Biomedical subjects
Publications and source records attributed to A Oppermann.
The authors report a case in which congenital microcoria was associated with glaucoma; a complete histopathological study was performed and the relation between microcoria and glaucoma was considered. The association with extra-ocular abnormalities, particularly renal lesions is noticed.
Pathological prognostic factors of rectal adenocarcinoma were studied retrospectively in 173 patients who underwent curative resection between 1970 and 1980. Analysis was mono- and multifactorial. Minimal and median follow-up were 24 and 66 months respectively. Three factors had a favorable influence on the local failure (LF) and distant metastasis (DM) risks: length of the tumor less than 2 cm; polypoid aspect; Astler-Coller's stage A. Four factors increased the LF risks: perineural invasion (LF = 57 p. 100); poorly differentiated or colloid tumors (LF = 50 p. 100); lymph node metastasis (LF: 43 p. 100); lymphatic invasion (LF = 36 p. 100). Two factors increased the DM risks: perineural invasion (DM = 43 p. 100); lymph node metastasis (DM = 37 p. 100). The multifactorial analysis showed that the risk factors were the same for LF as for DM. Perineural invasion (p less than 0.001), lymph node metastasis (p less than 0.002), level of extension of the tumor in the rectal wall (p = 0.005) were the most important factors for local recurrences. Lymph node metastasis (p less than 0.001), perineural invasion (p = 0.03) and level of extension in the wall (p = 0.05) were the most important factors for DM. These data suggest that a failure risks scale may be established and can be of help in stratifying patients in adjuvant treatment studies.
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During 1981-1984 13 patients with clinically manifest postoperative fistulas (11 small intestinal and 2 colonic) were treated with parenteral hyperalimentation. The therapy only ensued on intensive care conditions and a spontaneous closure of the fistula was observed in 7 patients, in 2 patients closure ensued after relaparotomy and parenteral hyperalimentation the time before. Time of therapy was 18 days on an average, the amount of calories was 2,900-3,400 kcal/day.
The authors report eleven new cases of nephrogenic metaplasia - a substantial addition to the sixty-three cases already reported in the literature. In their series, two cases involved the ureter, and nine, the bladder. They discuss the clinical and pathological aspects of the disease, and put forward suggestions concerning different aspects of the histogenesis. They consider the possibility of introducing new terminology.
In a significant number of cases, the administration of aminoglycosides induces renal failure. Electron microscopy has now shown that the renal lesion is mainly characterised by the appearance of myelin figures (myeloid bodies) in lysosomes of proximal convoluted tubules. These figures are then eliminated by urinary excretion. The search for and quantification of the myelin figures in urinary sediment seems to us to link the renal failure to the administration of aminoglycosides. Our study is based on 75 patients: 54 received aminoglycosides and 21 were controls. In each case myelin figures in the urinary sediment were grouped into one of 6 classes (O to V) according to their quantity. Comparison of the results with clinical factors showed 3 different correlations: 1) between the presence of myelin figures in the urine and the administration of aminoglycosides; 2) between the quantity of myelin figures and the accumulated dose of aminoglycosides; 3) between the quantity of myelin figures and obvious renal failure. The absence of myelin figures in control patients attests to their diagnostic value. Urine analysis to detect myelin figure appears to be a reliable technique in confirming the aminoglycoside's origin of an acute renal failure. It would also aid in determining and evaluating aminoglycoside nephrotoxicity in animal experimentation and human pathology. Since this method is non invasive, repeated studies are possible in man as well as animals.
