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Biomedical subjects

D Theegarten

Publications and source records attributed to D Theegarten.

36 records · Page 2Linked to original sources
PubMed2001

[Osteoma of the maxillary sinus].

BACKGROUND: Osteoma of the paranasal sinuses is a rare and benign entity that develops slowly. If they occur, locations within the frontal sinus and ethmoid cells are more frequent, whereas osteomas in the sphenoid or maxillary sinus are very rare. CASE: We report on a 25-year old female patient presenting with a bony mass in the right maxillary sinus. A standard external approach using a modified Caldwell-Luc procedure was successfully employed as endoscopic endonasal surgery was limited by the size of the bony lesion. CONCLUSIONS: Trauma or infection are often suggested as an etiologic factor in the pathogenesis of osteoma. In our case the development of maxillary osteoma was related to dental extraction and postoperative fistula. External standard procedures remain mandatory if endonasal endoscopic surgery fails in the removal of osteoma of the paranasal sinuses.

Adult↗
PubMed2000

The role of chlamydia in the pathogenesis of pulmonary emphysema. Electron microscopy and immunofluorescence reveal corresponding findings as in atherosclerosis.

Chlamydia pneumoniae has been detected in atherosclerotic plaques by various means. Chlamydiae are able to cause persistent infections. Serologically elevated antibody titers are found in severe chronic obstructive pulmonary disease. In atherosclerosis and pulmonary emphysema, inflammatory reactions can be seen by means of light microscopy. Specimens from patients with obliterative arteriosclerosis undergoing thrombendarteriectomy and with advanced emphysema undergoing lung volume reduction surgery were examined using scanning (SEM) and transmission (TEM) electron microscopy, and using immunofluorescence with monoclonal antibodies and antiserum against chlamydiae. SEM shows spherical bodies (SBs) with a diameter from 0.3 microm to 0.6 microm on the surface of the alveoli and bronchioles, as well as in atherosclerotic plaques. In atherosclerosis and emphysema, SBs reveal a double membrane, adherence to collagen fibers, tissue destruction, as well as intracellular and interstitial localization in TEM. They show in parts a densely packed central structure. SBs are seen both in alpha-1-antitrypsin deficiency emphysema and smoker's emphysema. Using immunofluorescence microscopy, spots are seen in corresponding distributions to the SBs. Morphological findings are typical for aberrant chlamydiae seen in persistent infections. Chronic infection and bacterial colonization associated with progressive disease seems to be relevant not only in atherosclerosis but also in pulmonary emphysema.

Arteriosclerosis↗
PubMed2000

Mesalazine changes apoptosis and proliferation in normal mucosa of patients with sporadic polyps of the large bowel.

BACKGROUND AND STUDY AIMS: Regular intake of nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the occurrence of colorectal adenoma and carcinoma, possibly by inducing apoptosis and/or decreasing proliferation in colorectal epithelial cells. Mesalazine is widely used in the treatment of patients with inflammatory bowel disease, and well tolerated. We investigated its effect on apoptosis and proliferation of colorectal mucosa in 21 patients with sporadic polyps of the large bowel. PATIENTS AND METHODS: In total, 17 patients with sporadic colorectal polyps (> or = 5 mm) underwent polypectomy and biopsy of uninvolved mucosa before and after treatment with 1 g/d mesalazine for 1, 3, 7 or 14 days. Four additional patients served as untreated controls. Apoptotic index (AI) was measured by terminal deoxynucleotidyl transferase-mediated d-uridine triphosphate nick-end labeling (TUNEL) assay; proliferation index (PI) was measured by immunohistochemical examination with anti-Ki67 antibody. RESULTS: AI was significantly increased 1 and 3 days after initiation of treatment with mesalazine compared with controls (P= 0.0107 for the 1-day treatment group and P=0.0142 for the 3-day treatment group), and seemed to remain largely unchanged after longer treatment duration. Proliferation appeared to be decreased by mesalazine in all treatment groups, while proliferation in controls did not change (P=0.0107 for the 1-day treatment group and P= 0.0142 for the 3-day treatment group compared with controls. CONCLUSIONS: Mesalazine significantly induces apoptosis and decreases proliferation in colorectal mucosa in patients with sporadic polyps of the large bowel. This may be clinically relevant in that it may lower the rate of polyp recurrence after polypectomy, thereby possibly contributing to the chemoprevention of sporadic colorectal carcinoma.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1999

The role of persisting infections in the pathogenesis of pulmonary emphysema. Electron microscopy reveals a probable bacterial colonization of the alveolar space and the bronchioles.

