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Biomedical subjects

H Dancygier

Publications and source records attributed to H Dancygier.

89 records · Page 5Linked to original sources

Neuraminidase deficiency presenting as non-immune hydrops fetalis.

A newborn infant with oedema, ascites and hepatosplenomegaly is described. In ascites fluid foamy macrophages were found, in a liver biopsy cytoplasmic inclusions and membrane-bound vacuoles were seen. Furthermore the child excreted excessive amounts of sialic acid-rich oligosaccharides in the urine, and therefore a neurovisceral degenerative disorder was assumed. The diagnosis of sialidosis was confirmed by enzymatic assay in cultured fibroblasts, in which a complete deficiency of the lysosomal enzyme neuraminidase could be demonstrated. After recurrent septicaemias the child became dystrophic and died at the age of 6 months. Our case is compared with sialidosis observed by other authors, the wide phenotypic diversity within this biochemical defect is emphasised. The occurrence of hydrops fetalis in lysosomal storage diseases is discussed.

Edema↗

Somatostatin-containing cells in the extrahepatic biliary tract of humans.

We investigated the presence of endocrine cells in the human extrahepatic biliary system using the avidin-biotin-peroxidase complex method. Twenty gallbladders obtained during operations for cholelithiasis, large portions of three common bile ducts obtained during Whipple's procedure for carcinoma of the head of the pancreas, and 155 endoscopic transpapillary biopsy specimens taken during control endoscopy from patients who had had a previous endoscopic sphincterotomy were examined. Somatostatin-containing cells were found in the glandular epithelium of the ampulla of Vater and the bile ducts. Only the surface epithelium in the ampulla contained endocrine cells. All somatostatinlike immunoreactivity was confined to cells and could not be detected in nerves. No somatostatinlike immunoreactivity was found in the gallbladder. These findings reveal a morphologic basis to reported actions of somatostatin on bile flow.

Ampulla of Vater↗

Ultrastructural changes in human hepatocytes in acute non-A, non-B hepatitis.

Ultrastructural findings in the liver of a 52-year-old man with acute non-A, non-B (NANB) post-transfusion hepatitis are described. Apart from non-specific alterations also known to occur in hepatocytes in hepatitis A and B--such as proliferation of membranes of smooth endoplasmic reticulum, formation of membrane-bound cytoplasmic vacuoles containing electron-dense material, and accumulation of distorted peroxisomes--unique cytoplasmic changes were observed that have not previously been described in man. A few hepatocytes contained in their cytoplasm tightly packed, bent, parallel structures and small clusters of virus-sized particles. No virus-like material was found in the nucleus of liver cells or in Kupffer and endothelial cells. Closely similar structures have been reported earlier in the acute-phase hepatocytic cytoplasm of chimpanzees with NANB hepatitis. These alterations may represent an ultrastructural hallmark of acute human NANB hepatitis.

Cytoplasm↗

Dacarbazine (DTIC)-induced human liver damage light and electron-microscopic findings.

The first electron-microscopic description of DTIC-induced human liver injury is presented. A 61-year-old man developed signs of hepatic failure during the second treatment cycle with DTIC for malignant melanoma. Light-microscopic examination revealed extensive centrilobular liver necrosis. Terminal hepatic venules did not show any signs of vasculitis or thrombosis and there was a lack of inflammatory infiltration. At the ultrastructural level intracytoplasmic, membrane-bound, organelle-free vacuoles were found in the hepatocytes. Liver cells showed bleb formation. Bile canaliculi were dilated and their microvilli flattened. In the pericanalicular exoplasm electron-dense fibrillary material, thought to be of microfilamentous origin, accumulated. The patient received 250 mg methylprednisolone i.v. at the very onset of symptoms and was discharged 12 days after the peak rise of transaminases with normal liver parameters.

Chemical and Drug Induced Liver Injury↗

[Endoscopic determination of the size of gastrointestinal ulcers (author's transl)].

A new method based on computer-assisted semi-automatic equipment for stereological analysis has been developed to measure ulcer size endoscopically. The main component is a graphic measuring table connected with a computer which is itself linked to a television monitor. The endoscopic picture is transmitted to the television monitor and the ulcer area is measured directly on the monitor using electronic overlay markers. The trace of the measuring markers remains visible on the monitor so that every lesion demonstrated is accurately outlined. The computer calculates the ulcer area by relating it to a known endoscopically inserted reference area. Numerous measurements from various distances, various angles of view and with variable reference area sizes showed the error to be 4.2 +/- 0.5%. Measurements by six different investigators showed variations of 2.9 +/- 1.2%. These results document the reliability of endoscopic planimetrics of gastrointestinal ulcers.

Anthropometry↗

Beneficial effect of somatostatin in phalloidin-intoxicated rats. Influence on survival rate, biochemical and morphological data, and 3H-demethylphalloin absorption rate by the liver.

