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Biomedical subjects

F Weidner

Publications and source records attributed to F Weidner.

At least 37 records · Page 2Linked to original sources
PubMed1980

Microstages in malignant melanoma--the basis for an elective lymph node dissection.

Our experience has shown that an increasing depth of invasion of the primary tumor is connected with a higher incidence of regional lymph node metastases. The incidence of subsequent metastases or recurrences is compared retrospectively for two groups: (1) 175 patients with elective dissection and (2) 33 patients with excision only. All patients suffered from high-risk melanomas of clinical stage I. The frequency of subsequent metastases was 21% (N = 36) for the first group and 46% (N = 15) for the second group (p less than or equal to 0.01). The 5-year survival rate (Berkson-Gage) of patients with high-risk melanomas and secondaries is 41% for the patient group (N = 27) in which elective dissection was performed and 21% for patients with therapeutic dissection (N = 52). The results speak for the elective dissection in cases of high-risk melanomas.

Female↗
PubMed1980

[Erythromelanoderma in pemphigus herpetiformis associated with eosinophilic spongiosis].

A 62 year old female was treated for several years with DDS because of Duhring-disease like symptoms. She developed erythro-melanoderma, generalized lymphadenitis and pachyderma. Histologically there were eosinophilic spongiosis and intraepidermal vesiculation, blood eosinophilia up to 42%, and intercurrent streptococcal septicemia, immunohistologically in vivo bound pemphigus antibody, but no papillary or linear IgA. Indirect immunofluorescence was negative. Paraproteinemia was excluded.

Dapsone↗
PubMed1979

[Lichen ruber ulcerosus (dystrophicans)].

Report on two women suffering from chronic painful ulceration of the feet combined with interdigital synechia, loss of nails, alopecia and oral lesions of lichen planus. Hint at certain clinical parallels of dystrophic skin symptoms with epidermolysis bullosa hereditaria dystrophica yet demonstrating different mode of blister formation.

Aged↗
PubMed1979

[Adjuvant DNCB immunotherapy in malignant melanoma].

Report on the application of a dinitrochlorobenzene ointment of 61 postoperative melanoma patients exhibiting clinical stages I and II. After contact sensitization the erythemogenic threshold concentrations of DNCB were mostly found in the range of 0,05% and 0,1%. Patients with reactions at low concentrations of 0,01% and 0,05% DNCB were in the mean 8 years younger than those with reactions at 0,1% and 0,5%, but no connection to different stages of malignant melanoma could be evaluated. 3 melanoma patients suffering from skin metastases were treated by epifocal DNCB-application. One of them became clinically tumor free since more than 1 year, whereas the two other exhibiting multicentric and/or profound tumor growth did not respond. In a 82-year-old wife a superficial lentigo maligna melanoma disappeared by DNCB-application. In none of the 61 cases we observed a "tumor enhancement" after immunoprophylaxis or adjuvant immunotherapy with DNCB. The DNCB-method in malignant melanoma is yet in the experimental stage and is not recommended for general use in practice.

Adult↗
PubMed1979

Comparative histological studies of regional lymph nodes of 201 melanoma patients. (Microscopic features in relation to individual age, site, and metastatic spread).

Since May 1968 a total of 2.108 regional lymph nodes (l.n.) dissected from 201 melanoma patients (86 axillary, 107 groin, and 8 neck) have become available for study. The purpose was to detect histological differences between the l.n. of 134 patients lacking and those of 67 patients exhibiting l.n. metastases, histologically verified in 104 of 706 nodes. The main finding is a more than six-fold increase in number and an eleven-fold increase in total area (evaluated by a microscope micrometer) of germinal centers in the lymph follicles of patients with, as compared to those without, l.n. metastases (P less than or equal to 0.05). Paracortical areas were found to be diminished in 56.7% of cases with metastatic spread. Accumulations of plasma cells were mainly seen in the nodes of elderly patients (48.4%) and of those exhibiting regional metastases (47.8%). The observation of numerous and dilated blood vessels in the interfollicular regions noticeably corresponded to the occurrence of lymphatic metastases (P less than or equal to 0.01), suggesting a "tumor angiogenic factor". A negative correlation with metastatic involvement was found as to histiocytosis of marginal sinuses and with respect to the observed fibrinoid hyalinosis of pulp vessels (P less than or equal to 0.01). The marked hyperplasia of lymph node B-lymphocyte regions as opposed to diminished T-lymphocyte areas prevailing in cases with metastatic melanoma is in accord with findings of humoral immunologic blocking activity and impaired T-cell response in advanced malignant melanoma.

Adolescent↗
PubMed1977

Histological features of "pagetoid reticulosis" (Woringer-Kolopp) in pre-mycosis fungoides.

