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Biomedical subjects

G W Herget

Publications and source records attributed to G W Herget.

17 recordsLinked to original sources
PubMed2004

[Tumor-like lesions].

Tumor-like bone lesions include various conditions of a non-neoplastic nature originating from or affecting the bone as solitary or sometimes multiple bone lesions. This review discusses the most important cystic tumor-like lesions, such as simple bone cyst, aneurysmal bone cyst, intraosseous ganglion, epidermoid cyst and subchondral cyst. MR is the most sensitive method of detection, and is the most accurate in depicting the extent of involvement of these lesions. MR signal characteristics may aid in differential diagnosis. Conventional radiographs are often more specific with respect to the underlying histopathology.

Bone Cysts↗
PubMed2004

Differential diagnosis of benign tumors and tumor-like lesions in the spine. Own cases and review of the literature.

Although benign tumors and tumor-like lesions of the spine are shown in every orthopedic teaching book, it is often surprising how little attention is paid to the differential diagnosis and diagnostic investigations, respectively, since surgical treatment and postoperative control depends on exact diagnosis. Clinically the importance of this fact can not be over-emphasized. The most common complaint is pain, either local or radicular in nature. Bone deviations are diagnosed radiologically. Different types of benign bone tumors and tumor-like lesions of the spine including osteochondroma, osteoblastoma, osteoid osteoma, aneurysmal bone cyst, eosinophilic granuloma, hemangioma, and giant cell tumor, their appearance relation to the age and location in the spine were reviewed and the common histologic subtypes described. Clinical, laboratory and histopathologic findings, radiologic inclusive MRT and scintigraphic features are evaluated. Diagnostic investigations including the invasive techniques of CT guided needle biopsy, Yamshidi needle biopsy and costotransversectomy for biopsy are shown. Treatment including radiation, chemotherapy and the surgical procedure as well as the postoperative treatment of patients with benign tumors and tumor-like lesions of the spine are discussed.

Adult↗
PubMed2003

Experimental use of an albumin-glutaraldehyde tissue adhesive for sealing tracheal anastomoses.

AIM: The purpose of this study was to test the performance of an albumin-glutaraldehyde tissue adhesive (BioGlue, manufactured by CryoLife Inc., Kennesaw, GA, USA) when used on tracheal resections in rabbits, which is a sensitive model to investigate the biocompatibility of the glue. METHODS: The 24 animals were anesthetized and underwent cervicotomy with resection of a 10 mm long tracheal segment. The experimental group (18 animals with 2, 4 and 12 week endpoints) had a tracheal anastomosis performed with a maximum of 4 sutures for the approximation of the tissue margins. The anastomotic line was then circumferentially covered with the adhesive. Control animals (6 animals, 4 week endpoint) had a tracheal anastomosis performed with the use of twice interrupted, airtight running suture. The experiments were conducted after approval by the Institutional Ethics Committee and in accordance with the European Convention on Animal Care. RESULTS: Macroscopic evaluation revealed a tight closure of the anastomosis in 23 animals. One rabbit developed tracheo-cutaneous fistula, 2 rabbits experienced intraluminal granulations due to infection, and 1 rabbit developed tracheal stenosis due to insufficient sutures with axis-displacement of the anastomosed tracheal lumina. On microscopic examination, after 2 weeks an inflammatory tissue response consisting of neutrophils, macrophages and foreign body giant cells was found surrounding the glued area. After 4 weeks the tissue was granulomatous in character with an increasing number of multinucleated giant cells. In general, persistent granulomatous inflammation and fibrous scar tissue was seen after 12 weeks. Both, macroscopically and microscopically, fibroangioblastic tissue responses were found in the control group after 4 weeks. CONCLUSIONS: Despite secondary healing disruptions such as granuloma formation, our investigations suggest that the results of albumin-glutaraldehyde tissue adhesive sealed tracheal anastomoses with a few approximating sutures are comparable with those using suture technique. Short term results demonstrated good biocompatibility of the glue.

Albumins↗
PubMed2001

[Psammous desmo-osteoblastoma of the right maxilla. Case report and differential diagnosis of a rare tumor].

