PubMed Health⌕ Search

Biomedical subjects

W A Schmidt

Publications and source records attributed to W A Schmidt.

At least 19 recordsLinked to original sources
PubMed1996

[Color Doppler ultrasound of the temporal arteries--a new method for diagnosing temporal arteritis].

BACKGROUND: Recently increasing attention has been paid to temporal arteritis which is not a very rare disease. Early establishment of the diagnosis and start of therapy can reduce serious visual complications. PATIENTS AND METHODS: The temporal arteries of 10 patients with temporal arteritis, 8 patients with polymyalgia rheumatica, and 23 controls were investigated with a high resolution ultrasound system, measuring size of lumen and wall as well as blood flow velocity. RESULTS: Colour doppler sonography of the superficial temporal artery showed a characteristic hypoechoic halo around the perfused lumen of an often stenosed or occluded artery. Neither patients with polymyalgia rheumatica nor controls had this hypoechoic halo. The halo disappeared 10-14 days after start of therapy with glucocorticoids. CONCLUSIONS: We think that colour doppler sonography of the temporal arteries is a simple, quick, and non-invasive method to diagnose temporal arteritis. When there will be more experience, sensitivity and specificity of the method can be defined. Perhaps sonography might replace biopsy in some cases in the future.

Aged↗
PubMed1996

Indications and immediate patient outcomes of pathology intraoperative consultations. College of American Pathologists/Centers for Disease Control and Prevention Outcomes Working Group Study.

OBJECTIVE: To evaluate the reasons (indications) for and immediate intraoperative surgical results (outcomes) associated with pathology intraoperative consultation. DESIGN: In 1992 and 1993, surgeons collaborated with pathologists in 472 voluntarily participating institutions from the United States (462), Canada (7), Australia (2), and New Zealand (1) in a study jointly sponsored by the College of American Pathologists and the Centers for Disease Control and Prevention. Pathologists selected 20 consecutive intraoperative consultations and assembled a cover letter, a checklist questionnaire, and a copy of the corresponding surgical pathology report, all of which were sent to the surgeon(s) for retrospective evaluation. PARTICIPANTS: The study was distributed to participants in the College of American Pathologists voluntary Q-Probes quality improvement and Surgical Pathology Performance Improvement programs and to Canadian and Australian hospitals with more than 200 beds. RESULTS: Evaluation of 9164 cases established the five most common indications for intraoperative consultation: (1) establish or confirm diagnosis to determine type or extent of operation (51%), (2) confirm adequacy of margins (16%), (3) confirm nature of tissue to direct sampling for immediate culture or other laboratory study (10%), (4) expedite obtaining diagnosis to inform family or patient (8%), and (5) confirm sufficient tissue submitted to secure diagnosis in permanent section (8%). The information provided by the intraoperative consultation resulted in changed surgical procedures that were either modified, terminated, or newly initiated in 47%, 30%, 6%, 9%, and 28% of cases, corresponding respectively to each of the above five common indications. Rarely cited reasons for intraoperative consultation were to expedite obtaining diagnosis for surgeon's knowledge (3%), to facilitate patient management, other professional communication or discharge planning prior to permanent section availability (3%), academic protocol (< 1%), and consultation not needed or no reason for request (< 1%). CONCLUSIONS: This multi-institutional, interdisciplinary database confirms that pathology intraoperative consultations, regardless of the initial indications, influence immediate patient care decisions, resulting in changed surgical procedures in an average of 39% of all operative cases.

Australia↗
PubMed1994

FNA of extraskeletal myxoid chondrosarcoma: cytomorphologic, EM, and X-ray microanalysis features.

Extraskeletal myxoid chondrosarcoma, an unusual soft tissue lesion which preferentially affects the extremities, is a prime candidate for "pathologist performed" fine-needle aspirates (FNA) because it preferentially affects the extremities [Enzinger and Shiraki, Hum Pathol 1972;3:421-435] and is usually an accessible lesion. Cytomorphologically, the neoplasm consists of clusters of fairly uniform cells, lacking cartilaginous differentiation, with a metachromatic matrix when stained with Diff-Quik (DQ). While subtle, this neoplasm has distinct features and must be distinguished for other neoplasms in the differential diagnosis because patient evaluation, prognosis, and therapy will vary greatly. We present a case characteristic of this tumor in which FNA derived material was subjected to light microscopy, X-ray microanalysis, and immunohistochemical studies; each modality provided data essential to the correct diagnosis.

Aged↗
PubMed1991

Effects of rotational atherectomy in normal canine coronary and diseased human cadaveric arteries: potential for plaque removal from distal, tortuous, and diffusely diseased vessels.

