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Biomedical subjects

W W Höpker

Publications and source records attributed to W W Höpker.

At least 19 recordsLinked to original sources

[Fat embolism--a too infrequently determined pathoanatomic diagnosis].

In 1993, pulmonary fat embolism occurred in 92 cases (17%) out of 527 clinical autopsies. It was found in 62% of patients who had suffered bone fractures, in 9% with soft tissue surgery and in 53% after resuscitation; non-traumatic fat embolism was present in 6% of the cases. The comparison group of 50 persons with lethal polytrauma revealed pulmonary fat embolism in 52% of the cases. Bone-marrow embolism and microthrombi accompanied fat embolism of the lungs; furthermore some of the persons with pulmonary fat embolism also expressed minor degrees of renal (55%) and cerebral (25%) fat emboli. A retrospective analysis of the clinical data revealed no specific symptoms: a so called fat embolism syndrome had not been discovered clinically in any of the cases with histologically proven fat embolism. The significance of pulmonary fat embolism as a cause of death with regard to histological and clinical findings is discussed.

Cause of Death↗

[Ectopic meningioma of the tonsil].

To our knowledge this is the first reported case of a primary extracranial meningioma located in the palatine tonsil. Immunohistochemical investigation of the tumour showed coexpression of vimentin and neuron-specific enolase (NSE). No staining was found with antibodies against cytokeratins KL1, 13/10, 8 and 18, epithelial membrane antigen EMA and melanoma protein (HMB-45). It seems justifiable to classify this tumour as an atypical meningioma because of the local increased mitotic activity.

Adult↗

[Adhesive (retractile) capsulitis of the hip joint in diabetes mellitus. An x-ray histomorphological synopsis].

Adhesive (retractile) capsulitis of the hip joint is a rare complication (association) of (juvenile) diabetes mellitus. The clinical features, plain radiographic and CT findings and histomorphological appearances of this condition are described and attention is drawn to changes in the elastic tissue in the fibrosed capsule. Three diagnostic radiological features have been defined; in their presence, arthrography or diagnostic arthroscopy need not be performed.

Adult↗

Histologic differential diagnosis of focal liver lesions by ultrasonically guided fine needle biopsy.

Ultrasonically guided fine needle biopsies were carried out in 84 patients with focal liver lesions and were subsequently evaluated histologically. A correct diagnosis of malignancy was made in 46 of 52 patients with proven hepatic malignancy, showing an overall accuracy of 93%. The specificity of the procedure was 100%. Such histological examination not only enables the differentiation between primary and secondary hepatic malignancy; it has the additional advantage of making a more precise tumour description and at the same time it pinpoints the primary site of the tumour.

Biopsy, Needle↗

Changes of the elastin compartment in the human meniscus.

We report on the elastin, collagen and ground substance compartments in the human meniscus and their interrelationships. Elastin is found in neonates and shows both an arrangement parallel to the collagen fibre and into net-like structures. Branching, caliber inconstancy, rupture and the phenomenon of the "rubber band" are findings within the different forms of the meniscopathy. The function of the elastin compartment cannot be visualised without suggesting "puncta fixa". The morphology of the collagen-elastin-junctions has been described and their possible mode of function is discussed with the help of a model.

Adult↗

[Nonsense--and sense?--in cause-of-death statistics. A validation study to test cancer mortality figures].

Death certificates for all clinics of the University of Heidelberg are centrally filled in at the University Pathology Institute. The certificate which accompanies the body gives the information for the official death certificate. There were 6263 autopsies between 1974 and 1978. The entry in the death certificate was compared with the complete morbid-anatomical diagnosis. Sensitivity and positive correctness showed many errors, the proportion of false-negative diagnoses being nearly three times higher than false-positive ones.

Autopsy↗

[DNA measurement of malignant tumors by impulse cytophotometry. The principles and importance for assessing growth behavior and the degree of abnormality].