CASE REPORT: We report the case of a 9-year-old female patient with a moderate swelling of the right maxilla. A tumor was diagnosed by conventional X-ray within the region of tooth 17 in the right tuber maxillae. The histological diagnosis after biopsy of the lesion was "fibrous dysplasia Jaffe-Lichtenstein". One year later, the tumor was still growing, and computed tomography was carried out. The first histological diagnosis was confirmed by another biopsy; the differential diagnosis was "ossifying fibroma". In the following years, the tumor grew and expanded into the right orbit and maxilla. Four years after the first diagnosis the tumor was removed operatively. DIFFERENTIAL DIAGNOSIS OF THE OPERATIVE SPECIMEN: The histology showed round, partially trabecular or calcified bodies, known as psammoma-like ossicles. Therefore, in light of the clinical course and the radiographic appearance, the correct diagnosis was "psammous desmo-osteoblastoma". DISCUSSION: The psammous desmo-osteoblastoma and its differential diagnosis are discussed in this article.

Child↗
PubMed2001

Experimental use of an albumin-glutaraldehyde tissue adhesive for sealing pulmonary parenchyma and bronchial anastomoses.

OBJECTIVE: Despite advanced surgical techniques, major complications of bronchial anastomoses and parenchymal repair, including early leak, fistula formation and granulations still occur. The purpose of this study was to test the performance of an albumin-glutaraldehyde tissue adhesive (BioGlue), CryoLife Inc., Kennesaw, GA) as a sealant for bronchial anastomoses and parenchyma lesions. METHODS: Twenty-four sheep were split into two surgical groups. The first group consisted of six control sheep receiving standard sutured bronchial anastomosis with a 4-week end-point. The second group included 18 sheep receiving both a bronchial anastomosis and parenchymal defect repair using the adhesive with 2, 4, and 12 week end-point. Histopathologic evaluation was conducted at the study end-points. RESULTS: Bronchial anastomosis and parenchymal tissue repair can be sealed successfully against air leakage with adhesive. Macroscopic evaluation revealed a tight closure of the anastomosis and parenchyma defect in all postoperative stages, initially by the adhesive layer, and later by connective tissue. On microscopic examination, an inflammatory tissue response consisting of polymorphonuclear neutrophils, macrophages, granulation tissue and foreign body giant cells were found surrounding the glued area after 2 weeks. After 4 weeks the tissue response presented a granulomatous character. No granulomatous or foreign body reaction was present in the hand sutured group. After 12 weeks few remnants of adhesive surrounded by fibrous scar tissue were detectable in bronchial anastomosis and parenchymal repair. Healing was not considerably complicated by foreign body reaction or tissue granulation. CONCLUSION: This study supports BioGlue to be effective as an adjunct in sealing bronchial anastomosis and lung parenchyma defects in sheep, with minimal secondary healing disruptions such as granuloma formation. The results of this study indicate that the use of BioGlue in human pulmonary surgery should be effective.

Anastomosis, Surgical↗
PubMed2000

[The intervertebral disk in anatomy and pathology].

One of the most frequent and incapacitating medical and social problems of our times is back pain. In most patients the cause of the symptoms remains unknown, although some relevant clues have been discovered over the last few years: mechanical, nutritional, chemical, social, psychological and genetic factors. Pathoanatomic conditions that are generally accepted as related to the symptoms include disc herniation, fracture, infection, spinal stenosis, spondylarthropathy and spondylolisthesis. Diagnostic problems will only be solved by considering and synthesis of all findings.

Back Pain↗
PubMed2000

[Late spreading of tuberculosis in tubercular spondylitis].

