Biomedical subjects

S Patt

Publications and source records attributed to S Patt.

At least 55 records · Page 3Linked to original sources

PubMed1993

How to run a "brain bank"? Clinical and institutional requirements for "brain banking".

"Brain Banking" or prospective sampling of tissues relevant to the study of neurological disease is a complex task which needs organization at various levels of operation such as the establishment of a donor system, recruitment of clinical assessment centres, establishment of standardized assessment protocols, the inauguration of logistic structures for brain removal and transport to the bank, proper storage of patient data and tissues, histological verification of the disease and availability of tissue and clinical data to researchers. This effort certainly promises to bear fruit since there is a striking lack of precise prospective studies into etiology and pathogenesis in most neurological diseases especially in the field of the neurodegenerative diseases.

Brain↗

PubMed1992

Spinal canal metastases: a late complication of glioblastoma.

The case of a 41 year old woman with a cerebral glioblastoma is reported who developed paraplegia due to a pathologically confirmed spinal metastasis. This and 22 other case histories from the literature suggest that spinal seeding is a rather late complication of cerebral glioblastomas that can be diagnosed on clinical grounds with the help of myelography, CSF cytology and MR imaging.

Adult↗

PubMed1992

Age-related immunoreactivity pattern in medulloblastoma.

Thirty-five paraffin-embedded medulloblastomas (19 from children and 16 from adults; 24 classic medulloblastomas, 10 desmoplastic medulloblastomas, 1 tumor with neuronal differentiation) were examined for reactions with antibodies against glial fibrillary acidic protein (GFAP), cytokeratins KL1 and MNF116, desmin, and vimentin. Only the tumor from the youngest patient, a 152-day-old boy, showed a positive immunoreaction for cytokeratins. Because of this age-related expression of cytokeratins in medulloblastomas primarily in very young children, cytokeratin positivity was interpreted as a sign of tumor immaturity. Five medulloblastomas showed scattered GFAP-positive reactive astrocytes and/or other positive, probably neoplastic, cells. Only two tumors showed GFAP immunoreactivity in unequivocally neoplastic cells. Of six tumors that reacted with vimentin, three showed strong reactivity throughout, one being the tumor from the 152-day-old boy. The remaining three demonstrated nests of vimentin-positive cells with weak or intense somatic immunoreactivity for vimentin. None of the 35 cases showed positivity for desmin; indicating that mesenchymal differentiation is restricted to the rare so-called medullomyoblastomas.

Adolescent↗

PubMed1992

Stereotactic brain biopsy in AIDS.

In the hope of finding a treatable condition, the need for rapid diagnosis in HIV-seropositive patients with brain lesions is apparent. In order to evaluate the efficacy of stereotactic brain biopsy in AIDS patients, we retrospectively studied 25 HIV-infected patients undergoing stereotactic biopsy. Brain lesions were identified with gadolinium-enhanced MRI and/or contrast CT. Brain biopsy was performed using the system of Riechert. From 8 up to 15 small tissue samples from one or two targets were obtained in every patient. The biopsy material was examined cytologically, histologically (including electron microscopy), immunohistochemically and, in part, by animal test and polymerase chain reaction (PCR). A definite diagnosis was achieved in 92%. Diagnosis included primary central nervous system lymphoma (PCNSL) (10), toxoplasmosis (10), progressive multifocal leukoencephalopathy (2) and one case of co-existing toxoplasmosis and cytomegalovirus infection. Two biopsies were non-diagnostic. All PCNSLs showed polymorphic B-cell populations of high malignancy; accurate classification according to the Kiel classification was not possible. In 3 lymphomas Epstein-Barr nuclear antigen (EBNA) 2-mRNA could be detected by PCR and confirmed immunohistochemically by EBNA 2 expression. In 6 cases autopsy confirmed the biopsy diagnosis. Conventional histology was not sufficiently decisive for toxoplasmosis and progressive multifocal leukoencephalopathy, so that immunohistochemistry and animal tests became very important for a final diagnosis. With the help of different morphological and molecular biological techniques stereotactic brain biopsy appears to be an effective method in the diagnosis of HIV-associated brain lesions. In view of the marked radio- and chemosensitivity of PCNSLs it is mandatory to establish an early and accurate histological diagnosis for adequate treatment.

Acquired Immunodeficiency Syndrome↗

PubMed1992

The form and structure of the extruded disc.

