Biomedical subjects
Publications and source records attributed to T Knösel.
Primary carcinomas of the vagina are very rare. Nevertheless, they need to be included in differential diagnoses when carrying out a urological examination of the pelvic floor and the vagina in patients with micturition problems, also in younger patients: we report a case of a 35-year-old woman with a primary carcinoma of the vagina and present a review of the literature.
This report describes the case of a 16 year old girl with a history of high fever, prolonged fatigue, and cervical lymphadenopathy of the right side. In addition, the patient showed neutropenia, thrombopenia, and pronounced reticulopenia. Cervical ultrasound showed unilateral hypoechoic lymph nodes up to 23 mm in diameter suspicious for malignant lymphoma. Histology of a cervical lymph node specimen revealed massive nodular histiocytic proliferation and prominent apoptosis without necrosis. Parvovirus B19 was detected by polymerase chain reaction and immunohistochemistry in the lymph node. In summary, this case is an unusual presentation of parvovirus B19 infection. The virus was identified as the potential causative agent of unilateral cervical lymphoma and apoptotic sinus histocytosis, thus broadening the clinicopathological spectrum of parvovirus B19 induced diseases.
BACKGROUND: Activated leucocyte cell adhesion molecule (ALCAM) has been implicated in tumorigenesis and tumour progression of malignant melanoma and prostate cancer. AIMS: To clarify the expression patterns of ALCAM in colon cancer and to correlate these with clinicopathological parameters, including patient survival. METHODS: One hundred and eleven colorectal carcinomas were immunostained for ALCAM (clone MOG/07) using a standard detection system. Cytoplasmic and membranous immunoreactivity were scored semiquantitatively. Fisher's exact test, chi2 test for trends, Kaplan-Meier analysis, and Cox's regression were applied. RESULTS: In colorectal cancer, 58.6% and 30.6% of cases showed strong cytoplasmic and membranous expression of ALCAM, respectively. No significant correlation with patient age, tumour grade, stage, or nodal status was apparent. In survival analyses, membranous ALCAM expression correlated significantly (Cox's regression, p=0.028; relative risk, 2.3) with shortened patient survival. CONCLUSIONS: ALCAM is frequently upregulated in colorectal cancer and is a new independent prognostic marker, underscoring the importance of ALCAM in tumour progression in this disease.
AIMS: To investigate the prognostic significance of chromosomal alterations in colorectal cancer patients. Histopathological tumour classification is still considered to be the gold standard for the characterization of solid tumours. However, it is well known that such established parameters do not satisfactorily predict the clinical outcome in individual cases. Markers that reliably predict survival are needed. These markers should guide the clinical treatment of neoplastic disease. METHODS AND RESULTS: Chromosomal imbalances in 61 colorectal carcinoma specimens in 37 patients determined by comparative genomic hybridization were correlated with patient survival using custom-made computer software which enabled the assessment of individual chromosomal loci. Kaplan-Meier analysis revealed that over-representations of 2p14-15, 6q23-6q24, 15q22-15q23, 22q11.2 and deletions of 1p36.1-36.2, 4q31.3, 4q35, 8q12-q21, 8p11.2 and 9p22 were significantly associated with shorter disease-specific survival, whereas over-expression of 20q13.3 and deletion of 18q11.2 were significantly associated with longer disease-specific survival in this collection of colorectal cancers. Multivariate Cox proportional hazards regression models consistently identified gains of 2p14-15, 15q22-23, 22q11.2 and losses of 1p36.1-36.2 and 4q35 as independent markers of shorter patient survival carrying greater significance than the classical clinicopathological parameters of nodal status and tumour grade. CONCLUSIONS: These five markers allow a molecular categorization of patients into high and low clinical risk groups. Thus, the genomic data have refined the histopathological classification highlighting the necessity for a supplementary genetically based stratification of colorectal cancer.
Metastases account for approximately 50% of the malignant tumors in the brain. In order to identify structural alterations that are associated with tumor dissemination into the central nervous system we used Comparative Genomic Hybridization (CGH) to investigate 42 brain metastases and 3 primary tumors of 40 patients. The metastases originated from lung cancer (14 cases), melanomas (7), carcinomas of breast (5), colon (5), kidney (5), adrenal gland (1) and thyroid (1). In addition, tumors of initially unknown primaries were assessed in 3 cases. The highest incidence of DNA gains were observed for the chromosomal regions 1q23, 8q24, 17q24-q25, 20q13 (>80% of cases) followed by the gain on 7p12 (77%). DNA losses were slightly less frequent with 4q22, 4q26, 5q21, 9p21 being affected in at least 70% of the cases followed by deletions at 17p12, 4q32q34, 10q21, 10q23-q24 and 18q21-q22 in 67.5% of cases. Two unusual narrow regional peaks were observed for the gain on 17q24-q25 and loss on 17p12. The incidence at individual loci can be viewed at our CGH online tumor database at http:// amba.charite.de/cgh/. The metastases of each tumor type showed a recurrent pattern of changes. In those cases with primary tumor and metastases available, the CGH pattern exhibited a high degree of conformity. In conclusion, our data suggests that specific genetic lesions are associated with tumor dissemination into the nervous system and that CGH analysis may be a useful supplementary tool for classification of metastases with unknown origin.
The effect of incongruous medial meniscal grafts on the articular surface was studied. We compared the cartilage degeneration in 4 Groups of 25 sheep knees. The histological changes were graded according to the score of Mankin, the morphological alterations by the score of Jackson. In Group 1 no surgery was performed. In group 2, the meniscus was totally detached from its base at the capsule and refixed without changes in the congruity or isometry. This group provided the basic data. In group 3, the contralateral medial meniscus was used as a transplant by reversing it. The reattachment was done according to isometric conditions. With this technique only the congruity of the tibial and femoral surface was modified. In group 4, the medial meniscus was completely removed. The results of group 1 (Mankin grade 0.58; Jackson grade 0.00) and group 2 (grade 0.50 and 0.47) showed no difference. The highest degree of degenerative changes occurred in the meniscectomized knees (group 4, grade 4.47 and 1.73), however considerable changes were also found in the knees with an incongruous meniscal graft (group 3, grade 3.37 and 1.27). The results suggest that incongruous grafts will lead to degeneration of the articular surface but still have a chondroprotective effect.