HISTORY AND ADMISSION DIAGNOSIS: A 65-year-old man, known to have had a gastric ulcer and chronic rheumatoid arthritis as well as alcohol and nicotine abuse, was admitted because of suspected endocarditis. Physical examination revealed marked pain on pressure over the throacic spine. Vesicular breath sounds were reduced over the entire thorax and there was a systolic murmur over Erb's point (above the right clavicle). There was a purulent bursitis over the olecranon. INVESTIGATIONS: Abnormal laboratory tests were: elevated C-reactive protein, elevated leucocyte count (up to 33 thousand during the hospital stay). Smears from the bursitis and blood cultures revealed Staph. aureus. Computed tomography demonstrated a fracture of the 7th thoracic vertebra with a paravertebral abscess. Echocardiography showed anatherosclerotic aortic valve with floating particles. DIAGNOSIS, TREATMENT AND COURSE: Treatment of the suspected staphylococcal bacteraemia with purulent bursitis, spondylitis and aortic valvar endocarditis was begun with broad-spectrum antibiotics, but the patient soon developed a severe acute respiratory distress syndrome and he died of multi-organ failure. Autopsy revealed as cause of death left heart failure with aortic valvar endocarditis and gelatinour pneumonia caused by late tubercular dissemination from the tubercular spondylitis. CONCLUSION: Tuberculosis can be a life-threatening infection. Uncharacteristic history and extrapulmonary manifestations can make it very difficult to arrive at the correct diagnosis.

Aged↗
PubMed2000

Prognostic significance of nuclear DNA content in chondrosarcoma.

Chondrosarcoma is the second most frequent primary malignant tumor of bone. Many of these tumors represent histopathologic borderline cases. In this study, DNA ploidy status, 2c deviation index (2cDI), and DNA malignancy grade (DNA-MG; based on the variation of nuclear DNA content of tumor cells around the normal DNA [2c] peak) were examined for their diagnostic and prognostic value in comparison with conventional histopathologic grading. Twenty-two paraffin-embedded samples were available for histopathologic investigation and for quantitative cytophotometric DNA determination of Feulgen-stained nuclei. Clinicopathologic parameters and prognosis were analyzed over a maximum follow-up period of 252 months. Nineteen of 22 (86%) chondrosarcomas showed aneuploid DNA content. 2cDI (r =.58, P <.01) and DNA-MG (r =.58; P <.01) correlate with the histopathologic grading. Significant correlation between the 2cDI (P <.01) and DNA-MG (P <.025) and the overall survival was found. Ploidy did not influence the overall survival rate. In metastasis-free patients, the 2cDI and DNA-MG gave better prognostic information than conventional histopathologic grading. When patients developed metastasis, however, histopathologic grading was the prognostic parameter of choice. Cytometric DNA measurement provide additional objective information regarding the diagnosis and prognosis of chondrosarcomas, even more than that obtained by conventional histopathologic grading, and may be helpful in planning the treatment.

Adult↗
PubMed1999

Prognostic significance of DNA image cytophotometry for osteosarcoma.

OBJECTIVE: To investigate the prognostic significance of DNA image cytophotometric data. STUDY DESIGN: Twenty-six osteosarcomas in patients without lung metastases were investigated for several cytophotometric data. In 24 cases, these data were correlated with the clinical course of the patients to assess the prognostic value of nuclear DNA content in osteosarcomas. RESULTS: Of all osteosarcomas, 96% showed aneuploid DNA content. Patients with tumors having a 2c deviation index (2cDI) of 12.00, DNA malignancy grade (DNA-MG) of 2.0, a mean DNA content (MDC) of 4.95 c, DNA index (DI) of 1.75 or mean nuclear area (MNA) of 130 microns 2 had a significantly lower overall survival rate as compared to those with lower values (P < .05). CONCLUSION: Image cytophotometric features, such as 2cDI, DNA-MG, MDC, DI and MNA, are of prognostic value in patients with osteosarcoma and free of lung metastases.

Adolescent↗
PubMed1998

[Regeneration of the heart muscle after myocardial infarct].

