The presence and significance of the Thomsen-Friedenreich antigen in breast cancer. I. Serological studies.

Serum levels of antibodies against the Thomsen-Friedenreich (TF) antigen were determined for a group of patients with malignancies of the breast, as well as a control group of healthy persons and patients with no breast disease. Despite recent claims of anti-TF levels being severely depressed in patients with breast cancer, we were unable to show any significant differences between the two groups. Standardised anti-TF containing sera or solutions of the TF specific agglutinin from peanuts (PNA) were absorbed with membrane preparations from normal and cancerous breast tissue, but again no differences in absorption were noted. Histological examination, by contrast, showed both free and sialic acid-covered receptors to be present on both normal and malignant breast epithelium. Based on these findings it was concluded that determination of serum anti-TF is an unsatisfactory method of diagnosing breast cancer and that the TF antigen cannot be considered to be carcinoma associated.

The presence and significance of the Thomsen-Friedenreich antigen in mammary gland. II. Its topochemistry in normal, hyperplastic and carcinoma tissue of the breast.

Normal tissue as well as various benign and malignant lesions of the breast were histochemically examined for the presence of the Thomsen-Friedenreich (TF)-antigen. Fluorescein- or 3H-labelled peanut agglutinin was used for this purpose, a lectin that is known to have a high affinity for the TF-antigen. The occurrence of this TF-antigen seemed in all cases, even in the carcinoma lobulare in situ that is regarded as being derived from myoepithelial cells by some authors, to be associated with a secretory condition. Its presence (free and neuraminic acid covered) in normal, hyperplastic and malignant breast tissue, however, cannot be considered a specific tumour associated antigen as has been previously assumed. Furthermore the investigations have shown that the intensity of fluorescence for peanut agglutinin (PNA)-receptors was generally stronger in differentiated carcinomas than in undifferentiated carcinomas of the breast. The histochemical findings are discussed with regard to diagnostical and immunotherapeutical aspects.

[Diagnosis of stromal hyperplasia of the endometrium (author's transl)]. / Zur Diagnose der Stromahyperplasie des Endometriums.

In three cases of endometrial stromal hyperplasia, nuclear DNA-content was determined by Feulgen microspectrophotometry. In two cases DNA-content exhibited the diploid pattern. In the third case values ranged from diploid to tetraploid, also showing an additional peak for hypotetraploid values. The two cases with diploid DNA patterns are considered to have less malignant potential. This corresponds well to clinical follow-up examinations performed three and nine years later, where no progression to malignant growth was established. The pronounced proliferative tendency observed in the third case would make progression to malignancy appear highly probable.

[The differential diagnosis of microcalcification. Micro-cyst (blunt duct) adenosis (author's transl)]. / Differentialdiagnostik der Mikroverkalkungen: Die kleinzystische (blunt duct-) Adenose.

One hundred and thirty-five operations were carried out because of a finding of microcalcification in the breast. In 10% of these, the calcification was shown histologically to be within foci of micro-cyst (blunt duct) adenosis. Analysis of the radiographic appearances of the microcalcification revealed a characteristic radiographic pattern. The differential diagnosis of groups of calcification in intraduct carcinomas and in benign lesions is discussed.

Blood gas tension and development of lung damage in mice exposed to oxygen at 1 ATA.

Oxygen and carbon dioxide tension in arterial blood were studied in mice breathing 100% oxygen at ambient pressure. The lungs were simultaneously investigated in order to relate the oxygen-induced pulmonary alterations to the altered pulmonary function. The development of an impairment in pulmonary diffusing capacity is initiated after 30 h of oxygen exposure, at which time the increase in lung weight is associated with beginning lung edema and beginning accumulation of carbon dioxide in the blood. Red spots or areas on the lung surface, which merged together to large streaks or areas after 20 h of exposure, preceded the measurable diffusing impairment noted at 30 h. Light microscope preparations revealed intraalveolar hemorrhagic exudation and proliferative changes in the alveolar walls. After 50 h, the development of severe pulmonary dysfunction is mainly due to an intense parenchymal reaction in the alveolo-capillary region with thickening in the alveolar walls, dystelectasis in the corresponding parenchyma, and further development of pulmonary edema. The resulting impairment in pulmonary diffusing capacity causes a steep decrease in oxygen tension and an accentuated increase in carbon dioxide accumulation. The present results are discussed in relation to the previous findings of oxygen-induced alterations in brain glutamate, GABA, and glutamine concentration.

