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Biomedical subjects

M Ruwe

Publications and source records attributed to M Ruwe.

4 recordsLinked to original sources

[Paraffinoma--a rare complication following endonasal surgery].

BACKGROUND: Paraffin is a mineral oil which was discovered by Reichenbach in 1830. Injection of paraffin into tissue causes a foreign body reaction that results in the formation of a paraffinoma. METHODS: We are reporting on two cases of paranasal paraffinomas, in a 30-year-old male three months after a septorhinoplasty in which paraffin nasal packing was used and in a 56-year-old female patient two months after sinus surgery. RESULTS: A paraffinoma is probably caused by penetration of paraffin through a mucous membrane defect into the adjacent soft tissue. Paraffinomas are usually treated by excision. Although recurrences are frequent, a complete removal should be attempted because of the potential carcinogenicity of paraffin. CONCLUSION: Paraffinomas must be considered in the differential diagnosis of periorbital or paranasal swellings that occur months after endonasal procedures where paraffin packing was used.

Adult↗

[Endometriosis: clinical, histological and morphometric findings before and after Gn-RH agonist therapy].

After bioptical diagnosis of endometriosis, 81 patients were treated with GnRH-agonists buserelin or leuprolide for six months. Biopsies before and after treatment were used to test a semiquantitative score-system, regarding atrophy of glands and stroma cells. Furthermore glandular diameter, circumference and area of nuclei were examined morphometrically using a microscopic semiautomatical measuring system. Morphometrical and histological alterations during therapy were evaluated. Additionally, data suitable for predicting a possible therapeutic success were described. After therapy 40 patients still showed endometriotic implants (partial responder) in contrast to 41 cases without foci (total responder). Therapeutic effect of GnRH-agonists was proved in every respect: clinical complaints decreased markedly during GnRH-agonists therapy. Both buserelin and leuprolide treated groups revealed increase of atrophy and reduction of extension of stroma. Correspondingly morphometrical analysed parameters such as diameter, circumference and area of glands decreased during therapy as well as area of cytoplasm and nuclei. Except the diameter of glands, the leuprolide treated partial responder group (residual foci after GnRH-therapy) revealed a stronger therapeutic effect than the buserelin treated partial responder group. Obviously this effect seems to be produced by the stronger estradiol suppression of leuprolide. Pretherapeutic comparison of measured values pointed out a minor distinct endometriosis in the total responder group. Success or failure of therapy seems to depend more on the pretherapeutic degree of expression of endometriosis. Obviously the kind of applicated GnRH-agonist plays a minor distinct role. Morphometrical data of endometriotic foci appear to be appropriate to predict a possible therapeutic success of GnRH-agonist therapy. But because of many exceptions only a roughly estimated prediction is possible.

Adult↗

Multiple myeloma with bone marrow biopsy features simulating concomitant chronic idiopathic myelofibrosis.

Multiple myelomas occasionally exhibit bone marrow lesions simulating a concomitant chronic idiopathic myelofibrosis. In the present study, trephine biopsy histologies of such "myelofibrotic" myelomas are described and compared to those from a case of true chronic idiopathic myelofibrosis which developed in the course of chronic lymphocytic leukaemia. "Myelofibrotic" myeloma are characterized by osteosclerosis, marrow fibrosis and focal megakaryocytic hyperplasia in the presence of plasma cell infiltration of the bone marrow. These myelomas are to be distinguished from the more commonly occurring multiple myeloma with simple marrow fibrosis and/or osteosclerosis. Furthermore, "myelofibrotic" myelomas are not identical to myelomas coexisting with true chronic idiopathic myelofibrosis, a condition which would appear to be extremely rare and should only be diagnosed if focal megakaryocytic hyperplasia with atypia can be unequivocally demonstrated. Avoidance of misinterpretation of "myelofibrotic" myeloma requires a knowledge of these different myeloma variants.

Adult↗

Developing a successful senior care program: a research based approach.

Shifting environmental pressures have moved healthcare organizations to look to new products and services as a means of survival. One new product offering that has developed in many hospitals is the senior care program. Unfortunately, many of the senior care programs developed across the nation have not been successful. The authors have described a senior care program that is research based and physician centered. The benefits of which include physician loyalty to the hospital, a managed referral network and the ability to measure the impact of the senior care program on the bottom line.

Aged↗