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Biomedical subjects

H Rotterdam

Publications and source records attributed to H Rotterdam.

At least 55 records · Page 3Linked to original sources
PubMed1989

Cytomegaloviral and cryptosporidial cholecystitis in two patients with AIDS.

We report two cases of acalculous cholecystitis due to infection with cytomegalovirus (CMV) and cryptosporidium. Both involved homosexual men who presented with right upper quadrant pain and elevations of serum alkaline phosphatase and bilirubin. Cholecystectomy specimens showed a thickened gallbladder wall and ulcerated mucosa. There were no stones. CMV inclusion bodies were found in granulation tissue at the base of ulcers and intact mucosa surrounding ulcers. Cryptosporidia were aligned along the luminal surface of intact mucosal epithelial cells. Both organisms have a patchy distribution; hence the diagnosis requires a high degree of suspicion. The prognosis is poor. Following cholecystectomy, both patients pursued a downhill course with development of pancreatitis and cholangitis. Both patients are now dead.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Urothelial injury to the rabbit bladder from alkaline irrigants useful in the treatment of uric acid stones.

Irrigation of the urinary tract with alkaline solutions may be used appropriately in some clinical situations to dissolve uric acid stones. Since in vitro studies have suggested that tham-E (pH 10.6) is somewhat more effective than tham (pH 8.6) in promoting dissolution of uric acid, these studies were undertaken to assess the relative toxicities of these two irrigating solutions to the urothelium. Rabbit bladders were irrigated antegrade via a ureterotomy for twenty hours. Tham E produced considerably more mucosal injury than did tham (p = 0.0001). The minimal advantage in rapidity of stone dissolution offered by tham E over tham is more than offset by the considerably increased potential for toxic side effects. The results suggest tham and not tham E should be used for irrigation to dissolve uric acid stones.

Animals↗
PubMed1987

AIDS: an overview of the pathology.

This article reviews the findings at postmortem examination on AIDS and separately details the surgical pathology of the gastrointestinal tract, liver, lymph nodes, and skin in these patients. Emphasis is placed upon the light microscopic features of the specimens commonly received in surgical pathology so as the promote the ready diagnosis of this important and grave disorder.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Tissue diagnosis of selected AIDS-related opportunistic infections.

Opportunistic infections are the most common initial manifestations of AIDS and, in many instances, are first encountered in surgical specimens. Pneumocystis carinii pneumonitis is by far the most frequent infection seen in biopsy specimens of AIDS patients. Most pathologists are familiar with its histopathologic presentations from previous experience. By contrast, many other opportunistic infections are either new or present clinically and pathologically in unfamiliar ways. Cytomegalovirus affects primarily the alimentary tract and lung. Colitis is the most common presentation. Penetrating ulcers may perforate. Most often, mesenchymal cells, endothelium in particular, show the typical intranuclear and intracytoplasmic inclusion bodies. The greater the number of inclusion bodies in tissues the shorter is the survival of the patient. Mycobacterium avium-intracellulare affects mainly small intestine and lymph nodes and produces a clinical and histologic picture similar to that of Whipple's disease. Diffuse infiltrates of histiocytes stuffed with acid-fast bacilli are characteristic. Cryptosporidiosis is the most ominous enteric opportunistic infection. Protozoa attach themselves to the epithelial surface and produce severe profuse, watery diarrhea. Cryptococcosis is seen in lung, lymph node, and brain biopsy specimens. Large numbers of organisms, sometimes with deficient mucinous capsules, and little or no inflammatory reaction, are notable. Toxoplasmosis is the most common cause of neurological complications in AIDS. Brain biopsy specimens show necrosis, microglial nodules, perivascular lymphocytic infiltrates, and, in 50% of cases, trophozoites.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Urothelial injury to the rabbit bladder from various alkaline and acidic solutions used to dissolve kidney stones.

Different irrigating solutions are used clinically to dissolve uric acid, cystine and struvite stones. These studies were undertaken to assess the toxicity to the rabbit bladder epithelium of several commonly used formulations. Test solutions were infused antegrade through a left ureterotomy overnight. Bladders were removed and routine histological sections made. A pH 7.6 solution of NaHCO3 appeared harmless. The same solution with two per cent acetylcysteine produced slight injury. All pH 4 solutions caused significant damage to the urothelium. Hemiacidrin, which contains magnesium, produced less damage than did other pH 4 solutions without that cation. Our data tend to support Suby's conclusions that addition of magnesium reduces urothelial injury even though the presence of magnesium will slow dissolution of struvite.

Acetylcysteine↗
PubMed1985

Embolization and vessel wall perforation in argon laser recanalization.

The primary concerns in the development of a laser catheter for intravascular use are the potential hazards of vessel wall perforation and distal embolization. We present evidence, using technetium 99-labeled thrombi in two rabbit aortas and one human cadaver coronary artery, that distal embolization does not occur after argon laser recanalization. Also, no vessel wall perforation was observed during recanalization of 15 thrombosed rabbit aortas and 1 inferior vena cava, used because of their extremely thin walls. Laser recanalization of three peripheral arteries with atherosclerotic plaque obstruction, in amputated human legs, showed no evidence of vessel wall perforation. The incidence of vessel wall perforation can be minimized by preferential use of the argon laser, strict maintainance of a coaxial relationship between the laser catheter and the vessel, and exercising care during the actual lasing process. Distal embolization does not appear to be an important consideration.

Animals↗
PubMed1985

Alimentary tract biopsy lesions in the acquired immune deficiency syndrome.

