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Publications (4)4.75 Total impact

  • J Wörl, M Wiesand, B Mayer, K R Greskötter, W L Neuhuber
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    ABSTRACT: In this study, we wished to clarify the distribution and co-localization of nitric oxide synthase and NA-DPH-diaphorase (NADPH-d) in nerve cells, nerve fibres and parenchymal cells in exocrine and endocrine pancreas, and to assess the influence of fixation on the staining pattern obtained. For this purpose, we applied nitric oxide synthase immunocytochemistry and NADPH-d histochemistry to rat and human pancreas under different fixation conditions. Antibodies to neuronal and endothelial nitric oxide synthase were similarly applied. We found complete co-localization of neuronal nitric oxide synthase and NADPH-d in ganglion cells, and in nerve fibres around acini, excretory ducts, blood vessels and in islets of Langerhans of rat and human pancreas. Immunoreactivity for endothelial nitric oxide synthase was co-localized with NADPH-d in endothelial cells. However, in NADPH-d reactive islet and ductal epithelial cells we could detect neither brain nor endothelial nitric oxide synthase immunoreactivity with any fixation protocol applied. There were marked differences in NADPH-d staining of both neurons and parenchymal cells under different fixation conditions. These results indicate the existence of different types of NADPH-d, which are associated or not associated with nitric oxide synthase(s), and which are differently influenced by various fixation procedures in rat and human pancreas.
    Histochemistry 12/1994; 102(5):353-64.
  • O Dworak, T Reck, K R Greskötter, F Köckerling
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    ABSTRACT: Ectopic mammary tissue in the inguinal region giving rise to a hamartoma is reported. This localization of ectopic breast is infrequent and hamartomas of the breast at this site have not been described previously. The unusual size of the lesion caused pre-operative diagnostic difficulties.
    Histopathology 03/1994; 24(2):169-71. · 2.86 Impact Factor
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    ABSTRACT: Vor 1978 unterschied man bei den zystischen Tumoren des Pankreas nur zwischen Zystadenom und Zystadenokarzinom [2]. Inzwischen wurden von den Pathologen eine Reihe weiterer Tumorentitten klassifiziert. Man differenziert heutzutage zwischen dem generell gutartigen sersen Zystadenom, dem potentiell maligne entartenden muzinsen Zystadenom, dem fakultativ malignen papillr-zystischen Tumor und dem muzinsen Zystadenokarzinom als obligat malignen Tumor. Weitere seltenere Tumortypen sind der solid-zystische Acinuszelltumor, der zystische Inselzelltumor sowie die muzinse duktale Hyperplasie. Aufgrund des langsamen Wachstums mit in erster Linie verdrngendem Charakter werden alle diese Tumoren hufig erst bet schon beachtlicher Tumorgre diagnostiziert. Bei der Diagnostik haben das CT, die Ultraschalluntersuchung sowie die ERCP einen festen Stellenwert. Dabei ist es in der Regel zwar mglich, eine Unterscheidung zur Pseudozyste zu fhren, eine Differenzierung der einzelnen Tumortypen ist mit Mitteln der Diagnostik nahezu unmglich. In unserem Krankengut sahen wir in den Jahren 1979 his 1990 10 Flle von sersen Zystadenomen, weiterhin 5 muzinse Zystadenome, 9 Zystadenokarzinome sowie 4 maligne papillr-zystische Tumoren. Von diesen konnten 9 der 10 sersen Zystadenomen, 4 von 5 muzindsen Zystadenomen, alle 4 papillr-zystischen Tumoren Bowie 5 von 9 Zystadenokarzinomen kurativ reseziert werden. Alle Patienten mit kurativ resezierten Adenomen blieben wie auch ein Patient mit einem RI -resezierten Zystadenom in der Nachbeobachtungszeit tumorfrei. Eine Patientin, bei der ein serses Zystadenom nur histologisch gesichert worden war, lebt inzwischen 8 Jahre nach Diagnosestellung mit nunmehr 86 Jahren unter langsamer Progression weiterhin beschwerdenfrei. Von den 5 Patienten, bei denen ein Zystadenokarzinom kurativ reseziert worden war, verstarben 2 Patienten postoperativ. Ein dritter verstarb 4 Monate nach dem Eingriff an einem ausgedehnten Tumorrezidiv. Die beiden restlichen Patienten leben nach 16 und 28 Monaten tumorfrei. Alle 4 palliativ operierten Patienten mit muzindsen Zystadenokarzinomen verstarben nach 8 bis 28 Monaten an ihrer Tumorerkrankung. Von den 4 Patienten mit einem malignen papillr-zystischen Tumor leben 2 73 und 30 Monate nach der Operation erscheinungsfrei. Ein Patient verstarb tumorfrei 45 Monate nach dem Eingriff und der vierte ist 39 Monate nach dem Eingriff wegen eines synchronen metastasierenden Zweittumors inzwischen in einem prfinalen Zustand. Eine Unterscheidung zwischen den einzelnen Tumortypen ist durch diagnostische Manahmen nicht mglich. Da aber nach kurativer Resektion zystische Pankreastumoren eine sehr gute Prognose aufweisen, ist grundstzlich eine komplette Entfernung des Tumors sowie anschlieend eine vollstndige