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S Hailemariam

Publications and source records attributed to S Hailemariam.

At least 37 records · Page 2Linked to original sources
PubMed1999

Cell proliferation, apoptosis, oncogene, and tumor suppressor gene status in adenosis with comparison to benign prostatic hyperplasia, prostatic intraepithelial neoplasia, and cancer.

There is scant information on the cell proliferation, apoptosis, oncogenes, and tumor suppressor genes status in adenosis. Forty-eight foci of adenosis were studied with immunohistochemistry for MIB-1; c-erbB-2, c-erbB-3, bcl-2 oncogenes; and p53. To evaluate apoptosis, the TdT dUTP nick end labeling (TUNEL) method was applied. Results were compared with the same studies on benign prostatic hyperplasia (BPH) (n = 20), low-grade prostatic intraepithelial neoplasia (PIN) (n = 10); high-grade PIN (n = 20), Gleason sum 2 to 6 cancer (n = 16); and Gleason sum 7 to 10 cancer (n = 22). MIB-1 proliferation index was lowest in BPH, followed by adenosis, low-grade prostatic intraepithelial neoplasia (PIN), low-grade cancer, high-grade PIN, and high-grade cancer. The apoptotic rate was generally low in all groups, although it was higher in PIN and cancer. In BPH and adenosis, bcl-2 was absent in luminal cells. In low- and high-grade PIN, both basal and luminal cells expressed bcl-2, whereas in cancer, expression was found in only 1 case (3%). C-erbB-2 showed absent or low values for cancer and adenosis, whereas it was commonly expressed in BPH and low- and high-grade PIN. Low expression in adenosis was also found with c-erbB-3 (6%) compared with all other groups. Expression of p53 was confined to cancer. Despite a significantly higher proliferation index rate compared with BPH, adenosis showed a markedly lower proliferating index when compared with low-grade PIN, high-grade PIN, and cancer. Expression of the oncogenes c-erbB-2 and cerbB-3 was very low in adenosis, and the staining pattern for bcl-2 was similar to that of BPH. These results provide additional evidence to that of prior studies that adenosis is a histological small acinar proliferation more akin to BPH than high-grade PIN or adenocarcinoma.

Adenocarcinoma↗
PubMed1998

[Glomerulopathy in Denys-Drash syndrome. Case report of a model disease].

About 10% of all nephroblastomas (Wilms' tumor) present as part of malformation syndromes. The Denys-Drash syndrome (DDS) comprises pseudohermaphroditism, glomerulopathy and, early, often bilateral Wilms' tumors. A nephrectomy was performed in a 4-month-old girl because of a Wilms' tumor. Two months later, low serum albumin levels and proteinuria had developed. A biopsy from the remaining kidney showed a glomerulopathy which could also be seen in the nephrectomy specimen. The morphology was highly characteristic: the innermost layer of the kidney cortex exhibited augmentation of the mesangial matrix only; the intermediate layer showed severe sclerosis of glomeruli with deposition of fibrillary material; and the subcapsular layer revealed very small glomeruli and atrophic tubuli. Fifteen months later, peritoneal dialysis was necessary and due to the high risk of tumor development in the remaining kidney, a nephrectomy was performed. Molecular analysis revealed a point mutation within exon 9 of the WT1 gene (394 ARG-->TRP), which was homozygous in the tumor and heterozygous within renal parenchyma. The DDS is caused by a mutation in the WT1 gene on chromosome 11p13 which occurs during oogenesis or spermiogenesis. The WT1 gene is highly expressed during the development of the genitalia and the kidney; damage in one allele only causes the malformation syndrome. Loss of the second allele of the WT1 gene constitutes the second step of tumorigenesis. The appearance of Wilms' tumors derived from cells homozygous for the mutation reveals the function of the WT1 gene as a tumor suppressor gene.

Chromosomes, Human, Pair 11↗
PubMed1998

Infrainguinal aneurysm formation in arterialized autologous saphenous vein grafts.

True aneurysm formation in arterialized autologous veins is an unusual complication. We studied a patient with 2 aneurysms occurring in the mid and distal portion of an in situ femoropopliteal bypass. The first aneurysm led to graft occlusion 4 years after the primary intervention, requiring replacement of the ectatic graft segment. The graft was still patent when the patient was examined 7 years after the primary intervention and 3 years after the first aneurysm. In the mid portion of the graft, a true aneurysm measuring 5 by 8 cm had developed. The aneurysm was replaced by a reversed segment of the contralateral greater saphenous vein. Recovery was uneventful. Advanced atherosclerotic changes with extensive intimal fibroplasia, subendothelial cholesterol deposits, and ulcerations were revealed by means of histopathology of the aneurysm wall. Atherosclerosis is considered to be the main cause of aneurysm formation in vein grafts, but a review of the literature suggests the additional etiopathogenic factors should be further investigated.

