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H Kerner

Publications and source records attributed to H Kerner.

71 records · Page 4Linked to original sources

Human pleuropulmonary gnathostomiasis: a case report from Israel.

We report a case of human gnathostomiasis presenting with bilateral pleural effusion and probable pericardial involvement. The diagnosis was made on the basis of the patient's country of origin (Nepal), the course of the disease, marked eosinophilia and the identification of Gnathostoma in a thoracic skin biopsy. The patient responded, presumably, to treatment with diethylcarbamazine (Hetrazan). This case is unique in its presentation and occurrence in Israel (although not necessarily acquired in Israel).

Adult↗

Unusual ovarian, tubal and pelvic mesothelial inclusions in patients with endometriosis.

Unusual mesothelial inclusions were observed in ovaries, fallopian tubes and pelvic wall in six out of 57 patients with endometriosis and in none of 100 ovaries without endometriosis. Although of the same origin as the common ovarian epithelial inclusion cysts, these mesothelial inclusions were different being small, closely packed mesothelial cell nests with or without central lumina and occasionally demonstrating a pseudoinfiltrative pattern, rather than the cystically dilated, non-crowded glands lined by a variety of Müllerian type epithelia. Histochemical reactions of these mesothelial inclusions were similar to those obtained in normal mesothelium, but differed from those seen in common epithelial inclusion cysts, endometriosis and adenocarcinoma. The association of these inclusions with endometriosis suggests that a common stimulus is responsible for the development of both conditions from the multipotential pelvic mesothelium.

Adenocarcinoma↗

Cutaneous sclerosis in eosinophilic fasciitis.

Eosinophilic fasciitis is an additional clinical entity to many others manifested by sclerodermic changes in the skin. A case with this process is reported. It presents vast cutaneous sclerodermic changes associated with eosinophilia, signs of muscular exertion, and a massive inflammatory infiltrate involving the lower part of the dermis, subcutaneous tissue and the muscle fascia. Prednisone therapy was followed by rapid and marked improvement.

Eosinophils↗

Ovarian surface papillomatosis of borderline malignancy.

Bilateral ovarian surface papillomatosis of borderline malignancy is a rare condition. In our case it was associated with benign serous cystadenofibroma. The histologic diagnosis and the clinical aspects are discussed.

Adenofibroma↗

Echocardiography in infective endocarditis. Lack of specificity in patients with valvular pathology.

59 patients with suspected infective endocarditis on a natural valve were studied by M-Mode echocardiography to determine the specificity of the ultrasonic technique in detecting valvular vegetations. All echocardiograms were read independently by two observers who were unaware of the final diagnosis. Among 40 patients who later proved not to have infective endocarditis, two (5%) were diagnosed by echocardiography as having either possible or probably vegetation by at least one observer. Both patients with a false positive diagnosis of vegetation had pre-existing valvular pathology, the presence of which greatly complicated the interpretation of the echocardiogram. Inter-observer disagreement occurred in 5 of the 59 studies (8.5%). The results of this study suggest that caution should be exerted in the echocardiographic diagnosis of vegetation in patients with pre-existing valvular pathology.

Adolescent↗

Myotonia dystrophica with heart involvement: an electron microscopic study of skeletal, cardiac, and smooth muscle.

The electron microscopic features of the striated skeletal muscle, the striated cardiac muscle, and the smooth muscle from a woman who had been suffering for many years from myotonia dystrophica with cardiac involvement are described. The skeletal muscle was studied at two different stages of the disease. In the first material the main changes consisted of centrally situated nuclei, disorganisation of the sarcomeres, and focal disruption of the Z-line. The satellite cells were well represented. Three years later atrophy and degenerative, necrotic changes of the skeletal muscle were evident. The satellite cells were absent. Few changes were seen in the striated cardiac muscle. These consisted of slight interstitial fibrosis and large accumulations of mitochondria with intramitochondrial dense granules. The smooth muscle cells of the oesophagus showed disorientated filaments and mild degenerative changes. It is concluded that the skeletal muscle was more severely affected than the other types of muscle.

Aorta↗

Granuloma formation in patients after injection of methanol extraction residue (MER-GCG).

