Biomedical subjects
Publications and source records attributed to B von der Stein.
A 82-year old woman had, since the age of 50, a history of 9 phases of monopolar endogenous depression with abnormal intestinal sensations and hypochondriac delusions that appeared as delusional parasitosis in 5 of these phases. Differential diagnosis and therapeutic aspects are discussed.
A 37-year old female with borderline personality disorder, who had experienced the cumulative trauma of a history of sadistic child abuse by her mother, developed the symptomatology of chronic factitious illness after an operation necessitated by an accident injury. Relationships between chronic factitious disease and obsession, addiction, perversion and suicidal behaviour are discussed against the background of a literature review.
A 29-year old patient with Gilles de la Tourette's syndrome exhibited severe compulsive self-mutilation and hostility leading to long-term hospitalisation. A history of refractory self-mutilation increases the risk for suicidal acts, which represent a rare complication in the course of the Tourette disorder.
Two demented patients, one with primary degenerative dementia and one with multi-infarct dementia, each showed attachment to a soft toy animal, which fulfilled the criteria of a transitional object as described by Winnicott. This could be regarded as a regression phenomenon, according to the basic pathogenetic concept that cerebral disease causes a dissolution of the highest central nervous functions.
Hemangiopericytomas (HP) have a characteristic vascular structure in histologic sections but this has not yet been visualized in three-dimensional form. Parts of typical vascular patterns were separated from paraffin blocks, re-embedded and cut in series. Three-dimensional images were created using the graphic reconstruction procedure of Staubesandt and Andres. The densely vascularized tumor tissue includes only very few arteries. Among these are some recurrent vessels and they abruptly divide into a large number of capillaries. Arterio-venous shunts could not be detected. Characteristic sinusoids, some of them like antlers in cross-section, change remarkably in calibre and have bizarre indentations and dilatations along their length. Their polymorphism includes an often collagenous wall, sometimes as spherical indentations. It seems that they are exclusively connected to the capillary network. The structure of the vessels can explain some angiographic characteristics such as diffuse accumulations of contrast media or their prolonged circulation time.