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Biomedical subjects

B W Berger

Publications and source records attributed to B W Berger.

At least 37 records · Page 2Linked to original sources
PubMed1986

Treating erythema chronicum migrans of Lyme disease.

The efficacy of antibiotic treatment of 117 patients with erythema chronicum migrans of Lyme disease was evaluated in terms of the necessity for retreatment and the prevention of the late manifestations of Lyme disease. Fifty-six patients with a minor form of the illness did not require retreatment and did not develop late manifestations following antibiotic treatment. Three pregnant patients were included in this group. Fourteen of sixty-one patients with a major form of the illness required retreatment, and five developed posttreatment late manifestations of Lyme disease consisting of Bell's palsy and persistent joint pain. Although the preferred antibiotic for treating erythema chronicum migrans of Lyme disease has not been conclusively established, tetracycline and penicillin proved effective. The use of probenecid plus penicillin may be of benefit to patients with the major form of the illness.

Adult↗
PubMed1985

Isolation and characterization of the Lyme disease spirochete from the skin of patients with erythema chronicum migrans.

The Lyme disease spirochete, which had previously been isolated with difficulty from human skin lesions of erythema chronicum migrans of Lyme disease, was grown from six of fourteen skin biopsies cultured in a newly modified Kelly's medium. In two instances the Lyme disease spirochetes that were grown were also seen in histopathologic sections. Organisms grew in clumps in liquid culture medium. All six isolates reacted with a monoclonal antibody to a 31,000-dalton outer membrane protein. Only three of six reacted to a monoclonal antibody to a 34,000-dalton outer membrane protein, suggesting that different subtypes of this organism may infect man. Penicillin, erythromycin, and minocycline were bactericidal agents to all six spirochetes. These in vitro findings may be helpful in determining specific antibiotic treatment of Lyme disease, which was previously based primarily on clinical observations.

Adult↗
PubMed1984

Erythema chronicum migrans of Lyme disease.

Erythema chronicum migrans (ECM) is the distinctive cutaneous lesion of the multisystem tick-borne spirochetosis, Lyme disease. Its clinical and histologic pictures are variable. Of the 51 patients with ECM of Lyme disease, 38 patients (75%) had single lesions, 13 patients (25%) had multiple lesions, and 32 patients (62%) had extracutaneous signs and symptoms. Only 15 patients (29%) had symptoms referable to ECM. Extracutaneous signs and symptoms were absent in 12 (80%) of the 15 patients. These patients had uneventful recoveries following treatment with systemic antibiotics. Thirty-four skin biopsy specimens were obtained from the ECM lesions of 30 patients. With Warthin-Starry silver stain, the Ixodes dammini spirochete was found in 14 specimens (41%) taken from 12 (40%) of the 30 patients. Two of the Ixodes dammini spirochete-positive specimens were obtained from secondary ECM lesions. Careful clinical and histologic examination of skin lesions suggestive of ECM of Lyme disease will expedite its early diagnosis and treatment.

Adolescent↗
PubMed1983

Malignant fibrous histiocytoma of the spermatic cord: the role of retroperitoneal lymphadenectomy in management.

Malignant fibrous histiocytoma of the spermatic cord is rare, with only 6 previously reported cases. We describe 2 new cases that were treated with retroperitoneal lymphadenectomy. To our knowledge, this is the first report in the literature of retroperitoneal lymphadenectomy for the treatment of this specific lesion. The literature is reviewed in regard to the sarcomatous nature of this tumor and the use of retroperitoneal lymphadenectomy performed for spermatic cord sarcomas. We conclude that this procedure should be considered strongly as a surgical adjunct to wide local excision in the management of this unusual tumor.

Castration↗
PubMed1983

Lyme disease is a spirochetosis. A review of the disease and evidence for its cause.

Fourteen patients with Lyme disease showed typical clinical features of erythema chronicum migrans. Eighteen biopsy specimens in all were obtained from the cutaneous lesions of these patients. The predominant histologic finding was a superficial and deep perivascular and interstitial infiltrate composed mostly of lymphocytes, or lymphocytes and either plasma cells and eosinophils or both. The plasma cells were found most frequently in biopsy specimens taken from the peripheries of the lesions, whereas eosinophils were found mostly in the centers of lesions. With the Warthin-Starry silver stain, spirochetes were found mostly at the borders of the lesions an in biopsy specimens containing plasma cells. Spirochetes were subsequently cultured from a typical skin lesion of erythema chronicum migrans. These findings corroborate previous indirect evidence that a spirochete might be the cause of Lyme disease.

Adult↗
PubMed1982

Renal arteriovenous fistula--angiographic and sonographic correlation.

We report a case of a markedly enlarged inferior vena cava and a cystic structure simulating a hydronephrotic kidney in the clinical setting of hypertension with cardiomegaly, congestive heart failure and a flank bruit. Ultrasonographic findings with the aid of angiography were highly suggestive of a renal arteriovenous fistula or malformation.

Adult↗
PubMed1981

Nephrogenic adenoma: clinical features and therapeutic considerations.

Nephrogenic adenoma is a benign metaplastic lesion that usually responds to endoscopic treatment. Although occasionally it has been present simultaneously with another malignancy there has been no evidence that a nephrogenic adenoma has ever transformed into a carcinoma. The symptoms of a nephrogenic adenoma can be severe but these lesions can be treated with transurethral surgery. The lesions can occur throughout the bladder and in the urethra. They usually are associated with trauma to the urothelium. Postoperative followup is needed because these lesions tend to have a symptomatic recurrence. An increased awareness of nephrogenic adenoma by urologists and pathologists may lead to its more frequent diagnosis.

Adenoma↗
PubMed1981

Nephrogenic adenoma of the urinary bladder and urethra.

The histologic and ultrastructural features of nephrogenic adenomas of the urinary bladder and urethra were studied in multiple specimens obtained from eight patients. Three of these were studied by indirect immunofluorescence for Tamm-Horsfall uromucoprotein. The lesions are uncommon benign metaplastic proliferations of urothelium, occurring most frequently in males as small cystic, papillary, or nodular masses and most often presenting with hematuria. Typically the metaplastic tubules resemble nephronic tubules. A florid atypical and pseudoinfiltrative proliferation of these tubules may led to an erroneous diagnosis of adenocarcinoma. Ultrastructural features of proximal convoluted tubules were identified in some of the tubules, but resemblance to specific segments of distal tubules was less certain. The ultrastructural features combined with the absence of Tamm-Horsfall protein in tubular lumina or cells suggest a mesonephric rather than metanephric homology. The lesions are appropriately treated by transurethral resection or fulguration, but persistent lesions were present in three patients up to 18 yeas after initial treatment.

Adenoma↗
PubMed1978

Multicentric bowen's disease of the genitalia: spontaneous regression of lesions.

The phenomenon of multiple lesions of Bowen's disease appearing on the genitalia of young adults is becoming increasingly recognized. We have seen two patients who had genital lesions with histologic features of squamous carcinoma in situ, but with an entirely different clinical appearance. In both patients, varying degrees of spontaneous regression occurred. A conservative approach to management of these lesions is suggested.

Adult↗
PubMed1977

Transitional cell carcinoma in a pyelogenic cyst.

A case of transitional cell carcinoma in a pyelogenic cyst is presented. The pathogenesis of pyelogenic cysts and the clinical management of avascular cystic renal masses are discussed.

Carcinoma, Transitional Cell↗