Nine patients with advanced cancer who were receiving the methanol extraction residue of BCG (MER-BCG) intradermally or intratumorally underwent biopsies from the injected sites or from locally enlarged lymph nodes. Most preparations showed a chronic granulomatous reaction consisting of lymphocytes, histiocytes, and epithelioid cells as well as either Langhans's or foreignbody type giant cells, or both. The degree of granuloma formation and giant cell infiltration varied. In only one case did the reactions consist merely of chronic lymphocytic and histiocytic inflammation with no granuloma formation. Examination of melanoma nodules injected with MER showed, in addition to granulomas, large numbers of giant cells penetrating the tumour.

Adult↗

Experiments on terminal disinfection by formaldehyde vapor in the case of smallpox.

The usually recommended terminal disinfection by formaldehyde vapor is unable to completely inactivate vaccinia viruses embedded in scabs. In view of our results, we recommend doubling the concentration of formaldehyde (10 g of formaldehyde per m3 of space) and prolonging the time of exposure to 24 h for terminal disinfection in the case of smallpox. Subsequent disinfection by scrubbing assumes special importance, since no complete inactivation of the scabs occurs.

Animals↗

Xanthogranulomatous appendicitis--an incidental finding of localized pathology.

The clinical, histopathological, and electron microscopic features of an unusual case of xanthogranulomatous appendicitis are reported. The patient, a 37-year-old female, presented with typical signs of acute appendicitis and the appendix appeared slightly dilated at laparatomy. The histopathological sections showed numerous xanthoma cells mixed with inspissated fecaliths. Electron microscopy disclosed the presence of xanthoma cells filled with electron-lucent lipid droplets of variable size. The ultrastructural characteristics of these cells enabled the distinction of two types of lipid-laden histiocytes, in relationship to the size of the lipid droplets. Since the lipid droplets were seen also in cells other than histiocytes, it appears that these changes are secondary to a common mechanism, comprising factors such as obstruction, hemorrhage, inflammation, and local hypoxia.

Adult↗

Occipital aneurysmal bone cyst: CT features.

A case of aneurysmal bone cyst arising from the lower occipital squama with intracranial extension is presented. The case is unique in that the cyst showed fluid levels on CT. Another peculiarity of this case was postoperative recurrence.

Bone Cysts↗

Localized amyloidosis in nasopharyngeal carcinoma diagnosed by fine needle aspiration and electron microscopy. A case report.

BACKGROUND: The association of amyloidosis and tumors is well known, but only rarely has it been found in the nasopharynx. Moreover, only a single case of tumor-associated amyloidosis in the nasopharynx has been diagnosed by exfoliative cytology and reported in the English-language literature. We describe a case of localized amyloidosis in metastatic nasopharyngeal carcinoma diagnosed by fine needle aspiration and confirmed by histology and electron microscopy. CASE: Bilateral neck enlargement appeared six months before consultation in a 57-year-old man. Both masses were resected, and during exploration of the nasopharynx, several blind biopsies were taken. Smears from the fine needle aspirate showed malignant epithelial cells, consistent with metastatic carcinoma, and Congo red stain showed the presence of amyloid. Histologic examination of the resected cervical masses and nasopharyngeal biopsies confirmed the diagnosis of nasopharyngeal carcinoma, nonkeratinizing variant with amyloid, and metastases in two lymph nodes. Electron microscopic examination of a lymph node showed extracellular, ribbon-like amyloid deposits as well as masses of amorphous amyloid, apparently intracellular. CONCLUSION: The origin of this form of amyloidosis is unclear in this patient since he had no other known etiologic factors for the condition. Increased awareness of the potential association of these two conditions and the use of fine needle aspiration may reveal a higher frequency than hitherto reported.

Amyloidosis↗

The lipofuscin-iron association in pigmentosis tubae.

Pigmentosis tubae (PT) is a rare condition characterized by the presence of numerous lipofuscin-laden macrophages in the lamina propria of the fallopian tube. Two women, who also had endometriotic ovarian cysts, showed polypoid pigmented tubal mucosae. In addition to lipofuscin, occasional cells showed spotty positivity for iron. Ultrastructural examination of the tubal mucosa showed the lipofuscin-containing bodies, which were similar to lipofuscin-containing lysosomes found in other pigmented conditions. Cytoplasmatic ferritin and hemosiderin in siderosomes were observed in macrophages and endothelial cells of the lamina propria. The present study is the first to demonstrate the presence of iron-containing particles and lipofuscin in the residual bodies of PT. The origin of the excess iron is not clear, but erythrophagocytosis and an abnormal tubal environment could play a role. Iron-promoted lipid peroxidation may alter the lysosomal membranes and contribute to the excessive accumulation of lipofuscin in these cells.

Adult↗