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  • 1
    ISSN: 1432-1238
    Keywords: Key words Pig ; Intramucosal pH ; Occlusive mesenteric ischemia ; Oxygen consumption ; Oxygen delivery ; Surface oxygen tension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To investigate the effects of superior mesenteric artery (SMA) flow reduction on the jejunal intramucosal pH (pHi) and to compare these effects with corresponding changes of mesenteric oxygen transport variables and oxygen tensions on the surfaces of the jejunal serosa and mucosa. Design: Prospective, randomized, controlled, experimental study. Setting: Animal research laboratory. Subjects: 20 domestic pigs. Interventions: Mechanical flow reduction in the SMA. The animals were randomized to have an SMA flow of 0%, 25%, 38%, 50% or 100% (control). Measurements and main results: Measurements (baseline, ischemia, reperfusion) consisted of hemodynamic and oxygen transport variables, SMA blood flow, mesenteric oxygen transport variables, pHi and oxygen tensions of the jejunal serosa and mucosa. Flow reduction in the SMA resulted in a significant decrease of pHi indicating ischemia earlier than mesenteric oxygen transport variables. The relationship between mesenteric oxygen delivery (DO2ms) and pHi during acute ischemia is best described by a sigmoid curve. There was a linear correlation between the changes of the jejunal surface oxygen tensions and pHi due to SMA flow reduction. Conclusion: The sigmoid relationship between pHi and DO2ms indicated that pHi is a sensitive parameter for detecting ischemia at 50% of the baseline oxygen delivery and that below 25% there was no further decrease of pHi. In contrast, mesenteric and whole body oxygen transport parameters were not indicative of impaired mucosal oxygen supply.
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  • 2
    ISSN: 1432-2307
    Keywords: Schönlein-Henoch's disease ; Glomerulonephritis ; Glomerular basement membrane
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In glomerulonephritis accompanying the Schönlein-Henoch syndrome (SHS) a characteristic subepithelial basement membrane change is present in 85% of cases. The subepithelial change is a reaction to subepithelial deposits and consists of a garland or dome-like new formation of thin densa lamellae. This change is much more frequent in SHS than in IgA-nephritis or idiopathic glomerulonephritis or any other systemic disease. Furthermore, subepithelial deposits (50% of cases) are nearly as frequent as subendothelial deposits (65%) and more often present than formerly assumed.
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  • 3
    ISSN: 1432-2307
    Keywords: Cardiac myxoma ; Immunohistochemistry ; Histogenesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Immunohistochemical investigation of 11 cardiac myxomas (CMs) including one malignant metastasizing CM showed a co-expression of epithelial (lu-5 and CAM 5.2), mesenchymal (vimentin) and neuroendocrine antigens (neuron-specific enolase) in all tumour cells. Factor VIII was found in the endothelial cells of capillaries only. In the subendocardium of fetal heart tissue close to the foramen ovale myofibroblasts reacting with the panepithelial antibody lu-5 were detected. We conclude that CMs are neoplasms that may develop from embryonic cell remnants.
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  • 4
    ISSN: 1432-2307
    Keywords: Phenacetin abuse ; Pigmentation ; Urinary tract
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The brownish discoloration of the mucosa of the urinary tract which is present in 10–42% of the patients with chronic abuse of analgesics containing phenacetin is, like the discoloration of liver, skin and cartilage, due to lipids similar in type to those in the lipid component of lipofuscin.
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  • 5
    ISSN: 1432-2307
    Keywords: Analgesic abuse ; Microangiopathy ; Urinary tract
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The ultrastructural appearances in Capillarosclerosis of the lower urinary tract in analgesic abuse are reported. The capillaries show thickened basement membranes consisting of numerous thin basement membrane lamellae. Between the newly formed basement membrane lamellae, masses of empty vacuoles (fat vacuoles) and a variety of membranous and vesicular structures are present. The pathogenesis of this alteration in the basement membrane is unknown. A common pathogenetic mechanism may be operative in the discoloration of renal papillae and mucous membranes of lower urinary tract on the one hand and capillarosclerosis on the other.
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  • 6
    ISSN: 1432-2307
    Keywords: Kidney ; Thromboxane ; Thromboxane synthase ; Tü 300 monoclonal antibody
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thromboxane, excreted in the urine in increased amounts in glomerular, vascular and tubulo-interstitial diseases, is considered to originate from the kidney. The localization of thromboxane synthase, a key enzyme of arachidonic acid metabolism, was studied in the human kidney by immunohistology using the monoclonal antibody Tü 300. In the interstitial tissue dendritic reticulum cells surrounding the tubules expressed high concentrations of the enzyme. In glomeruli the enzyme was weakly expressed in podocytes. This was confirmed by co-localization with an antiserum directed to podocalyxin, a marker of the visceral epithelial cells. In the study of various kidney diseases, massive accumulation of thromboxane synthase containing cells was observed in interstitial diseases, whereas in glomerular diseases there were no differences from normal kidney; in a case of thrombotic microangiopathy podocytes exhibited an increase in thromboxane-synthase. The thromboxane-synthase positive infiltrating interstitial cells were shown by conventional light microscopy to be mononuclear phagocytic cells. The physiological sources of renal thromboxane are dendritic reticular cells and podocytes. In interstitial renal disease infiltrating cells of the monocyte/macrophage system constitute the major site of thromboxane synthesis. In glomerular disease, a characteristic alteration of thromboxane-synthase was not found.
