Biomedical subjects
Publications and source records attributed to H Mitschke.
As in many parts of the world, mental health care in Austria is growing more progressive and multidisciplinary in scope, moving from an "alternative" to an established treatment. One region in Austria has established a counseling center that provides comprehensive in-home patient services to complement inpatient care and to keep individuals stabilized in society.
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With the aid of epicutaneous application of 2,4-dinitrochlorobenzene (DNCB) solution in acetone, we induced a cutaneous allergic reaction of the delayed type. Our question was whether the development of the DNCB cutaneous sensitivity could be suppressed by highly radiolabelled DNCB. On the basis of the clonal selection theory and our own results with other in vivo-experimental animal models, one could suppose that the highly radiolabelled DNCB as haptens binds to the Ig-membrane receptors of the genetically determined T-lymphocyte clone, and that the conjugated radioactivity (125I) causes a selective radioactive damage to this competent T-lymphocyte subpopulation. By means of intracardially applied radiolabelled DNCB, we are able to induce either complete or very significant suppression of the cutaneous DNCB immune response. In the second experiment, the highly radiolabelled DNCB was not able to inhibit sensitization to a simultaneously applied 4-ethoxy-methylene-2-phenyl-oxazolone (oxazolone). This result clearly demonstrates the antigen specificity of this form of immune suppression.
Non-alcoholic steatosis hepatitis and fatty cirrhosis represents an unfamiliar liver disease of yet unknown etiology, which is usually indistinguishable from alcoholic lesions by histological criteria. For the affected patients this means automatically the inappropriate assumption of hidden alcohol abuse. Out of 1467 liver biopsies during 1979 to 1982 we selected 25 patients (group I), who either denied alcohol intake or reported negligible consumption. None of them had taken steatogenous drugs or had been treated by jejuno-ileal bypass operation for morbid obesity. Nevertheless, in all cases liver biopsy demonstrated changes that were thought to be characteristic of alcoholic liver disease. This group was compared with an additional series of 25 patients (group II, selected out of 342 alcoholics), who admitted to a mean daily alcohol ingestion of 145 +/- 37 g. According to body weight, sex ratio, estimated degree of hepatocellular fat deposition and relation of steatosis hepatitis (n = 15) to fatty cirrhosis (n = 12) there were no differences between both groups. In contrast to the alcoholics (group II) significantly lower (p less than 0.001) values of serum gamma-glutamyltransferase (127 +/- 138 vs 669 +/- 588 U/l) and mean corpuscular erythrocyte volume (89 +/- 4,7 vs 102 +/- 7,8 fl) occurred among the abstinent patients (group I). However, the considerable overlap of measured values argued against a sufficiently discriminative function of both parameters. On the other hand, the serum SGOT/SGPT ratio (I: 1,0 +/- 0,4 vs II: 3,5 +/- 1,4) as well as the serum immunoglobulin-index IgG/IgA (I: 5,6 +/- 2,1 vs II: 2,7 +/- 0,7) allowed a more than 90% separation between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Between 1974 and 1978 three children with a nasopharyngeal carcinoma (stages: T3N3MO, T4N2MO, T4N1MO) were treated with primary radiotherapy (tumor dose: 45-67 Gy). Local control was achieved in two children, one of these (T4 primarily) had a local relapse five months after diagnosis. Only one of the three children had radiotherapy to the neck region. This child developed lung and mediastinal metastases with hypertrophic osteoarthropathy twelve months after diagnosis. In the other two children lung metastases were observed two and seven weeks after the diagnosis respectively. In these two radiotherapy of metastases and chemotherapy were considered more important than radiotherapy of the neck region. All three children showed disappearance or considerable reduction of lung metastases due to radio- and chemotherapy. Yet, all three died of progressive disease within a few months. Early diagnosis of nasopharyngeal carcinoma in children will only be possible when pediatricians are more aware of this disease, also in our regions. Radiotherapy should be done only with megavoltage equipment using extensive radiation fields for the primary tumor area and elective radiation of the neck region. The use of additional primary chemotherapy is suggested for stages T3/T4. This mode of management may help to prevent distant metastases.
