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Biomedical subjects

P Stoebner

Publications and source records attributed to P Stoebner.

At least 37 records · Page 2Linked to original sources

[Incidence of polyneuropathies in chronic obstructive bronchopneumopathies].

In a prospective study 43 patients with chronic obstructive lung disease and severe respiratory insufficiency were systematically investigated for polyneuropathy, although they had no risk factor of that disease. Electrophysiological recordings showed slight or significant signs of polyneuropathy in 17 and 15 patients respectively, thus indicating that the condition is frequent. Clinically, it was often silent or manifested only by sensory disorders predominant in the lower limbs. Electrophysiology suggested axonal degeneration associated with some degree of demyelinization, and these lesions were found at histology to be present in sensory nerves. Histological examination of the muscles showed peripheral mixed neurogenic atrophy probably due to hypoxia. Major thickening of basal material was observed in capillaries of the endomysium and endoneurium. Statistical analysis of clinical parameters and respiratory function values in relation to the presence and importance of polyneuropathy showed that the only significant difference was the longer duration of hypoxia in patients with nerve involvement. Age, alcoholism and the other respiratory function values did not seem to be correlated with lesions of the peripheral nervous system.

Aged↗

[Neuropathies and chronic respiratory insufficiency: electrophysiologic study].

In order to determine the frequency and the characteristics of neuropathies in chronic respiratory insufficiency, a systematic study of 43 patients affected by a chronic obstructive pulmonary disease was performed. In addition to neurological and electrophysiological examinations (including 6 nerve conduction studies on median, ulnar and peroneal nerves and EMG of 4 to 8 muscles), nerve and muscle biopsies (of the superficial peroneal nerve and lateral peroneus brevis muscle) were performed in 13 cases. Polyneuropathies were found in 74% patients: but mild in 39%, severe in 35%. Most were subclinical or poorly symptomatic. We determined the importance and distribution of abnormalities on the different nerves. From this we established that neuropathies are mixed but predominantly of the axonal type. Axonal degeneration and demyelination were confirmed by nerve biopsy; muscles presented neurogenic atrophy. Statistical analysis showed that the duration of hypoxemia was related to neuropathy. The pathogeny of these neuropathies is discussed.

Adult↗

The density of myelinated fibres is related to the fascicle diameter in human superficial peroneal nerve. Statistical study of 41 normal samples.

The density of myelinated fibres in the superficial peroneal nerve was studied in 41 samples from 24 control human subjects. Photographic montages of the whole nerve fascicle were made from semithin and ultrathin transverse sections and used for a statistical analysis of sampling procedures, range of variations and relations between density and other variables. The results indicate that the spatial distribution of myelinated fibres within a nerve is often non-uniform. Therefore, it was not possible to define a statistically valid sampling system. The study of relations between variables shows the lack of any correlation between density and age and a considerable variation in the density. In contrast, there is a strong positive linear correlation between the surface area of the nerve fascicle and its content of myelinated fibres. That is, the fibre density of a given normal nerve is related to its diameter and can be predicted within a narrow range of error. We propose the term "derived density" for this value, and its application as a tool in the diagnosis of peripheral neuropathies is now being studied.

Adolescent↗

[Muscular ultrasonic diagnosis. Etiological approach to various backaches].

Certain cases of mechanical back pain present unusual clinical and ultrasonographic features involving the posterior lumbar muscle groups, which can be used to distinguish various types. The clinical examination may isolate a juxta-vertebral territory in which pressure triggers or exacerbates the back pain; anaesthesia of this territory is accompanied by pain relief. Ultrasonography may reveal a hypoechogenic area in this muscle territory in which histomorphometric and ultrastructural studies, performed in three cases, revealed endomysial and perimysial adiposis associated with atrophy probably due to peripheral neuropathy.

Adipose Tissue↗

[Xanthoastrocytoma inf young subjects. Review of the literature apropos of 2 cases with discordant courses].

Two cases of pleomorphic xanthoastrocytoma (P X A) of young subjects (Kepes et al., 1979) are reported. Case 1 arose in 15-year-old boy admitted to the hospital with the complaint of severe headaches associated with nausea and vomiting of 1 month's duration. Computed tomographic scans showed a large well-defined low density area in the left temporo-parietal region of which an anterior portion was enhanced by contrast medium. Craniotomy revealed a large superficial and cystic tumor with a mural nodule. Histological and immunohistochemical features were those of a P X A confirmed by an electron microscopic study. No radiotherapy was given. The patient made a complete recovery, and 32 months later was asymptomatic. Case 2, a 17-year-old boy was admitted to the hospital in 1977. He presented with seizures that started 18 months prior to surgery. Carotid and humeral angiograms and air studies indicated the presence of a right, internal temporal mass with herniation. The craniotomy revealed a firm superficial tumor with an infratentorial, extraparenchymal extension. The histological diagnosis was giant cell glioblastoma or gliosarcoma. The patient received post-operative radiation of 5.500 rads and chemotherapy (CCNU and VM 26). He died on the 7th post-operative month. In this 2nd case, the diagnosis of P X A was made retrospectively based upon histological and immunohistochemical observations similar to case 1. We are aware of 24 P X A in the literature. In their clinical and histological features these neoplasms resemble closely each other. P X A are superficial, supratentorial astrocytomas occurring in youngs subjects (ages 3 to 32). Their typical microscopic structure include a marked cellular pleomorphism with bizarre giant cells, some mitotic figures and no necrosis. Many cells contain lipid and hyalin droplets in their cytoplasm. Characteristically, the tumoral stroma contain a very rich reticulin fiber network. Immunoperoxidase technique reveal glial fibrillary acidic protein in the tumor cells. Electron microscopic studies demonstrate abundant intracytoplasmic glial filaments. Individual cells or group of cells are surrounded by a prominent basal lamina. Some hemidesmosomes or primitive attachments are seen at the margins of the tumor cells. The biological behaviour of PXA with or without radiotherapy is relatively favorable. Long survival times (up to 25 years) are reported but in 5 cases, P X A follow a less favorable course with malignant transformation and death. Morphologic and immunohistochemical studies support the subpial astrocytic origin of P X A.

