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Biomedical subjects

C P Adler

Publications and source records attributed to C P Adler.

At least 19 recordsLinked to original sources
PubMed1992

Prediction of recurrence in giant cell bone tumors by DNA cytometry.

The most interesting therapeutic aspect of giant cell bone tumors is which patients can be cured without a risk of recurrence by intralesional surgery (curettage). To find out the suitability of some DNA cytometric and morphometric parameters for showing differences between this group of patients (n = 9) and those with recurrence (n = 12), the parameters mean ploidy, 2cDI (mean square deviation of the tumor cell DNA content from the normal 2c value), mean nuclear area and its variability were calculated from cytologic specimens prepared by a cell separation technique from formalin-fixed, paraffin-embedded tissues, measuring the values of 100 stromal cells per case by a TV image analysis system. Further measurements were performed on 19 cases of different diseases of the bone and on an additional 17 cases of giant cell tumors without follow-up. The 2cDI allowed us to distinguish the two groups of patients, with and without recurrence, without overlap; even the lowest value for patients with recurrence was higher than the highest value for cured ones. Mean ploidy analysis resulted in a less convincing discrimination of the patients. Mean nuclear area and its variability failed to predict recurrence. Single-cell DNA cytometry provided a parameter, 2cDI, that was able to predict recurrence in patients with giant cell bone tumors with high sensitivity.

Adult↗
PubMed1991

Accuracy of vertebral mineral determination by dual-energy quantitative computed tomography.

Quantitative computed tomography is an established method for the non-invasive assessment of bone mineral content. Scanning with two different X-ray energies allows material-selective image reconstruction and separation on the basis of differing atomic numbers. As proven by chemophysical analysis of 45 bone samples, dual-energy quantitative computed tomography with basis material decomposition allows highly accurate measurement of bone mineral density with an error of 1.4%, independent of fat and soft tissue content.

Bone Density↗
PubMed1991

[MR tomography of aneurysmal bone cyst].

The preoperative findings of magnetic resonance imaging (MRI) in six histology-proven aneurysmal bone cysts (ABC) are examined and compared with previous publications concerning MRI of ABC. The signal intensities differ considerably, and not all of our cases conform with the literature data. They can be summarised in three different subheadings: one form that is very inhomogeneous in T1- and T2-weighting, with fluid-fluid levels in the cystic spaces; one intermediate form without fluid-fluid levels, which is inhomogeneous only in T2-weighted images; and finally, an unusual form of ABC that has homogeneous low signal both in T1- and T2-weighting, and which has not been described in literature so far.

Adolescent↗
PubMed1991

[Tuberculous arthritis--a rare, but important differential diagnosis in juvenile chronic arthritis].

We observed a 13 year old Turkish boy suffering from chronic arthritis of the left knee since 1983. Clinical symptoms as slow progression of the disease and laboratory data including a positive HLA B 27 test suggests the diagnosis of juvenile chronic arthritis. A tuberculous arthritis was initially excluded by X-ray examination of the chest. The positive tuberculin test was attributed to the BCG vaccination. Because of insufficient response to antiinflammatory drug therapy a synovectomy was performed for diagnostic as well as therapeutic reasons. Histopathological results suggested sarcoidosis. A second synovial biopsy of the affected joint revealed granulomas combined with multiple necrosis typical for tuberculous infection. The animal experiments showed positive results. Tuberculostatic therapy was successful with INH, myambutol and rifampicin. Joint function and MRI results markedly improved.

Adolescent↗
PubMed1990

Massive pelvic osteolysis in the Gorham-Stout syndrome.

Massive osteolysis is a very rare tumour-like lesion usually affecting young adults. There are 132 reported cases which we have reviewed, including 31 single cases of pelvic involvement. The term "massive osteolysis" is based on the typical radiological findings, such as increasing translucency and loss of bone density. The diagnosis of the Gorham-Stout syndrome must be confirmed by the microscopic finding of intramedullary vascular structures. Our patient was a 23 year old white Caucasian, who had the full clinical signs of Gorham-Stout syndrome. She had achieved 2 normal pregnancies and deliveries in spite of her massive pelvic osteolysis.

Adult↗
PubMed1990

Case report 587: Adamantinoma of the tibia mimicking osteofibrous dysplasia.