The case of a 66-year-old female with chronic skin lesions is described, which clinically resembled parakeratosis variegata but histologically showed the pattern of "pagetoid reticulosis" (Woringer-Kolopp). The intraepidermal pagetoid cells were lymphoid cells which, by electron microscopy, could be identified as small Sézary cells. The intraepidermal presence of numerous atypical reticulum cells does not support the theory of "pagetoid reticulosis" as a separate nosological entity, but rather stresses the epidermotropic character of (pre-)mycosis fungoides just known from intraepidermal Pautrier microabscesses.

Aged↗
PubMed1976

Early metastases in regional lymph nodes and prognosis of malignant melanoma. Histological and clinical examinations in 104 lymphadenectomized patients.

In 104 malignant melanoma patients who underwent lymphadenectomy (67 females, 37 males), correlations were studied between histologically diagnosed lymph node metastasis, the type of malignant melanoma and the depth of invasion according to Clark, as well as other parameters. In 35.6% of the patients, metastases of the primary tumor were found in one or several regional lymph nodes. In about one third of the patients, the clinical and histological lymph node findings were proven to diverge. The female:male ratio of generally about 2:1 shifted to 1:1 in the group of patients with lymph node metastasis, i.e. cases with lymph node metastasis were found significantly increased in the male sex, and also, when primary tumors were localized on the trunk. A prognostic correlation between the two parameters, sex and localization, is suggested by the high incidence of histologicallly diagnosed metastases in 1 or 2 lymph node regions, when malignant melanomas were localized on the trunk in males. As to the types and the micro-stages of primary tumors, the number of cases collected until now does not permit establishing clear correlations with the incidence of lymph node involvement. Calculating the 5-year-survival rates for patients with and without lymph node metastasis according to the "actuarial method", we found the prognosis to depend largely on the presence or absence of lymph node involvement, even at a time as early as at primary tumor excision. Our results support the indication for prophylactic lymphadenectomy in malignant melanoma, provided the primary tumor has reached or surpassed the micro-stage 3.

Female↗
PubMed1976

[Treatment of malignant melanoma (clinical stages I and II) (author's transl)].

The uncorrected cumulative five-year survival rate ("actuarial method") among 195 patients with infiltrative malignant melanoma of the skin was 58% (160 cases) in clinical stage I, 26% (35 cases) in clinical stage II. In addition to clinical staging, microstaging - i.e. the histologically determined depth of invasion of the primary tumour - is of great prognostic significance. In microstages 2 and 3 with the largest vertical tumour diameter below 0.76 mm, five-year survival rate was 100% while in microstage 3 with greater vertical tumour diameter it was 66% in microstage 4 55% and microstage 5 31%. Results of treatment can be reliably interpreted only if they are divided according to microstage. Propylactic dissection of the regional lymph-nodes (dissection in clinical stage I) need not be undertaken in microstages 2 and 3 with vertical tumours diameter below 0.76 mm. Whether prophylactic dissection was done in one or two sessions has apprarently no significant influence on survival rate. A single X-radiation dose to the primary tumour of 4 000 -6000 R immediately before excision of the tumour did not significantly increase the results. The results were particularly bad when the primary tumour was removed after inadequate manipulation.

Adult↗
PubMed1976

[Malignant melanoma: depth of invasion and histologic typing].

INTRODUCTION: In classifying a malignant melanoma Clark et al. (1969) have suggested histologic typing (lentigo maligna-melanoma, superficial spreading melanoma, nodular melanoma) as well as the determination of the depth of invasion. The experiences made so far need further confirmation through respective research in additional material. This applies to the frequency of histologic types of melanoma and the microstages and primarily to the prognostic significance. There appear to be correlations whether the depth of invasion or the type of melanoma is decisive for prognosis or whether both have to be considered. MATERIAL AND METHODS: Between 1967 and 1974 the depth of invasion and the type of melanoma were determined according to Clark et al. (1969) in 139 invasive malignant melanomas. This classification has been carried out routinely following the excision of the tumor since Jan 1st, 1973; in previously operated tumors it was carried out in retrospect without knowledge of the follow-up. Without exception multiple sections of several blocks were used. Uncorrected survival curves and survival rates were drawn up using the acturaial method. Results 1. Of 139 malignant melanomas 3 (2%) were found to be in microstage 2, 50 (36%) in microstage 3, 71 (51%) in microstage 4 and is (11%) in microstage 5. 2. The type of 2 melanomas could not be defined. Among the remaining invasive malignant melanomas 17 (12%) were lentigo maligna melanomas, 48 (35%) were superficial spreading melanomas and 72 (53%) nodular melanomas. 3. Of the 72 nodular melanomas 53 (74%) were found in microstage 4 or 5; of the 65 other melanomas (lentigo maligna melanomas or superficial spreading melanomas), however, only 34 (52%) p less than 0,001) were in this stage. 4. The uncorrected 5-year survival rate was 100% in microstage 2 and 3 and in tumours diameter of 0.76 mm or more, 55% in microstage 4 and 31% in microstage 5. 5. At equal depth of invasion there are no significant prognostic differences between the various types of melanomas. DISCUSSION: It was possible to reproduce the type classification of melanomas as introduced by Clark et al. (1969) in our own material from 139 patients. Tumors of microstage 2 were less frequent in our material (2%) than in American and Australian series (17-28%). As far as the frequency of the types of melanoma and the correlation between the type of melanoma and depth of invasion are concerned, the Erlangen material does not show considerable deviation from the reports in the literature on the subject. Among tumors of equal depth of invasion the type of melanoma has little prognostic impact. The depth of invasion is decisive for the prognosis. It can be determined with little effort to a high degree of reliability.

