Biomedical subjects
F Borchard
Publications and source records attributed to F Borchard.
[HIV infection and kala-azar].
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Critical evaluation of histochemical and immunochemical methods for the demonstration of vascular supply in rectal and oesophageal cancer.
The vascularisation of rectal and oesophageal carcinomas and of normal mucosa was studied using histochemical and immunohistochemical methods. Endothelial cells were stained for alkaline phosphatase (AP) using an azo-dye procedure. Histochemical results were compared with the immunohistochemical identification of endothelial cells using the monoclonal antibody BW 200 recognising an epitope restricted to human endothelial cells. In the AP experiments the simultaneous reactivity of stromal tissue often precluded the exact evaluation of tumour blood vessels. Immunohistochemistry facilitated the identification of vessels in neoplastic tissues and allowed a quantitative analysis of vascular volume by means of point-counting. Vascular volumes of normal tissues exceeded those of tumours by a factor of 1.6. This immunohistochemical technique has potential application in studying the importance of tumour blood supply in man, especially in relation to radiotherapy.
[Disorders of intestinal absorption in patients treated with cytostatic chemotherapy].
We have investigated the acute and chronic side effects of cancer chemotherapy on the intestinal absorption of adult patients with neoplastic diseases. D-xylose absorption was reduced by 35% in 34 of 50 patients within 48 hours after one course (p less than 0.001), while the vitamin B12 absorption was diminished by 41% in 27 of 38 patients (p less than 0.001). The serum digoxin level fell in 7 of 8 patients by 43% at the first day (p less than 0.01) and normalized after one week. Electron microscopy of the jejunal biopsy specimens revealed damages of the microvilli and defects in the glycocalix. Chronic effects, which were measured after several courses and a pause of four weeks, showed a diminished D-xylose absorption of 36% in 16 of 19 cases (p less than 0.01). Vitamin B12 absorption was reduced by 37% in 11 of 13 patients (p less than 0.01). Microscopical investigations of the jejunum revealed a shortening of the villi and a destruction of microvilli. Acute and chronic malabsorption after cancer chemotherapy should be considered in patients, who are treated with enteral medication and nutrition.
[Pathologic anatomy of focal liver diseases].
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[Late initial manifestations of Crohn disease with atypical symptoms].
The case of a 55-year-old patient with Crohn's disease and chronic intermittent diarrhea as well as progressive weight loss of 20 percent of his body weight is reported. The establishment of the diagnosis was difficult at the beginning, since characteristic symptoms were missing and radiological and endoscopical findings were normal. Loam-coloured glossy stools, repeated registration of a reduced chymotrypsin concentration of the stool and the response of the symptoms to a substitution of pancreatic enzymes were initially regarded as signs of an exocrine pancreas insufficiency. Not before multiple biopsies were taken from the macroscopically largely normal small and large intestine during persisting complaints, an extensive infiltration with Crohn's disease could be shown. This case report emphasizes the importance of taking multiple biopsies in etiologically unexplained chronic diarrhea even from macroscopic inconspicuous intestinal mucosa. Because of the rising incidence of Crohn's disease late onset is gaining increasing significance in the differential diagnosis of chronic diarrhea in the elderly patients.
[Radiotherapy of esophageal carcinoma].
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[Intrahepatic cholestasis and aplastic anemia following administration of prajmaline].
Intrahepatic cholestasis and aplastic anemia after N-propylajmaline. A 43 year old female patient taking oral contraceptives for more than five years received the antiarrhythmic drug N-propylajmaline for treatment of ventricular arrhythmia. After twelve days (total dosage 510 mg N-propyl-ajmaline) acute severe intrahepatic cholestasis and aplastic anemia developed. The erythropoeisis improved after three weeks of treatment with corticosteroids. However, despite treatment with phenobarbital the jaundice receded very slowly. Even after nine years of follow-up cholestatic enzymes are still significantly elevated although serum bilirubin levels are in the normal range. This case report demonstrates that antiarrhythmic drugs may induce nearly irreversible intrahepatic cholestasis and severe hematological disturbances.
Neuritis cordis due to the acute polyneuritis of the Guillain-Barré syndrome.
Three patients with the Guillain-Barré syndrome which followed the course of Landry's acute ascending paralysis died a sudden cardiac death. Autonomic dysfunction had appeared clinically, consisting of sphincter disturbances in one patient and fluctuating blood pressure and bradycardia in the other. In a twenty-three year old female patient cardiac function had been inconspicuous, apart from tachycardia, but the ECG showed S-T segment depression and flat T waves. Postmortem examination revealed acute inflammatory demyelinating polyradiculoneuritis involving the peripheral autonomic nervous system and especially the nerves of the heart. Immunohistochemically, the inflammatory cell infiltrations of this neuritis cordis consisted of macrophages (MAC 387 positive) and T lymphocytes (UCHL1 positive). No indication of a direct viral infection of the inflamed cardiac nerves was detectable by immunohistochemistry (HSV, CMV, influenza virus) nor by electron microscopy. The neuritis cordis was classified as an inflammatory cardio-neuropathy secondary to a patchy acute polyneuritis of the Guillain-Barré syndrome, involving the autonomic nervous system. Myocarditis could be discounted, and the neuritis cordis was thought to be responsible for the sudden cardiac death.