[Spatial visualisation of an intraductal mamma carcinoma (author's transl)]. / Räumliche Darstellung eines intraduktalen Mammakarzinoms.

Layer radiology was performed in the roentgenographic visualisation of a mainly intraductal (comedo) carcinoma showing a characteristic triangular microcalcified group in the x-ray film. A three-dimensional model was constructed on the basis of this stratified visualisation. It was found to be wedge-shaped, as was to be expected on account of the anatomical conditions, proving that the "triangular principle" can be considered as correct.

[Differential diagnosis of star-shaped shadows on x-ray films of the female breast (author's transl)]. / Zur Differentialdiagnose der sternförmigen Verschattungen im Röntgenbild der weiblichen Brust

The mammographic demonstration of star-shaped shadows in the breast were reported in two cases. In both cases the lesions basically had to be classified as suspected malignancy, but the cytological examination showed the lesions to be benign scar tissue. Since mammography fails to demonstrate the boundry of a lesion which is seldom benign, such false positive diagnoses cannot be truly classified as "false diagnoses".

[Disseminated peritoneal leiomyomatosis. Light and electron microscopic study]. / Die Leiomyomatosis peritonealis disseminata. Eine licht- und elektronenmikroskopische Studie.

The rare case of disseminated peritoneal leiomyomatosis is reported. A 41 year old non-gravid patient had a laparotomy for uterine fibroids and numerous subperitoneal nodules were found in the abdominal cavity. The light and electron microscopic examinations showed disseminated peritoneal leiomyomatosis. The nodular proliferation of the sub-peritoneal stroma is characteristic for this disease. The patient is free of problems three years following the initial diagnosis of disseminated peritoneal leiomyomatosis.

[Incidence of locally confined growth of carcinoma of the breast (author's transl)]. / Häufigkeit des lokal begrenzten Wachstums von Mammakarzinomen

In 220 cases of breast carcinoma with an anatomical size of less than 2 cm metastases outside the primarily affected quadrant could be demonstrated in the remaining breast in 23.6% of cases (n = 52). Axillary lymph node metastases were present in 3.93% (n = 86). With a tumour size up to 0.5 cm neither metastases in remaining breast tissue nor lymph node metastases could be found. With a tumour size of 0.6 to 1.0 cm only 32 out of 51 cases (62.7%) could be considered to be locally confined. In tumours between 1.1 and 2 cm there was no spread demonstrable in remaining breast tissue or axillary nodes in 70 out of 164 cases (42.7%).

[Outcome of pregnancy following amniocentesis in the prenatal diagnosis of genetic birth defects]. / Schwangerschaftsausgang nach Amniozentese zur pränatalen Diagnostik genetisch bedingter Defekte.

From 1973 to 1982, genetic amniocenteses were performed in 2548 women with singleton pregnancies. Of the cases done up to the end of 1979 the outcome of the pregnancy is on record in 1163 of 1232 cases. Of the cases done from 1980 to 1982 the outcome up to three weeks after the amniocentesis is known in all cases. The final outcome of the pregnancy is known in 25% of these cases. The over-all abortion rate due to the amniocentesis was 0.5%. In the first group, the abortion rate was 0.8% for ultrasound guided amniocenteses and 2.9% for blind punctures. The fetal loss rate from abortion and stillbirth was 3.5%. The abortion rate was correlated to the maternal age, threatened abortions prior to the amniocentesis, the placental site and the technique of puncture. Because of pathological findings, the pregnancy was terminated in 3.2% of the cases. The majority of the amniocenteses was performed between the 16. and 18. week of gestation. Repeat punctures were required in 1.9% of the women. The incidence of discoloration of the amniotic fluid was 2.0%. The rate of frankly blood stained fluid was 2.2%. The frequency of minimally blood stained fluid was 3.2%. Blood stained samples of amniotic fluid were significantly more often obtained with larger canulas , blind punctures and in cases with anterior placentas. A feto-maternal transmission of red blood cells was detected in 10 of 699 tested cases (1.4%). Serious maternal complications or fetal injuries did not occur.(ABSTRACT TRUNCATED AT 250 WORDS)

[Prenatal diagnosis of triploidy (69, XXX) (author's transl)]. / Pränatale Diagnose einer Triploidie (69,XXX) bei fortgeschrittener Schwangerschaft.

By amniocentesis we succeeded in finding a case of triploidy (69,XXX). Because of an extreme fetal dystrophy and missing fetal movements in the 33rd week a severe malformation was suspected. The clinical, ultrasonographical, cytogenetital, hormonal and autopsy findings are reported and discussed.