Aneurysm↗
PubMed1998

Primary erectile dysfunction in combination with congenital malformation of the cavernous bodies.

Primary erectile dysfunction in combination with congenital malformation of the cavernous bodies has only rarely been reported. We report on 2 young patients with different congenital malformations. To our knowledge this is the first time partial aplasia of the distal part of the cavernous bodies is described, whilst complete isolation of the cavernous bodies in combination with veno-occlusive dysfunction has yet been described in 3 cases. After complete examination, including penile angiography and cavernosometry, a surgical correction with a fully satisfying result was achieved in the patient with distal aplasia. In case of isolated cavernous bodies with severe veno-occlusive dysfunction, the implantation of a penile prosthesis remains the treatment of choice.

Adult↗
PubMed1998

Bronchial manifestation of acute febrile neutrophilic dermatosis (Sweet's syndrome).

We describe a 62 yr old female with acute febrile neutrophilic dermatosis (AFND) or Sweet's syndrome, involving the bronchial mucosa. The patient presented with classical skin manifestations of AFND accompanied by bilateral pneumonia, pleural effusions and lesions of the oral mucosa. The diagnosis was confirmed by skin and mucosal biopsies. Bronchoscopy revealed raised pustules, similar to the lesions of the skin, suggesting bronchial involvement of AFND. The patient responded to systemic corticosteroids only for a short period and died as a result of multiorgan failure. Postmortem findings confirmed dense, focal neutrophilic infiltrates of the bronchi and bronchioles. No underlying disease was found.

Bronchial Diseases↗
PubMed1998

Primary, pure, large-cell neuroendocrine carcinoma of the urinary bladder.

We report what to our knowledge is the first case in the English-language literature of a primary, pure, undifferentiated large-cell neuroendocrine carcinoma of the urinary bladder. To date, only one case of a large-cell neuroendocrine carcinoma was reported, and it was associated with an adenocarcinoma most likely of urachal origin. On the other hand, slightly more than 100 cases of undifferentiated small-cell carcinoma of the urinary bladder were reported, approximately one-half of which were associated with poorly differentiated transitional-cell carcinoma of the conventional type. The patient in our case was a 73-year-old man with a history of prostatic cancer treated with radiation therapy. He presented with hematuria, leading to the discovery of a solitary tumor on the dorsal wall of the urinary bladder. A diagnosis of large-cell neuroendocrine carcinoma was made, supported by immunohistochemical reactivity for chromogranin, neuron-specific enolase, and synaptophysin; a variety of other hormonal markers of neuroendocrine tumors were negative. The radical cystoprostatectomy and bilateral pelvic lymphadenectomy specimen showed a transmurally invasive tumor, without regional lymph node metastases. The patient died 2 months after surgery, and the autopsy revealed disseminated metastases histologically identical to the urinary bladder neoplasm. Awareness of the occurrence of large-cell neuroendocrine carcinoma of the urinary bladder seems to be important because of the possible aggressive outcome associated with this tumor and because of differential diagnostic considerations, which include malignant lymphoma and metastasis from another primary, especially in tumors occurring in a pure form.

Aged↗
PubMed1997

Primary mediastinal germ cell tumor with intratubular germ cell neoplasia of the testis--further support for germ cell origin of these tumors: a case report.

BACKGROUND: The histogenesis of extragonadal germ cell tumors remains an enigma. The majority of patients with retroperitoneal tumors are male, and careful histologic evaluation reveals preinvasive intratubular germ cell neoplasia (ITGCN) or scars in the testis suggesting a so-called "burnt out" germ cell tumor. However, in the testes of patients with primary mediastinal germ cell tumors, no ITGCN has been described in the literature to date. The authors report the first case of simultaneous germ cell neoplasia in the mediastinum and the testis, providing further insights into the biology and origin of these lesions. METHODS: The authors report the pathologic features and cytogenetic findings in an adult male with a mediastinal germ cell tumor and asymmetric testis. This patient died shortly after diagnosis. RESULTS: A locally invasive mediastinal nonseminomatous germ cell tumor was associated with ITGCN in one testis. Metastases were not present clinically or on autopsy during a detailed and systematic examination of retroperitoneal lymph nodes and other viscera. Neither an invasive germ cell tumor nor a scar was found in either testis (both testes were serially sectioned and entirely examined histologically). CONCLUSIONS: The findings of this study suggest that the mediastinal tumor is a primary neoplasm with concomitant in situ lesion in one testis, suggesting a more generalized defect of germ cell and thus providing new information about the unresolved issue of the histogenesis of extragonadal germ cell tumors. This article presents a review of the literature concerning the issues highlighted by this case and discusses the hypotheses regarding the development of extragonadal germ cell tumors.