Myocardial infarction is characterized by the loss of contractile cardiomyocytes. This results in an increased load on the spared myocardium. The aim of this article is to describe the response of the non-affected myocardium after infarction. Human hearts were investigated by microscopical, biochemical and cytophotometrical methods. The number of nuclei was calculated from the numerical ratio of connective tissue nuclei/myocyte nuclei, the values of the total DNA amount and the percentage proportion of the various ploidy classes in the myocyte nuclei. After myocardial infarction the DNA concentration as well as the DNA content was increased. Different DNA distribution pattern could be found in infarcted hearts. Percentage proportion of higher ploid nuclei and aneuploid nuclei was increased. Number of connective tissue nuclei was increased in infarcted hearts. And, in spite fibrosis of the necrotic area, number of myocyte nuclei did not change significantly. Beside scarring of the necrotic tissue, hypertrophy and hyperplasia of cardiomyocytes occur after myocardial infarction and may compensate the loss of contractile fibres to guarantee myocardial function.

Cardiomegaly↗
PubMed1998

Change in size, number and morphology of the nucleoli in human hearts as a result of hyperfunction.

In the present study we examined light-microscopically the nuclei of 16 hearts (7 normal hearts, 7 hearts with hypertrophy and 2 hearts with atrophy) for the size, number and morphology of their nucleoli. The size of the nucleoli, defined as the total area of all nucleoli per nucleus, was an early and sensitive indication of a beginning hypertrophy of the myocardium. It increased in parallel to the total heart weight and to the total area of the nucleus of the cell, but initially the size of the nucleoli changed earlier than the other parameters. We found an increase of the ratio in the total area of the nucleoli per nucleus to the total area of the nucleus at the beginning of clinical hyperfunction. This ratio normalised during chronic hyperfunction. The number of the nucleoli also increased during hyperfunction, but it did not exceed the number of nucleolus organiser regions (NOR) given by the number of chromosomes. Nevertheless, we found numbers of nucleoli higher than 10 because, the number of NORs increases during polyploidization. Regarding the morphology of the nucleoli in hearts with hypertrophy, we found a predomination of the nucleoli with a highly branched nucleolonemal structure as an indication of an increased RNA synthesis.

Atrophy↗
PubMed1997

Regeneration processes in human myocardium after acute ischaemia--quantitative determination of DNA, cell number and collagen content.

We examined and compared 22 human hearts (6 normal hearts, 4 with hypertrophic cardiomyopathy and 12 after acute ischaemia) for their DNA and collagen content and their cell number. A positive correlation between total heart weight and DNA content was demonstrated in all hearts. The relative DNA content decreased and the rate of polyploidy increased in the infarcted and hypertrophied hearts. An aneuploid DNA content was found only in the infarcted hearts. Both hypertrophied and infarcted hearts showed a significantly higher collagen content than did the normal hearts. There was a positive correlation between collagen content and total heart weight in the hypertrophied hearts but not in the infarcted hearts. In the infarcted hearts, the increase in the relative collagen content in the left ventricle was significantly larger than that in the right ventricle. Heart cell number was higher than normal in some hearts with acute ischaemia, which was possibly a sign of compensatory regeneration of heart cells in hearts damaged by ischaemia.

Aged↗
PubMed1997

DNA content, ploidy level and number of nuclei in the human heart after myocardial infarction.

OBJECTIVE: Cardiac hypertrophy due to a prolonged functional activity is associated with an increase of cell size and polyploidization of the myocyte nuclei. Myocardial infarction is characterized by loss of myocytes. Increased load and as a consequence hypertrophic growth of the surviving myocardium has to be expected. The aim of this study was to investigate the response of cardiomyocytes after infarction. METHOD: Biochemical and cytophotometric analysis was performed on myocyte and connective tissue nuclei to determine whether the human heart after myocardial infarction is accompanied by an increase in the ploidy level, DNA content and in the number of nuclei. A total of 15 hearts obtained from autopsy material was studied, among them 8 after myocardial infarction. The number of nuclei was measured by indirect computation. RESULTS: We found a decrease of 4c and no significant difference of 2c nuclei in infarcted hearts. DNA ploidy level (> 8c) as well as the proportion of aneuploid myocyte nuclei were increased in infarcted hearts. DNA concentration and total DNA content were increased in the hearts after myocardial infarction. Numerical ratio of connective tissue nuclei/myocyte nuclei, total number of nuclei, number of myocyte nuclei and number of connective tissue nuclei were increased in infarcted hearts. CONCLUSION: Polyploidization and nuclear hyperplasia of myocytes may represent an adaptive response of the myocardium to an ischemic injury.