This case emphasized that the differential diagnosis of osteofibrous dysplasia and adamantinoma of the tibia can be difficult on roentgengrams as well as on histological studies. A radiological and histological diagnosis of osteofibrous dysplasia of the tibia in a young adult should always raise the consideration of the possibility of an adamantinoma, and in the correlation of the radiological features with the biopsy findings it is very important to gain representative tissue material for establishing the correct diagnosis of adamantinoma.

Adolescent↗
PubMed1989

[Obstructive-restrictive cardiomyopathy. On the clinical aspects and pathology of Löffler endocarditis].

Löffler's endocarditis parietalis fibroplastica represents a special entity among the cardiomyopathies which is seldom to be seen. The disease can be diagnosed by clinical findings including a myocardial biopsy. Prognosis is bad because no adequate therapy exists. The mean survival rate is 18 months and congestive heart failure is cause of death. Etiology of endomyocardial fibrosis is unknown. Included is a case report of Löffler's endocarditis in which the patient had an unusually long survival time of more than three years. Characteristic for the disease were an initial right heart failure followed by left heart insufficiency and multiple septic embolies into peripheral organs (spleen, liver, brain). The patient died from a cerebral emboly in the age of 50 years. Autopsy findings showed a severe endomyocardial fibrosis, typical for Löffler's endocarditis.

Cardiomyopathy, Hypertrophic↗
PubMed1989

[Clinical and morphologic aspects of benign bone tumors and tumorous bone lesions. Follow-up, therapy and prognosis].

In this study, a total of 1434 benign bone tumors and 384 tumor-like bone lesions that have been diagnosed from 1945 until 1974 in the Institute of Pathology of the University of Freiburg was reviewed and statistically analysed. The most frequent tumors include 720 osteochondromas, 345 enchondromas and 93 osteomas (80.8%). The remainder of 276 cases included several tumorous bone lesions with an individual share of below 5%. Our 64 osteoclastomas (4.5%) are in reality tumors of low grade of malignancy. There was an equal distribution among both sexes (737 male, 695 female). Predominate location were the bones of extremities and the skull. Most often, we have found these tumors in the lower legs, and one third was localized in hands and feet. 60% of the benign bone tumors of the hands have been enchondromas. Osteomas and hemangiomas have been localized most often in the skull, and ossifying and non-ossifying fibromas in the jaws. Main localization of osteoclastomas was the knee. Roentgenograms have always been put into consideration for diagnoses and have, together with the histological findings, facilitate an exact classification. Clinical findings have only exceptionally shown indicative symptoms (e. g. night pain in cases of osteoid osteomas); otherwise there were vague swelling, pain or disfunction. Benign bone tumors are poor of symptoms. Concerning therapy, most bone tumors have been cured by operation (curettage, excision). In some tumors (especially in chondromyxoidfibromas) recurrences have occurred. No investigated bone tumor has shown a malignant transformation.

Adult↗
PubMed1989

Osteodensitometry of vertebral metastases after radiotherapy using quantitative computed tomography.

Bone density has been assessed during and after radiotherapy of metastases of the spine using quantitative computed tomography (QCT) in 19 patients with osteolytic vertebral lesions. All patients underwent external photon radiation with a total dose of 40 Gy over a period of 4 weeks. Measurements of vertebral mineral density were performed at the beginning, at the end, and 3 months after radiotherapy. In 13 patients with osteolytic metastases, radiotherapy achieved complete release of pain; it was unsuccessful in the remaining 6 patients. Immediately after successful radiotherapy, osteolytic metastases showed a decrease of bone density of 24.7% followed by an increase of 60.6% 3 months later. Normal bone surrounding the osteolysis showed an increase of density at the end and 3 months after radiotherapy. QCT has proved to be a helpful tool in assessing successful radiotherapy of metastases of the spine.

Absorptiometry, Photon↗
PubMed1989

[Pathologic bone fractures: definition and classification].

A bone fracture is a complete or incomplete discontinuity of bone caused by a direct or indirect force. A pathological bone fracture is a bone fracture which occurs without adequate trauma and is caused by a preexistent pathological bone lesion. Causes include resorption of bone mass (osteoporosis), reduction of bone quality (osteomalacia, osteonecrosis), insufficient bone production (osteogenesis imperfecta, fibrous dysplasia), augmented bone resorption (giant cell granulomas, aneurysmal bone cyst), pathological bone remodelling (Paget's disease), or local bone destruction due to tumorous growths. A pathological bone fracture has to be detected clinically as well as radiologically and its cause diagnosed histologically in order to ensure adequate therapy.

Bone and Bones↗
PubMed1989

[The pathology of spinal diseases].