Adult↗
PubMed1997

Structural basis of geriatric voiding dysfunction. V. Standardized protocols for routine ultrastructural study and diagnosis of endoscopic detrusor biopsies.

PURPOSE: Previous ultrastructural and clinical studies have established criteria for distinctive ultrastructural patterns in the normal, overactive, hypocontractile and obstructed detrusor of the elderly. This study was conducted to standardize procedures of detrusor biopsy processing, identify and address pitfalls and difficulties in applying the criteria to routine evaluation of biopsies in the surgical pathology laboratory, verify reproducibility of ultrastructural observations and diagnosis in biopsies from different sites in the bladder wall, and develop a standard approach to routine ultrastructural evaluation of the biopsy. MATERIALS AND METHODS: Blinded to clinical information, 25 randomly selected detrusor biopsies were evaluated by a pathologist with prior knowledge of electron microscopy but none of detrusor ultrastructure. The observations and diagnoses made were subsequently correlated with urodynamic bladder behavior evaluated comprehensively before biopsy. Biopsies from different sites of 4 detrusors and specimen samples of multiple sites from a bladder obtained at autopsy were also blindly assessed to determine the reproducibility of single site biopsies. RESULTS: Essential parameters of all criteria were verified. Potential pitfalls and sources of difficulty in some were identified and corrected to refine the criteria. Diagnoses were reproducible in all 5 detrusors with multiple site biopsies. Detailed protocols for electron microscopic study and diagnosis of dysfunctional detrusor biopsies were generated. CONCLUSIONS: The protocols eliminate problems that may be encountered in ultrastructural evaluation of biopsies from dysfunctional detrusors, and have been applied readily and successfully in our subsequent studies. Uniformity of structural organization of detrusor allows valid application of the protocols and study criteria to small biopsies obtained from different sites in the bladder wall.

Aged↗
PubMed1997

Structural basis of geriatric voiding dysfunction. VI. Validation and update of diagnostic criteria in 71 detrusor biopsies.

PURPOSE: Refined criteria of distinctive patterns of detrusor ultrastructure in geriatric voiding dysfunctions have been developed as standard protocols for pathological evaluation of detrusor biopsies. This study was performed to test completeness and routine applicability of these protocols, corroborate our original ultrastructural/urodynamic correlations in larger material and identify subtle correlations that may have been elusive in our original study of 35 cases. MATERIALS AND METHODS: A total of 71 endoscopic detrusor biopsies was obtained from 44 elderly subjects grouped following comprehensive clinical and urodynamic evaluation into those with normal aging bladder, detrusor overactivity, impaired detrusor contractility, bladder outlet obstruction or a combination. Biopsies were evaluated ultrastructurally and randomly, and blinded to clinical information. Using standard protocols the primary ultrastructural pattern(s) was identified, additional auxiliary features were recorded and pathological diagnoses were made. Biopsies were grouped accordingly, still blindly, and correlated with urodynamic groups determined independently prior to biopsy. RESULTS: Our observations confirmed that the standard protocols are complete and readily applicable to routine ultrastructural evaluation of detrusor biopsies. They corroborated our previously reported ultrastructural/urodynamic matching of the biopsies in every case and revealed new constant features of the normally aging detrusor. We identified ultrastructural correlates distinguishing moderate and severe from mild or borderline (but not moderate from severe) impairment of detrusor contractility. CONCLUSIONS: The proposed protocols are consistently applicable to the routine pathological diagnosis of geriatric voiding dysfunction in detrusor biopsies. A diagnostic algorithm was developed to serve as a practical guide for making such diagnoses, and gaining insights into the pathophysiology of geriatric and possibly other voiding dysfunctions.

Aged↗
PubMed1997

Structural basis of geriatric voiding dysfunction. VII. Prospective ultrastructural/urodynamic evaluation of its natural evolution.

