PubMed Health⌕ Search

Biomedical subjects

E Machacek

Publications and source records attributed to E Machacek.

At least 19 recordsLinked to original sources
PubMed1999

Implications of histological grade of tumour for the prognosis of radically resected periampullary adenocarcinoma.

OBJECTIVE: To study the influence of histological grade of tumour on the prognosis of radically resected periampullary cancers. DESIGN: Retrospective study. SETTING: Teaching hospital, Austria. SUBJECTS: 156 patients (papilla of Vater, n = 34, head of the pancreas, n = 105, and distal common bile duct, n = 17) who underwent partial pancreaticoduodenectomy for periampullary adenocarcinoma between 1 January, 1967 and 31 December, 1996. OUTCOME MEASURES: The relation between grade of tumour and site, T and N classification, extramural growth, invasion of vessels and resection margins, tumour volume, and survival time. RESULTS: Well differentiated lesions were significantly more common in the papilla of Vater (n = 15, 44%, p = 0.01) than in the pancreatic head or the common bile duct (n = 20, 19%, and n = 5, 29%, respectively). Only in ampullary lesions did the grade of tumour significantly affect the incidence of other histopathological risk factors (T p = 0.003; nodal status p = 0.01; extramural growth p = 0.0001; tumour volume p = 0.02) and survival time (p = 0.02); no significant correlations were found in cancers of the head of the pancreas or common bile duct. CONCLUSIONS: There was a significant difference in the distribution of grade of tumour between the different sites of origin of resected periampullary cancers. Grade of tumour correlated with T and N classification, tumour volume, extramural growth, and survival only in ampullary lesions.

Adenocarcinoma↗
PubMed1995

[Inflammatory demyelinating neuropathy in neuroborreliosis].

A patient with acute onset of radicular pain developed an asymmetric neuropathy within a few weeks. Neurophysiology and nerve biopsy findings revealed a demyelinating neuropathy. Cerebrospinal fluid showed mild pleocytosis, increased protein levels and elevated antibody titers against Borrelia burgdorferi suggesting Lyme neuroborreliosis. Although peripheral nervous system complications of Lyme borreliosis are common, the association with chronic demyelinating neuropathy has not been described before.

Antibodies, Bacterial↗
PubMed1994

Intravascular lymphomatosis: a clinicopathological study of three cases.

In patients with intravascular lymphomatosis (IL) a broad spectrum of neuro-psychiatric disorders including dementia, focal neurological signs and seizures has been reported. Clinical diagnosis is difficult since neuroimaging findings are nonspecific. The clinical histories, biopsy and autopsy findings of three patients with IL, one with brain biopsy, are described. Two of them presented with rapidly progressive, fluctuating dementia. The third patient suffered from seizures followed by aphasia. Histology revealed large-cell lymphoma of the B cell type. The prognosis of IL, in general, is poor.

Aged↗
PubMed1993

Spindle cell variant of pulmonary adenocarcinoma.

A 45-year-old male developed a transverse lesion of the spinal cord two years after resection of a pulmonary adenocarcinoma. Laminectomy revealed a spindle cell tumor, immunohistochemically considered as leiomyosarcoma. Autopsy disclosed a spindle cell variant of an adenocarcinoma of the lung. The present report demonstrates that spindle cell formations can be found not only in squamous cell carcinomas but also in adenocarcinomas of the lung, and that metastases may be composed of this spindle cell component only.

Adenocarcinoma↗
PubMed1993

The importance of tumour volume in the prognosis of radically treated periampullary carcinomas.

OBJECTIVE: To assess the influence of tumour volume on clinicopathological findings and survival time after radical operation for periampullary carcinoma. DESIGN: Retrospective study. SETTING: Kaiser-Franz-Josef-Hospital, Vienna, Austria. SUBJECTS: 72 of 75 consecutive patients who underwent pancreaticoduodenectomy for periampullary carcinoma between 1 January 1979 and 31 December 1991. OUTCOME MEASURES: Cancers were divided into four groups according to volume (mm3) and the incidence of lymph node involvement, infiltration of surrounding tissues and of visceral vessels, and histologically non-radical resections were calculated, as was the length of survival after resection. RESULTS: There were 22 tumours with a volume of 0-2500 mm3 (group 1), 12 with a volume of 2,501-5,000 mm3 (group 2), and 19 each in groups 3 (5,0001-10,000 mm3) and 4 (more than 10,000 mm3). All carcinomas of the common bile duct (n = 5) and the papilla of Vater (n = 18) were in groups 1 and 2, whereas 38 of the 49 carcinomas of the head of pancreas were in groups 3 and 4. Lymph nodes were involved in 3 (14%), 6 (50%), 13 (68%) and 14 (74%); the surrounding tissues were infiltrated in 6 (27%), 8 (67%), 11 (58%) and 12 (63%); the main visceral vessels were involved in 0, 3 (25%), 5 (26%) and 8 (42%); and the resections were histologically not radical in 0, 2 (17%), 7 (37%) and 9 (47%), respectively. There was significant negative correlation (p < 0.0001) between tumour mass and survival. CONCLUSIONS: These results explain at least in part the poorer prognosis after radical resection of carcinoma of the head of the pancreas.