The effect of somatostatin in phalloidin-intoxicated rats was studied. Animals were given phalloidin i.p. 1.2 mg/kg (LD 90-100). Somatostatin, 250 microgram/animal, was administered i.p. in saline 5 min prior and s.c. in protamine-sulphate/ZnCl2 suspension 30 min prior and 30 min after intoxication, unless stated otherwise. In vivo and in vitro uptake studies of the toxin were performed. Liver enzymes (GPT, GLDH) and kallikrein-like activities were determined in blood obtained by orbital venipuncture. Light and electron microscopy was carried out. Somatostatin treatment led to an increase in survival rate. Of the 20 treated rats six died whereas of the 20 untreated animals 18 died. A dose dependency was proven effective when half of the initial dose of somatostatin was given. In vivo and in vitro uptake studies of the toxin demonstrate that somatostatin does not alter uptake rate by rat livers. Liver enzymes remained elevated in treated and control rats. Kallikrein-like activities showed a 61% decline in treated animals whereas they rose up to 120% in controls as compared to pretreatment conditions. Light and electron microscopy reveals less severe lesions in somatostatin-treated animals. A possible interaction of somatostatin in shock development is discussed, phalloidin seems to be a suitable tool for further investigations concerning cell protection by somatostatin.

Alanine Transaminase↗

A new method for the endoscopic determination of gastrointestinal ulcer area.

Current endoscopic measurements of gastrointestinal ulcer area using forceps or graduated probes are associated with a high degree of inaccuracy. Based on a computer-assisted, semiautomatic device for stereological analyses, we have developed a new method for the endoscopic determination of ulcer size. The basic elements are a graphical measuring tablet coupled with a computer, the later being connected to TV-monitor. The endoscopic picture is transmitted to the TV-monitor and the ulcerated area is measured directly on the TV-monitor by means of an electronic overlay marker. The trace of the marker remains visible on the screen so that any circumscribed lesion can be labelled exactly. From the relation of a known, endoscopically introduced reference area to the circumscribed ulcerated area, the latter is calculated by the computer. Multiple measurements obtained at different distances, and visual angles, and with different reference areas, revealed an error of 4.2 +/- 0.5%. Inter-observer variation among 6 different examiners was 2.9 +/- 1.2%. These results document the reliability of endoscopic planimetry of gastrointestinal ulcers.

Computers↗

Endoscopic ultrasonography in esophageal diseases.

Endoscopic ultrasonography (EUS) was performed prospectively in 38 patients with various esophageal disorders. Twenty-four had a histologically proven carcinoma and EUS was done to assess its ability in preoperative staging. In 9 of 24 patients (37.5%), tumor stenosis could be passed with the endoscope and EUS preoperative findings regarding tumor extension and the presence of enlarged periesophageal lymph nodes were confirmed in those operated on (n = 4). In five patients with achalasia, a periesophageal tumor was reliably excluded by EUS. In one of four patients with Barrett's esophagus, EUS demonstrated a small (less than 1 cm) carcinoma that could not be visualized with any conventional technique. For differentiation of cancer recurrence after operation from periesophageal scar tissue EUS-guided transmural biopsies are needed. Our experience shows that at the present time EUS is the most reliable method to demonstrate small (less than or equal to 1 cm) intra- and extramural esophageal lesions and that it should therefore be applied early in the work-up of patients with dysphagia.

Aged↗

Local staging and assessment of resectability in carcinoma of the esophagus, stomach, and duodenum by endoscopic ultrasonography.

Eighty-eight patients with carcinoma of the esophagus (N = 44), stomach (N = 41), and duodenum (N = 3) who underwent surgery were pre-operatively examined by endoscopic ultrasonography (EUS). The ability of EUS to accurately predict the T stage and the N stage was 82% and 70% for esophageal carcinoma, 71% and 75% for gastric cancer, and 100% and 66% for duodenal malignancy. In esophageal carcinoma, the accuracy of T staging was only slightly lower in cases with non-traversable tumor stenoses (77%) compared with traversable carcinomas (84%). This was probably due to the fact that all non-traversable tumors were either in stage T3 or T4. The accuracy of EUS in predicting the stages T1 to T3, which correspond to R0 resectability (no macroscopic or microscopic tumor remains), was 92% for adenocarcinoma of the distal esophagus and 85% for gastric cancer. However, in squamous cell carcinoma of the esophagus, R0 resection was possible in only 66% of all cases, whereas EUS predicted an 84% R0 resection rate. In adenocarcinoma of the distal esophagus and stomach, EUS prediction of stages T1 to T3 correlated well with the actual rate of R0 resection. These results show that EUS is a reliable diagnostic method for the local staging of upper gastrointestinal cancer. Its impact on treatment and hence on prognosis of patients with these malignancies has yet to be determined.

Adenocarcinoma↗

[Endoscopic sonography for staging of duodenal cancer].

A case of an adenocarcinoma of the duodenum is reported, in which the diagnosis and the staging was made by endoscopic ultrasound. Barium meal, conventional ultrasound and CT scan showed a stenosis of the pars horizontalis of the duodenum, the origin of which could not be assessed. The stenosis could not be reached with a conventional gastroscope, but with a colonoscope. Endoscopic ultrasound demonstrated a thickening of the duodenal wall with loss of the normal layer structure and infiltration beyond the outer margin. Not only the site of the tumor origin but also the malignant nature of the lesion could be determined by endoscopic ultrasound.

Adenocarcinoma↗