[Chromosome Anomalies in cases of habitual Abortions (author's transl)]. / Chromosomenanomalien bei Ehepaaren mit wiederholten Aborten.

Chromosome examinations in the case of 78 married couples with recurrent abortions are discussed. The analyses were based on 141 caryogrammes--78 women, 63 men. Inheritied chromosome anomalies as cause of the recurrent abortions could be ascertained with 7 patients (5%): 4 autosomal anomalies in the form of balanced translocations; 1 gonosomal anomaly occurring as X-trisomy with deletion of the short arms of an X-chromosome; 2 cases of striking fragility of the chromosome no. 2. The significance of such chromosome anomalies in women and recurrent miscarriages is discussed. Cytogenetic and histological examinations of the aborted product of conception can give valuable indications for the detection of a chromosome anomaly in the parents. The prognosis and consequences of parental chromosome anomaly and the necessity of prenatal chromosome analyses are discussed.

[Criteria for the definition of early cancer of the breast (author's transl)]. / Kriterien zur Abgrenzung von Frühfällen des Mammakarzinoms.

In order to define cancer of the breast limited to the breast parenchyma 114 infiltrating carcinomas with a maximum size of 1 cm and 88 non-infiltrating carcinomas (without size limitation) were investigated histologically for axillary lymph node metastases. All carcinomas with a size of up to 0.5 cm (25 cases) were free of lymph node metastases. Infiltrating carcinomas with a size of more than 0.5 cm up to 1 cm (108 cases) showed metastases in 25%. Non-infiltrating carcinomas of more than 0.5 cm (69 cases) had lymph node metastases in 1.4%. Considering the excellent prognosis, by histologically criteria infiltrating carcinomas of up to 0.5 cm and all non-infiltrating carcinomas can be considered as cases of "early breast cancer". For detection of these carcinomas mammography is of considerable importance, particularly when micro-calcifications are demonstrated. Among non-invasive carcinomas 74% were thus discovered by this method.

[Penetration of spermatozoa with Y-chromosomes in cervical mucus by an in-vitro test (author's transl)]. / Nachweis Y-Chromatin-positiver Spermien im Zervixsekret beim In-vitro-Penetrationstest

PIP: The percentage of Y spermatozoa was determined in sperm specimens from 73 donors with known spermiogram; mean value was 46%. No difference between donors with high or low sperm counts was observed. The penetration capacity of the sperm in cervical mucus was investigated in 59 cases using an in vitro test. The cervical mucus content of Y spermatozoa was significantly higher (54.2-56.7%) than that of the sperm specimens. It thus appears that cervical mucus may be somewhat selective of Y spermatozoa.^ieng

[Indications and results of antenatal karyotyping (author's transl)]. / Indikationen und Ergebnisse der pränatalen Chromosomenanalyse

From 1972 to 1975, 64 genetic amniocenteses and 72 cell cultures from amniotic fluids were done for antenatal karyotyping. In 3 cases a therapeutic abortion for genetic indication was carried out. The indications for antenatal karyotyping, the technique and complications of genetic amniocentesis in early pregnancy and the methods of cell cultures of amniotic fluid are discussed. A compilation of the results of 1918 antenatal karyotypings reported in the literature shows the following probability for the presence of an unbalanced chromosomal anomaly in the fetus: in mothers over age 40 4.25%, in mothers age 35-39, 1.45%, in cases with trisomy-21 in a previous sibling 0.73%, in cases with balanced chromosomal anomalies in the parents, 15.2%. In the next few years an increase of antenatal karyotyping in the different risk groups can be expected. In the individual case the indication for genetic amniocentesis must be balanced against the risk of complications.

[Polymorphonuclear infiltration of the placenta in cases with internal fetal monitoring (author's transl)]. / Leukozytäre Infiltration der Plazenta bei Intensivüberwachung in der Geburtshilfe

The infectious morbidity due to intra-amniotic fetal monitoring was studied morphologically in 100 spontaneous deliveries with intra-amniotic fetal monitoring. The control group consisted of 100 spontaneous deliveries with external fetal monitoring. It was shown that internal fetal monitoring does not increase the infectious morbidity with total labours of up to 12 hours. The occurrence of inflammatory cell infiltrates in the placenta, the membranes and the umbilical cord is not in each case due to a bacterial intra-uterine infection. The pathogenesis of these infiltrates is discussed comparing the results of the literature and this study.