Adult↗
PubMed1996

Variability of cardiomyocyte DNA content, ploidy level and nuclear number in mammalian hearts.

DNA content, ploidy level, cell size and nuclear number were investigated in 54 mammalian hearts from nine species. DNA content was determined biochemically and ploidy level of cells was studied by the means of Feulgen cytophotometry. Nuclear number was calculated by a new method, while cell size was determined by using ocular micrometry. In most mammals diploid cell nuclei predominate. Higher ploidy levels were found in the human and the pig hearts. The total amount of DNA correlated with the myocardial weight. Eight million heart muscle cell nuclei were found in mice (myocardial weight 160 mg), and 2600 million heart muscle cell nuclei in the human heart (myocardial weight 210 g), but in the hearts of horses up to 35000 million heart muscle cell nuclei (myocardial weight 3.4 kg) were found. The number of heart muscle and connective tissue cell nuclei was correlated with myocardial weight. The ratio of connective tissue cell nuclei to heart muscle cell nuclei was between 2:1 and 3:1. In cardiac growth this ratio shifted towards connective tissue cell nuclei. Increased heart weight corresponds to an increase in cell size. Diameter between 11 microns and 18 microns may be an optimum for heart muscle cells of mammals.

Animals↗
PubMed1996

Cytophotometric DNA-analysis of bone-tumors. A new method for preparing formalin-fixed tissue and the regarding of DNA-malignancy grade and its prognostic value.

78 benign and malign, formalin-fixed bone or bone-associated tumors of different origin were prepared for image-cytophotometric measuring with a new method of preparing. The DNA-content of the tumors and the so resulting malignancy-grade were determined and compared with the corresponding measurements of unprepared fresh tumors respectively paraffin-embedded tissue sections. Regarding the comparison of the fresh material with the formalin-fixed material, no significant difference (p < or = 0.01) of the data could be found. There was also no significant difference (p < or = 0.01) concerning the comparison of the data obtained from the formalin-fixed material and the data from the tissue sections. The criterium aneuploidy showed a sensitivity of 86% and a specificity of 100% in regards to identifying a malignant tumor, irrespective of the preparation method. A strong correlation could be found (p < 0.001) between the DNA-malignancy grade and the survival rate of the patients.

Age Factors↗
PubMed1995

Cartilaginous tumors: prognostic applications of cytophotometric DNA analysis.

BACKGROUND: Traditionally, selection of cancer therapy is based on the assessment of the prognosis of the individual patient. The specific type of tumor and the stage of disease have been the most reliable indicators of prognosis. METHODS: Image cytometry to determine DNA content was used in conjunction with clinicopathologic parameters and patient survival to investigate 16 cartilaginous tumors. Histopathologic characteristics, cytometric DNA ploidy status, 2c deviation index (2cDI), DNA malignancy grade (DNA-MG), and 5c-exceeding event (5cEE) were used to learn more about the determination of tumor prognosis. Prognosis was analyzed with a maximum follow-up of 148 months. RESULTS: DNA ploidy status, 2cDI, DNA-MG, and 5cEE are indicators of prognosis. After 148 months of follow-up, patients with aneuploid tumors had a significantly lower overall survival rate compared with those with diploid tumors (P < 0.05). Patients with DNA-MG less than 0.8 or 2cDI less than 1.5 had a significantly longer overall survival rate with respect to the group of patients with a DNA-MG greater than 0.8 or 2cDI greater than 1.5 (P < 0.001). A significant difference was noted in the overall survival rates between patients with tumors with 5cEE less than 3 and 5cEE 3 or greater (P < 0.001). CONCLUSION: Image cytophotometry DNA ploidy status, 2c deviations index, DNA malignancy grade, and 5c exceeding event were investigated and were found to be of prognostic value for patients with cartilaginous tumors.

Adult↗