histologische Aufarbeitung der gesamten Zyste zu fordern. Diese Resektion sollte nach den Grundstzen der onkologischen Radikalitt durchgefhrt werden.Before 1978, where cystic tumors of the pancreas were concerned, pathologists only differentiated between cystic adenomas and cystadenocarcinomas. Recently, however, further tumor entities have been introduced. We now differentiate between the generally benign serous cystic adenoma, the potentially malignant mucinous cystadenoma, the possibly malignant papillary cystic tumor, and the always malignant mucinous cystadenocarcinoma. Other rare tumors include the solid cystic acinous-cell tumor, the cystic islet tumor, and mucinous ductal hyperplasia. Because of their slow growth and primary displacement nature, all of these tumors can usually be detected only after they have attained considerable size. Computed tomography (CT), sonography and endoscopic retrograde cholangiopancreatography (ERCP) have an established role in diagnosis. With these methods, as a rule, it is possible to identify pseudocysts; however, differentiation between the individual tumor types is almost impossible. In our study from 1979 to 1990, we observed ten cases of serous cystic adenomas, nine cystadenocarcinomas, and four malignant papillary-cystic tumors. Of these, nine of the ten serous cystic adenomas, four of the five mucinous cystadenomas, all four papillary-cystic tumors, and five of the nine cystadeno-carcinomas were curatively resected. All patients with curatively resected adenomas and one patient with an R1-resected cystic adenoma remained free of recurrence throughout the follow-up period. One 86-year-old female patient in whom a serous cystic adenoma was histologically determined still has no symptoms 8 years after diagnosis despite slow tumor progression. Two of the five patients in whom a cystadenocarcinoma was curatively resected died postoperatively; a third patient died of tumor recurrence 4 months following resection. The two remaining patients are alive and tumor-free at 16 and 28 months postoperatively. All four patients with mucinous cystadenocarcinomas who underwent palliative operations died of their tumor 8 to 28 months later. Two of the four patients with a malignant papillary cystic tumor were alive and recurrence-free 73 and 30 months postoperatively. One patient died free of tumor 45 months postoperatively, and the fourth patient is presently at the preterminal stage following development of a synchronous metastasizing second tumor. Diagnostic techniques cannot be used to differentiate between the individual tumor types; however, because cystic tumors of the pancreas have a good prognosis following curative resection, complete removal of the tumor and a complete histological workup of the entire cyst is required. The resection should be performed in accordance with the oncological rules radical operations.
    Langenbeck s Archives of Surgery 08/1993; 378(5):281-287. · 1.89 Impact Factor
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    ABSTRACT: Before 1978, where cystic tumors of the pancreas were concerned, pathologists only differentiated between cystic adenomas and cystadenocarcinomas. Recently, however, further tumor entities have been introduced. We now differentiate between the generally benign serous cystic adenoma, the potentially malignant mucinous cystadenoma, the possibly malignant papillary cystic tumor, and the always malignant mucinous cystadenocarcinoma. Other rare tumors include the solid cystic acinous-cell tumor, the cystic islet tumor, and mucinous ductal hyperplasia. Because of their slow growth and primary displacement nature, all of these tumors can usually be detected only after they have attained considerable size. Computed tomography (CT), sonography and endoscopic retrograde cholangiopancreatography (ERCP) have an established role in diagnosis. With these methods, as a rule, it is possible to identify pseudocysts; however, differentiation between the individual tumor types is almost impossible. In our study from 1979 to 1990, we observed ten cases of serous cystic adenomas, nine cystadenocarcinomas, and four malignant papillary-cystic tumors. Of these, nine of the ten serous cystic adenomas, four of the five mucinous cystadenomas, all four papillary-cystic tumors, and five of the nine cystadenocarcinomas were curatively resected. All patients with curatively resected adenomas and one patient with an R1-resected cystic adenoma remained free of recurrence throughout the follow-up period. One 86-year-old female patient in whom a serous cystic adenoma was histologically determined still has no symptoms 8 years after diagnosis despite slow tumor progression. Two of the five patients in whom a cystadenocarcinoma was curatively resected died postoperatively; a third patient died of tumor recurrence 4 months following resection.(ABSTRACT TRUNCATED AT 250 WORDS)
    Langenbecks Archiv fü Chirurgie 02/1993; 378(5):281-7.