The surgical pathology of the alimentary tract complications of the acquired immune deficiency syndrome (AIDS) is described and illustrated by a review of one year's material accessioned at a New York Community Hospital. Cytomegalovirus, Cryptosporidium and Mycobacterium avium-intracellulare were particularly notable among diverse opportunistic infectious agents. Visceral Kaposi's sarcoma and malignant lymphomas were the principal malignancies recognized, and their occurrence in young men should alert clinicians to the possibility of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Renal disease in patients with AIDS: a clinicopathologic study.

To determine the nature and frequency of renal disorders in AIDS we reviewed the records of thirty-two patients hospitalized over a twenty-two month period. Group I, including all patients with AIDS who demonstrated proteinuria and/or renal insufficiency, numbered thirteen patients, in ten of whom renal tissue was available. Renal abnormalities included proteinuria in twelve patients, which exceeded two grams per day in seven. The glomerular histologic lesions included focal glomerulosclerosis, diffuse mesangial hypercellularity, diffuse proliferative glomerulonephritis, and membranoproliferative glomerulonephritis. The nonglomerular histologic lesions included acute tubular necrosis, nephrocalcinosis, focal interstitial nephritis, and one case each of intrarenal cryptococcal infection and renal cell carcinoma. Nine of these thirteen patients developed renal insufficiency, and four of them required dialysis. Their mortality by the end of the study period was eleven of thirteen patients (85 percent), significantly worse in the short term than AIDS patients without renal problems. The patients in Group I were compared to the nineteen AIDS patients without renal abnormalities in Group II. The Group I patients had a higher incidence of oral and esophageal candidiasis, other fungal infections, and infections with Mycobacterium avium-intracellulare. They also had a higher incidence of exposure to aminoglycoside antibiotics and amphotericin B, and experienced more clinical shock than their Group II counterparts. It is concluded that patients with AIDS may demonstrate renal abnormalities on the basis of immune, hemodynamic, infectious, and neoplastic derangements.

Acquired Immunodeficiency Syndrome↗
PubMed1978

Vascular invasion as a prognostic factor in stage IB cancer of the cervix.

One hundred ninety-one cases of histopathologically confirmed invasive carcinoma of the cervix were available to study. Until early diagnosis is made routinely and treatment instituted with a predictable promise for cure, attention must be devoted to studying the natural history of disease, its histologic and nuclear grading, stromal reaction, and whether lymphatics and/or blood vessels are involved. The results are impressive since patients with Stage IB carcinoma with lymphatic and/or blood vessel involvement treated by radical hysterectomy have had a 59.4% 5-year survival rate which has increased dramatically to 90% when there was no involvement. Other features which were analyzed, including tumor type, histologic and nuclear grades, size and number of nucleoli, and stromal leukocyte reactions showed no significant statistical relationship to survival. This may represent a bias because of the small number of cases in each group. This study helped identify the patient at high risk. The high-risk group as outlined by the parameters listed should receive additional therapy. Since the cancer had invaded a vascular channel, the authors selected these patients for combination anticancer chemotherapy. Those patients for combination anticancer chemotherapy. Those patients have not been followed long enough to evaluate the results of the treatment.

Adenocarcinoma↗
PubMed1977

Microgranulomas in grossly normal rectal mucosa in Crohn's disease.

Rectal biopsies of sigmoidoscopically normal mucosa from 99 patients with Crohn's disease of the ileum, colon, or both were studied histologically, with particular reference to the presence of granulomas. Among the 14 cases of granulomas, some were of the usual sarcoid type and could easily be detected. Other microgranulomas were less well defined and were found only by mid- or high-power microscopic screening of serial sections. The morphologic characteristics, the relationship to ordinary Crohn's-disease granulomas and the possible significance of microgranulomas are discussed.

Biopsy↗
PubMed1976

Radiologic and pathologic characteristics of the WDHA syndrome.

A case of a non-beta islet cell tumor of the pancreas that produced the WDHA (watery diarrhea, hypokalemia, and achlorhydria) syndrome is presented. An enlarged body-tail region of the pancreas is demonstrated on transaxial views; multiple fluid-filled loops of small and large bowel are also noted. The angiography of the tumor is similar to other non-beta islet cell lesions consisting of a large hypervascular mass with hypertrophied feeding vessels and a persistent, dense capillary stain. The demonstration of elevated levels of vasoactive intestinal polypeptide in both tumor and plasma and the ultrastructural description of endocrine granules may help to explain the pathophysiology in this case.

Achlorhydria↗
PubMedDate not supplied

Gastric sarcoidosis.

Sarcoidosis of the gastrointestinal tract is uncommon even though involvement of the liver, spleen, and adenopathy are becoming recognizable entities on computed tomography (CT). Involvement of the stomach, the most common site of sarcoidosis of the gastrointestinal tract, is usually associated with pulmonary disease. The radiologic appearances of gastric involvement are variable. Positive biopsies may be obtained in a radiologically normal stomach. Ulceration resembling peptic ulcer disease may occur, and mucosal enlargement may be minor, diffusely nodular, or significant enough to mimic Menetrier disease. In its most dramatic form, a linitis plastica appearance resembling scirrhous carcinoma has been reported.

Adult↗
PubMedDate not supplied

Abdominal manifestations of sarcoidosis. CT appearances.

Sarcoidosis frequently involves the abdomen, although imaging studies often fail to demonstrate disease. The most common computed tomography (CT) findings in abdominal sarcoidosis are hepatosplenomegaly and retroperitoneal adenopathy, followed by focal low-attenuation lesions of the liver and spleen. Other abdominal viscera are involved infrequently. We present four cases of abdominal sarcoidosis demonstrating a range of CT findings.

Adult↗