This study applies to the agency of vitamin C on chemical carcinogenesis in the small intestine of rats. Administration of N-Ethyl-N'-nitro-N-nitrosoguanidine (ENNG) in drinking water produced tumors of the small intestine after 18 weeks in more than 90%. The induction of tumors could not be suppressed by a large amount (2-3%) of sodium ascorbate in food, but the depth of tumor infiltration was restricted. Cancer developed in 29 of 36 rats receiving ENNG only. In 25 animals of this group growth of tumor corresponded to a P4 stage. In 24 of 35 animals, additionally receiving vitamin C, P4 stage was observed in only 13 cases. Pathological changes in the small intestine could not be observed after the sole administration of vitamin C.
Within a period of 7 years a total of 113 patients could be oto-rhino-laryngologically examined. The cases comprise chronic uremic patients under conservative therapy, patients with chronic intermittent haemodialysis treatment, and patients after successful renal transplantation. In 52% of all patients examined an impairment of hearing can be diagnosed and specified as inner ear deafness. As common etiological factors for inner ear deafness can be excluded, an accumulation of so-called uremic toxins is regarded to be the most probable cause of uremic deafness. This is confirmed by the fact that uremic deafness is not affected by haemodialysis treatment, but can be influenced favorably by a normal transplant function. Besides infiltrations of chronic inflammation and metaplasia of epithelium, nasal biopsies on uremic patients yielded histological findings invariably showing wide, thin-walled vessels in the subepithelium and the stroma. This phenomenon is possibly another pathogenic factor for epistaxis in chronic uremic patients. The depression of immunological resistance in uremia and the medication of immunosuppressive drugs after renal transplantation may explain the fact that serious otorhino-laryngological injections could frequently be observed in our patients. Careful observation may be helpful for early diagnosis and treatment of possible bacterial and mycotic infections in a very early stage.
Wistar rats spontaneously develop adenomatous polyps with cell dysplasia (Figs. 2 and 3) and finally, adenocarcinomas (Fig. 1) at the preternatural anus 120-200 days after the formation of a double loop colostomy. With respect to the potential significance of bile acid metabolites in the pathogenesis of colonic cancer, the effect of continuous oral administration of chenodeoxycholic acid (CDCA) on the rate of carcinomas at the preternatural anus was examined. This animal model gained special interest because until now the possible cocarcinogenic rule of bile metabolites was generally demonstrated only after additional administration of chemical carcinogens like dimethylhydracin or nitrosoguanidin. Of ten rats in the CDCA-treated group, three already showed a malignant transformatin to adenocarcinomas at the preternatural anus 60 days after a colostomy (Fig. 4). Apparently the alteration of natural ecologic conditions diminishes the resistance against external and internal carcinogenic or coarcinogenic agents. The role of bile acid metabolites is discussed under these circumstances.
Report about 12 cases of defect of the frontal bone: state after radical operation of the frontal sinus (Riedel's operation) or after removal of bone splinters after injury. 6--12 months later a paladon-inlay (acrylate prosthesis) can be implanted to fill the defect and to restore the profile. Description of the production, forming, sterilization and operative implantation of the prosthesis. The patients have been observed up to 18 years. In one case the implanted material was removed after 10 years because of recurrent local suppurations. All the other patients showed an uncomplicated course until today; the cosmetic and functional result was permanently good.
With respect to the potential significance of bile acids in the pathogenesis of colorectal cancer the effect of continuous oral administration of chenodeoxycholic acid--which is used for conservative therapy of radiolucent gallstones--on the rate of colonic tumors was examined. In rats treated with chenodeoxycholic acid a higher incidence of 1,2-dimethylhydrazine induced adenocarcinomas was detected. On the basis of these results it is postulated that all patients treated with chenodeoxycholic acid due to gallstones are registered systematically in order to gain definite information about its possible role as tumor promoter.
