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Biomedical subjects

G Widhalm

Publications and source records attributed to G Widhalm.

5 recordsLinked to original sources

Cardiac transplantation and simultaneous surgical repair of an aortic aneurysm.

Simultaneous cardiac transplantation and surgical repair of an aortic aneurysm has not been reported previously. At our institution, a 59-year-old patient with an aneurysm of the ascending aorta and aortic arch required orthotopic cardiac transplantation for end-stage cardiomyopathy. He underwent successful surgical replacement of his ascending aorta and transverse arch (in circulatory arrest and deep hypothermia) at the time of heart transplantation.

Anastomosis, Surgical↗

[Regional lymph node micrometastases in malignant melanoma of the skin].

Histological studies were conducted into 352 primary malignant melanomas of the skin together with 4,003 associated and surgically removed lymph nodes at the Institute of Pathology and Bacteriology of Kaiserin-Elisabeth-Spital, between 1982 and 1987. Particular attention was given to micrometastases of regional lymph nodes. 27 lymph node micrometastases were recorded from 25 patients. Spots of melanin were also found in lymphatic tissue, but no tumour cells were detectable. There is no clinical aid by which micrometastases of lymph nodes might be possibly diagnosed, and, on principle, they are greatly accidental findings even for the pathohistologist. However, undetected lymph node micrometastases may have a deteriorating impact upon the prognosis of malignant melanoma. Complete microscopic elucidation of surgically removed lymph nodes, there fore, is absolutely essential. Capillaries are present in abundance deep inside lymph nodes, and from these points of departure tumour cells may enter into the blood flow and cause haematogenic metastases. That is why the prognostic importance attributed to histologically verified micrometastases is just as great as that attached to macrometastases.

Female↗

[The importance of atypical adenoma of the thyroid gland].

Histological appraisals were made of 8,741 specimens of removed thyroid glands at the Pathologico-Bacteriological Institute of Kaiserin Elisabeth Spital, between 1978 and 1987. Included, according to classification, were 234 atypical adenomas, 47 encapsulated follicular carcinomas, and 158 invasive follicular carcinomas. Atypical adenoma was found to differ histologically from encapsulated follicular carcinoma by non-detectability of vascular invasions. The age distribution of the patients involved failed to provide any conclusive clue to the effect that atypical adenoma was a precursor of encapsulated follicular carcinoma. Females were more often affected than males with atypical adenoma. No recurrence, metastasation nor complaints are recordable at present from any of the surviving patients with atypical adenoma. Patients who died did not reveal any sign indicative of a thyroid disease as cause of death. The five-year survival rate has been 95 per cent for encapsulated follicular carcinoma. Diagnosis of atypical adenoma is not merely a qualitative problem but a quantitative problem as well. Atypical adenoma of the thyroid gland should be classified as a neoplasia in its own right and as absolutely benign.

Adenocarcinoma↗

CD15 (LeuM1) immunoreactivity: prognostic factor for sporadic and hereditary medullary thyroid cancer? Study Group on Multiple Endocrine Neoplasia of Austria.

Patients treated for sporadic and hereditary medullary thyroid carcinoma (MTC) have varying rates of persistent disease, recurrence, and survival. The aim of this study was to correlate the immunoreactivity of the monoclonal antibody CD15 (LeuM1) to initial clinical findings and the outcome of treatment. The primary tumors of 75 patients with sporadic MTC, 7 with hereditary disease, and 3 members of MEN 2A families were studied. Of these subjects 74 (87%) showed no or little immunoreactivity (< 15% positive cells; score 0) in most tumors. The remaining 13% had surgery for tumors with more than 15% cells with positive staining (score I). There was no correlation between LeuM1 immunoreactivity and sex, age, and type of MTC. There was, however, a significant correlation with the pTNM classification and UICC staging. The prognosis for patients with score 0 was significantly better than score 1 patients. CD15 immunoreactivity appears to be a predictive factor in sporadic and hereditary MTC. Lymph node dissection seems to be more successful in patients with score 0 tumors than in those with score 1 tumors. The question of reoperation in patients with recurrence of disease (especially with biochemical recurrence or persistence) should be discussed on the basis of CD15 immunoreactivity.

Adolescent↗