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Biomedical subjects

R Goertchen

Publications and source records attributed to R Goertchen.

At least 19 recordsLinked to original sources

[Autopsy in peri- and neonatology--an essential step in quality control. Data on autopsy frequency in Saxony].

In the framework of a general quality assurance compaign the working group for peri- and neonatology at the General Medical Council of Saxony has investigated the frequency, conclusiveness and development of autopsies in Saxony between 1992 and 1997/98. There were observable different autopsy rates depending on the degree of neonate maturity. Thus, the autopsy rate of stillbirths having birth weights from 500 to 999 g amounted to 79.7%, and that of stillbirths above 1000 g birth weight to only 59.4%. The abduction rate of neonates dying before day 7 of life was 65.7%. It is remarkable that the abduction rates declines from 79.1 to 62.9% in all weight classes of premature and full-term neonates from 1992 to 1997. The possible reasons for the decline of autopsies and the problems emerging for quality assurance are discussed.

Autopsy↗

[Frequency of histopathological heart findings in representative autopsy material. An epidemiological contribution to quality assurance].

Only few representative autopsy studies can be found about the frequency of histopathological alterations of the myocardium. One reason, no doubt, is the low rate of abductions. Based on 1,073 autopsies made during 1987 and 1987, a macroscopically inconspicuous region of the left-ventricular myocardium was analysed light-microscopically in addition to the other histological investigations. Slightly more than one half (53%) of them revealed a severe coronary sclerosis, especially with advanced age. Still more frequent was an interstitial fibrosis of the myocardium (71.5%). Surprising was the proportion of an uncharacteristic focal fibroplastic carditis of 24.8% and of lymphocyte pericarditis of 8.9%. Only rarely was there observed an acute, exudatively fibrinous pericarditis. Fibroses of the endocardium were found histologically in 177 cases (16.5%). More frequent than expected was the light-microscopic detection of myocarditis (4.7%). Surprising as well was a high frequency of amyloidoses of the heart muscle (12.8%), especially from the 60th year of age on. The study has underlined once again the value of autopsy and, in particular, the importance of additional, targetted histological organ investigations for a high level of epidemiological knowledge and quality assurance.

Autopsy↗

[Clinical pathology of inverted papillomas of the urinary bladder. A complex morphologic and catamnestic study (2)].

The histopathology, ultrastructure, pathological status and clinical course are described in a total of 29 cases of inverted papilloma of the urinary bladder (IP). The IP was isolated in 16 cases and occurred in combination with a papillary urothelial carcinoma in 13 cases. Histologically, a trabecular, a glandular and a mixed type can be differentiated. The trabecular form predominates in a ratio of 4:1. The glandular form is further subdivided into a cystic form and an adenomatous form containing cylindrical cells. Contrary to earlier assumptions, dysplasia and malignant transformation also occur in IP. Amongst the 16 isolated IP observed, four showed slight and four showed moderate dysplasia. One isolated IP was malignant and invasive. In IP in combination with papillary urothelial carcinomas, malignant transformation is somewhat more frequent. Four malignant IP and up to 85% dysplasias were found among the 13 cases. The ultrastructure of IP reveals two cell types: a light cell form which corresponds to a slightly dysplastic urothelium and a darker cell form with or without microvilli which is observed in the glandular type. A frequent characteristic is a thickening of the basement membrane besides abundant "tight junctions". The immunohistochemistry is relatively uncharacteristic. This also applies to the blood group isoantigens, which showed irregular and relative uninformative results in the SCRA test. IP is observed in all age groups and the sex ratio (M/F) is 3:1. The average age of manifestation is 56 years, about 10 years earlier than bladder carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Immunohistochemical studies of the antibody pattern (tumor markers) of the larynx].

Tumour markers are gaining in importance for the histological differentiation of the squamous cell tumours. They can be implemented in the differentiation of precancerous lesions from cancers. Until now, such immunohistochemical methods have been reported only for the larynx for differentiating precancerous transformation from the normal epithelium by means of antigen specificity; none of these methods, however, are suitable for cytological application. We investigated via the immunopap method a palette of antibodies including our own markers (B/A 2). The proliferation marker Ki 67 is found to be specific in various cells, especially in basal cells. Markers with broad spectrum such as CEA and EMA are of little importance for routine laryngeal diagnosis because of uncharacteristic diffuse reactions. EMA antibodies marked the cylindrical cells. S-100, Vimentin, Ulex, and Factor VIII reacted as non-squamous cell markers. S-100 marked, besides the peripheral nerves, also the small salivary glands of the larynx. Ulex showed mild reaction with all squamous cells. We recommend the epithelial markers B/A 2 and CK 13 for routine histological and cytological examination of the larynx. For detection of proliferation Ki 67 is the appropriate marker.