Aged↗
PubMed1993

[Necrotizing myopathy with antilipemic agents. Case report and review of the literature].

A 73 year old male who had been prescribed fenofibrate for years developed a slightly asymmetric paraparesis of both lower extremities. CPK values rose to 9800 U/l, EMG of the quadriceps femoris muscle was myopathic. Muscle biopsy revealed a necrotic myopathy. Discontinuation of fenofibrate induced a rapid decline of CPK values, followed by a slower remission of muscular symptoms and persisting pseudo-myotonic discharges in EMG. The spectrum of neuromuscular side effects of cholesterol lowering agents, consisting of myalgia, cramps and reversible CPK elevation, is discussed. Only rarely necrotic myopathies have been described.

Aged↗
PubMed1992

Expression of cathepsin D in head and neck cancer.

To determine overexpression of cathepsin D in head and neck tumours we examined cytosols from 53 primary tumours, nine cytosols of lymph node metastases and 12 cytosols from adjacent normal tissue. We found a significantly lower concentration in normal tissue compared with tumour cytosol as well as with metastases, even when we compared tumours and corresponding metastases pairwise. In addition, we found a significantly higher concentration of cathepsin D in five lymph node metastases than in the corresponding tumours. We conclude that the reported role of cathepsin D is not restricted to breast cancer but could also be important in head and neck cancer.

Biomarkers, Tumor↗
PubMed1991

Angiotropic lymphoma (malignant angioendotheliomatosis) presenting with rapidly progressive dementia.

An 87-year-old male presented with rapidly progressive dementia, disorder of consciousness and myoclonus, suggesting Creutzfeldt-Jakob disease, but with nonspecific EEG and negative CT findings. Autopsy revealed a malignant angiotropic lymphoma with accumulation of tumor cells within small vessels of the brain and visceral organs. Immunohistochemistry disclosed a large cell lymphoma of B cell type.

Aged↗
PubMed1990

Risk-adapted treatment choice in stage I nonseminomatous testicular germ cell cancer by regarding vascular invasion in the primary tumor: a prospective trial.

Based on the results of a retrospective study, which found blood vessel invasion to be the most important prognostic factor in clinical stage I nonseminomatous testicular germ cell cancer (NSTGCC I), a prospective study was started in 1985 which assigned NSTGCC I patients without evidence of vascular invasion to surveillance and patients with vascular invasion to two cycles of adjuvant chemotherapy with cisplatin, etoposide, and bleomycin. Twenty-two patients entered the surveillance group and 18 patients received adjuvant chemotherapy. Median follow-up is 30 months (3 to 50 months). Relapses occurred in three patients (7.5%), one in the surveillance group (4.5%), two in the chemotherapy group (11%). Thirty-eight patients (95%) are alive and without evidence of disease. Two patients of the adjuvant-treated group died, one of progressive germ cell cancer and one of lung cancer. We conclude that low- and high-risk NSTGCC I patients can be identified by considering blood vessel invasion. The presence of embryonal carcinoma and vascular invasion seem to be interrelated prognostic factors, because in 94% of vessel invasion the invading element was embryonal carcinoma. The exclusion of patients with vascular invasion from surveillance decreases relapse rates remarkably. Adjuvant chemotherapy diminishes relapse rates in high-risk patients but does not entirely prevent relapse.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[Correlation of tumor site and tumor volume in radical surgery of cancer of the peripapillary area].

In a group of 52 partial duodenopancreatectomies (34 cancers of the head of the pancreas, 14 cancers of the papilla and 4 cancers of the common bile duct) the dependence of tumour volume and tumour localisation on carcinomatous lymph node involvement, infiltration of surrounding tissues, infiltration of great visceral vessels and not radical resection was determined. The analysis demonstrates that there is significant difference in volume between radically treated carcinomas of the common bile duct, the papilla of Vater and the head of the pancreas with mean volumes of 463:1,851:11,835 mm3 or 1:4:26! Furthermore the investigation shows that for every analysed parameter median volume is larger for positive observations than for negative ones: lymph node involvement 10,606:6,459 mm3, infiltration of surrounding tissues 10,444:6,703 mm3, infiltration of great visceral vessels 14,923:7,144 mm3, not radical resection 18,130:5,343 mm3. From these results it is concluded, that early stages of periampullary carcinomas with a good chance for cure are only present in radically treated cancers of the papilla and the common bile duct. In cancers of the head of the pancreas the significant larger primary cancers and the more advanced staging results in a dismal prognosis.

Ampulla of Vater↗
PubMed1989

[The high autopsy rate in Vienna].