There are no detailed data in literature concerning the histologic nature of the sequestered (extruded) lumbar disc, and on the frequency with which an extruded fragment, a prolapse or a protrusion are found at surgery. A prospective analysis of 100 consecutive cases of sequestered lumbar disc herniation submitted to surgical treatment revealed this group to represent 28.6% of all cases operated on for lumbar disc herniation. Patients (both male and female) with sequestered lumbar discs are significantly older than those with prolapsed (P < 0.01) and protruded (P < 0.001) discs. Single extruded fragments (n = 68) were twice as frequent as multiple ones (n = 32). The general belief that a 'sequestered (extruded) disc' is almost invariably composed of nucleus pulposus is not substantiated by this study: In 54 cases the extruded fragment consisted predominantly of nucleus material, whereas in 44 cases it consisted mainly of end-plate material. Multiple as well as recurrent sequestered fragments almost always consist of end-plate material. These findings may reflect the result of metabolic alterations in the course of disc degeneration.

Adult↗

PubMed1992

[Immunohistochemical studies using synaptophysin in intestinal biopsies in Hirschsprung disease].

Rectal biopsies of 5 children with Hirschsprung's disease and biopsies of 41 patients with chronic constipation of other causes, such as neuronal intestinal dysplasia, hypoganglionosis and chronic intestinal pseudo-obstruction (CIPSO), were investigated, using a monoclonal antibody against synaptophysin. Electron microscopy was performed in some cases. Synaptophysin, which stained adrenergic, cholinergic and neuroendocrine structures, as well, consequently, was not a suitable marker for one particular transmitter system. Normo-, hypo- and hyperganglionotic submucous plexuses were reliably stained. Hypertrophic submucosal nerve fibers, characteristic of Hirschsprung's disease, were of poor synaptophysin positivity, whereas acetylcholinesterase-positive mucosal nerve fibers exhibited stronger immunoreactivity. A comparable but regionally varying staining reaction in mucosal nerve fibers was found in CIPSO cases. Mucosal portions of histologically normal biopsies were synaptophysin-negative. Synaptophysin antibodies may support acetylcholinesterase investigation and thus are useful under diagnostic aspects. However, they are practicable neither for better distinction in differential diagnosis of Hirschsprung's disease nor for pathogenetic research.

Acetylcholinesterase↗

PubMed1992

Combined erbB gene overexpression and decreased H-ras gene expression in human gliomas.

The expression of 15 oncogenes including erbB and H-ras in 18 human glial tumors -10 glioblastomas, 1 astrocytoma grade III-IV, 2 oligodendrogliomas grade III, 2 astrocytomas grade II-III, 1 astrocytoma grade II, 1 oligodendroglioma grade II and 1 oligoastrocytoma grade II--was determined by hybridizing RNA against oncogene probes using the Dot Blot technique. Compared with bovine cerebrum (control), the oncogenes abl, erbA, fms, fos, K-ras, mil, mos, myb, rel, sis, src and yes were expressed equally in both bovine cerebrum and the gliomas. However, the expression of erbB was increased 2-9-fold in all except one glioma, and the expression of H-ras was decreased by the factor 0.3-0.7 in 15 tumors. No obvious correlation was found between tumor histology and changed expression of erbB and/or H-ras or between the grade of malignancy and the expression of any oncogene tested. A connection between erbB and H-ras has been shown by several studies. Our results confirm the relationship between H-ras and erbB. However, the meaning of the H-ras decrease in combination with the erbB elevation has to be clarified.

Animals↗

PubMed1991

Tangle-bearing neurons show more extensive dendritic trees than tangle-free neurons in area CA1 of the hippocampus in Alzheimer's disease.

To elucidate the pathogenetic significance of neurofibrillary tangles in Alzheimer's disease, the dendritic tree of tangle-bearing and unaffected pyramidal cells of area CA1 of the hippocampus was morphometrically examined. Golgi-stained neurons were assessed which were deimpregnated and counterstained with Congo red to visualize neurofibrillary tangles. The study revealed that tangle-bearing neurons have more extensive apical dendritic trees than tangle-free neurons. It is concluded that metabolic processes associated with the formation of neurofibrillary tangles may increase neurotrophic activity on a single cell level and counteract the cellular degeneration process.

Aged↗

PubMed1991

Cytokeratin expression in a congenital multipotential primitive neuroectodermal tumor.

