Biomedical subjects
Publications and source records attributed to L Reich.
Usually the myeloblastoma of the tongue (Abrikossoff's tumour) is a benign tumour. Two cases are reported that differ from those described in the literature in respect of findings, course and histology. Particular reference is made to the malignant nature of this tumour.
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Adenocarcinoma of the nose and of the paranasal sinuses occurring in employees in the wood processing industry is recognized as an occupational illness in Great Britain and France. This report illustrates a case of adenocarcinoma which has also been recognised and compensated by the responsible trade association. The article draws attention to this disease and to the responsibilities of the ENT specialist.
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Dicalcium phosphate dihydrate, CaHPO4 . 2H2O (DCPD) crystals were grown in solutions and in different types of gels (silica, agar, collagen) at different pH's, in the presence of other ions, and on different Ca-bearing substrates (enamel, dentine, bone, calcite). Hydrolysis of DCPD to other calcium phosphates and calcium oxalates were made in solutions containing different ions at 37 degrees C, 24h. Results showed that the type of media (solution or gel), type of gel, pH, presence of other ions affect the morphology (size/shape) and growth of DCPD. In systems of changing pH, the more basic calcium phosphate (e.g., apatite, OCP) formed in the first zone, DCPD in the last zone, regardless of the initial Ca/P of the system. Growth of DCPD was suppressed in the presence of F-(which favored growth of apatite), of Cd2+, Pb2+ (which favored OCP). Hydrolysis of DCPD to apatite was promoted in solutions containing Ca2+, F-, CO3=, and inhibited by Mg2+, P2O74-. Hydrolysis of DCPD to calcium oxalate occurs in presence of C2O4=. Results indicate that the variation in morphology of DCPD occurring in various human tissue calcinosis and the co-existence of DCPD with other calcium phosphates and oxalates in urinary and dental calculi are due to variations in pH, and presence of different ions in the media.
With an alpha-galactosidase, B erythrocytes can be converted to blood group O under conditions that neither impair their viability in vitro nor affect their ability to survive normally after transfusion to individuals of groups O, A, and B. Such an approach has the potential for producing enzymatically converted group O cells for use in transfusion therapy. It should also be possible to convert A cells to group O by using the appropriate alpha-N-acetylgalactosaminidase.
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The M-2 protocol (vincristine, cyclophosphamide, BCNU, melphalan, and prednisone) was administered monthly to 63 evaluable patients with advanced chronic lymphocytic leukemia. Complete remission (absence of all clinical and bone marrow evidence of leukemia) and partial response (greater than 50% decrease in organ enlargement and reduction of WBC count to below 15,000 x 10(6)/liter) were achieved in 17% and 44%, respectively, for a total response rate of 61%. The median survivals from therapy of patients achieving a CR, RR, or no response were 73+, 40, and 14 mo respectively. The median survival time from onset of treatment for stages II, III, and IV disease were 47, 20 and 19 mo, respectively, which was not statistically different from historical controls. However, when untreated patients are compared to this latter group, a significant survival advantage from diagnosis was found (p = 0.01), stressing the importance of prior therapy as the only unfavorable prognostic factor. Although complete remissions in CLL, as reflected in apparently normal bone marrow B-lymphocyte markers, can be induced wih acceptable morbidity, the majority of patients relapse after cessation of therapy. An alternative approach to the M-2 protocol will be needed to eradicate the disease.
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Two patients with epidermoid carcinoma treated with mitomycin-C (Mit-C) and 5-fluorouracil (5-FU) developed microangiopathic hemolytic anemia (MAHA), renal failure, and altered mental status. Patient 1 was free of metastatic disease, on maintenance Mit-C and 5-FU when MAHA changes appeared. Patient 2 had recurrent carcinoma in the pelvic area when MAHA changes appeared. In both patients, MAHA changes and neurologic function improved after exchange plasmapheresis. This is the first report of epidermoid carcinoma manifesting MAHA changes after chemotherapy. Speculation as to pathogenesis and appropriate therapy are discussed.
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Plasma beta-thromboglobulin (beta-TG) levels were measured in 14 healthy subjects and in 20 acute leukemia (AL) patients, newly diagnosed, with highly variable values for venous platelet counts. For healthy subjects the plasma beta-TG levels ranged 12-38 (mean 17) ng/ml. In this group of patients with AL, a highly significant positive correlation (P < 0.001) between the values for plasma beta-TG and venous platelet count was present. During a thrombocytopenic period, the plasma beta-TG concentraton was measured in nine of the AL patients immediately before and 10 to 12 hours after platelet transfusion therapy. Fourteen platelet transfusions were administered when the patient's highest temperature of the day was < 38.5 degrees C, and 18 when the highest temperature of the day was greater than or equal to 38.5 degrees C. The mean pre-transfusion and post-transfusion beta-TG values for the 14 platelet transfusions were 7 +/- 2 and 20 +/- 5 ng/ml, respectively. The corresponding means for the 18 transfusions given to febrile patients were 5 +/- 2 ng/ml and 11 +/- 2 ng/ml, respectively. Of the pretransfusion values, 11/14 and 14/18 were below the control range. We conclude that the plasma beta-TG values are considerably lower in thrombocytopenic patients than in subjects with normal platelet counts. Further work should provide reference values for plasma beta-TG over a wide range of venous platelet counts.
Horses' kicks can produce two types of head and neck injuries: injuries of the mid-face and injuries of the larynx. Typical cases as seen by the author are presented. The treatment of mid-face injuries is performed according to principles of plastic surgical repair. After frontal-nasal injuries, a revision of the nasal septum must be done. Involvement of the larynx requires external layer repair of mucosa and cartilage.
Surgery of the posterior diverticulum of the hypopharynx is almost exclusively carried out today from an external approach. 19 patients, of whom 15 were surgically treated by invagination of the pouch, are presented and over a ten year period none have recurred. The indications and advantages of this surgical procedure are described and discussed.
The reconstruction of the pharynx can be done in one or two operations. The deltopectoral flap has proved successful in both cases, as well with the forming of the new pharynx as with the covering of the big throat defect. The methods of operating with own modification, the results in seven cases, and the advantages of the deltopectoral flap are described.
Osteomyelitis of the frontal bone occurs in an acute and in chronical form. Aetiology and pathogenesis of the chronical form will be described. It is said, that by usage of antibiotics the typical findings and courses have been changed. According to three own cases osteomyelitis appeared in a haematogene metastatic form after a maxillary sinusitis in different intervals. The outcomes are described and compared with literature. The cause is considered being an unsufficient antibiotical treatment of maxillary sinusitis.
A case of isolated nonpenetrating traumatic rupture of the pharynx is reported. The possible explanations of origin and treatment are discussed and compared with similar cases reported in literature.