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Biomedical subjects

B Helpap

Publications and source records attributed to B Helpap.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Anesthesiologic peculiarities in bilateral pheochromocytoma and suspected multiple endocrine neoplasia].

Based on a case report with surgical removal of bilateral giant phaeochromocytomas with heredofamilial affliction and suspicion of multiple endocrine neoplasia type II (MEN-II syndrome) and of malignancy, the anaesthetic implications are discussed in a patient inadvertently not prepared by antiadrenergic treatment. It is pointed out that in MEN II syndrome, a combination of phaeochromocytoma and medullary carcinoma of the thyroid, surgical removal of the phaeochromocytoma merits utmost priority before thyreoidectomy. The most important laboratory parameters in the diagnosis of MEN II syndrome are pre- and postoperative determinations of calcitonin and carcinoembryonal antigen (CEA).

Adrenal Gland Neoplasms↗
PubMed1985

[Cystic pancreas neoplasias].

For the treatment of cystic changes of the pancreas, it is essential to distinguish cysts and pseudocysts from neoplasm. Since clinical parameters are usually not characteristic, only morphologic analysis will prove a diagnosis. Nowadays, the cystic pancreatic neoplasms are described as: microcystic adenoma (rich-in-glycogene cystadenoma), and mucinous cystic neoplasms (cystadenocarcinoma or cystadenoma). Morphology, etiology, clinical findings, and treatment are discussed on 3 cases. The new classification of cystic pancreatic neoplasms is important for prognosis in two aspects: 1) On the clinical finding of a pseudocyst, every surgeon should think of a mucinous cystic neoplasm and look for solid tumours digitally. 2) For the pathologist, any mucinous neoplasm should cause him to analyse such cysts macroscopically and, if possible, also microscopically, to rule out an adenocarcinoma.

Adenocarcinoma, Mucinous↗
PubMed1985

Treated prostatic carcinoma. Histological, immunohistochemical and cell kinetic studies.

Classification, histological and cytological grading of prostatic carcinomas, as well as the exact determination of the tumor stage, are the decisive criteria for the therapy to be followed. 163 morphological control examinations were analyzed for a period of 5 years on 97 patients before, under and after hormonal or radiotherapy. 57% of the controlled prostatic carcinomas were uniformly glandular, or predominantly glandular, i.e., of pluriform structure, malignity grade Ib/IIa. 41% corresponded to cribriform and solid trabecular carcinomas with grade IIa, IIb and III. Under hormonal therapy, the typical epithelial and stromal changes were evident, like coarse vacuolization of cytoplasm, progressive nuclear pyknosis, stroma edema, as well as stroma sclerosis and hyalinosis. Under radiotherapy, the degree of stroma sclerosis and nuclear changes was even more evident. Polynuclear, bizarre tumor cells predominated. With responsiveness of the carcinomas to hormonal or radiotherapy, the immunohistochemical markers (prostate-specific antigen, acid prostate phosphatase) were markedly reduced or missing. Glandular carcinomas, up to 5 years after therapy, showed regression grade I in 30.1%, II in 18.3, III in 43.0% and X in 8.6%. In cribriform/solid trabecular carcinomas, the regression was less marked. Grade I was observed in 42.9%, grade II in 21.4%, and grade III in 35.7% of the cases. There was no regression grade X. The results have shown that responsiveness of carcinomas to therapy can well be analyzed by use of certain histological and cytological criteria for grading and regressional grading. The experiences so far have shown that concerning radiation, 12-18 months after conclusion of therapy is a favorable moment for posttherapy controls. Under hormonal therapy, the therapy control should be performed 6 months after beginning. The same applies for cytological therapy controls.

Carcinoma↗
PubMed1984

[Hypotension and shock in pheochromocytoma].