A case of an uncommon congenital primitive neuroectodermal cerebellar tumor (PNET) in a 5-month-old child is reported. After subtotal surgical resection, the residual tumor did not respond to radiation and chemotherapy. Histologically, the tumor was composed of small, round, undifferentiated cells and several other patterns like astrocytomatous, oligodendrogliomatous, and ependymomatous structures. Immunostaining was positive for most of the cells for vimentin and S 100, fewer were positive for glial fibrillary acid protein (GFAP) and neuron-specific enolase, and only a few for synaptophysin. Surprisingly, the tumor showed strong expression of several monoclonal cytokeratins (CK) with different molecular weights, together with epithelial membrane antigen. Furthermore, we found a coexpression of the tumor cells for CK and vimentin, while CK-GFAP and CK-S 100 were negative. Ultrastructurally, intracytoplasmic intermediate filaments could be observed corresponding to immunohistochemical CK expression. The very strong CK and vimentin expression in this case was interpreted as a sign of the embryonic nature of the tumor.

Biomarkers, Tumor↗

PubMed1991

Strategy for diagnosis of Toxoplasma gondii in stereotactic brain biopsies.

The colloidal gold method using polyclonal antitoxoplasma antibodies was used to detect Toxoplasma organisms in stereotactic brain biopsies of patients with AIDS. For comparison, conventional histologic staining and additional other immunohistochemical methods were also studied in the same cases. Compared to the other stains, a reliable diagnosis of Toxoplasma gondii could be established with the colloidal gold method in all patients investigated. This method was highly specific and sensitive and stained both the encysted and the tachyzoite forms of the organism. Stronger contrast of the single parasite and better identification is possible if it is applied together with silver enhancement. Conventional staining and immunohistochemical peroxidase techniques are not advantageous, because they allow a diagnosis only by observation of the rare pseudocysts and not by free parasites in tissue, so the colloidal gold method appears to be the preferred method for a rapid diagnosis of cerebral toxoplasmosis, especially in cases where only small amounts of tissue can be obtained.

Acquired Immunodeficiency Syndrome↗

PubMed1991

[Brain biopsies in HIV-infected patients].

Stereotactic brain biopsies of 25 HIV-seropositive patients (age range between 20 and 56 years, 23 males, 2 females) were retrospectively studied. Biopsy material was examined cytologically, histologically, immunohistochemically and electron microscopically. A definitive diagnosis could be established in 23 cases (92%). Diagnosis included non-Hodgkin's lymphoma (10 cases), toxoplasmosis (10 cases), progressive multifocal leukoencephalopathy (PML) (2 cases) and combined toxoplasmosis and lymphoma (1 case). Two biopsies were non-diagnostic. All lymphomas were B-cell lymphomas of high malignancy including one K1-lymphoma. In six cases, in which autopsy was performed, biopsy diagnosis could be confirmed. In one patient suffering from toxoplasmosis, autopsy demonstrated an additional cytomegalovirus infection. Conventional histology was not sufficiently decisive for toxoplasmosis, for some lymphomas and for PML. Stereotactic brain biopsy appears to be an effective method in the diagnosis of HIV-associated brain lesions.

Adult↗

PubMed1991

Pathological changes in dendrites of substantia nigra neurons in Parkinson's disease: a Golgi study.

Neurons of the substantia nigra show severe morphological changes in Parkinson's disease. Pathological alterations of cell bodies have been described, whereas those of neuronal processes have hardly been investigated. Golgi impregnation has been the chosen method for demonstrating neuronal processes and dendritic and somatic spines. We therefore used the Golgi-Braitenberg method to qualitatively and semi-quantitatively study the substantia nigra of eight patients with Parkinson's disease compared with eight control cases. Golgi impregnation of substantia nigra neurons was good in all control cases. In full agreement with the analysis of Braak and Braak (1986) three neuronal types within the substantia nigra were found. In cases of Parkinson's disease, severe pathological changes such as decrease of dendritic length, loss of dendritic spines and several types of dendritic varicosities were found only in the melanin-containing pars compacta neurons. Pars reticulata nerve cells were intact. These findings support the predominant role played by the dopaminergic efferent pathway in the degenerative process. The afferent pathway was not affected. This suggests that the substantia nigra lesion is primary in Parkinson's disease. Loss of neurons found in H & E sections corresponded to a lesser amount of impregnated pars compacta neurons in cases with Parkinson's disease when compared to controls. Evidences exist that the duration of the disease may be related to the extent of pathologically altered Golgi-impregnated pars compacta cells. The amount of Lewy bodies in H & E sections corresponded to the quantity of round varicosities in impregnated pars compacta neurons. These round dendritic varicosities were considered to be Lewy body inclusions.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1991

Experience with the intraoperative frozen section technique for stereotaxic brain tumor biopsies.

