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T Rott

Publications and source records attributed to T Rott.

At least 19 recordsLinked to original sources
PubMed2003

Amniotic fluid embolism with involvement of the brain, lungs, adrenal glands, and heart.

The case of a healthy 31-year-old woman in the 40th week of second pregnancy is presented. During preparation for an emergency caesarean section, she developed an amniotic fluid embolism (AFE) with unusual and unique features. The acute onset of disease with cardiorespiratory failure with hypotension, tachycardia, cyanosis, respiratory disturbances and loss of consciousness, suggested at first a pulmonary thromboembolism, but the appearance of convulsions led to the diagnosis of AFE. The patient died after 5 days due to an untreatable brain edema. At autopsy, AFE with the usually associated disseminated intravascular coagulation was found in the lungs, brain, left adrenal gland, kidneys, liver and heart. Eosinophilic inflammatory infiltrates were found in the lungs, hepatic portal fields and especially in the heart, suggesting a specific hypersensitivity reaction to fetal antigens. Moreover, intravascular accumulation of macrophages in the lungs also favored a non-specific immune reaction to amniotic fluid constituents.

Adrenal Glands↗
PubMed2003

De novo diabetic nephropathy on renal allografts.

BACKGROUND: Posttransplant diabetes mellitus (PTDM) is a well-recognized clinical problem following renal transplantation. Long-term risks of PTDM are similar to those of diabetes mellitus in general population. The aim of our study was to identify de novo diabetic nephropathy (DN) in our group of patients with PTDM. METHODS: Thirty-four patients with PTDM were reviewed retrospectively. Light microscopy, immunofluorescence, and electron microscopy techniques were performed in 10 of 21 patients with graft biopsy. RESULTS: Five patients (four women, one man), aged 47.4 years (range, 29 to 58), four of whom received cadaveric grafts, were found to have de novo DN. Their serum creatinine was 211.4 micromol/L (range, 140 to 294). Three patients were slightly proteinuric (0.3 to 0.5 g/L). PTDM was diagnosed 2.4 months after transplantation (range, 1 to 6). Histologic diagnosis of de novo DN was made, on average, 52.6 months after transplantation (range, 8 to 115), and 50.2 months (range, 2 to 114) after PTDM. De novo DN presented as diffuse diabetic glomerulosclerosis in four patients and nodular diabetic sclerosis in one patient, and combined with transplant glomerulopathy in all five patients. The mean graft survival time for this group of patients was equivalent with a control group. Although the difference in slopes of serum creatinine between the studied groups was clinically relevant, it was not statistically significant. CONCLUSION: In view of our findings, when histologic de novo DN was found in 5 out of 10 patients, one could conclude that de novo DN could be a frequent complication of PTDM.

Creatinine↗
PubMed2000

Antineutrophil cytoplasmic autoantibodies-antigen specificity and associated diseases.

Antineutrophil cytoplasmic antibodies (ANCA) are widely used as a useful diagnostic marker for small vessel vasculitides, although the test may occasionally be positive in various other conditions. The aim of this study was to assess ANCA in various clinical-pathological settings. ANCA were tested by indirect immunofluorescence and enzyme-linked immunosorbent assay and were found to be positive in 423 patients in the period from 1989-1999. Patients were grouped in accordance with their clinical-pathological setting as follows: 1. pauci-immune vasculitis confirmed by biopsy (n = 151), 2. clinically suspected vasculitis (n = 59), 3. inflammatory bowel diseases and autoimmune hepato-biliary disorders (n = 83), and 4. miscellaneous diseases (n = 130). The association of proteinase 3 ANCA with Wegener's granulomatosis (45/56) and myeloperoxidase ANCA with microscopic polyangiltis (45/54) and pauci-immune necrotising glomerulonephritis (24/28) was established. However, ANCA with other specificities were also shown to be present in these forms of vasculitides. ANCA, specific mostly for myeloperoxidase but also for other or unknown ANCA antigens, frequently revealing atypical immunofluorescence patterns, were characteristically found in other diseases. The titres of ANCA were significantly higher (p < 0.05) in patients with pauci-immune vasculitis than in those with clinically suspected vasculitis and other diseases. In conclusion, well standardised techniques for ANCA testing in conjunction with the clinical picture and histopathologic findings, if available, may significantly contribute to the diagnosis of small vessel vasculitides.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed2000

ANCA-associated vasculitis--an autopsy study.