A 22-year-old woman was admitted to hospital in shock, the admission diagnosis being lobar pneumonia with septic shock. Ultrasound demonstrated a tumour in the region of the left adrenal, but because of the absence of hypertensive symptoms and hypoglycaemia this was interpreted as a non-contributory finding. Despite intensive therapeutic measures the patient died within a few hours. At autopsy a phaeochromocytoma of the left adrenal gland was found. "Catecholamine myocarditis" resulting in acute cardiac failure, was demonstrated histologically. Phaeochromocytoma with predominant adrenaline or dopamine secretions often takes a normotensive or hypotensive course. Sudden excessive catecholamine release can, as in the described case, cause so-called adrenaline shock. The catecholamine-induced hypoxic-toxic myocardial changes determine the likely outcome.

Adrenal Gland Neoplasms↗
PubMed1984

Cytomorphological and histological studies on the urothelium during and after chemoimmune prophylaxis.

During and after chemoimmune prophylaxis with i.v. cyclophosphamide (CTX) and both intravesical and systemic BCG-treatment, the bladder mucosa is prone to morphological changes which might resemble tumor recurrences. Therefore, morphological parameters which can discriminate between treatment effects and tumor recurrences are of interest. In a prospective study, routine cytology, determination of granulocytes, lymphocytes, and macrophages in the urine sediment as well as flow-cytophotometry (FCM) for DNA analysis were performed before, during, and after chemoimmune prophylaxis. In addition, bladder biopsies and all recurrent tumors were histologically analysed. Our results show that FCM is the best method for monitoring the bladder mucosa for recurrent tumors during treatment. After termination of BCG, it takes at least 4 months for cytological normalization to take place. Urine excretion of granulocytes, lymphocytes, and macrophages does not correlate with this process. Histological alterations during treatment are demonstrated; their normalization requires at least 3 months. In 10% of the patients chronic inflammatory lesions ("pseudotumors") develop.

BCG Vaccine↗
PubMed1984

Suppression and acceleration of DNA synthesis in megakaryocytes after partial hepatectomy.

3H-thymidine labelling indices of megakaryocytes were determined in the spleen and bone marrow of normal, sham-operated and partially hepatectomized rats. Compared with controls, the labelling indices were much lower in megakaryocytes but much higher in other cells such as erythroid cells or proliferating duodenal mucosal cells when measured in rats from 12 to 36 h after partial hepatectomy. From 48 to 72 h after hepatectomy the labelling indices of megakaryocytes became higher than control values. On the other hand the labelling indices of megakaryocytes from 12 to 36 h after sham operation were higher than controls. The accelerated DNA synthesis of megakaryocytes after sham operation was considered to reflect the additional DNA synthesis in this cell line which leads to an increase of the average ploidy level. The initial decrease in labelling indices of megakaryocytes after partial hepatectomy did not occur if serum from normal or thrombocytopenic rats was injected. These findings suggest that the liver may produce a humoral factor which influences the so-called endomitosis of megakaryocytes.

Animals↗
PubMed1984

Thymus in myasthenia gravis: a light and electron microscopic study of a case with thymic follicular hyperplasia.

The present study has focused mainly on microenvironmental aspects of the thymus from a 17-year-old female patient suffering from myasthenia gravis. The most striking lightmicroscopic feature was again the well known presence of lymphoid follicular hyperplasia. Ultrastructurally, the configuration, cellular composition and fine structure were to a large extent the same as in other, peripheral lymphoid organs. Cells showing the typical morphologic characteristics of fibroblastic reticulum cells, which are most probably precursors of dendritic reticulum cells, were observed within germinal centers. Additionally the morphology of the unaffected medulla and corticomedullary region was studied, thereby paying particular attention to the structural changes of interdigitating cells. These contained frequently Birbeck granules, which have not been described before in human thymus.

Adolescent↗
PubMed1984

Cell proliferation and growth of gastric carcinoma induced in inbred Wistar rats by N-methyl-N'-nitro-N-nitrosoguanidine.