Humans↗
PubMed1975

Immunofluorescent investigations in cutaneous vasculitis. II. Histotopical demonstration of IgD and fibrin.

The histotopical distribution of IgD and fibrin was examined in skin lesions of 12 patients with cutaneous vasculitis, by means of the direct IF method. IgD was found in 9 cases mostly in a striking fixation to the PMN-leucocytic inflammation cells. Homogeneous depositions of IgD in cutaneous blood vessel walls were seen twice. In 3 cases with older, lympho-histiocytic infiltrations, IgD was lacking. Fibrin was constantly present in the blood vessel walls of fresh and older vasculitis lesions, and showed up in the regions of "fibrinoid necrosis" in form of distorted vascular rings. Although neither IgD nor fibrin appear in a disease-specific histotopical distribution, their simultaneous in vivo demonstration, connected with the result of vascular bound complement, is a good aid to substantiate the diagnosis of cutaneous vasculitis.

Fibrin↗
PubMed1975

Immunofluorescent investigations in cutaneous vasculitis. I. Histotopical demonstration of complement/complement factors.

Using an indirect double layer immunofluorescence method, fresh skin lesions of 10 patients with different forms of cutaneous vasculitis were tested for the occurrence of complement-factors C1q (C1), alpha2D(C3) and beta1F (C5). In contrast to the irregularly found complement fixing immunoglobulins IgG and IgM, complement could be regularly seen bound to the cutaneous vessel walls; mostly the C3-factor alpha2D. C1q was demonstrable, combined with IgG and/or IgM only in 2 cases. In 5 patients there was a non-homogenous, roddy fluorescenece of the epidermal basal membrane zone and the cutaneous vessels, when alpha2D or beta1F were tested. Our findings suggest that the "alternate pathway" beginning with C3-activation is followed in most cases, whereas a typical "immune complex vasculitis" is obviously rare. The constant occurrence of complement in the cutaneous vessel walls of vascultis lesions is consistent with the known chemotactic and destructive role of complement factors in experimental models of angiitis, but it may not necessarily involve a specific immunological process.

Antigen-Antibody Complex↗
PubMed1975

[Allergic reactions of the eczema type due to drugs (author's transl)].

Drug-induced allergic skin reactions of the eczema type may relatively frequently appear as allergic contact eczema or more rarely as "hematogenous contact eczema." In both types of eczema, a positive patch test to one or more allergens is essential for diagnosis. In 1971 and 1972, there were 85 patients with drug-induced eczema reactions (allergic reactions to the ointment bases and preservatives have not been taken into consideration). In 80 cases, topical applications were the contact allergens. The frequent contact allergies to benzocaine and Balsam of Peru seems significant. In 5 isolated cases we saw hematogenous contact eczema due to internal medication, e.g. with antibiotics.

Anti-Bacterial Agents↗
PubMed1975

Dermatitis herpetiformis and small intestinal lesion--no strict association in german patients.

Dermatitis herpetiformis (DH) has been reported to be associated with various degrees of intestinal villous atrophy in 19 to 68 percent of the cases studied. This was true particularly in British and American populations. The present investigation deals with morphological and functional characteristics of small intestinal mucosa in a group of German DH patients (n=16): No case of villous atrophy could be detected, whereas interepithelial lymphocytes were shown to be slightly but significantly elevated. Intestinal disaccharidase activities were not statistically different from those of healthy control subjects, and oral lactose tolerance tests were normal in each of 8 patients tested. Genetical and immunological differences between our DH patients and those studied by British and American authors may be responsible for the basically different results as to "dermatogenic enteropathy".

Adult↗