Family occurrence of achalasia and diffuse spasm of the oesophagus.
In view of the unknown aetiology of achalasia and diffuse oesophageal spasm we report four families (father/son, mother/son, brother/brother, cousin/cousin) with achalasia and oesophageal spasm examined by radiology, endoscopy and manometry. Family occurrence of oesophageal motor disorders supports the hypothesis that a genetic trait may play a role in the pathogenesis. The family coincidence of achalasia and oesophageal spasm supports a close relationship between the two diseases.
[Nuclear size and differentiation status in normal tissue, preneoplastic lesions, and malignant tumors. Karyometric comparisons with regard to collecting and processing tissue].
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[Echinococcus cysticus of the thyroid gland].
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[Adenocarcinoma of the large intestine in a 20-year-old patient with Crohn disease].
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Carcinoma of the extrahepatic bile ducts: a postmortem study of 65 cases and review of the literature.
From 1950 to 1982, 65 patients with carcinoma of the extrahepatic bile ducts were autopsied in the Institute of Pathology of the University of Düsseldorf. The average age of men was 64.5 years and that of women was 70 years. The ratio of men to women was 1 to 1.71. The greatest number of tumors was found in the common bile duct (40.1%), followed by the hepatic ducts (29.2%) and the confluence of the common hepatic duct with the cystic duct (27.7%). Adenocarcinomas of various differentiation were found in 96.7% of the cases and anaplastic carcinoma in 3.3%. Metastases were present in 49 cases (75.4%). Cholelithiasis was found in 51% of the cases. The results of the present postmortem study are compared with the literature.
Effect of N-ethyl-N-butyl-nitrosamine on the esophageal mucosa of the rat. Histometric investigation of early tumor stages.
80 male Wistar rats received an oral ad libitum application of N-ethyl-N-butyl-nitrosamine in a concentration of 0.18 g per litre of drinking water. The changes induced in the esophageal mucosa and determined at three intervals (up to 48 days, up to 91 days, and up to 112 days after commencement of carcinogen exposure) were compared by microscopy with the results from a control group of 10 male Wistar rats of the same age. Several histomorphometric parameters were investigated with the aid of a Leitz ocular micrometer. The earliest localized changes found were an increase in the thickness of the epithelium and the horny layer, and an elongation of the papillary bodies and a widening of the parabasal cellular layer. Later--with a substantial increase in the rate of mitosis in all layers of the epithelium, there was a significant thickening of the non-papillomatous and papillomatous epithelium, an enlargement of the nuclei, especially in the middle and upper layers of the epithelium and a thickening of the horny layer, parts of the latter being parakeratotic. The papillomatous changes corresponded in some cases to moderate epithelial dysplasias. As expected, no fully-developed invasive carcinomas occurred in the early period investigated. The histometric data permit the conclusion to be drawn that the lesions described are demonstrable not only at the exophytic-papillomatous epithelium but also in multifocally localized form at the flat, non-papillomatous mucosa, and that they can definitely be regarded as the expression of an incipient field cancerification.
[Effect of lipid emulsions on nitrogen balance within the scope of perioperative parenteral feeding regimens].
Patients with colorectal cancer were parenterally fed before and after surgery by two different isocaloric regimens: One group was infused with high carbohydrate solutions (carbohydrate group), the other group with carbohydrate in combination with fat emulsions (fat group). The daily dose of fat was restricted to 1 g fat/kg BW/day. These conditions led to the following results: No significant changes in the protein balance were observed between the patients of the two regimens. The protein sparing effect and the synthesis of short living proteins were comparable. The infused fat emulsions were utilized without metabolic complications. Patients in the fat group were adequately supplied with essential fatty acids which was documented by the higher level of linolic acid in the blood. The biochemical and histological analysis of the liver samples which were excised on occasion of surgery gave comparable triglyceride content in both groups. In the fat group little lipid deposition was seen in the parenchymal cells but lipid droplets were observed in the reticuloendothelial system (v. Kupffer cells). Thus, distribution of fat droplets is different in the 2 groups. Unfortunately analysis of lipid depositions in the liver at the end of the parenteral nutrition could not be performed.
[Role of Pseudomonas maltophilia and "Pseudomonas like bacteria group Va" in the etiology of Crohn disease].
In 1976, Parent and Mitchell isolated cell-wall defective bacteria of the species Pseudomonas maltophilia and Pseudomonas like bacteria group Va from resected bowel tissue of 8 consecutively operated patients with Crohn's disease. The control group, which included patients with ulcerative colitis, was negative in this respect. The isolated strains were available for our own investigations. New Zealand white rabbits were inoculated with killed bacteria to produce specific antisera. Frozen sections of affected tissue from 6 consecutively operated Crohn patients were incubated with the various antisera and investigated by indirect immunofluorescence. No positive reactions were demonstrable in repeated tests with different dilutions of antisera. Our results do not support the hypothesis that bacteria of the species Pseudomonas maltophilia and Pseudomonas like bacteria group Va are an etiologic factor in Crohn's disease.
[The bile ducts and pancreas].
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