The purpose of the study was to analyse the autopsies of 31 patients (20 female, mean age 67 years, range 28-87 years; and 11 male, mean age 66 years, range 47-80 years) with antineutrophil cytoplasmic antibodies (ANCA)-positive vasculitis, which was clinically confirmed in 25 patients and suspected in 6 patients, who had been treated and had died between 1989 and 1999. Kidney biopsy was performed in 22 patients on average 33 months (range, 1-132 months) prior to death. Biopsy and autopsy tissue specimens were examined by standard light and immunofluorescence microscopy techniques. Pauci-immune extracapillary glomerulonephritis was found in nearly the same percentage of 22 renal biopsies and 31 autopsies, namely in 91% and 84%, respectively. Active necrotising extracapillary glomerulonephritis was the prevailing lesion in 75% of biopsies, while advanced sclerosing glomerular lesions prevailed in 69% of autopsies. In the biopsies, necrotising lesions predominated in patients with ANCA of proteinase 3 specificity, while sclerotic lesions were more often associated with myeloperoxidase-ANCA. In the autopsies, florid necrotising systemic vasculitis coexisted in 2 patients with advanced sclerosing glomerulonephritis. Autopsies revealed the actual expansion of vasculitic disease, disclosed clinically silent vasculitic involvement of unusual locations and, in 3 patients, confirmed the clinically suspected vasculitis. The final diagnoses in 31 patients were as follows: Wegener's granulomatosis (5 men, 2 women), microscopic polyangitis (10 women, 2 men), pauci-immune crescentic glomerulonephritis (4 women, 3 men), a single case each of polyarteritis nodosa and isolated cutaneous vasculitis. In 3 patients, suspected vasculitis was not confirmed at autopsy. Nineteen of 31 patients died from septic infections or necrotising pneumonias, and 6 patients from progressive or recurrent vasculitis with complications, altogether nearly 80%. Cardiovascular failure, including pulmonary thrombembolism, caused death in 6 patients.

Adult↗
PubMed1997

Our experience with the enhanced polymer one-step staining in frozen sections.

The enhanced polymer one-step staining (EPOS) method is presented with minor modifications for intraoperative frozen sections. It can be applied in almost every department of pathology where there is a necessity, because no special equipment is required. The method is rapid and immunostaining can be performed in less than 15 min. Antibodies are available for more than 20 important tissue and tumor markers. Out of those, antibodies against human cytokeratin, leukocyte common antigen (LCA) and chromogranin A were introduced in routine work. The first 2 antibodies yield excellent results and are a big advantage in routine diagnostic work: the use of cytokeratin is useful for confirmation or exclusion of suspected tumor invasion, especially in cases of atypical hyperplastic lesions, for detection of spindle cell carcinomas, and the detection of lymph node micrometastases. LCA demonstration is helpful in differentiating various round cell tumors, such as poorly differentiated carcinomas, sarcomas, malignant lymphomas, and evaluation of inflammatory response. Chromogranin A may detect neuroendocrine differentiation in the tumors.

Epithelium↗
PubMed1997

Bronchopulmonary changes after laryngeal cancer treatment--differentiation between metastatic laryngeal and second primary cancer.

The survivors of laryngeal cancer have an increased risk of second primary cancer, especially in the lung. Therefore, the authors were interested, if there is an increase of precancerous lesions or malignancies in bronchopulmonary biopsies of the patients after laryngeal cancer treatment. There were 70 (38 transbronchial and 32 bronchial) of 5,097 bronchopulmonary biopsies in 58 patients (55 men and 3 women) with history of laryngeal carcinoma. The age of the patients ranged from 39 to 81 years (mean value 62.5 years). The biopsies were performed from 1 month to 23 years after surgical treatment and/or radiation therapy due to squamous laryngeal carcinoma. The frequency of metaplastic, dysplastic and tumorous lesions was contrary to expectation a bit lower than in routine bronchial biopsies. But in contrast with the latter, metastases were 10 times more common among tumorous lesions. In 19 of 58 patients malignancies appeared from 1 month up to 276 months after laryngectomy. Four patients had definitively, and another 5 very probably second primary carcinoma. Ten patients presented with metastases from laryngeal cancer. The possibilities to differentiate metastatic laryngeal and second primary carcinoma are discussed.

