[Osteoarticular determination of ochronosis. Ultrastructural study. Report on a case (author's transl)].
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Biomedical subjects
Publications and source records attributed to L Garbe.
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Authors have studied 9 parathyroid carcinomas under electron microscope (3% of their parathyroid lesions). Two types of the ultrastructural features were significant: 1) architectural: basal membrane abnormalities, sparse desmosomes, absence of nerve fiber; 2) cytological: nuclei atypism and abnormal mitochondria in tumors cells resembling dark chief cells. Also noticed were signs of cell hyperactivity and/or trouble in parathormon production or regulation.
In dogs the immediate value of transplanted lungs was tested after preservation in Collins 3 solution and administration of aprotinin. 15 animals received a left or right homograft, which had been preserved for 24 h. In 3 cases preservation time was prolonged to 48 h, and in another 2 dogs both of the lungs were replaced by 24-hour preserved organs in a one-stage operation. The value of the transplants was tested by several physiological, morphological and clinical phenomena. (1) A positive O2 uptake of the transplant after a temporary occlusion of the opposite pulmonary artery documented its capacity for gaseous exchange. (2) Scintigraphic visualization of perfusion and ventilation in 3 dogs demonstrated satisfactory results. (3) A positive response to acetylcholine of the bronchial muscular system was observed in all transplants. (4) Normal light microscopy showed a lack of obvious morphological change. (5) Only slight alterations in electron microscopy were found when compared to those found before preservation. (6) The absence of acute bronchial edema excludes the possibility of irreversible altertions of the alveolocapillary wall. The results demonstrate that preservation of the lung is possible up to a period of 48 h.
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A 53-year-old man, who had been exposed for 23 years to polyvinyl chloride (PVC) in the bagging area of a vinyl chloride polymerisation plant, presented with a diffuse micronodular infiltrate on his chest radiograph. Light microscopy of lung obtained by drill biopsy showed a diffuse infiltration with histiocytes and multinucleated giant cells, with some collagen formation. Ultrastructural studies showed foreign particles in the macrophages, which were identical with PVC powder viewed under the electron microscope. Incubation of PVC powder with human lung macrophages in vitro showed that the macrophages englufed the powder to give a similar ultrastructural appearance.
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A case of a 24 year-old man in whom, following acute pulmonary oedema complicating hypertension known for a period of three years, stenosis of the thoraco-abdominal aorta produced by a large calcification within a zone of the aorta with an inflammatory appearance was demonstrated. This case is included within the context of the aortic syndrome. Operation led to normalisation of blood pressure immediately afterwords, but there was moderate hypertension 56 months later.
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In 3 comparing series the behavior of platelets after experimental lung transplantation was examined in 33 dogs. After allogenic transplantations (21 animals) the ultrastructural findings were pathologic changes of the platelets, such as hyperaggregability with irreversible aggregation prevailing, as well as capillary wall alterations. X-rays showed considerable reduction of functioning parenchyma. Since these findings were absent in animals which underwent merely pulmonary re-implantation (4 animals) and can be considered a controll group, the authors conclude that these alterations are caused by mainly immunologic reactions. Acetylsalicylic acid given to animals with grafted lungs significantly inhibited is specific and certainly immuneinduced pathologic development. Absolutely necessary, therefore, appears the application of such aggregation inhibitor as additional treatment in lung transplantations.
Eighty-seven biopsies were performed on 76 patients with the pneumatic trephine of Steel: -- 87% of biopsies were interpretable; -- 22% of fragments revealed only unspecific lesions or normal lung tissue; -- 65% of samples gave a credible histological diagnosis. Occurring incidents were mostly pneumothorax (41%) usually minor ones. In only 2 patients was drainage necessary. The superiority of the Steel method over the others arises from its usefulness in diffuse pneumopathies and its being better tolerated.
The authors study the results of a series of 536 mediastinoscopies performed by P. Humbert. Out of 239 mediastinal tumours, 206 had a history done. Out of 200 bronchial cancers, 123 pathological diagnosis were made. The recommendation of mediastinoscopy in bronchial cancers is discussed. Joining their experiences. P. humbert and H. Longefait report a positive percentage of 86% out of 902 examinations.
The techniques of different bioptic and cytological examinations performed in pneumology are presented. The various indications for these biopsies in pulmonary, pleural and mediastinal pathology are considered. Interpretation of results leads to a precise diagnosis and to diagnostic information on lesions otherwise difficult to define. In some cases conclusions cannot be reached because of the insignificant changes observed on too small samples.
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