Gastric carcinoma was induced in inbred Wistar rats by p.o. administration of N-methyl-N'-nitro-N-nitrosoguanidine for 25 weeks, and cell proliferation and growth of the gastric carcinoma in an incipient stage were studied. A microscopic cancer was found by 24 weeks, and macroscopic cancers were found after 27 weeks. All the cancers were a single lesion located at the midpoint of the lesser curvature of the stomach. Histologically, they were tubular adenocarcinomas. The mucosal changes predisposing to the development of carcinomas were focal erosions and dysplasias confined to the midpoint of the lesser curvature. The malignant transformation appeared to occur in the dysplastic cells of the eroded mucosa by 17 to 18 weeks after N-methyl-N'-nitro-N-nitrosoguanidine treatment. Following the malignant change, the labeling indices of the tissues with [3H]thymidine decreased, suggesting an elongation of cell cycle time. By repeated injections of [3H]thymidine, a time required for all the cancer cells to enter S phase (reflecting the maximum cell cycle time) was estimated to be about 3.5 days. This gave a theoretical doubling time for the gastric cancers. On the other hand, from the temporal observations of tumor volumes, it was shown that the gastric cancers in an incipient stage underwent exponential growth with a doubling time of 14 days. The difference between the theoretical and actual doubling time might reflect a cell loss rate in the cancer tissue.

Animals↗
PubMed1983

The morphological consequences of thermosurgery.

Immediately after electric coagulation or laser surgery, black-brown carbonizations were observed on the surface of different human tissue biopsies and in the experimental studies of rat organs. In specimens of liver, urinary bladder, and prostate coagulation necrosis developed, followed by a cell-rich granulation tissue with giant cells of the foreign body type. More than 3 months after the thermoinjury the granulomas could still be demonstrated in the tissue. After 6-8 weeks postoperatively (p.o.) a fibrous scar tissue began to develop. The number of lymphocytes in the central T-dependent peripheral lymphatic sheaths (PALS) of the spleen and their labeling index decreased within the first 2 days after thermoinjury followed by a slight hyperplasia after day 5. This initial T-cell alteration may reflect the clinico-serologic finding which shows that after skin burn a temporary reduction of the cell-mediated immune defense mechanism of the organism is observed. Compared with wound healing after scalpel or cryosurgical injuries, the delayed wound healing after thermosurgery may be caused by the alteration of the lymphoid system due to a disturbed co-operation of T- and B-lymphocytes with macrophages.

Animals↗
PubMed1983

[Is tubal sterilization with the Tupla-clip a reversible method?].

Between 1976 and 1981 402 tubal sterilizations were performed with Tupla-clip most of them by laparoscopic application. 11 tubes were removed between 15 and 47 months following the sterilization with the Tupla-clip. The local changes both macroscopically and microscopically to the tupla-clip were evaluated. The possibility of tubal patency following removal of the clips was tested by carbon dioxide pertubation. The tubal-occlusion with the tupla-clip is definitive since all tubes had a fibrous tissue strand where the clip had been applied which still carried blood vessels. No tube was patent with the carbon dioxide pertubation. The intra-operative testing of correct application of the clip and the documentation of this correct application is again mentioned. This is especially important in view of the recent judgements of the federal supreme court regarding liability in failed tubal sterilizations. The excellent chance of reversal by tubal anastomosis and the 100% success rate of this method of sterilization within the 6 years under observation will increase the acceptance of the tupla-clip as a method for tubal sterilizations.

Female↗
PubMed1983

[Comparative histologic studies following esophageal varices sclerosing with different substances].

Sclerosing varices of the lower esophagus by endoscopic injection of phenol-peanut oil or ethoxysclerol into the submucosal tissue induces inflammatory changes of varying degree. The process of inflammation leads to formation of connective tissue surrounding and protecting the varices, or to obliteration of these vessels. Phenol-peanut-oil induces a rather mild inflammatory process which contains many macrophages and runs a slow course, leading to fibrosis and sclerosis without complications worth mentioning. Ethoxysclerol on the other hand can induce suppurating, almost phlegmonous inflammation; complications like mediastinitis and pleural exsudates are definitively more common than after injection of phenol-peanut oil. Life threatening situations and death may occur after previous treatment by balloon compression and subsequent sclerosing procedures. Therefore, treatment of esophageal varices by sclerosing procedures should only be done, if the esophageal wall has not been altered by mechanical therapeutic measures.

Esophageal and Gastric Varices↗