Adolescent↗

[Association of cryoglobulins and hepatic disease: incidence, nature and immunochemical characteristics of cryoglobulinemia].

Mixed cryoglobulinemia associated with liver disease is well known, but its mechanism and signification still have to be elucidated. The purpose of this study was to identify and to characterize hepatic disease by their immunochemical features among 60 patients presenting with mixed cryoglobulinemia. Thirteen cases of alcoholic liver disease and 8 of virus B hepatitis out of 40 cases in all of hepatic disease in this group were studied. A higher frequency of type III immunochemical features of cryoglobulinemia in alcoholic disease (83 p. 100), no matter how severe, as well as a higher frequency of type II in virus B hepatitis (62 p. 100) was demonstrated. There was no relationship between virus B hepatitis and cryoglobulinemia in our population. Therefore, the responsibility of virus B hepatitis in essential mixed cryoglobulinemia genesis has to be clarified. The localization of cryoglobulin in the Kupffer cell in two patients with chronic hepatitis confirms the essential role of the reticuloendothelial system in blood clearance of circulating immune complexes.

Adult↗

Effect of chrysotile and crocidolite on the morphology and growth of rat pleural mesothelial cells.

The effects of the UICC asbestos fibers chrysotile A and crocidolite on the morphology and growth of rat pleural mesothelial cells were examined. The response was different according to the fiber used. Within 4 hr of treatment with 5, 10, 20, or 50 micrograms/ml of chrysotile fibers, cell morphology showed intense vacuolization, in both logarithmic and confluent cells. Following treatment of growing cells with 20 or 50 micrograms/ml of chrysotile fibers, cell spreading was also observed. Four hours after treatment of cells with 5, 10, or 20 micrograms/ml of crocidolite fibers, no such changes were seen. Vacuolization appeared later and was much less marked than for chrysotile fibers. The mesothelial cell population-doubling time of about 30 hr was not significantly altered by addition of 5 to 20 micrograms/ml of crocidolite fibers, but a concentration of 50 micrograms/ml lengthened doubling time to about 90 hr. Treatment with 5 or 10 micrograms/ml chrysotile fibers usually prolonged this time, but 20 or 50 micrograms/ml caused cell lysis. After 48 hr of incubation with both types of fiber, the proportion of mitosis was the same as in control cultures, whatever the fiber concentration, and asbestos fibers were often seen inside dividing cells.

Animals↗

[Muscles and nerves in rheumatoid arthritis].

The authors report the results of a systematic study of 37 hospitalized cases of rheumatoid arthritis. The neurological and muscular clinical signs are usually discrete. Electrophysiological examination is the basis for a classification in terms of the extent and the intensity of the neuropathy. Clinical and laboratory correlations are established permitting the individualization of a group of patients with severe neuropathy. The histological, morphometric and ultrastructural examination of 12 muscle and nerve biopsies reveal the high incidence of these lesions and the constancy of capillary involvement.

Adult↗

Buschke-Ollendorf syndrome. An electron microscopic study.

Two identical twins with the Buschke-Ollendorf syndrome (dermatofibrosis lenticularis disseminata with osteopoikilosis) are described. Ultrastructurally elastic fibers show clumps of electron-lucent elastin material coated with fine fibrils. The fibroblasts show enlarged endoplasmic reticulum containing abnormal fibrillar material. Juvenile elastoma seems to be a better term than dermatofibrosis. The pathogenesis of the elastic defect is discussed.

Child↗

Ultrastructural diagnosis of pleural tumors.

The significant association of two kind of mesothelial cells, differentiated and fibroblastoid, caracterises the ultrastructure of malignant pleural mesotheliomas. The differentiated mesothelial cancer cells (MCC's), whether they are observed in fluids or in biopsies, are not caracteristic enough to assert the diagnosis of mesothelioma. They can easily be mistaken for metastatic cells. Therefore, the diagnosis of mesothelioma relies on the identification of fibroblastoid MCC's, whether they are in association with the preceeding form in epithelial-like tumors, or the main component in sarcomatous-like tumors. Since the absence of fibroblastoid MCC's would eliminate the diagnosis of mesothelioma, patient and careful search for these cells must be done in all pleural tumors with a unique differentiation (epithelial-like or sarcomatouslike). This justifies the need for electron microscopy in the diagnosis of these pleural tumors: for this reason, pleural biopsies should routinely be embedded for possible future ultrastructural examination.

Cytoskeleton↗

Idiopathic pulmonary hemorrhage. Ultrastructural and mineralogic study.

A nine-year-old girl was hospitalized because of hypoxemia and anemia. Antibasement-membrane antibodies were present in the serum, but there was no renal involvement suggestive of Goodpasture's glomerulonephritis. Biopsy of the lung showed pulmonary hemosiderosis. In ultrastructural analysis, no lesion of the alveolar basement membrane or capillary endothelial cells was found; however, ferritin-looking deposits were present on alveolar basement membranes and the elastic lamina of arterioles and venules. Mineralogic studies showed these deposits to be made of iron and calcium (this latter element was probably precipitated on altered basement membranes or elastic lamina). Hemosiderin inclusions in the macrophages contained iron but no detectable calcium.

Basement Membrane↗