The smear preparation technique is usually employed intraoperatively for stereotaxic brain tumor biopsies, whereas the frozen section technique is used in conventional operations, where larger tissue specimens can be obtained. 130 brain tumor biopsies were processed with the frozen section technique and postoperatively submitted to immunohistochemical examination. Subsequent paraffin embedding was not performed. In our study, frozen section diagnosis corresponded in 84% with the immunohistochemistry. Broggi et al. (1984) and Kleihues et al. (1984) demonstrated a similar positive correlation between intraoperative smear preparations and postoperative paraffin embedding. In our investigation, the greatest difficulties arose in cases of suspected lymphoma. Postoperatively, all lymphomas could be immunohistochemically clarified. Due to insufficient material 8% of the cases remained unclarified. Compared to smear preparation, the intraoperative frozen section technique during intervention provided a more accurate assessment of the histology. Furthermore the time needed for the procedure is not much longer than for smear preparation techniques. Reliable antibodies can be used in the remaining frozen material for further differentiation.

Biopsy↗

PubMed1990

[Acute progressive paralysis caused by intraneural ganglion--a neurosurgical emergency].

Intraneural ganglia, particularly of the peroneal and ulnar nerves may produce rapidly progressive paresis after minor trauma, for instance, following a sport injury. The chance of recovery of nerve function depends on the timing of surgical treatment. A patient with a ganglion of the peroneal nerve is reported in order to stress the relevance of intraneural ganglia, the danger of missing the lesion and the importance of early treatment. It is stressed that in the presence of rapidly progressing paralysis and the clinical suspicion of an intraneural ganglion, early decompression offers the best prognosis for recovery.

Adult↗

PubMed1990

Pituitary metastases.

Over the past 12 years we encountered three histologically confirmed pituitary metastases. Primary cancer had been diagnosed and treated previously in only one patient. In the remaining two a transsphenoidal operation provided the initial diagnosis of metastasis, and the primary lesion was subsequently detected at autopsy in one. In two of the three patients symptoms and signs of pituitary dysfunction were the first manifestations of the malignant disease. The main symptoms and signs were impairment of visual acuity, visual field defect, headache, adenohypophyseal insufficency and diabetes insipidus. A sellar mass was demonstrated by CT or MRI in all patients. The tumours were all completely extirpated by subfrontal route in one case and transsphenoidally in the remaining two patients. Following surgery the presenting symptoms improved satisfactorily in all patients.

Adenocarcinoma↗

PubMed1990

A case of dyschondroplasia associated with brain stem glioma: diagnosis by stereotactic biopsy.

We present a 24-year-old patient with multiple chondromas of both hands, the pelvis, the left leg, and an associated brain stem glioma. There was no evidence of hemangioma or dyschromia, and the condition was diagnosed as Ollier's disease, a special type of dyschondroplasia like Maffucci's syndrome and Kast's disease. An increased overall risk for development of malignant skeletal and nonskeletal tumors is associated with Maffucci's syndrome. The risk of malignant degeneration is lower in Ollier's disease. A glioma in the pons and the right lobe of the cerebellum was found in this patient. The literature describes an association with gliomas in only 12 cases of dyschondroplasia and an infratentorial localization in just one case. Signs of malignancy were histologically confirmed in 7 cases without significant preponderance of any one type. Our patient had a low-grade brain stem astrocytoma with fibrillar and gemistocytic components. A stereotactic serial biopsy made it possible to rule out malignant degeneration. Stereotactic brain tumor biopsy as a routine neurosurgical procedure is particularly valuable for deep space-occupying processes and forms the basis for therapy. In the present case, irradiation was not recommended.

Adult↗

PubMed1990

[Intramedullary neurinoma. Case report].

The case of a 36-year-old patient with an intramedullary neurinoma of the thoracic spine without Recklinghausen's disease is presented. The intramedullary neurinoma is a very rare condition. Only 33 cases have been reported in the literature. To our knowledge, the case presented here is the first in German literature. The treatment of choice is tumor removal. The case described here was diagnosed by magnetic resonance imaging (MRI). Histologically, the tumor showed all features characteristic of a neurinoma. Postoperatively, the patient is nearly without complaints.

Adult↗

PubMed1989

The effects of CDP-choline on newborn rat pups with experimental alcohol fetopathy. A Golgi study.

Generally accepted features of alcoholic fetopathy are delayed maturation and retarded dendritic development of neocortex, hippocampus and cerebellum. The present study investigates the effects of a membrane stabilizing agent (CDP-choline) on Purkinje cells of chronically alcohol intoxicated newborn rat pups, employing a Golgi impregnation technique. Both quantitative and qualitative data indicate that CDP-choline modifies the alcohol induced lesion.

Animals↗