[Obligation to report occupational diseases. Importance of external post-mortem examinations before cremation]. / Meldepflicht von Berufskrankheiten. Bedeutung der Leichenschau nach dem Feuerbestattungsgesetz.

The practical use of the legally required documentation of occupational diseases is demonstrated by a case of asbestos-related pleural mesothelioma. During the mandatory inquest before cremation, information of manifest pleural mesothelioma had been relayed to the widow of the patient, and an investigation for a possible occupational disease was performed. Reconstruction of the case showed that in the course of 3 months at least 13 physicians had been involved in in-hospital as well as ambulatory therapeutic measures. Until death, none of them informed the trade association about a suspected occupational disease in accordance with BK 4105 of the codex of occupational diseases, although the diagnosis of manifest pleural mesothelioma had been histologically confirmed already 10 weeks prior to the death of the patient. This case demonstrates obvious and evident deficiencies in applying the Code of Social Law VII, which requires physicians to report occupational diseases. In addition, it shows the importance of the post-mortem examination as a control function before cremation.

[Tuberculosis of the large intestine--a differential diagnosis of inflammatory and neoplastic colon tumors]. / Dickdarmtuberkulose--eine Differentialdiagnose inflammatorischer und neoplastischer Colontumoren.

We report on a case of ileocoecal tuberculosis. The clinical, radiological, endoscopic and pathologic findings are considered. The differential diagnosis between tuberculosis, chronic inflammatory bowel diseases and carcinoma of the colon are described.

Immunocytochemistry of eruptive haemangiomas (pyogenic granulomas).

Eight eruptive haemangiomas (pyogenic granulomas) were stained immunocytochemically. Many of the cells reacted with markers for endothelial cells. The reactions with anti-vWF antibody were weaker than those with UEA-I-lectin and with the monoclonal antibody BMA 120. These results probably reflect reduced capability for storage of vWF by proliferating endothelial cells. Many cells were negative for endothelial-cell markers, and they reacted with a monoclonal antibody against muscle actin. These cells may be myofibroblasts and pericytes. The studies indicate that eruptive haemangiomas are composed of pericytes, myofibroblasts and endothelial cells.

[Satellite recurrence of eruptive angioma. A clinical, histologic and immunocytochemical study]. / Satellitenrezidive eruptiver Angiome. Eine klinische, histologische und immunzytochemische Studie.

Some weeks after operative removal of an eruptive angioma, satellite angiomas may develop within and around the scar. During the further course they remit spontaneously. So far these recurrences have been observed almost exclusively on the trunk in children and young adults, especially in male patients. Four new cases are reported. The course is consistent with earlier observations. Histologically, the cell proliferations follow the ramifications of afferent arteries. In older satellites, there are focal changes of intravascular papillary endothelial hyperplasia. These are interpreted as regression phenomena. Immunocytochemically, desmin-negative cells positive for muscle-actin are found in addition to endothelial cells. They are considered to be pericytes and myofibroblasts. Because of the close relationship with the afferent arterioles, disturbances in the vascular system are thought to be responsible for the development of angioma. If such underlying vascular disorders are not corrected by primary excision, satellite recurrences may occur. Because of their tendency to spontaneous remission, active therapeutic measures are not recommended.

[Churg-Strauss syndrome]. / Churg-Strauss-Syndrom.

The Churg-Strauss syndrome, or allergic angiitis and granulomatosis of the lungs, is one of the systemic vasculitides with predominantly involvement and an unclear genesis. The clinical picture is characterized by a combination of intrinsic bronchial asthma, eosinophila with elevated IgE, and systemic vasculitis of the small blood vessels. Apart from the lungs, other organ systems may also be involved. We report, here, on a case, observed for a period of eight months, that showed complete remission under treatment with corticosteroids.

[Cutaneous metastatic angiosarcoma of the forearm]. / Kutanes, metastasierendes Angiosarkom des Unterarmes.

Cutaneous angiosarcoma are rare tumours and occur particularly rarely on the extremities. There are only a few reports in the literature concerning their clinical and catamnestic behaviour. We report the case of a 57-year-old male North African with a large exophytic and nodular tumour of the left forearm that showed a vasoformative histological pattern. The endothelial cell origin was proven by immunocytochemistry using endothelial cell antibodies such as anti-vWf (syn.:anti F VIII R:Ag), UEA I and the monoclonal antibody BMA 120. The patient's history revealed that the neoplasm had grown slowly for more than 15 years. After partial resection, the tumour enlarged rapidly and the patient died of widespread metastases.

Immunocytochemistry of angiosarcomas. A study of 19 cases with special emphasis on the applicability of endothelial cell specific markers to routinely prepared tissues.

Since the advent of endothelial cell specific antibodies, immunocytochemistry has become an increasingly used tool in the diagnosis of malignant endothelial tumors or tumors of an alleged vascular nature. In surgical pathology the most frequently applied markers are anti-Factor VIII-related antigen (anti-FVIII-R:AG) and Ulex europeus I agglutinin (UEA I) because of their ability to work on routinely formalin-fixed paraffin-embedded tissue. However, these markers label angiosarcomas inconstantly, which has prompted the search for more reliable markers, especially monoclonal antibodies specific for endothelial cell specific antigens. BMA 120 (formerly designated BW 200) is an endothelial cell specific monoclonal antibody detecting an epitope of a formalin resistant antigen. This marker labels a considerable number of angiosarcoma cells and it was compared with the staining patterns of anti-FVIIIR:Ag and UEA I in 19 angiosarcomas. Special regard was given to the distribution of antibodies in different parts of angiosarcomas.

