Biomedical subjects
Publications and source records attributed to K Pintar.
A case of a 55-year-old man with known Fabry's disease, complicated by entero-vesical fistula and associated with enlarged mesenteric lymph nodes, is reported. Histopathologic and ultrastructural findings of the involved lymph nodes are described, and pathogenesis of the entero-vesical fistula is briefly discussed. This is the first case, to the authors' knowledge, of urologic complication in Fabry's disease.
Histological examination on lung tissue obtained from 10 symptomatic welders was performed by two certified pathologists without the knowledge of the patients' clinical condition. In all cases, there was some degree of interstitial fibrosis; in five the degree of fibrosis was considered to be moderate to pronounced. The tissue was also analysed by energy dispersive x ray analysis and elemental contents were compared with age matched controls. There was a large amount of iron in the lungs of welders but the silicon content did not differ from the control subjects. No specific foreign element was detected. It is concluded that (1) interstitial pulmonary fibrosis is seen in some welders and (2) the cause of fibrosis does not appear to be coexisting silicosis.
This report describes an unusual multisaccular vein graft aneurysm that developed in a patient who had undergone aortocoronary bypass with a saphenous vein graft. The aneurysm was a complication of an atherosclerotic lesion. This case supports the belief that aortocoronary vein grafts have an increased susceptibility to aneurysm formation.
Studies were conducted in 14 mongrel dogs to compare resistivities in normal muscle with those from muscle subjected to electrical burns. One-ampere, 60-Hz currents were passed between the hind limbs of the dogs producing injury in three measurement regions of the gracilis muscle. Histology, heart rate, body temperature, arterial and pulmonary artery pressure, cardiac output, hematocrit, leukocyte counts, fibrinogen levels, and platelet levels were determined. Muscle resistivity associated with severe tissue necrosis was 70% lower than control values. Resistivity in tissue showing edema and minimal necrosis decreased 20 to 40% from control values. Muscle showing only edema had a 10 to 30% decrease in resistivity.
Two cases of rectal polyps that showed foci of squamous metaplasia are reported. In one, the squamous metaplasia was observed in an area of intramucosal adenocarcinoma. This finding tends to reinforce the contention previously made by some authors that squamous metaplasia in colorectal polyps may represent the precursor of primary colorectal squamous cell carcinoma or colorectal adenocarcinoma with squamous components (adenoacanthoma or adenosquamous carcinoma).
Sixty-one cases of adenocarcinoma of the urinary bladder presenting between 1966 and 1981 were reviewed. Among the only seven cases of primary adenocarcinoma of the urinary bladder, three were classified as primary signet-ring cell carcinoma. These 3 cases were reviewed with the 11 previously reported cases in the literature. Primary signet-ring cell carcinoma of the urinary bladder occurs predominantly in men (12 men, 2 women) with age ranging from 38 to 83 years. It usually runs a rapidly fatal course despite therapy. The characteristic clinical, gross, and histomorphologic findings and pathogenesis of this rare bladder malignancy are discussed.
Pulmonary specimens obtained from ten normal subjects and 53 patients with various pulmonary diseases were studied with energy-dispersive x-ray analysis. The amount of silicon in the pulmonary tissue was determined and expressed as a silicon/sulfur (Si/S) ratio. This Si/S ratio was below 0.2 in the ten normal subjects and in 14 patients who had various interstitial pulmonary diseases but had no previous history of exposure to silica or other dusts known to cause pulmonary fibrosis. The Si/S ratio was greater than 0.3 in 19 of 22 patients who had a history of exposure to silica dust and had clear-cut histologic evidence of silicosis. The Si/S ratio was less than 0.2 in 12 and between 0.2 and 0.3 in two of the 14 patients who had a history of exposure to silica dusts but no clinical or histologic evidence of silicosis. We conclude that the determination of the silicon content of tissue by energy-dispersive x-ray analysis is useful in separating the fibrosis due to silicosis from the other causes of pulmonary fibrosis.