Antibodies, Neoplasm↗

[Cytokeratins in inverted papillomas of the urinary bladder. (Part 1.)].

Inverted papilloma (transitional cell papilloma, inverted type) is a rare, benign urothelial tumor. The distribution of cytokeratin (CK) expression in 22 cases was investigated and compared with normal urothelium and urothelial carcinomas: CK7/8, basal increased positivity; CK13, diffuse positivity; CK18, loss of intensity and loss of umbrella cell staining; CK19, reduction of positivity; CK20, reduction of umbrella cell staining. The data indicate that the inverted papilloma is a basal cell urothelioma.

Biomarkers, Tumor↗

Detection of cancer metastases in regional lymph nodes: comparative histological and immunohistological investigations with the broad-range anticytokeratin monoclonal antibody A45-B/B3.

A total of 113 patients with carcinomas of breast, testis, stomach and colon were examined for lymph node metastases by means of an exact case-by-case comparison by conventional histology and by immunohistochemistry using the anticytokeratin monoclonal antibody A45-B/B3. Among 891 examined lymph nodes, 90% of metastases were recognized by both methods, about 2% by histology alone, and more than 10% by immunohistochemistry alone. The method can be applied for intraoperative frozen section diagnosis.

Breast Neoplasms↗

[The epidemiology and importance of metaplasia and dysplasia of the urinary bladder mucosa in autopsy material from a middle-size industrial city (study of Görlitz)].

This study had been conducted for the purpose of obtaining information on incidence and biological significance of metaplasia and dysplasia of the urinary bladder. Therefore, postmortem investigations were made of 1,117 urinary bladders, using optical light microscopy and mapping. They were related to a medium-size industrial town with an autopsy frequency of 98%. Metaplasia (58%) and dysplasia (13%) are no rare urinary bladder findings and occur particularly to individuals in somewhat advanced age, with no significant sex-related difference. Urocystitis was recorded from over 50% of all cases reviewed. More strongly pronounced inflammatory processes appeared to be risk factors for higher severity of dysplasia. Inconspicuous as well as metaplastic von Brunn's nests or squamous and glandular metaplasia without atypical cells should not be considered precarcinomas. However, atypical cells in terms of dysplasia were recordable from a small number of these metaplasias. Precancerous importance might be attributed to few of them, particularly in male patients with dysplastic squamous cell metaplasia. No reliable information, however, was available on premature development of dysplasia in lower age groups which would have meant a long-drawn process of carcinogenesis.

Adult↗

[Pathology of inflammatory diseases of the central nervous system--an autopsy analysis 1967-1988].

This paper deals with investigations of CNS-inflammations based on 23,338 autopsies in the period from 1967 to 1988. Inflammatory CNS-findings were observed in 210 cases (0.9 per cent). Their etiology was caused bacterially in 66 per cent and viral infections were found in 20 per cent. Additionally multiple sclerosis appeared in 14 per cent of all CNS-inflammations. The meningitis dominated among the bacterial infections and the leukencephalitis and nekrotizing polioencephalitis of Herpes type among the viral inflammations. The histological classification of the nonbacterial inflammations was difficult or impossible in 9 per cent. A clinical diagnosis was established only in 70 per cent of all cases. Especially babies and patients at the age about 60 or 70 were involved.

Adult↗

[Morphology, clinical aspects and therapy of perinatal hypoxic central nervous system damage. A pedoneuropsychiatric follow-up analysis in relation to the neurohistologic spectrum of findings].