In painful lesions of the spine, the diagnosis must be established by different radiological methods and, in addition, confirmed histologically by a biopsy. For this purpose, representative tissue samples can be obtained by needle biopsy. The cause of backache may be degenerative processes, systemic osteopathies, traumatic lesions, bone necroses, bone granulomas, metabolic disorders, inflammation, pathologic bone remodelling, or bone tumors. Using autopsy material, even macroscopic analysis is possible. Pathological-anatomical, and radiological findings are essential for the diagnosis and therapy of most lesions of the spine.

Biopsy, Needle↗
PubMed1988

[Bone biopsy of uncertain bone lesions using a new biopsy cannula measuring 1.4 mm].

Bone biopsy for the clarification of ambiguous lesions has until now been the last resort in diagnostic procedures because obtaining the material for histological evaluation has involved very traumatizing methods (biopsy by surgical intervention, percutaneous biopsy with high-caliber needles). A new bone-biopsy apparatus has now been developed that is provided with a cannula not much larger than a fine needle (1,4 mm); it can be used to obtain histologically evaluable biopsy material from almost all regions of the skeletal system. As the procedure can be carried out under local anesthesia, there is no undue stress to the patient. The complication risk is no higher than when using conventional fine-needle biopsy. Despite the small diameter of this needle it is possible to obtain biopsy specimens not only of osteolytic but also of osteoplastic lesions. An electric motor (20 rotations/min) is the power source for apparatus. The value of bone biopsy in diagnostic procedures has increased considerably.

Biopsy↗
PubMed1987

[Bone and soft tissue tumors--progress in this decade].

Conventional plain film roentgenography is the basic examination of bone tumors. Modern digital roentgenography offers technical innovations but no fundamental new diagnostic dimensions. Computerized and magnetic resonance-tomography allow a far better delineation of the tumor spread (staging). These new imaging methods together with ultrasound have revolutionized the diagnosis of soft tissue neoplasms, not visible on plain film roentgenograms except lipomas and calcifications.

Bone Neoplasms↗
PubMed1987

Radiologic findings in peripheral neurilemoma.

Neurilemoma is a primary nerve sheath tumour that usually arises from a peripheral nerve. In a series of eight solitary neurilemomas four benign and four malignant tumours are observed. Three neoplasms are of intrathoracic origin, four tumours arise in the retroperitoneal space and one tumour develops in the duodenal wall. Radiographic findings using computed tomography, ultrasonography and arteriography are presented. All neurilemomas show relatively low density in CT compared with other parenchymal tumours. All benign and three of the malignant neurilemomas reveal good contrast enhancement. Arteriography has an important role in defining the tumour's blood supply and establishing the origin of the tumour. Five of six neurilemomas show hypervascularity in arteriography. Ultrasonography shows cystic degeneration in three malignant and in one benign neurilemoma. Pathologic correlation of peripheral neurilemoma is discussed by using a special immunoperoxidase technique.

Adolescent↗
PubMed1986

Histochemically determinable changes in cardiac insufficiency and their functional significance.

Chronic cardiac insufficiency can be produced by a variety of causes which may be partly determined by means of macroscopic, histological and electron microscopic investigations. By using quantitative histochemical methods, changes of substances in the myocardium can be observed indicating myocardial insufficiency and giving an explanation of its cause. Hypertrophied hearts without insufficiency show cardiac muscle fibres having increased in width, volume and dry weight up to a maximum value which will not be exceeded even in further progressing cardiac hypertrophy. The biochemically determined amount of collagen increases significantly with the growing weight of the myocardium. Both the myocardial amount of DNA and the amount of myoglobin, correlated with the width of the fibres, have also increased. The heart muscle nuclei showed a polyploidization which is also correlated with the weight of the myocardium. In insufficient hearts suffering from myocardial hypertrophy, the increase of the total DNA content is significantly decreased as compared to non-insufficient hearts. The mean ploidy level is increased in case of lower weights of the myocardium and decreased in higher weights in comparison to non-insufficient hearts of the same weight. In insufficient hearts a more significantly increased amount of the connective tissue cells is observed than in the case of cardiac hypertrophy alone. In contrast to this, the increase of the heart muscle cells is significantly reduced. A lack of contractile proteins, decreased DNA synthesis, increased fibrozation and, in particular, the reduced number of cardiac muscle cells must be considered as essential factors for cardiac insufficiency.

Cardiomegaly↗