Biopsy↗
PubMed1996

Postoperative radiotherapy for radically resected N2 non-small-cell lung cancer (NSCLC): randomised clinical study 1988-1992.

In the period 1988-1992, 74 consecutive radically resected patients with NSCLC were randomised to postoperative radiotherapy or surgery alone in order to evaluate the influence of postoperative radiotherapy on survival. There were 61 males and 13 females, aged 35-80 years, median 59 years. Their distribution by stage was as follows: pT1N2 = 19, pT2N2 = 54, pT3N2 = one patient; histology: 32 squamous, 32 adeno and 10 large cell carcinomas; surgery: atypical resection in six, lobectomy in 27, bilobectomy in ten, and pneumonectomy in 31 patients. In 27 patients, only one lymph node in a single mediastinal lymph node site was affected; in 31 patients more than one lymph node in one site; in 16 patients more sites were affected. In 35/74 patients radiotherapy of hilar and mediastinal sites with 3000 cGy in 2 weeks was performed. On December 31, 1994, 19 patients (26%) were still alive; 39/55 patients died of the following causes: locoregional failure-10(26%), distant metastases- 25 (64%), other tumor-unrelated causes-four patients (10%). Five-year survival rates did not show statistically significant differences between the irradiated and surgically treated patients only with respect to sex, pTNM stage, histology and frequency of locoregional failure. The number of metastatic mediastinal lymph nodes was the only significant prognostic factor (P < 0.005) in both randomised groups.

Adult↗
PubMed1994

Cytology of bronchoalveolar lavage in some rare pulmonary disorders: pulmonary alveolar proteinosis and amiodarone pulmonary toxicity.

Cytological patterns of bronchoalveolar lavage (BAL) in pulmonary alveolar proteinosis (PAP) and amiodarone pulmonary toxicity (APT) are presented together with light and electron microscopy (EM). The differential cell count of BAL in both diseases is similar in that alveolar macrophages predominate. However, the cytology of PAP is characterized by scanty macrophages and alveolar epithelial cells in abundant periodic acid-Schiff (PAS)-positive extracellular material. The gross appearance of the BAL fluid is therefore opaque. In contrast, the cytology of APT is characterized by foamy alveolar macrophages with numerous lamellar bodies in their cytoplasm, and the BAL fluid is clear.

Amiodarone↗
PubMed1993

Acute renal failure in patients with drug-induced acute interstitial nephritis.

The clinical features, laboratory evaluation, and outcome were analyzed in 23 patients with acute renal failure (ARF) and drug-induced acute interstitial nephritis (21 proven with biopsy). The groups of drugs implicated were: antibiotics (20 cases), nonsteroidal anti-inflammatory drugs (2 cases), and other drugs (phenobarbitone, 1 case). The clinical and laboratory signs of the disease appeared 3 to 28 days after exposure to the drug. Fever, skin rash, and flank tenderness were the most common clinical features observed (87%); and hematuria (100%), sterile pyuria (83%), and eosinophilia (39%) were established by laboratory tests. Hemodialysis (HD) was performed in 7 patients. Complete normalization of kidney function was observed in 3 patients; improvement to basal level in 3 patients (this group had preexisting renal disease); and CRF, requiring HD, in 1 patient. Renal function improved in all patients with mild to moderate renal insufficiency regardless of the therapy involved. Statistical evaluation could not confirm any significant differences between status of renal function at presentation, treatment (corticosteroids versus symptomatic and supportive measures only), and outcome of drug-induced acute interstitial nephritis (AIN). In summary, ARF due to drug-induced AIN has a favorable course with good prognosis regardless of the use or nonuse of corticosteroids in management strategy.

Acute Kidney Injury↗
PubMed1991

Cytology of endobronchial granular cell tumor.

Cytologic features of four cases of endobronchial granular cell tumor are presented. The diagnostic cells were found in bronchoscopically obtained material. They were arranged in smaller clusters and had finely granular cytoplasm with uniform oval or round nuclei. Frequently the cells are overlooked on regular cytologic examination owing to their benign nature. Nevertheless, there are enough cytomorphologic features that help to distinguish these cells from macrophages and bronchial epithelial cells. It is essential that the possibility of granular cell tumor is considered on cytologic examination. Final diagnosis, however, requires histologic verification.

Adult↗