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Biomedical subjects

H J Colmant

Publications and source records attributed to H J Colmant.

At least 19 recordsLinked to original sources

Differentiation between brain lesions in experimental thiamine deficiency.

Dietary deprivation of thiamine combined with pyrithiamine administration in rats was used for pathophysiological and morphological investigations. The animals passed through three different symptomatic stages, ranging from slight neurological abnormalities to generalized seizures from day 8 up to day 11. Hypothermia was a consistent finding during the second week. Histological examination revealed two types of neuropathological lesions in the rats. Those in the colliculi inferiores and the vestibular nuclei were characterized by a bullous spongiform appearance of the neuropil with severely damaged, pale and oedematous nerve cells. Alterations in the thalamus and inferior olives, however, showed eosinophilic nerve cell necrosis of the ischemic type which resembles the thalamic pathology found in human cases of Wernicke's encephalopathy.

Animals↗

[Clinical manifestations of rabies in the human. Case report and review].

Clinical symptoms and course in a 28 year old woman who suffered from rabies are reported. Neurophysiological and neuropathological findings in this patient, who died 21 days after developing initial symptoms, are presented in more detail. This disease appears to be rare in Central Europe. It can be treated effectively only by means of early detection and a special vaccination programme. Late recognition of lyssa specific symptoms in non-vaccinated patients is invariably associated with a fatal outcome. A review of current knowledge concerning rabies research is presented.

Adult↗

[The phenomenology and morphology of spontaneous fatal cerebral aneurysmal hemorrhages].

Hemorrhages from rupturing aneurysms in the main cerebral arteries are repeatedly the object of forensic dissection. The victims are often relatively young, death is sudden and unexpected, and there is no known history of serious illness. Of a total 62,888 dissections carried out by the Institut für Rechtsmedizin of the Free University of Berlin (1956-1984), the University of Hamburg (1970-1984), and the University of Munich (1964-1984), there were 246 such cases (0.39% of the dissected material); 122 were male and 124 female. To compare possible differences between these cases and clinically conducted autopsies with regard to localization and extent of the aneurysm, age and sex of the deceased, an evaluation of the dissected material of the Department of Neuropathology, University Hospital, Hamburg-Eppendorf (1960-1984) was carried out simultaneously in altogether 160 cases, 66 male and 94 female. The phenomena are discussed. In the morphological findings, particular attention is focused on the occasional difficulty in establishing the source of the hemorrhage, which is of crucial importance when differentiating from traumatically caused hemorrhages. Some specific, particularly problematic causes (e.g., where errors were made in medical treatment), are presented in the form of case histories.

Adolescent↗

Comprehensive monitoring and computerized tomographic follow up in patients with acute severe head injury: coma-outcome correlations.

In 88 patients with acute severe head injury the Glasgow coma scale (GCS), computerized tomography and autonomic monitoring during the first 24 hours were used to characterize different types of post-traumatic brain dysfunction. A subgroup is defined--GCS 8.1--with signs of diffuse brain swelling and autonomic instability which included two cases with dorsal midbrain lesions. These preliminary results suggest that autonomic instability is a valid criterion for identifying patients suffering from diffuse axonal injury.

Atrophy↗

[Analysis of a boxing match with fatal outcome resulting from unusually severe brain damage (author's transl)].

A boxing match with fatal outcome is described. The boxer received 21 punches in the nape of his neck, as well as many other blows. After a knock out in the 15th round he conceded the fight; some minutes later he suddenly collapsed. Deep unconsciousness, maximal dilated pupils and extensor-spasms were observed but respiration continued. Although it was possible to evacuate a subdural hematoma 30 to 45 min later, a high-grade cerebral oedema remained resistant to therapy. In addition hypoxemia caused disseminated necroses of heart-muscle fibres. Intensive hemorrhages were detected in the cervical muscles and in the dorsal parts of the intervertebral discs on the level of C 2/3 and C 3/4. Neuropathological investigation revealed the typical alterations brought about by craniotomy carried out for a subdural hematoma caused by the tearing off of Vv. cerebralis superiores, as well as extensive contusion hemorrhages. The high-grade cerebral oedema caused congestion and dislocation which led to massive hemorrhages, hypoxemia to unusually extensive hemorrhagical and white necroses of cortex and brain stem ganglions. Special attention is paid to the pathogenesis of these findings. A report on boxing--particularly professional boxing--issued by the Federal Institute of Sport Medicine in Cologne in 1977 is critically analysed.

Adult↗

Carcinomatous encephalomyelopathy in conjunction with encephalomyeloradiculitis.