A report is given on a 25-year-old man who was admitted to the hospital because of severe headache (CSF: 280 cells per mm3, 90% lymphocytes, later normal). Headache persisted for one year when acute deterioration occurred. The CSF showed 140 cells per mm3 (100% lymphocytes), 1 g% protein. Improvement of the patient's state after corticosteroid therapy. 9 months later he interrupted the intake of prednisolon and provoked exacerbation of the disease with motor and sensor disturbances. 21/2 years after the beginning of the symptomatology he suddenly developed cerebral coma and died. The autopsy revealed ischemic necrosis of both the left and the right thalamus, hemorrhage with destruction of the left-sided thalamus, nucleus caudatus, internal capsula and rupture into the lateral ventricle. Histologically, preparations from all parts of the brain revealed granulomatous angiitis of arteries, capillaries and veins with fibrinoid necrosis, infiltration of lymphocytes, histiocytes, epitheloid and plasma cells as well as numerous giant cells. Microaneurysms were found frequently. The inflammatory process showed various stages of the development indicating that more and more vessels had been involved at different times. Contrasting to giant cell arteritis of A. temporalis, in giant cell angiitis of the brain the blood sedimentation rate is frequently normal. In all reported cases, vessels of the leptomeninges were involved. Therefore, leptomeningeal biopsy is regarded as diagnostic procedure. The own observation as well as data of the literature demonstrate that giant cell angiitis of the brain is distinct from temporal arteritis (Horton's disease), not only because of differences in location, but also because of differences in age incidence and prognosis. It is supposed that giant cell angiitis is not a nosological entity, but the expression of different etiologic and pathogenetic mechanisms.
The authors reported a pathology and clinical study about 215 cases of non infiltrating transitional cell carcinoma of the bladder. During the successive treatments of these lesions 475 specimens were collected. 5 tumours characteristics were analyzed: size of the tumour, multiplicity, microscopic structure, grade, mitotic index. The average time of supervision was 39,6 months. 75% of the patients presented a tumour recurrence over the 5 years period and in 3% of the cases deaths were directly attributable to the tumour. Multiplicity and especially mitotic index are the only tumour characteristics which correlated well with the likelihood of new tumour occurrence. The grade and the mitotic index are the best criteria to assess the risk of recurrence as an infiltrating carcinoma. The distribution of tumour characteristics shows that this type of lesion roughly keeps the same pathological pattern during recurrences. Nevertheless there exists a cellular dedifferentiation trend as well as an increase of mitotic index.
The authors report a case of Lupus nephritis shown by ultrastructural analysis of subendothelial, mesangial and especially subepithelial deposits formed by aggregates of electron-dense straight tubular structures 20 to 30 nm in diameter. These unusual structural deposits, always identical, are observed in 4 biopsies performed over 8 years during the management of Systemic Lupus Erythematosus in a young woman. They are compared to the usual "Fingerprint" deposits of Systemic Lupus Erythematosus and to the geometric type deposits of cryoglobulinemic glomerulonephritis.
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The present study compares the cicatrization of the dura by administration of I.M. hemocoagulase. This study was done on 6 rabbits and 6 control animals. The authors think that the cicatrization is a little slower but of better quality. The hemocoagulase seems to favorize the vasculo-exsudative process of cicatrization. The fibrinous deposits are more important too. Perhaps the occlusion of C.S. fluid fistulas could be favorized by means of the used product. Definitive conclusions are not possible for the moment but a work on a larger scale is projected.
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Uterine adenomyosis is a common, almost banal, lesion, since it is found in one uterus out of three by careful histological examination. In a continuous series of 926 hysterectomies for various indications, 246 adenomyosis lesions were demonstrated. In only 65 cases, adenomyosis was the sole histological lesion explaining bleeding or pain, symptoms refractory to routine conservative treatment (haemostatic curettage and/or hormone treatment) and therefore justifying surgical removal of the uterus. The role of adenomyosis in the failure of conservative treatment for diffuse fibromatosis at around the age of the menopause must be remembered. Almost 50% of specimens of hysterectomy for fibroma show evidence of associated histological lesions of internal uterine endometriosis. Whilst the hysterographic diagnosis may be suspected in almost 2/3 of cases, direct appearances of adenomyosis are found in only one case in four.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.