on admission. The etiology was alcoholism in three patients, hypothermia in one, biliary tract disease in one, and unknown in three patients. In five patients, acute pancreatitis developed after gastric, pancreatic, or biliary tract surgery. Abdominal pain was present in only one patient. Amylase levels had been estimated in 11 patients, but the level was in the diagnostic range (greater than or equal to 3 times of upper normal level) in only four. Consequently, ultrasound examination was performed in only two of the latter four patients, but failed to show the pancreas because of intestinal gas. To diagnose acute pancreatitis at an earlier stage and to improve therapy and prognosis, we recommend that serum amylase levels be measured and ultrasound examination be performed. If the results are inconclusive, this should be followed by computed tomography for all abdominal emergency cases and for patients who have undergone cardiopulmonary or upper abdominal surgery, especially when the patients deteriorate or fail to improve postoperatively.

Acute Disease↗
PubMed1990

Development of N-butyl-N-(hydroxybutyl)-nitrosamine-induced tumors in the partially resected, proliferating rat urinary bladder in dependence upon the time of onset of stimulated DNA synthesis.

Tumor development was investigated in the partially resected, proliferating urinary bladder of rats in dependence upon the onset of stimulated de novo DNA synthesis related to carcinogen dosing. N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN) was used as carcinogen and administered by gavage in three fractionated doses (100 mg/kg body weight each) either during the phase of the most pronounced proliferation of the urothelium 30, 45 and 70 h after one-third resection of the bladder or 24 h and 1 week prior to partial cystectomy. When BBN was given during most increased DNA synthesis subsequent to one-third resection, the incidence of bladder tumors was reduced to 8.7% compared with 19.6% found in control animals with a non-resected, quiescent bladder. Tumor formation was neither inhibited nor enhanced when BBN was initially administered, followed by partial cystectomy 24 h or 1 week after the last carcinogen dose, yielding tumor incidences of 18.2% and 22.5%, respectively. Thus, the feeding of BBN during the period of maximum DNA synthesis inhibited tumor development in the partially resected bladder, while stimulation of cell replication subsequent to carcinogen administration did not influence the carcinogenic process initiated. The results obtained indicate that time of onset of stimulated DNA synthesis related to carcinogen dosing is the decisive factor in modifying urothelial carcinogenesis in the proliferating urinary bladder.

Animals↗
PubMed1990

Lectins and heparin-binding features of human spermatozoa as analyzed by flow cytometry.

Sperm cell surface characteristics may serve as a useful diagnostic feature for the evaluation of seminal samples, but to date no useful analytical method(s) is available for their routine quantitative analysis. Fluorescein isothiocyanate-conjugated lectins, proteins with unique and specific saccharide-binding characteristics, and heparin are potentially useful markers for such an analytical procedure. A protocol is outlined whereby frozen semen is thawed and treated with either fluorescein isothiocyanate-conjugated soybean agglutinin SBA (Glycine max), peanut agglutinin PNA (Arachis hypogaea), and garden pea agglutinin PSA (Pisum sativum) lectins or fluorescein isothiocyanate-heparin to assess differences in spermatozoa-bound fluorochrome by flow cytometry. Use of propidium iodide to identify nuclei containing sperm cells within the ejaculate is essential to the method because of the large amount of debris associated with the samples. The precision of the assay is high, with the coefficient of variation for the individual probes being less than 20%. Analysis of a patient pool of 22 revealed that a range in binding properties is observed and a mode of grouping these samples into classes for later analysis is outlined. Semen parameters and fluorescein isothiocyanate-ligand binding values were different in a population of unproven fertility as compared with a comparable population of known fertility. A positive correlation (p less than 0.001) for garden pea agglutinin PSA binding and concentration of motile cells, percentage of motility, and number of motile cells was found. These data suggest the possible utility of flow cytometry for the assessment of human seminal samples.

Fertility↗
PubMed1990

Analysis of sperm cell viability, acrosomal integrity, and mitochondrial function using flow cytometry.