A man, aged 63, had an illness which lasted 11 months from onset with pain under the left costal margin which radiated to the epigastrium, until his death from cardiac failure. His symptoms consisted principally of parasthesias and proximal weakness of both upper and lower extremities with atrophy of the shoulder and pelvic girdles. He developed pyramidal tract signs, became euphoric, emotionally unstable and mentally retarded. There was no clinical evidence of cerebellar dysfunction. Bronchogenic carcinoma was suspected from a tomograph of the thorax, but, in spite of extensive clinical and laboratory studies, the diagnosis was verified only postmortem. The CSF cell count was high at first but diminished as the disease progressed. Muscle biopsies revealed chronic generalized denervation without signs of myopathy. Neuropathologically, encephalomyeloradiculoneuritis concentrated on the spinal cord was combined with severe rarefaction of the ganglion cells of the anterior horns and with bilateral degeneration of the lateral pyramidal spinocerebellar and posterior tracts. A more diffuse process was obvious in the anterolateral tracts of the lumbar region. Polyneuropathy concentrated in the distal region was accompanied by slight inflammatory reaction in the sciatic nerve. Cerebellocortical degeneration which exceeded physiological age-related rarefaction was also present. The findings are discussed in relation to the literature.

Carcinoma, Bronchogenic↗

Juvenile type of generalized ceroid-lipofuscinosis (Spielmeyer-Sjögren syndrome) I. Clinical findings.

Thirteen patients with the clinical course of the juvenile type of generalized ceroid-lipofuscinosis were examined clinically, ophthalmologically, neurologically and psychiatrically. This included registration of EEG, x-ray, brain scintigraphy, motor nerve conduction velocity, ERG, fundus photography and bioptical investigations including electron microscopy. The children suffered from progressing decrease of visual acuity, decline of mental capacities, and later on speech and gait disturbances. The most characteristic findings are presented in case reports, two tables and fourteen pictures.

Adolescent↗

Juvenile type of generalized ceroid-lipofuscinosis (Spielmeyer-Sjögren syndrome1 II. Biopsy findings.

Rectal biopsies were obtained from 11 children, clinically presumed to suffer from the juvenile type of generalized ceroid-lipofuscinosis. In addition, sural nerve biopsies were performed in 4 cases. Of the various staining procedures applied for light microscopy, Sundan Black B was found to be the most useful, revealing in each of the rectal biopsies at least some nerve cells with coarse black droplets as well as numerous mucosal macrophages with a more greyish, dustlike material. In sural nerve biopsies a slight reduction of the thick myelinated nerve fibers was seen in two cases, accompanied by regeneration phenomena. The latter were also detectable in one other case, the remaining sural nerve biopsy being histologically unremarkable. By electron microscopy neuronal perikarya revealed lipopigment bodies with a fingerprint-like pattern in each of the rectal biopsies. In one case only was this pattern combined with distinct curvilinear profiles. In 4 cases, however, the fingerprint-like deposits were intermingled with different lamellated bodies, some of them reminiscent of MCB's or zebra bodies. In two of the 4 cases, these were even seen exclusively in some neurons. In each of the rectal as well as the sural nerve biopsies, most of the non-neuronal cell types presented lipopigment bodies, likewise, displaying both curvilinear and fingerpring-like profiles, with some characteristics related to the various cell types. With regard to generalized ceroid-lipofuscinosis the diagnostic value of rectal biopsies, though being disputed in the literature, appears reestablished by the findings presented.

Biopsy↗

[Excessive hyperplasia of the exocrine pancreatic tissue and Wernicke's encephalopathy (author's transl)].

A 52 year old woman with a history of mild pancreatitis had a palpable mass in the upper abdomen. She died in an unexplained coma. The autopsy revealed an excessive hyperplasia of the exocrine pancreatic tissue resulting in the largest pancreas ever reported (254 gramm). This hyperplasia was accompanied by a chronic pancreatitis. In the central nervous system a Wernick's encephalopathy had developed; severe loss of neurons was stated in the thalamus; extensive degeneration was found in the upper vermis of the cerebellum. The discussion of this case includes the relationship between the diseases of the pancreas and neuropsychiatric and neuropathologic findings. It is assumed that the hyperplasia of the exocrine pancreatic tissue could only be an additional factor in the occurence of post alcoholic complications. This hyperplasia of the exocrine pancreatic tissue is considered to be a hamartom-like formation and it should therefore be distinguished from other pancreatic hyperplasia.

Diagnosis, Differential↗

[Spongious dystrophies].

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Amino Acid Metabolism, Inborn Errors↗