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Biomedical subjects

M J Lotz

Publications and source records attributed to M J Lotz.

10 recordsLinked to original sources

Oral cancer in women nonusers of tobacco and alcohol.

A retrospective study of private surgical experience (L.J.T.) in the treatment of primary oral carcinoma was undertaken to compare the demographics, disease history, and clinical behavior patterns in women nonusers versus users of tobacco and alcohol. From a clinical group of 109 patients with oral carcinoma, an unexpectedly high percentage were women (41%, 45/109) and of these women, 31% (14/45) were nonusers of either substance. Differences were found in age (71 vs. 60 years), location of the primary tumor (0% vs. 35% floor of mouth), clinical stage at presentation (early, 80% vs. 50%), histologic parameters, clinical behavior patterns, and occurrence of secondary primaries (0% vs. 26%). The differences identified have prognostic and therapeutic implications.

Age Factors↗

The lymphatic pathology of Brugia pahangi in nude (athymic) and thymic mice C3H/HeN.

The nude (congenitally athymic) mouse, C3H/HeN is highly susceptible to infection with Brugia pahangi (Nematoda: Filarioidea). Normal, hairy mice show a strong thymus-dependent resistance and usually terminate the infection in the larval stages. The present study examined chronological histopathologic changes in the lumbar lymph nodes and adjacent lymphatic vessels of both hosts. In thymic mice, lymphangitis and perilymphangitis reached a maximum 14 to 17 days PI, about the time of disappearance of live worms. The infiltrate showed characteristics of both acute and chronic inflammation: eosinophils, neutrophils, eosinophilic precipitates, and sometimes necrotizing lymphangitis, as well as macrophages and plasma cells. The cellular infiltrate in nude mice was weaker and developed more slowly. Inflammatory responses to identifiable dead worms were seen in both types of hosts but appeared more frequently in thymic mice. Although variable in both models, the granulomas of thymic mice generally showed more tendency to cavitation, greater macrophage or epithelioid cell infiltration, more granulocytes, and appeared to be more destructive than the foreign body responses of nude mice. Whereas lymphangiectasis was generally progressive in nude mice, it was arrested before the end of the third week in thymic mice. In thymic mice, at maximum lumbar lymph node size (17 days), there were large areas of lymphocyte hyperplasia and heavy infiltration of plasma cells. Most nodes returned to normal mean size by the end of the second month. Little or no reactivity was seen in athymic mouse nodes. Our results suggest that some lesions of lymphatic filariasis are potentially thymus-independent: lymphatic fibrosis, lymphangiectasis, accumulations of macrophages and giant cells around disintegrating worms, calcification of worms, intralymphatic thrombosis, and moderate vascular infiltrates including eosinophils.

Animals↗

Systemic mast cell disease.

We present a case of systemic mast cell disease because of its unusual lack of significant manifestations in skin or bone. Clinicians and pathologists alike must be aware of this entity and consider it when atypical round cell infiltrates are present in visceral organs. It should be included in a differential diagnosis with Hodgkin's and non-Hodgkin's lymphomas, leukemias, myeloproliferative disorders, and a variety of nonneoplastic diseases. Cytochemical stains and electron microscopy may be diagnostic.

Aged↗

Role of splenic red pulp in endotoxin-induced disseminated intravascular coagulation.

As an extension of our studies on vascular responses to endotoxemia, we evaluated sequential ultrastructural lesions of splenic red pulp and correlated these lesions with coagulation changes observed in rhesus monkeys following infusion with endotoxin either as a single bolus (10 mg. per kg.) or at a continuous rate of 10 mg. per kg. per hour for periods up to 16 hours. Controls included monkeys infused with Ringer's lactate solution. Progressive reactions of the splenic cords included increased phagocytic activity of macrophages in association with aggregation and degranulation of platelets and prominent fibrinous deposits characteristically abutting basement membranes of endothelial and reticular cells. The sinuses demonstrated endothelial damage, platelet-fibrin microthrombi obstructing interendothelial slits, and severe engorgement with entrapment of erythrocytes by tactoids of fibrin. The thrombotic lesions of the red pulp developed earlier than similar lesions in hepatic sinusoids, and they were accompanied by progressive thrombocytopenia and disseminated intravascular coagulation. The findings suggest that the unique microcirculation of the spleen is an early target and trigger of endotoxin-induced microthrombosis. It is proposed that phagocytosis of endotoxin by splenic phagocytic cells and associated inflammatory events result in disruption of reticular cells and endothelium leading to massive microthrombosis with breakdown of the splenic filter. In addition, rapid activation of coagulation mechanisms in the red pulp as well as liver sinusoids may promote the development of thrombocytopenia and disseminated intravascular coagulation in endotoxic shock.