A triple staining procedure was developed to evaluate bull spermatozoa using flow cytometry. Flow cytometric estimates of cell viability, measured by propidium iodide (PI) exclusion, and acrosomal integrity, measured by Pisum sativum agglutinin (PSA) binding acrosomal contents, were equivalent to estimates made by using standard laboratory assays. Mitochondrial function, measured by rhodamine 123 (R123) fluorescence, was depressed by the mitochondrial inhibitors rotenone (64%) or monensin (52%), establishing that mitochondrial damage can be detected. Dilauroylphosphatidylcholine (PC12) or lysophosphatidylcholine (LPC) was used to destabilize sperm membranes. When challenged with 15-30 microM PC12, selective exposure of PSA binding sites occurred without induction of PI uptake or loss of R123 staining. However, PC12 concentrations greater than 60 microM resulted in a loss of R123 fluorescence intensity. In contrast, greater than 1200 microM LPC was required to expose PSA binding sites, which also resulted in PI uptake. By using flow cytometry, these three stains in combination can be used to correlate three different features simultaneously on individual spermatozoa and assay thousands of cells per sample without extensive preparation.

Acrosome↗
PubMed1990

Inhibition of tumour development in the partially resected, proliferating rat urinary bladder.

Autoradiographic studies have shown that the urothelium of the rat urinary bladder is capable to considerably proliferate in response to a partial cystectomy (one-third resection of the bladder) as is indicated by a 190-fold increase of the 3H-thymidine labelling index above normal levels 45 h postoperatively and an enormous increase of the compartment of proliferating cells (so-called growth fraction). The stimulated urothelial proliferation can be synchronized by multiple, fractionated doses of hydroxyurea (HU), resulting in a high degree of synchrony. Based on these findings, the partial cystectomy model seemed to be a useful tool to examine whether stimulated proliferation exerts a modifying effect on initiation of urothelial carcinogenesis. Following feeding N-butyl-N-(4-hydroxybutyl)-nitrosamine by gavage in 3 fractionated doses during most pronounced proliferation 30, 45 and 70 h postoperatively, the development of bladder tumors proved to be significantly dose- and time-related inhibited. Accordingly, N-methyl-N-nitrosourea (MNU)-induced tumour formation was considerably reduced following intravesicular instillation of the carcinogen at a single dose 45 h postoperatively, when stimulated DNA synthesis reached its peak. Experiments testing a possible cell cycle specific dependence of MNU-initiated tumor development in the partially resected bladder after synchronization of the stimulated proliferation by HU revealed an inhibition of urothelial carcinogenesis in particular, when the carcinogen was administered during the early DNA synthesis phase. The mechanisms underlying the observed inhibition of tumor development in the regeneration urinary bladder are unknown. It is assumed that an increased capacity of the proliferating urothelial cells to repair carcinogen-induced DNA-damage may play an important role.

Animals↗
PubMed1990

Histopathology of N-methyl-N-nitrosourea-induced mesenchymal tumours of the rat urinary bladder.

The present study reports the induction, histopathology, immunocytochemistry, growth pattern and proliferative behaviour of mesenchymal tumours of the urinary bladder of rats induced by a single intravesical dose (5 mg/kg/body weight) of N-methyl-N-nitrosourea (MNU). In 14 of 283 female Wistar rats (incidence: 4.9%). 16 non-epithelial tumours had developed after an experimental period of 14 months. The most common histological type induced was of fibrohistiocytic origin (eight benign-appearing and three malignant fibrous histiocytomas). Furthermore, two pure histiocytomas (one benign and one malignant) and three capillary and cavernous haemangiomas were produced. Since no metastases occurred and no clear-cut distinction between a merely expansive and a truly invasive growth was possible, the diagnosis of malignancy was based on the degree of cellular atypia and the mitotic activity. The benign-appearing fibrous histiocytomas showed a mean mitotic index of 0.06% and the malignant fibrous histiocytomas of 0.34%. The mitotic activity of the malignant histiocytoma was threefold (0.78%) as high as in the benign-appearing histiocytoma (0.25%). There exist close morphological similarities between the induced mesenchymal tumours in the rat and those occurring in the human bladder. Although the spectrum of histological types of mesenchymal tumours seen in the rat bladder was narrower than that encountered in man, MNU seems suitable for further studying the histogenesis, histopathology and biology of experimentally induced non-epithelial bladder neoplasms to gain information for a better understanding of the pathogenesis of human disease.

Animals↗