To test the hypothesis that tortuous, diseased vessels could be successfully treated with a flexible rotational atherectomy device we evaluated the BARD atherectomy device with quantitative angiography and histology in normal canine coronary arteries and diseased human below-knee amputation specimens. The mid left anterior descending and the circumflex vessels were treated in 4 dogs serially with 1 wk separating treatments. The acute and follow-up anterior descending artery size was unchanged (1.41 mm before, 1.39 mm after, and 1.59 mm at 1 week). Similar findings were obtained in the circumflex vessels. In 4 adult human amputated legs, diseased peroneal or tibial arteries were treated with a significant reduction in the percent luminal diameter stenosis from 62.75 prior to intervention to 36.5 following intervention (p = 0.021). The luminal diameter increased from 0.81 to 1.54 mm (p = 0.06). In 2 canine arteries there was histologic evidence of localized perforation of the arterial wall, but there was no angiographic evidence of perforation or dissection and no significant myocardial necrosis in the distribution of the treated vessels at 1 wk. The majority of the diseased human vessels demonstrated smoothly cut atheromas with sparing of the media. The rotational atherectomy catheter system holds promise for removal of plaque in relatively small, diffusely diseased, tortuous vessels.

Animals↗
PubMed1991

Fine-needle aspiration of a solitary pulmonary nodule following treatment of metastatic giant-cell tumor of bone.

Giant cell tumor (GCT) of bone is a local, variably aggressive neoplasm with high local recurrence and occasional pulmonary metastases. Radiographically guided fine-needle aspiration (FNA) plays a large role in establishing a tissue diagnosis of lung metastases prior to therapeutic intervention. We present a patient with histologically proven pulmonary metastases from a femoral grade II GCT. These lesions were obliterated with combination HT-CT (hyperthermia and chemotherapy). The patient subsequently developed another pulmonary nodule at a site previously occupied by a GCT metastatic deposit. Radiographically guided FNA revealed that this new lesion was an adenocarcinoma, apparently of pulmonary origin. We suggest that this second neoplasm arose within a scar that developed after HT-CT ablation of one of the metastases. Additional intriguing features of this case are the effective HT-CT therapy of GCT metastatic to lung and the extended temporal course (some 16 yr from initial diagnosis to death).

Adenocarcinoma↗
PubMed1991

Chronic tophaceous gout with severely deforming arthritis: a case report with emphasis on histopathologic considerations.

The dramatic clinical presentation of a patient with severe deforming arthritis secondary to chronic tophaceous gout is described. Polarization microscopic examination and use of the De Galantha stain identified the dermal amorphous material as urate crystals. When the possibility of gout is entertained and a lesional biopsy specimen is examined to confirm the diagnosis, it is useful to fix the fresh tissue in absolute ethanol and process the specimen using an anhydrous technique to preserve the crystals.

Acute Disease↗
PubMed1989

Limitations of flow cytometric DNA analysis for the diagnosis of bladder cancer.

Flow cytometric analysis was done on exfoliated urothelial cells from 11 control patients and 31 patients with transitional cell carcinoma: 9 grade I, 11 grade II, and 11 grade III. The determination of aneuploidy by DNA analysis did not provide identification of low-grade tumor cells. Other flow cytometric parameters of cellular change such as cell size, nuclear size, nuclear/cytoplasmic ratio, or cell refractivity may provide better identification of low-grade lesions.

Carcinoma, Transitional Cell↗
PubMed1989

Physiologic characterization of transformed and cloned rat granulosa cells.

Properties of a clonal line of SV40-transformed rat granulosa cells (DC3 cells) were elucidated. DC3 cells were maintained in vitro in Iscove Modified Dulbecco Medium that contained 20% fetal bovine serum. The cells had a logarithmic growth phase doubling time of approximately 18 h and produced detectable quantities of estrone, estradiol, and progesterone. Steroidogenesis was increased by supplementation with either steroidogenic substrates or agents that stimulated activity of adenylate cyclase. Production of progesterone and estrogens was enhanced when medium was supplemented with 25-hydroxycholesterol, and production of estradiol was enhanced by medium supplementation with androstenedione. Treatments with forskolin and cholera toxin resulted in marked increases of cyclic adenosine 3',5'-monophosphate (cAMP) in medium and cells and enhanced steroidogenesis. Isoproterenol and vasoactive intestinal peptide, but not follicle-stimulating hormone (FSH), luteinizing hormone (LH), insulin or prolactin, stimulated cAMP secretion by suspended cells. DC3 cells had small but detectable levels of binding to FSH, but binding of LH and epidermal growth factor could not be detected. DC3 cells possess characteristics expected of granulosa cells arrested in an early stage of differentiation and may provide a useful model for studies of "immature" granulosa cell functions.

Animals↗
PubMed1989

Virilizing serous cystadenoma.

