[Diagnosis and therapy of malignant soft tissue tumors].
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Biomedical subjects
Publications and source records attributed to A Wild.
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The inflammatory destruction of cartilage in rat adjuvant arthritis has been studied by histochemistry and autoradiography. Naphthol-AS-D-chloroacetate esterase has been used as a marker for polymorphs. The evidence presented here shows that polymorphs accumulate at the cartilage-pannus border and in areas of cartilage loss. These cells appear therefore to be of decisive importance for the destruction of cartilage. Proteoglycans were demonstrated by safranin-O staining: there is a loss of PG that is particularly prominent in zones where pannus had invaded cartilage. By means of 35S labelling of proteoglycans it was possible to show that pannus containing polymorphs can invade living cartilage.
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Using the Lauren approach of histological classification, 300 cases of early gastric cancer (EGC) were analysed with regard to their age distribution, to predisposing lesions, including gastritis, and survival rate. The average age of onset for EGC of the diffuse type is 56, ten years earlier than for the intestinal type. There was a significantly high percentage of EGC of the diffuse type without gastritis. On the other hand, gastritis in pernicious anaemia falls in the high-risk group. The survival rate in our cases is 98%, corrected for age. The results show that it is of utmost importance to differentiate between the histological types of gastric carcinoma; for there may be indeed a difference in pathogenesis and aetiology.
The incorporation of 3H-proline into the hyaline articular cartilage of rats with and without adjuvant-induced arthritis was investigated 1 h after the intravenous injection of radioactive proline. In the control animals, silver grains were present predominantly over the chondrocytes at all times; on the 28th day the intensity of labeling was notably reduced. In the animals with adjuvant disease reduced radioactivity was observed in the cartilage of the arthritic joints from the 14th experimental day onwards. At all times, however, silver grains occurred over the chondrocytes, including those in the pannus-covered cartilage and in cartilage sequesters. It is concluded from the investigations that the arthritic process accompanying the development of pannus reduces collagen synthesis and that the pannus tissue ingrows vital cartilage.
After the injection of complete adjuvant, rats develop arthritis with increased proliferation of synovial tissue cells at the attachment of the synovial membrane to cartilage and bone. From this synovial tissue a connective tissue pannus develops which covers the cartilage surface as a monocellular or multicellular layer of proliferating cells. Areas with cartilage destruction are usually characterized by a great number of proliferating connective tissue cells. Cartilage destruction is not restricted to the superficial pannus, since granulation tissue of the subchondral bone may also participate in cartilage resorption. The quantitative determination of 3H-thymidine labelled chondrocytes excludes participation of these cells in pannus formation.
Cell proliferation in the pannus formation of adjuvant arthritis was studied by autoradiography. It was found that after day 9 an increased cell proliferation starts in the joint capsule recessus and synovial villi on the injected side. From these proliferating cells a pannus, which during the first phase frequently consists only of few cell layers, extends over the cartilage surface. With advancing disease the thickness of the pannus increases and further centripetal growth may cause the entire cartilage surface to be covered. This proliferating pannus tissue may invade the cartilage and destroy it. Since in this area of destruction labelled cells are frequently present, it may be assumed that proliferating cells with a high enzyme content are particularly responsible for the immediate degradation of cartilage. No involvement of chondrocytes in pannus formation was confirmed by the methods employed. There was neither increased proliferation of surface chondrocytes nor increased proliferation of chondrocytes in the depth of cartilage.
29 patients using a home respirator have been studied. Management of the respirator and inhalation were correct in 86%. Bacteriologic contamination in home treatment poses few problems. Blood gases and spirometric lung function tests do not demonstrate amelioration but show stabilization in long term treatment. Costs are high. Nevertheless, this treatment is indicated in certain carefully selected patients. Follow-up checks are essential.
Surgical excisional biopsies, needle biopsies and aspiration biopsies are at present the most frequently used technical procedures in the diagnosis of tumors or other pathologic conditions. An additional, lesser known method of obtaining tissue for microscopic examination with a high speed pneumatic drill biopsy device is described. Over a period of 29 months 118 biopsies have been performed in 99 patients for histologic examinations limited to breast lymph nodes, skin and scars, thyroid gland, bone and parotic gland. Only 8 (6.8%) out of 118 biopsies were inadequate for microscopic evaluation. The 110 (93.2%) histologically adequate biopsies showed 76 (64.4%) specimens with pathologic changes and 28 (23.7%) were correctly negative. Consequently, 104 (88.1%) of the biopsies performed gave correct results. 6 cases (5.1%) were false-negative. False-positive cases were not obtained. In view of the number of successful examinations with adequate results, it can be concluded that the method presented is a useful diagnostic tool. The procedure involves little stress for the patient and can be performed under local anesthesia on an out-patient basis.
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Proliferation of synovial lining cells and fibroblasts in adjuvant arthritis of rats was investigated by autradiographic methods. As manifestation of the generalized experimental disease increased labelling rates of both cell types were found in all joints. While in the knee joint this cellular proliferation was of a short duration, it progressed in the ankle joint until the joints were destroyed. It is concluded that increased cellular proliferation is an important mechanism leading to joint destruction in adjuvant arthritis.
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Strain TEA, a strictly anaerobic, motile rod with one to four lateral flagella and a crystalline surface layer was isolated from a mixed culture that completely reduces chlorinated ethenes to ethene. The organism coupled reductive dehalogenation of tetrachloroethene or trichloroethene to cis-1,2-dichloroethene to growth, using molecular hydrogen as the electron donor. It was unable to grow fermentatively or in the presence of tri- or tetrachloroethene with glucose, pyruvate, lactate, acetate or formate. The 16S rDNA sequence of strain TEA was 99.7% identical to that of Dehalobacter restrictus. The two organisms thus are representatives of the same species or the same genus within the Bacillus/Clostridium subphylum of the gram-positive bacteria.
PURPOSE: Scaglietti introduced a method of steroid injection for the management of unicameral bone cysts in 1974. Subsequently the intralesional infiltration of corticosteriods has also been recommended as a primary therapy for localized Langerhanscell histiocytosis (LCH). We report our experience with the administration of methylprednisolone acetate in children and young adults localized LCH. MATERIAL AND METHODS: [corrected] Nine patients with localized LCH, aged 2 3/12 to 29 years, were treated with a single--in only one case two--intralesional injection of methylprednisolone acetate as a crystalline suspension. The dose was between 40 and 150 mg depending on the size of the radiolucent defect. We treated 4 lesions in the skull, 3 in the femur, 1 in the distal humerus and 1 in the mandibula. In each case the diagnosis was established by biopsy. Follow-up ranged from 2 to 8 8/12 years (4 years 4 months on average). RESULTS: 7 out of 9 patients with localized LCH had excellent results with complete healing of the lesion. In 2 patients there was no response to the initial injection therapy and dissemination of the disease occurred. In 4 patients with an additional soft tissue tumor, after injection therapy of the bone lesion, the soft tissue tumor resolved without further treatment. CONCLUSION: Intralesional infiltration of methylprednisolone acetate as a primary therapy for localized Langerhans cell histiocytosis leads to rapid relief of pain, restoration of bone morphology and reduction of associated soft tissue tumors. Performed with appropriate skill under sterile condition with the reported high percentage of effectiveness and low recurrence rate, this low invasive method is the treatment of choice, resulting in a lower morbidity and lower costs.