Monometric DNA impulse cytophotometry of ploidism state (diploid or aneuploid tumors with stemmline shift, polyploidism ) and proportion of DNA-synthesized cells (S-phase proportion) were determined on over 500, mostly malignant, tumors of different sites. The results were compared with histopathological findings (TNM stage and degree of differentiation). Large diploid carcinomas of the oral cavity have lower S-phase activity than aneuploid tumors. Carcinomas of the breast, stomach and ovary are frequently diploid. Aneuploid carcinomas of these regions generally have high synthesizing activity. Mucoid signet-ring carcinomas of the stomach have lower S-phase activity than non-mucoid carcinomas. In the colorectal region aneuploid carcinoma predominates, in the colon more than in the rectum. Tumor metastases from colon and rectum into the liver predominantly are from aneuploid primary tumors. For tumors of the breast, corpus uteri and ovary with high and moderate differentiation there is a direct correlation between histological grade of differentiation and the S-phase proportions. Aneuploid tumors vary from low to high synthesizing activity. Diploid meningioma and glioma have a low S-phase proportion, aneuploidism correlates with an increase in growth. Supplementation of histopathological diagnosis by determining ploidism and S-phase activity makes an important contribution in the assessment of the degree of malignancy, as well as for therapeutic purposes.

Aneuploidy↗

[Liver damage caused by chronic cadmium poisoning].

A case report is given of a 46 year old person concerned professionally with melting gold, who exhibited bioptically and histologically verified lesions of the liver after chronic intoxication with cadmium. This patient was exposed throughout 8 years during his job activities to cadmium vapors. He exhibited during the time of investigation decreased renal function with tubular proteinuria as well as a polyneuropathy. In addition, hepatic lesions could be found, as small focal necrosis, fatty degeneration and fibrosis. Cadmium content of the liver was increased 13 times above normal.

Cadmium Poisoning↗

Scanning electron microscopic comparison between the thrombogenic properties of heparinized and non-heparinized vena cava catheters. A long-term study.

In an experimental comparative study on rabbits, the efficacy of the reduction of surface thrombus formation was investigated using heparinized central venous catheters compared with non-heparinized. Up to a central indwelling period of ten days, there was a reduction of the thrombus layer thickness on the heparinized catheters of 80% (with a trial duration of three days this was as much as 90%). The action of the stabilized surface heparin, which leads to a substantial thromboresistance, is complex in nature. 1) By intensified adsorption of plasma proteins in the early phase (proteins consist of antithrombin III, factor IX, X and XI), there is very much less thrombocyte adhesion and aggregation on the heparinized catheter surfaces. 2) The externally orientated negative net charge of the heparin shows a similar effect. 3) If there is thrombocyte adhesion despite this, further heparin effects become more prominent. Thus the release of ThF 3 and ADP, which leads to aggregation, is markedly inhibited. On the other hand, this leads to easier dissolution of already aggregated thrombocytes and on the other to a reduction of the catalytic thrombocyte surface for the plasma clotting factors. 4) This effect is supported by the increased adsorption of antithrombin III onto the control surface. 5) Finally there is also an inhibitory effect of heparin on the activated Stuart-Prower factor. Local thrombosis on the venous catheter surface can thus be effectively reduced by local therapy, without greater risks for the intensive care patient.

Animals↗

Loss of differentiation in intestinal metaplasia in cancerous stomachs. A comparative morphologic study.

229 stomachs resected for duodenal and gastric ulcer and carcinoma were examined with special regard to the morphological and histochemical pattern of intestinal metaplasia (IM). The results of qualitative and semiquantitative studies were analysed statistically. Whereas duodenal and gastric ulcer cases are best discriminated by the presence or absence of IM, the strongest discriminating factor between carcinoma and gastric ulcer is the content of goblet cells in metaplastic crypts. Metaplastic crypts lined exclusively with goblet cells producing sulfated acid glycoproteins could be identified in more than one third of the cancer cases. The increase in goblet cells coincides with a loss of the more differentiated cells in the metaplastic glands, such as enterocytes, APUD cells, or Paneth cells. This "enterocoli metaplasia" seems to be specific for cancer bearing mucosa and occurs more often in cancer of intestinal type; it may represent a form of a derepressive dedifferentiation. The significance of enterocoli metaplasia as a premalignant lesion remains to be elucidated.

Adult↗

[Colon carcinoma pathogenesis. An epidemiological study (author's transl)].

The mean incidence age for rectal carcinoma in women rose significantly in the township of Karlsruhe between 1971-1975 from 61,5 to 70,9 years, while the incidence age for colon carcinoma in men decreased significantly from 67,5 to 65,0 years. In the world incidence statistics of colon carcinoma in males, Karlsruhe ranks 16th (13,2 cases per 100 000 inhabitants), whereas the city ranks second for rectal carcinoma in males (18,5 cases/100 000). Prevalence patterns of gastric, colonic, and rectal carcinoma differ between individual districts of Karlsruhe. Time-related pathogenetic influence factors are discussed in extenso.

Aged↗