A progression in the development of gastritis is not observed following selective proximal vagotomy. Morphometrically, a moderate compensatory foveolar hyperplasia can be noticed in addition to a reduction of parietal cells. Paralleles can be found concerning the ultrastructural alterations of parietal cells following vagotomy or after anticholinergic treatment. They consist in an increase of lamellar osmiophilic bodies, reduction of tubulovesicles, a narrow canalicular lumen and sparse mitochondria. A few years after vagotomy, the parietal cells appear rather unstimulated. After vagotomy, numerous antral G-cells can be demonstrated, with ultrastructural features of increased secretory activity in correlation to raised plasma gastrin levels. This moderate G-cells hyperplasia may, however, already exist preoperatively with the duodenal ulcer. 5 years after vagotomy, there is no pronounced alteration concerning the number of granular or agranular vesicles inside the terminal axons. Experimentally, a degeneration of sympathetic nerves has been described a few days after vagotomy.
A case of a feminizing adrenocortical tumor associated with Cushing's syndrome in a 29 year old male is presented. The ultrastructural features are compared with adrenal tumors secreting aldosterone, glucocorticoids of androgens. As in adrenal carcinomas, this tumor demonstrates nuclear pleomorphism with enlarged nucleoli and nuclear pseudoinclusions. The cytoplasmic organelles show some parallels between feminizing and androgen-secreting adrenal tumors. Different types of mitochondria occur with varying amounts of smooth endoplasmic reticulum. Numerous microbodies are present. Histological and ultrastructural signs indicating probably malignancy are discussed and it is noted that most of the feminizing adrenal tumors are carcinomata. Neither local recurrence nor distant metastases have yet been detected in this case, two years after excision of the tumor.
This is the first report on a primary choroidal alveolar soft part sarcoma in a 37-year-old male, who died 1 1/2 years following enucleation secondary to multiple metastases. Histology and differential diagnosis of this tumour are discussed. Histogenetically, because of the localization in the choroid, as far as the origin of these tumour cells is concerned, they supposedly stem from cell systems of the neuroectoderm. Since from these cell systems the malignant melanoma of the choroid arises too, a close relationship of these tumours is concluded.
By means of virologuc--serologic examination methods it was possible to find in four patients with sudden deafness a cytomegaloinfection, whereby the complement-fixation reaction was determined with the CMV antigen. With the usual therapeutical measures all cases with an, in part high-degree, labyrinthine deafness improved or normalized simultaneously with the serologically ascertained subsiding of the virus infection. The paper discusses the pathogenesis of viruscaused sudden deafness and tries to explain the benign nature of central complications in cytomegaloinfections.
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The purpose of this study was to find whether the reflux of bile and pancreatic juices following stomach resection (duodenogastric reflux) enhances the incidence of carcinomas near the gastroenteric anastomosis. 72 male Wistar rats were subjected to stomach resection. The gastroenteric anastomosis (GE) was performed either as short loop anastomosis (Billroth II; n = 39), thus providing a continuous duodenogastric reflux, or as Y-shaped GE (according to Roux; n = 33). By the latter technique, bile and pancreatic juices are derived quantitatively into the jejunum without coming into contact with the remaining part of the stomach. During a period of 33 weeks, operated rats as well as intact animals were given the carcinogen N-methyl-N'-nitro-N-nitrosoguanidine (NG; 120 mg/l) in the drinking water. At autopsy, 33 to 36 weeks after daily oral administration of NG, most of the tumours were found in operated rats undergoing continuous reflux (Billroth II group). In contrast to these findings, the incidence or carcinomas was significantly lower in animals without reflex (Roux group or intact control rats).-The results of our experiments demonstrate that, in rats, the duodenogastric reflux contributes substantially to the development of carcinomas of the resected stomach.