A 71-year-old woman, 26 years post-menopause, presented with virilization. Facial hirsuties, non-hereditary frontal balding, voice changes, male escutcheon, and mild clitorimegaly accompanied a right adnexal mass. Blood hormone studies showed testosterone 430 ng/dL, FSH 118 mIU/mL, and LH 210 mIU/mL. By ultrasound examination, the cystic adnexal mass involved the right ovary. An 18-cm, 1300-g, unicameral mass with 1200 mL of clear serous fluid and with smooth inner and outer surfaces was removed from the right broad ligament. Intraoperative testosterone levels were as follows: peripheral vein 285 ng/dL, left ovarian vein 301 ng/dL, and right ovarian vein 1635 ng/dL; tumor cystic fluid was 3032 ng/dL. Peripheral vein testosterone was 15 ng/dL 3 days postoperatively. Histopathologically, the tumor was a serous cystadenoma. No evidence of stromal luteinization, hyperplasia, or inflammation was found, and other virilizing lesions were not encountered in either ovary or in other tissues. Epithelial cells constituting the tumor may have been the source of the excess testosterone in this unique case of virilizing serous cystadenoma.

Aged↗
PubMed1988

Histologic response to microsuture materials.

Long- and short-term reactions of reproductive tract tissue to microsurgical suture materials were compared. The five materials were: polyglactin 910 (Vicryl), polyglycolic acid (Dexon-S), polypropylene (Prolene), nylon (Ethilon and Dermalon) and chromic catgut; the calibers ranged from 6-0 to 10-0. Sixteen days after suture placement the smallest tissue reaction was seen with 9-0 and 10-0 suture materials; Dexon-S caused a slightly greater reaction than did Vicryl. Prolene, 8-0 and 9-0, produced the smallest tissue response when compared to other sutures of similar size. Larger sutures incited greater tissue reactions. Forty-two days after placement, each suture was associated with similar or lower reaction scores than those observed at 16 days. At 90 days all the Dexon-S sutures had been absorbed. Vicryl had less of a late reaction as compared to the other sutures. Reactions persisted longer with nonabsorbable suture, and the tissue response depended on both the suture material and caliber. Vicryl, 8-0 to 10-0, incited the smallest short- and long-term tissue reaction; at those sizes it seems optimal for reconstructive tubal surgery.

Animals↗
PubMed1988

Primary cardiac rhabdomyosarcoma: definition of a rare entity.

Primary cardiac rhabdomyosarcoma (PCR) is a highly malignant tumor that is rarely recognized prior to surgery or necropsy. We present the pathologic findings of a primary atrial rhabdomyosarcoma in an 82-year-old woman and an update on PCR as a clinicopathologic entity. In addition to pleomorphic tumor cells with cross-striations and a positive immunoperoxidase reaction for myoglobin, some areas of our patient's tumor had features of sarcoma botryoides. Electron optic studies showed primitive cells with fibroblastic and/or myoblastic differentiation. A comprehensive study of 77 cases in the international literature yielded new information and perspectives on PCR. The incidence of PCR is bimodal among males, being highest in infancy and early childhood with a secondary peak in the sixth and seventh decades. Females, however, have a single peak incidence in the fifth decade. Septal origin is 35.2% among infants and children but only 5.2% among adults. The predilection for the pediatric age group in conjunction with common septal origin among these patients suggests a congenital form of PCR that may arise from embryonic cell tests.

Aged↗
PubMed1987

Bilateral ovarian thecosis and virilization in pregnancy. A case report.

Virilization is usually associated with amenorrhea, infertility and ovarian stromal lesions. Paradoxically, however, it may also be seen in pregnancy; this type of virilization is rare and accompanies ovarian thecosis. Thecosis, also known as thecomatosis and stromal thecosis, is a complex assortment of types of ovarian stromal proliferation associated with various types and amounts of hormonal activity. A patient had progressive virilization that began about seven years after menarche. Nonetheless, she had six pregnancies and bore five normal living children. Her last child, a female, was not affected by the high maternal testosterone levels. The patient's virilization was associated with an ovarian stromal hyperplasia classified as combined thecosis. In this case, as in some others, there was reason to suspect a genetic basis for such progressive virilization with retained fertility; an analysis of it provides insight into the complex nature of ovarian stromal hyperplasia and hormonal activity.

Adult↗
PubMed1986

Calcofluor white detection of fungi in cytopathology.

Calcofluor/Cellufluor (CFW) binds to fungal cell walls and causes them to fluoresce blue-green when illuminated with UV light. Retrospective and prospective studies were made to determine if CFW could be added to the Papanicolaou (PAP) stain procedure without altering diagnostic cytopathologic features while still allowing fungi to be identified. The retrospective study included 136 cytology specimens that were designated positive for fungus by PAP stain; these were stained with a 0.1% aqueous solution of CFW and examined by fluorescent microscopy. The overall agreement between the two methods in the detection of fungi was 90.4%. The incorporation of CFW into the PAP stain was tested at various points in the PAP stain sequence; optimum results were obtained when CFW was introduced after acid eosin. A total of 197 random, sequentially accessioned cytology specimens were stained with the PAP/CFW combination in the prospective study. The results indicate that detection of fungi by a combination of regular light and fluorescent microscopy was far more effective than was examination for the organisms by light microscopy alone.

Benzenesulfonates↗