PURPOSE: In cross-sectional studies ultrastructure of geriatric detrusors consistently correlates with their urodynamic behavior. This study was conducted to determine whether the ultrastructural observations were stable with time, changed in concert with urodynamic change and predicted or preceded such change. MATERIALS AND METHODS: Twenty-three elderly subjects underwent clinical and urodynamic evaluation plus endoscopic detrusor biopsy with ultrastructural study. The subjects were grouped according to urodynamic status. All were followed for up to 67 months and the same studies were repeated once in 19 (mean followup 27 months) and twice in 4 (mean followup 42 months) subjects. Biopsies (50) were classified according to their distinctive ultrastructural patterns without knowledge of clinical and urodynamic information. After all cases were studied, ultrastructural and urodynamic observations were correlated. RESULTS: Ultrastructural and urodynamic diagnoses matched in all 23 cases at baseline. After 1 followup period both diagnoses were unchanged in 16 (70%) and both changed concordantly in 7 (30%), as expressed by progression of ultrastructural features with new development or increased severity of the associated dysfunction. Auxiliary ultrastructural features underwent some change as well. One of 4 subjects with 2 followup studies had the same ultrastructural and urodynamic diagnoses, while in the other 3 complete dysjunction pattern developed with detrusor overactivity after the first followup and both remained unchanged after the second study. CONCLUSIONS: Ultrastructure of the detrusor corresponds perfectly to its urodynamic behavior with time whether the latter remains stable or changes. Although we cannot as yet determine the temporal sequence of changes in detrusor ultrastructure and function, the change in the former is clearly not a mere result of long-standing change in the latter. Auxiliary ultrastructural features may represent transitional changes that precede development of the ultrastructural patterns and the corresponding urodynamic abnormalities.

Aged↗
PubMed1996

Spondylodiscitis caused by Tropheryma whippelii.

We describe the first case of spondylodiscitis caused by Tropheryma whippelii in which this so far unculturable organism was shown to be present at the site of infection in a patient without significant gastrointestinal symptoms. The methods used included broad-range PCR amplification with universal primers complementary to constant sequences of the gene coding for 16S rRNA, direct sequencing of the amplified fragment, and comparison of the sequence determined with those deposited in sequence databases. In addition to demonstrating the presence of this organism in the affected vertebral body, we found in our patient that the specific PCR is more sensitive than histology for detecting Whipple's bacilli in bowel biopsy specimens. Because histology of small bowel biopsies from the duodenum were-in contrast to PCR from the same site-not diagnostic for Whipple's disease in our patient, we recommend PCR whenever Whipple's disease has to be excluded.

Actinobacteria↗
PubMed1996

[Pathologic-anatomic examination of prostatovesiculectomy samples in prostate carcinoma].

The incidence of the prostatic carcinoma as well as the cases treatable by radical prostatovesiculectomy with curative intention is increasing. The exact pathological examination of the specimens defines the stage of disease and subsequently the prognosis and therapeutic consequences. The compatibility of different scientific studies is made difficult by the lack of a standard in the pathological examination of the specimens. Our exactly defined rational method helps eliminate these troubles and ameliorate the interdisciplinary dialogue.

Cystectomy↗
PubMed1996

[Unusual crystalline inclusions in plasmacytoma cells of the testis in primary medullary plasmacytoma].

At the autopsy of a 68 year old man with plasmacytoma of the lambda light chain type we found polygonal interstitial cells with unusual crystalline inclusions, which were not readily identifiable and slightly resembled Leydig cells in conventional microscopy. In electron microscopy these could be identified as plasmacytoma cells, representing a testicular involvement. Comparable cells could be shown in the bone marrow. In immunochemistry we found a polyclonal reaction for lambda light chains suggesting a similar phenomenon as the so-called Russell bodies. As far as we know the literature, this finding in a testicular metastasis has not been described.

Aged↗
PubMed1992

Intestinal infarction after nonabdominal trauma; association with cerebral trauma.

Nonocclusive bowel infarction in nonabdominal trauma has been ascribed to periods of hypotension. However, to our knowledge only 17 cases have been reported, and hypotension was not always found. We studied the frequency and possible causes of intestinal infarction in all patients treated at our traumatologic intensive care unit from 1977 through 1986 (n = 2350). Intestinal infarction was diagnosed at the time of surgery or autopsy; patients with pre-existing vascular disease were excluded. We found 12 patients (incidence: 0.5%) of age 45 +/- 20 years (mean +/- SD). All had severe cerebral trauma [Head and Neck Abbreviated Injury Scale (AIS) score: 4-5, admission Glasgow Coma Scale (GCS) score: 6.5 +/- 3.8]. Eight patients suffered from additional injuries. The Injury Severity Score (ISS) was 27 +/- 7. All patients received ventilator assistance continuously before the diagnosis of intestinal infarction or death. The leading symptom of intestinal infarction was sepsis and multiple organ failure with abdominal distention. Five patients with favorable cerebral prognosis underwent surgery: one survived with good cerebral and gastrointestinal recovery. Four patients did not have surgery because of a poor cerebral prognosis. Three patients died of their cerebral trauma before intestinal infarction was clinically manifested. The data show that early diagnosis in ventilated patients with head injuries is extremely difficult because of the heterogenicity of this group of patients, the low frequency of the complication, and the complexity of the clinical picture. Although patients inevitably were exposed to several agents or situations associated with intestinal infarction, the ubiquitous causes were dehydration and diuretic therapy.

Adolescent↗