Animals↗

Pathological staging of 100 consecutive untreated patients with non-Hodgkin's lymphomas: extramedullary sites of disease.

One hundred consecutive untreated cases of non-Hodgkin's lymphomas were reviewed according to Rappaport's classification. There were 49 males and 51 females, almost evenly distributed between nodular (49) and diffuse (51) patterns. Only diffuse lymphomas were seen in patients under age 20 and they were twice as common as nodular lymphomas in patients over 60. Nodular lymphomas were predominantly lymphocytic (61%) or mixed (35%) while diffuse lymphomas were commonly histiocytic (43%). Standardized pathological staging was based upon the serial performance of bone marrow needle biopsy, percutaneous hepatic biopsy, peritoneoscopic hepatic biopsies and exploratory laparotomy. For all patients this sequence terminated with the first positive biopsy. Hepatic involvement was documented in 40 patients by either percutaneous biopsies,18 peritoneoscopic biopsies,9 or wedge biopsy at laparotomy.13 Thirty-seven of 49 patients who underwent laparotomy had biopsy-proven abdominal involvement. Overall incidence of biopsy-proven abdominal disease was 64%. Positive spleens varied widely in weight but all negative spleens weighed less than 270 g. Constancy of histologic type in multiple sites was observed in 90% of cases.

Age Factors↗

Psoas abscess localization by gallium scan in aplastic anemia.

Gallium 67 scanning is an effective method of detecting inflammatory lesions, especially abscesses. A 10-year-old boy with aplastic anemia and severe leukopenia and granulocytopenia had a psoas abscess diagnosed by gallium scan. The patient died with Candida spesis 18 days after bone marrow transplantation. At autopsy, a chronic psoas abscess with Candida was found. The gallium scan offers a clinically effective and noninvasive means of evaluating suspected infection in the granulocytopenic patient.

Abscess↗

Multiple neoplasms in two siblings with a variant form of Fanconi's anemia.

Two siblings with a variant form of Fanconi's anemia developed multiple neoplasms after prolonged survival and treatment with androgens. One of the siblings developed two separate oral squamous cell carcinomata, and the other developed acute leukemia and hepatoma. Androgens may have had a carcinogenic role in the appearance of the hepatic neoplasm. There is an increased incidence of neoplasm associated with Fanconi's anemia. This may be related to frequent spontaneous chromosomal abberations and/or to increased cellular susceptibility to viral transformation.

Acute Disease↗

Thiosulfate-citrate-bile salts-sucrose agar and its selectivity for clinical and marine vibrio organisms.

Recently documented Vibrio cholerae and non-cholera vibrio infections in Florida and other American waters led to a study to determine the selectivity of thiosulfate-citrate-bile salts-sucrose media (TCBS). Thirty-one species with 188 different strains of clinical, marine, and stock origin were examined on the TCBS media. One hundred seventy-seven of the 188 strains grew. Nine species had the typical yellow colony appearance that might be confused with V. cholerae and nine species were green, potentially confused with V. parahemolyticus or V. vulnificus. Old versus new media were compared with mixed results. Consistent with earlier studies, TCBS grew vibrios well with distinctive morphology. However, its limited selectivity needs be more widely appreciated in clinical laboratories. Its widespread use is advocated to detect the vibrio infections associated with seafood ingestion or wounds exposed to seawater.

Agar↗