In 1983 34% of all persons who died in the Republic of Austria were autopsied. We examined the frequency of postmortem examinations in the capital city, Vienna, between 1983 and 1987 in view of this high overall autopsy rate. The annual autopsy rate in all 9 pathology institutes and the department of legal medicine of the University of Vienna was on average 51 to 53%. There was a slight statistically verifiable decline in 1987. The reason for this high necropsy rate is that Austrian law permits the autopsies without the consent of next of kin if it appears indicated for medical, scientific or educational reasons; further more the fact, that the chairman of the department is at the same time the coroner for the hospital. A high autopsy rate is necessary to maintain a high standard of diagnostic accuracy even in modern medicine. The diagnoses were inaccurate or incomplete in 15% of all cases. The high autopsy rate is the basis for extremely accurate mortality and morbidity statistics and provides the basis for long range public health planning. Medical students develop an insight in disease patterns, which cannot be gained in any other way. The pathology departments of Vienna introduce a new city-wide computer-supported diagnostic file system, which will provide a baseline for comparative scientific studies.

Austria↗
PubMed1988

[Para-articular osteoporosis in chronic polyarthritis].

In patients with rheumatoid arthritis according to the criteria of the American Rheumatism Association (ARA) (4) the head of the femur was resected during reconstructive hip joint operation. The area of increased radiological translucence near to the joint space was histologically investigated. The rarefication of the trabecula was found distal of the articular cartilage. In this radiologically translucent area numerous osteoclasts and inflammatory cells could be found.

Arthritis, Rheumatoid↗
PubMed1987

[Eosinophilic gastroenteritis].

Eosinophilic gastroenteritis represents a very rare inflammatory disease of the stomach and bowel. Aetiologically an allergic diathesis must be assumed, but it is only very seldom that a particular allergen can be identified as being responsible for any case. Characterized by peripheral blood eosinophilia and eosinophilic infiltration of various parts of the gastro-intestinal tract, together with disturbed gastro-intestinal function, complications can arise in this disease requiring surgical intervention. In general, however, conservative therapy is adequate. The clinical features are discussed on the basis of an own case report.

Duodenum↗
PubMed1987

Testicular cancer: prognostic implications of vascular invasion.

In a retrospective study the primary tumors of 33 patients with seminomas and 53 with nonseminomatous germ cell tumors were re-evaluated for vascular invasion. The significance of vascular invasion was analyzed in respect to the appearance of visceral metastases and the effect of adjuvant chemotherapy. Vascular invasion was demonstrated in 27 per cent of the patients with seminomas and 53 per cent with nonseminomatous germ cell testis tumors, while visceral metastases appeared in 9 and 32 per cent, respectively. Without adjuvant chemotherapy all 13 patients with nonseminomatous germ cell testis tumors and vascular invasion had metastases, compared to only 3 of 13 without vascular invasion (p less than 0.0005). Of 9 patients with seminoma and vascular invasion 3 had tumor progression, compared to 1 of 24 without vascular invasion (p greater than 0.05). With adjuvant chemotherapy only 1 of 15 patients (7 per cent) with nonseminomatous germ cell testis tumors and vascular invasion had metastases, compared to 100 per cent of 13 without this treatment. No significant correlation was noted between pT stage versus vascular invasion and pT stage versus tumor progression. The results demonstrate the importance of vascular invasion in the staging of and choice of treatment for early nonseminomatous germ cell testis tumors.

Adolescent↗
PubMed1986

[Development of carcinoma of Vater's ampulla in an adenoma. Analysis of a personal case load and review of the literature].

A retrospective analysis was undertaken of our case material of 40 histological preparations of carcinoma of the ampulla of Vater, as well as a survey of the literature of 103 adenomas of the ampulla of Vater. Signs of malignant transformation were detected in 25% of the adenomas, whilst adenomatous residues were identified in 72% of the examined carcinomas of the ampulla of Vater. Thus, an adenoma-carcinoma sequence seems to be as significant in the case of Vater's papilla as in the colo-rectal region. An epidemiological investigation confirms this hypothesis since 1. adenomas of the papilla Vateri develop 4 years prior to a carcinoma and 2. the relative sex distribution of the two diseases is approximately equal.

Adenoma↗
PubMed1985

[Beta-HCG-producing choriocarcinoma of the pineal area as a cause of precocious puberty].

We report the case of an eight-year-old boy with precocious puberty due to a beta-HCG producing choriocarcinoma of the pineal region. beta-HCG-levels were elevated initially (9659 mU/ml) and did not normalize completely after surgical removal of the brain tumor. A relapse of the tumor in the hypothalamic region led to a new increase of beta-HCG-level up to 41258 mU/ml. Histopathology of a subsequently removed metastasis in the right lung showed immunohistological evidence of beta-HCG production. Introduction of chemotherapy was followed by a normalization of the beta-HCG-level and of the previously elevated hormone values.

Brain Neoplasms↗
PubMed1985

[Extreme kidney displacement caused by an adrenal pseudocyst].

Renal displacement is very infrequently associated with a space occupying adrenal disease and sometimes imposes major diagnostic problems. The diagnosis of monstrous, retroperitoneal cysts is of particular difficulty. In a 51-year-old female patient the diagnosis and the association of a cystic formation to the adrenal gland could only be made at surgery, despite the steadily increasing renal displacement. The etiology of adrenal cysts, the diagnostic procedures and the possible concurrence of hypertension are discussed.

Adrenal Gland Diseases↗