Infectious and inflammatory diseases.
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Biomedical subjects
Publications and source records attributed to H Z Rotterdam.
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Kaposi's sarcoma is a well-known manifestation of the acquired immune deficiency syndrome. Involvement of the gastrointestinal tract, including the colon, by this tumor usually causes no gastrointestinal symptoms. However, Kaposi's sarcoma has never been reported in association with ulcerative colitis in patients with acquired immune deficiency syndrome. Herein, the second reported case of colonic Kaposi's sarcoma associated with ulcerative colitis in a non-acquired immune deficiency syndrome patient is presented. Alimentary tract lesions typical of Kaposi's sarcoma are reviewed.
Mixed cellularity Hodgkin's disease and diffuse non-Hodgkin's lymphoma, mixed cell type, occurred consecutively in a husband and wife. Both patients demonstrated monoclonal IgM gammopathies. The unusual nature and possible significance of these findings are discussed.
Alimentary tract cytomegalovirus (CMV) infections of 24 patients were reviewed, including 19 with the acquired immune deficiency syndrome. CMV inclusion bodies (CMV-IB) were calibrated per mm2 of tissue. CMV-IB counts were correlated with biopsy site, inflammatory response, and clinical parameters. Colonic biopsies showed the highest counts. Biopsies of the right colon had about three times as many CMV-IBs as those of the left. Upper alimentary tract biopsies had low counts. Mesenchymal cells were most affected (97%); 35% were identified as endothelial and 6% as smooth muscle. Only 3% of CMV-IBs were in epithelial cells. Grades of inflammation, 1-5, correlated directly with CMV-IB counts up to grade 4. In grade 5 inflammation tissue destruction was so severe that CMV-IBs were difficult to recognize. Ulcers were demonstrated in more than half of all patients, either histologically or endoscopically. The inflammatory response was nonspecific, except for patchy infiltrates and the absence of lymphoid follicles, crypt abscesses, or granulomas. Gastrointestinal infections, such as shigellosis, candidiasis, mycobacteriosis, and cryptosporidiosis coexisted in 17 patients. No correlation was found between CMV-IB counts and severity of symptoms or length of survival. Alimentary tract CMV infections was the first manifestation of the acquired immune deficiency syndrome in 11 patients. Survival ranged from 2 wk to 19 months.
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The first transluminal laser angioplasty in animals is reported herein. An Argon laser and a specialized coronary arterial catheter with a fiberoptic wave guide were used. Immediate histologic changes consisted of a moderate degree of intimal necrosis and some loss of elastic tissue. At 5 days the intima was repaired, but focal elastic tissue loss persisted.
Experience with laser angioplasty in 16 coronary arteries in 9 cadaver hearts is presented. Coronary obstructions were due to experimentally created thrombi as well as to naturally occurring calcified plaques. Successful laser angioplasty was achieved in 14 of 15 arteries. One artery was sacrificed to determine factors necessary for deliberate perforation of the arterial wall. This procedure required more than 30 seconds of laser energy at 3.0 W with the catheter tip almost perpendicular to the wall. Penetration of the arterial wall occurred only in the second left anterior descending artery which was plaque-occluded because of operator inexperience.
A case history is presented and the treatment discussed. The literature is reviewed for reports of other instances of a giant cell tumor occurring in this unusual location.
Two cases of dermatopathic lymphadenitis involved external mammary lymph nodes and presented clinically as breast masses. The variable position and number of external mammary lymph nodes account for the difficulty in differentiating intrinsic breast pathological conditions of the lateral margin of the breast from lymphadenitis. Recent publicity may account for a lower threshold for detection of such lesions by patients as well as physicians. Dermatopathic lymphadenitis should be included in the differential diagnosis of persistent solid masses involving the lateral margin of the breast and should be confirmed by excisional biopsy.
Two cases of double primary prostatic adenocarcinoma are described. A periurethral papillary adenocarcinoma coexisted with the common acinar type of cancer, which tends to arise deep in the corpus of the gland. We are of the opinion that the patterns observed in these tumors are not mere variations of one neoplasm, but rather two dissimilar growths of diverse cell origin, varried histology, and possibly also of disparate biologic potential.