Lung volume reduction surgery (LVRS) yields resection specimens from patients with advanced pulmonary emphysema. Regarding the development of lung function parameters, recent results obtained by light microscopy revealed an unfavorable prognosis in patients with remarkable inflammation, particularly in the bronchioli. Tissue from ten patients (alpha1-antitrypsin level in the normal range) was furthermore investigated by electron microscopy. Scanning electron microscopy shows 0.4-0.6 micron spherical bodies variably densely arranged in the whole alveolar space and in the bronchioles of all patients. These bodies are mostly seen on the microvilli of type II pneumocytes. An immunological reaction with activation of macrophages and granulocytes occurs simultaneously. Macrophages show cytoplasmic extensions to the spherical bodies, which exhibit a cellular membrane but no cellular wall. This favors the diagnosis of bacterial colonization of the alveolar space and the bronchioles by mycoplasmas or L-forms of other bacteria. As patients undergoing lung volume reduction surgery are under optimal medical treatment and without any infection clinically, these findings appear to be relevant for the pathogenesis and/or progression of pulmonary emphysema.

Acute Disease↗
PubMed1998

Mixed malignant germ cell tumour of the liver.

Germ cell tumours of the liver are rare neoplasms, with fewer than 20 cases reported in the literature following presentation as teratomas, choriocarcinomas or yolk sac tumours. We report a 52-year-old patient who complained of upper abdominal pain and anorexia. Ultrasonography and computed tomography of the abdomen revealed a large hepatic mass. Among the laboratory values we found elevated levels of alpha-fetoprotein and beta-chorionic gonadotropin. Repeated biopsies via CT scan, laparoscopy and laparotomy disclosed a poorly differentiated adenocarcinoma. Subsequently liver function deteriorated and, on the basis of clinical data highly suggestive of a malignant germ cell tumour, a modified chemotherapeutic protocol (PEI) was initiated. The elevated levels of alpha-fetoprotein and beta-chorionic gonadotropin declined rapidly, but the patient died 10 days later of liver dysfunction and bronchopneumonia. Subsequent autopsy confirmed the initial clinical diagnosis of a multilocular extragonadal malignant germ cell tumour of the liver with components of choriocarcinoma and embryonal carcinoma.

Chorionic Gonadotropin, beta Subunit, Human↗
PubMed1998

Two-year results after lung volume reduction surgery in alpha1-antitrypsin deficiency versus smoker's emphysema.

Lung volume reduction surgery (LVRS) improves exercise capacity and relieves dyspnoea in patients with smoker's emphysema (SE). It is unclear, however, whether LVRS similarly improves lung function in alpha1-antitrypsin-deficiency emphysema (alpha1 E). To address this question, this study prospectively compared the intermediate-term functional outcome in 12 consecutive patients with advanced alpha1E and 18 patients with SE who underwent bilateral LVRS. Before surgery there were no statistically significant differences between the two groups in the six-minute walking distance, dyspnoea score, respiratory mechanics or lung function data, except for the forced expiratory volume in one second, which was lower in the deficient group (24 versus 31% of the predicted value; p<0.05). In both groups, bilateral LRVS produced significant improvements in dyspnoea, the six-minute walking distance, lung function and respiratory mechanics. In the alpha1E group, the functional data, with the exception of the six-minute walking distance, returned to baseline at 6-12 months postoperation and showed further deterioration at 24 months. The functional status of the SE group remained significantly improved over this period. In conclusion, the functional improvements resulting from bilateral lung volume reduction surgery are sustained for at least 2 yrs in most patients with smoker's emphysema, but this type of surgery offers only short-term benefits for most patients with alpha1E.

Dyspnea↗
PubMed1998

[Pathologic-anatomic findings in surgical lung volume reduction of advanced emphysema].

