Biomedical subjects
Publications and source records attributed to G Nisch.
On the basis of the example of two observations by the author the diagnostic and therapeutical problems of the esthesioneuroblastoma are discussed. Neurosurgical problems result from the growing of the tumor into the inner space of the skull or the destruction of the anterior base of the skull with subsequent inflammatory consequences.
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A report is given on three patients in whom after interventions in the region of the vertebral column and the spinal cord haemorrhages in the area of the posterior cranial fossa had occurred. An excart diagnosis is only possible by exact neurological findings and computer tomography. The causes of these complications are discussed, therapeutically there is only the restoration of the cerebrospinal fluid passages through the efferent systems.
On the basis of two observation of aneurysmatic bone cysts in the region of the skull, the diagnostic and therapeutic problems of this clinical picture are discussed. The highest diagnostic value is offered by computed tomography. The operation with a total extirpation to be aimed at is recommended.
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Three of 5 human meningiomas tested in cell culture expressed SV40-related tumour (T) antigen as measured by indirect immunofluorescence with four different hamster anti-SV40 tumour sera. The per cent of T-antigen-positive nuclei varied depending on the antisera used. In one case (meningioma G. S.), only 25% of the T-antigen-positive nuclei detected with one antiserum could be demonstrated with another serum. The possible explanations are discussed. None of the meningioma cell cultures tested expressed SV40-related viral capsid (V) antigen.
A human glioblastoma multiforme (M27) tested in early cell cultures by indirect immunofluorescence staining showed SV40-related tumor (T)-antigen, 95% of the cells being positive. SV40-related viral capsid (V)-antigen was absent in all cells tested. Experiments to rescue this virus were performed by fusing M27 cells with CV-I monkey cells, which were permissive for SV40, using polyethylene glycol (PEG) as fusion factor. We succeeded in isolating virus particles SV40-GBM which electron microscopy showed to correspond in size and morphology to papovaviruses. Serological tests (hemagglutination, neutralization, fluorescent antibody) revealed that the virus is indistinguishable from SV40. Despite this apparent antigenic identity SV40-GBM differs slightly from SV40 wild type. This virus can propagate and produce CPE in both CV-I cells and primary fetal human kidney cells. Furthermore digestion of SV40-GBM DNA with the HindII/III restriction endonucleases revealed minor differences compared with the SV40 DNA. Therefore the virus SV40-GBM obtained from glioblastoma cells seems to be closely related to the SV40-PML viruses described earlier.
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In spite of refined diagnostic and therapeutic possibilities, the cerebral abscess continues to be a disease involving great risks. A comparison of surgically treated groups of patients of the periods 1954 to 1962 and 1963 to 1977 does not show any reduction in lethality. This amounted to 15 per cent for the first group and 17.6 per cent for the second group. Extirpation of cerebral abscesses shows the most favourable results of treatment as compared to other surgical procedures. In our opinion, however, it will not remain the only method of treatment in future because it can only be employed if the patient is in a condition permitting an operation. That is why the open abscess treatment will continue to be justified for all cases where cerebral abscesses occur in combination with subdural or epidural empyemas. Certainly, modern anaesthesia methods as well as intensive pre- and postoperative therapy will further reduce the number of patients who are subjected to a primary puncture treatment. Since 1972, we have treated our patients exclusively by abscess exstirpations. Until 1977, none of the total number of 12 patients treated by us has died. We consider the use of scintigraphic and EEG controls of inflammatory cerebral processes to be of decisive importance. These controls enable a differentiation between diffuse and local inflammatory processes which are accompanied by a liquefaction and in this way permit the selection of the optimum time of operation. A basic condition, however, will always be a good interdisciplinary co-operation with infection departments, paediatric and ENT hospitals where in most cases patients suffering from brain abscesses are first admitted.
Two cases of leptomeningo-cerebro(-spinal) sarcoidosis which were not clinically diagnosed in two women (22 and 33 years old) are described. The two women died because of this disease, 8 months, and 1 1/2 years, resp., after the first manifestation. In the first case there was a largely isolated local affection of the hypothalamus and neurohypophysis. In the second observation, beside an involvement of the bifurcate lymph nodes and of the lungs, it was only the central nervous system that showed massive diffuse changes partially due to a granulomatous angiitis of cerebral and visceral vessels. On the basis of pathohistology, the differential diagnosis to the histiocytosis X for case 1 and to the granulomatous giant cell angiitis for case 2 are discussed.
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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.