Microvascular endothelial cells from human omental tissue: modified method for long-term cultivation and new aspects of characterization.

A method for long-term cultivation of large amounts of human microvascular endothelial cells from the omental tissue (human omental tissue microvascular endothelial cells, HOTMECs) was devised. The method originally described by Kern, Knedler, and Eckel was modified: HOTMECs were isolated by enzymatic dissociation with collagenase. For primary cultivation and passages, HOTMECs were plated either onto fibronectin-coated petri dishes or onto a human fibroblast extracellular matrix (HFB-ECM) prepared from the same tissue. Omental tissue (10-15 g) yielded 4-8 X 10(5) HOTMECs; more than 90% of the cells adhered to precoated dishes and grew in Waymouth's culture medium supplemented with 20% heat-inactivated fetal calf serum. Confluence was reached 3-5 days after seeding with an average of 1-2 X 10(6) cells/dish. Confluent HOTMEC layers were subcultured at a split ratio of 1:3 up to 11 passages by plating the cells onto dishes coated with HFB-ECM and maintained in long-term culture for up to 3 months. The endothelial origin of these cells was demonstrated as follows. The cells in culture showed the typical "cobblestone" growth pattern and synthesized von Willebrand factor (vWF) as determined by metabolic labeling. Using an indirect immunostaining technique, the cytoplasm of the HOTMECs stained for vWF. A monoclonal antibody specific for human endothelial cells bound exclusively to the cultured cells. The expression of thrombomodulin on the surface of the cultured cells was demonstrated by the activation of protein C by thrombin. In control experiments, these features could be detected on neither fibroblasts nor mesothelial cells.

Hemangioblastoma of the cerebellum--an immunocytochemical study.

Immunocytochemical studies using a new antibody against endothelial cells and commercially available antibodies against glial fibrillary acidic protein (GFAP) and S-100 protein were performed on 10 cerebellar hemangioblastomas in order to clarify the controversy over the origin of stromal cells. Neither cytoplasmic immunoreactivity for endothelial cell markers nor for anti-GFAP and anti-S-100 protein was found in these cells. Endothelial cell markers reacted positively only with neoplastic capillaries of the tumors and anti-GFAP and anti-S-100 protein were only found in glial remainders in the centers and margins of the tumors.

Immunohistochemical and immunochemical characterization of a new endothelial cell-specific antigen.

A new monoclonal antibody (moab BW 200) of IgG3 kappa-isotype was generated which recognizes an epitope located on an antigen molecule restricted to human neoplastic and non-neoplastic endothelial cells. The molecular weight of the antigen was determined using immunoprecipitation analysis followed by SDS-PAGE. Despite its similar molecular weight to FVIII-RAG, the antigen detected by moab BW 200 was shown to be different from FVIII-RAG.

Immunocytochemical markers (endothelial and histiocytic) and ultrastructure of primary aneurysmal bone cysts.

Since the first description of an aneurysmal bone cyst in 1942, the pathogenesis of this tumor-like lesion has been controversial. Aspects of interest for elucidating the nature of this lesion include the cellular linings of the aneurysmal cavity systems as well as the character and cellular composition of the stromal septa. To clarify these features, seven aneurysmal bone cysts were studied electron microscopically and immunocytochemically with endothelial (Factor VIII-related antigen, monoclonal endothelial marker) and histiocytic (alpha 1-antitrypsin, alpha 1-antichymotrypsin, lysozyme, acid phosphatase) markers. Both immunocytochemical and electron microscopic examination revealed that the aneurysmal cavernous spaces have no endothelial lining but are delimited by fibroblasts and histiocytic cell forms at varying stages of differentiation. These cell forms are also the main component of the mononuclear stroma cells of the septa between the aneurysmal cavities. From these findings it is concluded that the aneurysmal cavities are not vascular. The sinusoidal septal capillaries might play a special role in their pathogenesis. Due to the lack of basal membrane structures, rupture of the wall gives rise to erythrocyte extravasates, which can undergo secondary transformation into cysts.

[Phospholipase A2 inhibitors in hemorrhagic-necrotizing pancreatitis. Animal experiment evaluation of a new treatment concept]. / Phospholipase A2-Inhibitoren bei hämorrhagisch-nekrotisierender Pankreatitis. Tierexperimentelle Uberprüfung eines neuen Behandlungskonzeptes.

In mongrel dogs with induced pancreatitis we studied the effects of the nonspecific phospholipase A2-inhibitors chlorpromazine, gabexate mesilate and CaNa2EDTA on the course of pancreatogenic shock and the intrapancreatic lysolecithin production. The local level of lysolecithine the metabolite of phospholipase A2 was lower in the treated than in the untreated control groups. Gabexate mesilate was the most active inhibitor. However, none of the drugs had a beneficial influence on hemodynamics, chlorpromazine made it even worse. Morphologically no difference was seen between the treated and untreated groups.

Embryologic and diagnostic aspects of associated malformation of upper urinary and genital tracts.

The embryologic aberration leading to associated malformation of the upper urinary and genital tracts is discussed. Two typical cases of seminal vesicle cyst combined with ipsilateral renal agenesia or dysplasia are presented and the therapeutic possibilities discussed.