Biomedical subjects
Publications and source records attributed to W De Coster.
A case, which is clinically characterized by a subacute vertebrobasilar syndrome, is presented. The necropsy reveals multiple infarcts in brainstem, cerebellum and left cerebral hemisphere, due to tumoural emboli of a non-detected primary tumour. It is postulated that the latter has to originate in the lungs in order to produce this unique type of cerebral arterial embolism.
7 brains out of a series of 124 necropsies of treated leukemic patients show a communicating hydrocephalus, without invasion of the central nervous system by the malignant blood cells. In 4 cases it is proven that the hydrocephalus is due to obstruction of the liquor drainage at the level of the arachnoidal villi and dural sinuses, by the leukemic invasion of these structures. It is shown that, even in case of preventive brain irradiation and intrathecal-administered cytotoxic drugs, these structures remain areas, in which the leukemic cells are difficult to destroy.
Reye's syndrome or encephalopathy with fatty infiltration of the liver occurs mainly in childhood and to a lesser degree in adult age. This report concerns a rare adult case of this syndrome in Europe. The different diagnostic steps are described, with special emphasis on the enzymatic disturbances of the Krebs-Henseleit cycle and on the morphological criteria needed to confirm the diagnosis.
The gastrocnemius muscles of 3 groups of 10 rats, sacrified 5, 7, and 12 days respectively, following tenotomy, were submitted to different types of fixation, fixative and embedding. The occurrence of target fibres is shown not to be an artefact due to the histological procedures. Further examination demonstrates that the target phenomenon occurs in the shortest fibres on the medial side of both heads of the gastrocnemius muscle and that it consists mainly of a disarrangement of the contractile elements of the muscle fibres. This study argues that this phenomenon represents some kind of myotonic state of a pathological muscle.
A right gastrocnemius muscle biopsy of a 13-month-old floppy male infant, which appeared at a more advanced age to suffer from an infantile spinal muscular atrophy, showed unusual histochemical changes: the chequer-board distribution was replaced by three groups of muscle fibers with a same mean narrow diameter of 12.5 micrometer. The smallest groups could easily be recognized as type I and type IIB fibers, while the largest group, involving more than 75% of the whole biopsy, revealed an intermediate hybrid fiber population, which would be classified as type I, if based on their phosphorylase and myofibrillar ATPase activities alone. The pathogenesis of this unusual finding is discussed.
The sequence of development of the target phenomenon in tenotomized gastrocnemius muscle was studied: the presence of target fibres was preceded by the occurrence of contraction bands and of "moth eaten" appearance of the fibres. This phenomenon was far more pronounced and occurred earlier in type II than in type I fibres. This target phenomenon and the contraction artefacts could be inhibited in the tenotomized muscles by simultaneous neurotomy or immobilization of the muscle with a plaster cast. Delayed denervation inhibited also the target phenomenon, if performed less than 5 days after the tenotomy. These series of experiments seem to indicate that the target phenomenon occurs in more irritable muscle fibres and that muscular activity is needed for its development.
Target fibers were checked at regular intervals in two groups of rat gastrocnemius muscle namely after tenotomy and neurotomy. The highest amount of target fibres was observed during the first week following tenotomy and around the seventh week, when the muscle became again functional by spontaneous union of the tendon. The target phenomenon was restricted to the type II fibres. It appeared also in the early stage of re-innervation, 5 weeks following neurotomy and remained present subsequently in a transitional zone between denervated and re-innervated muscle fibres and was restricted to the type I muscle fibres. The target phenomenon was not the only histochemical alteration observed following tenotomy and neurotomy. This experimental study allowed to determinate more precisely the causal factors of the target phenomenon.
A 20-month-old mentally retarded girl developed an acute upper respiratory infection, followed by breathing difficulties, leading to death. Picorna virus-like particles were demonstrated in a mildly affected quadriceps femoris muscle biopsy, while the necropsy findings demonstrated an acute polymyositis with predominant diaphragm involvement. The mental retardation was due to micropolygyria of the brain. Initial respiratory difficulties are an unknown feature of polymyositis. In this case the upper respiratory infection, possibly caused by a Coxsackie B2, is evoked as responsible for this unusual distribution of the acute viral polymyositis.
An uncommon case of initial respiratory distress during the first months of life as the result of bilateral diaphragmatic weakness is presented. The biopsy and necropsy findings show a progressive congenital myopathy with type I muscle fiber atrophy and predominant involvement of the respiratory muscles. The lesions, observed in the central nervous system are due to the severe hypoxia. The morphological findings are discussed in relation to the etiology and the clinical picture of the disease.
A large number of target fibres is observed in a muscle biopsy from a patient with an acute flaccid paraplegia of the lower limbs due to a polyneuroradiculopathy of unknown origin. With the electron microscope up to 4 structural zones are seen in the target fibers. The histochemical and ultrastructural observations in this case, suggest that the "target fiber" phenomenon is due to a disturbed trophic influence of the nervous system.
The long-term effects of elective induction of labor at term by amniotomy and the intravenous infusion of prostaglandin F2alpha were studied in 40 children. No untoward effect of this procedure on the psychomotor development of the children during the first 30 months could be demonstrated.
The case report of a 23-year-old man with polymyositis and some myasthenic features is presented. The biopsy findings suggest a preferential involvement of the neuromuscular junctions by the inflammatory process, a fact which explains the clinical syndrome.
A case report of a 46-year-old Belgian man with a subacute myelo-optic neuropathy is presented. Arguments in favour of a neurotoxic etiology are stressed.
The morphological and histochemical findings in a brain biopsy of a case of Creutzfeldt-Jacob disease are compared. The histochemical changes in the cytoplasm of the neurons precede the morphological alterations found with the electron microscope. In this way the neuronal enzymatic failure can explain the clinical picture of this disease.
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Normal gastrocnemius muscle of Wistar rats at various ages to 2 1/2 years was studied. No light microscopic or qualitative electron microscopic changes were seen. However, stereologic determinations revealed significant reductions in volume and surface densities of sarcoplasmic reticulum, t-tubular system, and glycogen content. These alterations were considered to be the morphologic expression of the very early age-related changes in gastrocnemius muscle.
Quantitative and/or qualitative changes in cerebrospinal fluid (CSF) cytology were observed in 31.5% of 225 samples, obtained from patients with recent non-haemorrhagic cerebral infarctions. These changes were variable and did not correlate with the stroke pattern or with the topography of the softening. The CSF cytological abnormalities were statistically different according to the aetiology of the stroke. In those infarctions, due to vasculitis lesions, either of infectious or of auto-immune nature, an abnormal cytology pattern was more frequently observed than in those of atherosclerotic thrombo-embolic origin.