Two men who had been exposed only to silicon carbide for many years in a factory manufacturing refractory bricks developed bilateral reticulonodular densities, as shown on chest radiograms, and complained of dyspnea. An open lung biopsy of one of them showed a large amount of black material in the fibrosed alveolar septums. Studies by X-ray diffraction revealed that the silicon carbide to which they were exposed did not contain quartz; X-ray powder diffraction analysis of the lung tissue revealed at least 6 different silicon carbides, traces of tungsten carbide, and an insignificant amount of quartz. Line-width analysis of the pattern suggested that the lung contained foreign material, with a significant number of particles smaller than 0.1 micron. The etiologic role of silicon carbide for tissue fibrosis is discussed.
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Papillary fibroelastoma is a rare cardiac lesion, mostly encountered as an incidental finding at the time of autopsy but occasionally seen during life. Although this condition generally is asymptomatic, a few cases had been associated with clinical problems, such as embolic phenomena, angina pectoris, outflow tract obstruction, and sudden death. We studied six examples of this lesion, five occurring on the cardiac valves and one on the left ventricular septum. In one, the lesion was detected by echocardiography, which represents to our knowledge only the third published case in which the lesion was visualized by this diagnostic procedure and only the fourth in which the lesion was seen during life. We believe that echocardiography is sensitive in the detection of this often small, intracardiac lesion, useful in evaluating whether a case, by virtue of its size or location, carries a significant risk of causing clinical problems and therefore requires treatment.
The elemental content of alveolar septa in various pneumoconioses was examind for a possible relationship to interstitial fibrosis. Silicon content, as well as heavy metal content, were evaluated to deterrmine possible interrelationships between the various inorganic dusts. Silicon levels were determined on the basis of silicon-sulphur ratios to accommodate for differences in tissue mass. A study of the variation of silicon-sulphur ratios in silicotics and normal individuals showed no false positives by our diagnostic criteria. A study of 11 cases of siderosis revealed that silicon was not responsible for the fibrosis as previously believed. An analysis of the lungs of 25 non-silicotic fibroses revealed that silicon-sulphur ratios were within normal limits. This technique should be useful in quantitating high exposure to certain dusts and in studying the relationship of such dusts to fibrosis.
Examination of totally or partially obstructed human aortocoronary vein grafts, obtained at different time intervals after the bypass operation, has shown that the initial occlusive process is due to thrombosis and may appear a few hours or days after surgery. The cellular phase of intimal proliferation affecting most of the grafts becomes apparent about 4 weeks after the operation. After 1 year the intimal hyperplasia acquires a cell-poor, fibrotic character; the graft usually remains patent. About one-half of the vein grafts obtained 3 or more years after the operation show complicated atherosclerotic lesions. These findings indicate that most of the vein grafts undergo extensive structural changes and some may show similar degenerative lesions as they develop in the coronary arteries.
An atherosclerotic aneurysm was found in aortocoronary vein grafts of two patients who had a second revascularization because of reappearance of anginal symptoms five and six years, respectively, after the initial bypass operation.
Identification of inorganic substances in the lung is an important step towards the establishment of a cause and effect relationship in the study of pneumoconiosis. The conventional methods for this identification usually require an ashing which makes it difficult to study the localisation of these substances in relation to pathology. A method is described to identify foreign substances in the tissue obtained either on biopsy or autopsy without destroying them. The technique employs scanning electron microscopy together with energy dispersive x-ray analysis. This method not only allows simultaneous multi-elemental analysis of over 80 elements, but also permits detailed morphological examination while the tissue is being analysed.
Aorta-coronary artery vein grafts, obtained from 2 patients 37 and 59 months after an aorta-coronary bypass operation, showed extensive mural changes characterized by degenerative tissue lesions, loss of normal morphological features of the intima, and extracellular accumulation of lipids. Both patients had increased plasma triglyceride levels.
Aortocoronary vein grafts removed at autopsy of 182 patients who died up to 5 years after the bypass operation were examined by light and electron microscopy. During the first month after surgery, graft occlusion was due to thrombi, some of them recent, some organized and recanalized. Intimal proliferation of the graft first appeared 4 weeks after the bypass surgery; several cases of total occlusion of the lumen by this process were seen within 6 months of the operation. A change in the morphological features of the intimal thickening from cellular to fibrotic and hylain-like was observed in several grafts implanted for more than 1 year. Typical atherosclerosis developed in vein grafts in three of the six patients surviving the operation for more than 3 years.
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