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  • 7
    ISSN: 1432-2307
    Keywords: Bladder neoplasm ; p53 ; erbB-2 ; Metastasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Overexpression of p53 anderbB-2 was studied by immunohistochemistry in formalin-fixed tissue samples of 179 patients with transitional cell carcinoma of the urinary bladder. p53 immunostaining was strongly correlated with tumour stage (P〈0.0001). This was driven by a marked difference in p53 expression between pTa (37% positive) and pT1 (71%) tumours, while there was no difference between pT1 and pT2-4 tumours. Similarly, a strong overall association between p53 expression and grade (P〈0.0001) was driven by a marked difference between grade 1 (28%) and grade 2 tumours (71%), and there was no significant difference between grade 2 and grade 3 tumours. Surprisingly, the frequency oferbB-2 overexpression was higher in pT1 tumours (74%) than in either pTa (49%;P=0.0265) or pT2-T4 (56%;P=0.0645) tumours. Both p53 anderbB-2 expression was also associated with metastasis. Metastases were found in 77% of patients with p53 positive primary tumours, but in only 50% of the patients with p53 negative primary tumours (P=0.022). Metastases were found in 66% of patients witherbB-2 positive primaries, but in only 37% of theerbB-2 negative primaries (P=0.020). Of 32 patients with positivity for both p53 anderbB-2, 84% developed metastases, as compared to 49% of patients with positivity for either one or neither positive (P=0.002). We conclude that both p53 anderbB-2 over-expression are associated with early invasion in bladder cancer. Furthermore, p53 anderbB-2 may be important predictors for metastasis.
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  • 8
    ISSN: 1432-2307
    Keywords: Telepathology ; Frozen section diagnosis ; Integrated digital services network
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Telepathology may be used to provide a frozen section service to hospitals without a department or institute of pathology. We have developed a telepathology system using the commercially available Integrated Services Digital Network (ISDN). The main software and hardware elements of our system are: Apple Macintosh workstations, a program for simultaneous transfer of image, voice and data, and a data bank for storage of patients' data and microscopic images. A picture instrument manager (PIM) makes remote control of microscopes or other instruments possible. The system connects the Department of Pathology of the University of Basel with the Regional Hospital of Samedan, 250 km away, and the Regional Hospital of Burgdorf, 100 km away. During a period of 20 months, frozen sections with the hospitals in Samedan and Burgdorf were performed in 53 patients. Between 54 and 58 s were required for the transfer of a diagnostic 8-bit grey level image containing 341±26.1 (standard error) kbytes (n=13) or a diagnostic 24-bit colour image containing 165±16.9 kbytes (n=40). Frozen section diagnosis was completed in 20–40 min. True-positive diagnoses of malignant tumours were achieved in 85.7% of cases (sensitivity=0.857). No false-positive diagnosis was made. In 3 of the 53 cases telepathological diagnosis was not possible for technical reasons.
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  • 9
    ISSN: 1432-2307
    Keywords: Key words Podocyte protein 44 KD ; Focal segmental glomerulosclerosis ; Podocyte damage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The podocyte protein, 44 KD (pp44), is a podocyte-specific antigen that is selectively distributed in the cytoplasm of foot processes. It has been suggested that the pp44 antigen is associated with the cytoskeleton and helps to maintain the complex architecture of podocytes. To answer the question as to whether changes in pp44 expression are associated with changes in podocyte morphology , we investigated the distribution of the pp44 antigen in different kidney diseases. Twenty-one kidney biopsies and one nephrectomy specimen were studied by indirect immmunofluorescent technique and electron microscopy. The pp44-antigen is preserved in cases associated with foot process fusion. In contrast, the antigen could not be detected in areas of capillary wall necrosis, cellular crescents or early and advanced stages of focal segmental glomerulosclerosis – even in the presence of podocytes. Our results show that the pp44 antigen is preserved in diseases associated with reversible loss of foot processes (in cases with foot process fusion associated with proteinuria). In contrast, the pp44 antigen is not detectable in the area of FSGS and cellular crescents, suggesting that in these conditions, podocytes undergo irreversible injury even if they are still present on conventional light microscopy.
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  • 10
    ISSN: 1434-0879
    Keywords: Renal cell carcinoma ; Prognosis ; p53 ; mdm-2 ; Survival ; Proliferation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The clinical course of renal cell carcinoma (RCC) is highly variable. Overexpression of the p53 protein has been suggested as a possible prognostic parameter in RCC. Overexpression of the mdm-2 oncogene product has been shown to interact with the p53 function. To investigate the immunohistochemical overexpression of mdm-2 protein in comparison with that of p53 protein in RCC, 50 nonpapillary pT3 RCCs were immunostained for p53 protein (DO-7) and mdm-2 (1172). Tumor growth fraction (Ki-67 labeling index; MIB-1) was determined by immunohistochemistry. p53 positivity was detected in 16% of tumors. mdm-2 overexpression was seen in 30% of RCCs. There was a significant association between p53 and mdm-2 immunostaining (P=0.0006), suggesting that mdm-2 protein may contribute to p53 protein stabilization in RCC. p53 overexpression was associated with a high Ki-67 LI (P=0.0002), suggesting that p53 overexpression is involved in growth control in RCC. Survival analysis showed that Ki-67 LI (P=0.04) and p53 overexpression were associated with poor prognosis (P=0.0021), whereas mdm-2 overexpression was not related to patient outcome (P=0.73). A Cox regression analysis revealed tumor stage (P〈0.001) and p53 overexpression (P〈0.05) to be independent prognostic parameters. It is concluded that p53 but not mdm-2 may be of practical relevance in predicting patient prognosis in RCC.
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