Surgical lung volume reduction is a method for treatment of advanced pulmonary emphysema after all other therapeutic approaches have failed. 280 atypical lung resection specimen of 81 patients were examined pathologico-anatomically using routine stains. In all cases combinations of various forms of emphysema were found; in 65.8% there were also bullous changes (with > or = 1 cm diameter) focally. Acute bronchiolitis was seen in 41.8% of the specimens, an only slight (if at all) chronic bronchiolitis in 26.7% and bronchioloectasia in 45.4% of the cases. Focal intraalveolar aggregates of granulocytes were identified in 16.1%, and the process of permanent scarring resulting in "organised pneumonia" in 20.6% of the specimens. Occult neoplasms were found in 9.9% of the patients and specific changes in 27.2%. Bronchiolitis is relevant for postoperative prognosis and an indication for intensifying antibiotical and antiinflammatory therapy. Preoperative diagnostical procedures should be intensified to find out these patients. Inflammatory changes must be investigated in respect of etiology and pathogenesis.

Bronchiolitis↗
PubMed1998

Proliferative activity, p53 accumulation and neoangiogenesis in pulmonary carcinosarcomas and pulmonary blastomas.

Carcinosarcoma and pulmonary blastomas are rare biphasic tumors. Lung cancer pathogenesis is a multistep process. Proliferative activity, p53 accumulation and angiogenesis are of well-known relevance and ought to be evaluated in the epithelial and mesenchymal components of these tumors. Using antibodies against Ki-67 epitope MIB1 and proliferating cell nuclear antigen (PC 10) in 10 carcinosarcomas, tumors revealed a significantly higher proliferative activity in the epithelial component compared with the mesenchymal component in the MIB1 reaction (p = 0.013). In three pulmonary blastomas of the biphasic subtype, proliferative activity was similar in both parts. In five of 10 carcinosarcomas and in one of three pulmonary blastomas, accumulation of the p53 epitopes Pab 1801 and/or DO-1 was found. At the tumor front, a significantly higher vessel density was found compared with the central parts (p < or = 0.015) using a monoclonal antibody against human endothelium (CD 31). No differences were found between carcinosarcomas and pulmoblastomas. Higher proliferative activity in carcinosarcomas revealed a better prognosis regarding metastasis behavior (p = 0.05) and tumor-associated death in the follow-up (p < or = 0.017). p53 accumulation and microvessel density were of no prognostic value. This is in contrast to results in non-small cell lung cancer, pointing to a different biologic behavior.

Aged↗
PubMed1997

[Expression of proliferation markers PCNA and MIB 1 in verrucous squamous epithelial carcinoma of the oral cavity].

Expression of proliferation markers PCNA and MIB 1 was evaluated in 17 verrucous carcinomas and in five cases of normal squamous epithelium of the oral cavity. Immunohistochemistry revealed no significant differences in the proliferative activities. Highest expression was seen in the basal zones. Proliferative activity in more than 26% of cells is no longer compatible with verrucous carcinoma, but favours the diagnosis of squamous cell carcinoma.

Aged↗
PubMed1995

Tracheal carcinoma and mixed pneumoconiosis. A causal relationship?

We report on a 58-year-old man who had worked as a plumber and fitter for over 41 years and had been exposed to asbestos, man-made mineral fibers and welding fumes. Eighteen months before death, squamous cell carcinoma of the trachea occurred. Energy-dispersive X-ray analysis revealed intrapulmonal dust deposits in accordance with his exposure. A relationship between the tracheal carcinoma and the dust exposure causing a mixed pneumonoconiosis seems to be probable.

Asbestos↗
PubMed1995

[Malignant fibrous histiocytoma in the area of a total endoprosthesis of the hip joint].

Up to now 8 cases of malignant fibrous histiocytoma are reported in whom the tumor had developed after total hip replacement. Direct contact between tumor and prosthesis was proved in 7 cases. We report on a female patient of 74 years of age in whom a malignant fibrous histiocytoma of the gluteal region had formed 15 years after total hip replacement. Tumor was located in the old operation scar. Not only a direct effect of the foreign material, but also the scar has to be regarded as an etiological factor in pathogenesis of malignant fibrous histiocytoma in these cases.

