Biomedical subjects
Publications and source records attributed to M Aschwanden.
Multiple glomus tumours represent a special variant of glomangiomatosis. Based on our observation, the clinical features, diagnosis and differential diagnosis are presented and possible therapeutic approaches are discussed.
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A 49-year-old woman from Croatia, resident in Switzerland for 22 years, had a history of headaches and arterial hypertension for 8 years. While in hospital for assessment and treatment she developed focal seizures. She had an eosinophilia (10%) and computed tomography of the skull demonstrated cysts and multiple calcified foci in the left cerebral hemisphere. Antibodies against Taenia solium antigen were found in both serum and cerebrospinal fluid. Anthelminthic treatment with albendazole (15 mg/kg daily for 25 days) and anticonvulsive treatment with phenytoin (serum levels between 10 and 20 mg/l) markedly improved the symptoms and the cysts regressed. Neurocysticercosis, caused by the larvae of the pork tapeworm, is occurring even more frequently because of the migration of people from countries where the disease is endemic.
A case of a 61-year-old women 15 years after right-sided renal transplantation is discussed. She suffered from rest pain in her right leg. Examinations revealed an occlusion of the right common iliac artery without signs of renal dysfunction or severe hypertension. After performing a extraanatomic femoro-femoral crossover bypass the patient had improved leg perfusion without a change in renal function.
We found spiral bacteria (non-Helicobacter pylori, SB) in gastric biopsies of 5 patients corresponding to an incidence of 0.3%. The bacteria were found on the surface of the gastric mucosa and in part tightly packed within the crypts. Contrary to Helicobacter pylori, most of them had no direct contact to the surface and crypt epithelium. They are distinctly coiled, 3.6-5.5 microns in length and on average 0.5 microns thick. Ultrastructural studies revealed sheathed flagella at each pole. In one case the bacteria displayed periplasmic fibrils in pairs as also described in cultures of SB from cats' stomachs. In all 5 cases there was histological evidence of inflammation of the gastric mucosa, i.e. one acute diffuse gastritis, one case of granulomatous and three of slight to medium grade chronic gastritis. Biopsies of 2 patients showed a positive urease reaction in the CLO test. Morphologically very similar SB occur as commensals in the stomachs of various animals, in particular dogs and cats. We investigated the stomachs of four dogs and four cats and found all to be infested with SB. The bacteria were found not only on the surface of the mucosa and in crypts, but within the glands of the corpus and antrum and often also within parietal (oxyntic) cells. Yet despite bacterial colonization there was no evidence of gastritis in dogs. However, all of the cats' stomachs showed slight to medium grade chronic gastritis. Cultivation of SB has not been successful so far, with the exception of cats' stomachs. Since the germs have been defined only morphologically, the question as to how close the relationship is among SB of various origins must for the time being remain unanswered. Furthermore, species-specific pathogenicity and the possibility of contagion from animal to man has not yet been clarified.
In a 40-year-old man who collapsed after sporting activity and died shortly after in spite of surgery, autopsy revealed a small ruptured dissecting aneurysm of the left common iliac artery. At the site of rupture, in the aorta and in multiple visceral arteries extensive mucoid degeneration of the media was found. Additional findings (bone deformities, bullous emphysema of the apices of both lungs, and familial affliction) made it possible to establish the diagnosis of an oligosymptomatic form of Marfan syndrome.
A case of a 73-year-old man is discussed who underwent an operation due to a suspected rupture of an aneurysm of the abdominal aorta. A ruptured fist-sized aneurysm of an artery of the greater omentum was found. A dilated arterial segment was linked by a normally sized segment to the aneurysm. Fibromuscular dysplasia is considered to be the base of these vascular changes. In addition there is a light fibromuscular dysplasia of the splenic artery.