The histological localization and extent of ZNS-lesions caused by perinatal hypoxia has been examined in 83 cases. The neuropsychiatrical patterns of 71 in preschool and school age children after perinatal hypoxia were also investigated. Predominantly a brain stem damage with nerve cells lesions, hemorrhages and disturbance of neuroglia are found. In 1 fourth of the cases, nerve cell damage was localized in the medulla spinalis. Intramedullar hemorrhages can be observed in 10% of the cases. 41% of the cases showed subarachnoidal bleedings. Neuropsychiatrical examinations showed varying degrees of brain stem dysfunction in accordance with neurohistological findings. 1 third of the risk children demonstrated minimal brain dysfunction. In 10% an early rehabilitation of resulted in an amelioration of the ZNS-function. Special attention should be drawn to partial ZNS-disturbance-children. The problems of therapy are discussed.

Adolescent↗

[Neuropathology of hypertensive encephalopathy].

An account is given of hypertensive encephalopathy on the basis of neurohistological studies into 54 brains, with additional reference being made to autopsies. Vasculopathy of peripheral arteries and arterioles along with thickening of vascular walls, change of media, and lumen stenosis were primarily recorded by means of optical light and electron microscopy. A difference of more than seven per cent was found to exist between wall thicknesses of arterioles in hypertensive brains, on the one hand, and those in normotensive brains, on the other. Vessels with thickened walls were not rigid but were rather capable of dilation just as under normotensive conditions. Their inner diameters, however, were below normal. Vascular wall fibrosis, to which little attention had been given in the past, was repeatedly recordable from the venous and capillary systems. Impairment of the endothelial barrier function was quite often recorded, with lipid deposits being incorporated in peripheral arterioles and capillaries. No relevance to pathogenesis can be reliably attributed at present to detection of IgG in the arterial system. Microinfarction, micro-haemorrhage as well as disseminated damage to nerve cells are recordable from roughly one third of all hypertensive brains and are primarily located in brain stem ganglia. Demyelinisation and cerebral oedema are quite infrequent. High-protein cerebral oedema was found in some rare cases. Hypertensive encephalopathy should be considered as a nosological entity in which morphological and clinical phenomena are not always correlated to each other.

Arterioles↗

[Histology and cytology of a rare dysplastic adenosis of the cervix uteri with formation of a highly differentiated adenocarcinoma ("adenoma malignum")].

Extremely well-differentiated adenocarcinomas of the cervix are rare neoplasms and are often termed "adenoma malignum". Histology and cytology of the tumor are described in a 37 year old woman. Such adenocarcinomas are of four histological types: endometrioid, mucinous, clear cell and mixed. The cytological evaluation should be useful in some cases, a substantial number of cases show a normal smear or moderate dysplasia. When this disease is identified at an early stage and treated appropriately, the prognosis is not as unfavourable as earlier reports suggest.

Adenocarcinoma↗

[Significance of the stromal reaction in bladder cancer].

The stromal reaction (SR) is to be regarded as a cellular immunological defense reaction of the host organism against the tumor. Based on an analysis of inflammatory infiltrates in 60 bladder cancers the significance of SR was examined. An increase of the cellular reaction up to 1.0 cm tumor diameter and of the lymphocytes at the beginning of the cancer infiltration could be observed, but there exists no statistically evaluable correlation between SR and size, grading or infiltration of the cancer. From these findings it is suggested that stromal reaction in bladder cancer is unimportant for prognosis.

Humans↗

[Comparative immunohistochemical and lectin histochemical studies of ependymal cells and the epithelium of the choroid plexus].

In a previous investigation we reported on the distribution of intermediate filaments in normal epithelium of choroid plexus and ependyma (Kasper et al. 1986). The present paper describes the results obtained with an enlarged panel of monoclonal antibodies against intermediate filaments and additionally with lectins. Ependymal cells contain GFAP and vimentin filaments, whereas epithelial plexus cells express cytokeratin, vimentin and neurofilament 200 KD. Using Concanavalin A, we found a strong cytoplasmatic staining of plexus epithelia and a reduced or failed reaction in ependymal cells. The differences in both cell types may find an explanation in their function or are determined during the ontogenic development.

Animals↗

[Light microscopic studies of concanavalin A binding in the choroid plexus epithelium and ependymal cells of the cerebral ventricle and human tumors derived from those tissues].

Histochemical investigations of human choroid plexus with lectins revealed strong cytoplasmic binding of concanavalin A to plexus epithelium, whereas ependymal cells were unstained or only weakly reactive. A similar but less clear-cut staining pattern by concanavalin A was observed with plexus papillomas and ependymomas. A clear discrimination however, between the two tumor types using this method is not possible.

Cerebral Ventricle Neoplasms↗