Aged↗
PubMed1995

[Primary germ cell tumors of the mediastinum].

This is a report on 5 cases of mediastinal germ cell tumours. Of three mature teratomas seen in a 48-year old male and a 21-year old and 19-year old female, one was asymptomatic, another one associated with streptococcal pneumonia and the third associated with progressive cough irritation. In addition, a seminoma was seen in a male of 58 years of age and a yolk sac tumour (mesonephroma type 2) in a male of 23 years. Whereas in mature teratomas surgical resection can be considered sufficient, resection combined with chemotherapy should be performed in patients suffering from malignant germ cell tumours, and in addition also radiotherapy in case of seminoma. This approach may result in a significant improvement of the prognosis in malignant mediastinal germ cell tumours.

Adult↗
PubMed1994

[Pneumocystis carinii pneumonia with recurrent pneumothorax and pleuritis].

A report on three HIV-positive patients with recurrent pneumothorax in pneumocystis carinii pneumonia on whom partial parietal pleurectomy and in two cases also a wedge-shaped pulmonary resection were performed. Histology revealed granulomatous necrotising pneumonia involving the visceral pleura, and a partly honeycomb-shaped metaplasia of the pulmonary tissue. A fibrinous and partly granulomatous necrotising pneumocystis carinii pleuritis of both pleural membranes was seen, being the morphological correlate of an in all cases prolonged exudation to the pleural cavity. Conservative treatment remained unsuccessful due to the marked lung and pleura involvement in the inflammatory process, necessitating surgical revision.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Pneumatosis cystoides intestinalis: associated diseases, morphology and presumed pathogenesis].

Based on six cases, the clinical presentation, morphology and presumable pathogenesis of pneumatosis cystoides intestinalis (PCI) are discussed. As a rule PCI is not a disease in its own right, but a complication of very different, in part extraintestinal diseases. These can be subsumed in three groups. Group 1 includes patients with PCI as a complication of lung disease and initially normal intestinal status. The patients in group 2 develop pneumatosis on the grounds of intestinal disease secondary to primary extraintestinal or generalized disease. In group 3 pneumatosis develops as a complication of primary gastrointestinal disease.

Aged↗
PubMed1993

Scar carcinoma of the trachea after tracheotomy. Case report and review of the literature.

We present another case of squamous cell carcinoma of the trachea developed in a tracheotomy scar. In the literature 6 cases of cancer found in tracheotomy scars or tracheostomies are reported. The patients' ages ranged from 6 to 66 years. The interval between tracheotomy and the occurrence of cancer ranged from 3 to 41 years. Local extirpation and radiotherapy were tried. The use of stents is emphasized.

Adult↗
PubMed1993

[Malignant fibrous histiocytoma of the thoracic wall in the area of a tuberculous pleural callosity].

The authors report on a patient of 85 years of age in whom a malignant fibrous histiocytoma of the thoracic wall had formed 51 years after a healed pulmonary tuberculosis that had resulted in the development of a pleural callosity. The malignant fibrous histiocytoma is interpreted as a neoplastic transformation of cells of the primary repair process. Age assumes the role of a predisposing factor.

Aged↗
PubMed1992

[Esophago-thoracic fistula after pneumonectomy and long-term main bronchus stump fistula].

A woman patient admitted for treatment, who had reached the age of 65 years, had a previous history of an open pulmonary tuberculosis in 1946 that had been treated at that time by means of collapsotherapy and phrenico-exeresis. Pleuropneumonectomy was performed in 1976 because of a residual cavity of a thoracic empyema. Since 1978 the patient suffered from a fistula of the bronchus treated by postural therapy without achieving a cure. In 1989 a fistula formed between oesophagus and pneumonectomy cavity. Clinically this was associated with an increasing reduction of performance and a suddenly ineffective postural drainage, resulting in triphasic and eventually fatal aspiration. Histology revealed a suppurative inflammation in the fistular channel and a slight superficial Candida colonisation of the pneumonectomy cavity, of the fistular channel and of adjacent mucous glands of the oesophagus. Formation of the fistula was probably due to a small traction diverticulum followed by perforation because of obstructed oesophageal passage due to scarified distortions.

Aged↗