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Biomedical subjects

H H Goebel

Publications and source records attributed to H H Goebel.

At least 235 records · Page 13Linked to original sources
PubMed1981

[Myoglobinuric renal failure in hyperosmolar diabetic coma (author's transl)].

Acute rhabdomyolysis with myoglobinuric renal failure occurred in a 66-year-old woman who was in hyperosmolar non-ketotic diabetic coma. No previous description of such a case has been found. The clinical picture was characterized by the typical findings of hyperosmolar coma, in addition to excessive serum creatine kinase and myoglobin levels and massive myoglobinuria with acute renal failure. The rhabdomyolysis became fully manifest only under insulin treatment, possibly the result of insulin-induced hypophosphataemia, which seems to be of importance in the causation of the rhabdomyolysis.

Acute Kidney Injury↗
PubMed1981

Tumor-like amyloid formation (amyloidoma) in the brain.

An almost walnut-sized tumor was removed surgically from the left occipital lobe of a 46-year-old woman, who had suffered for 4 year from progressive visual loss with scotoma and finally from hemianopia, associated with attacks of headaches and recurrent episodes of depression each lasting for some weeks or months. Neuropathological examination, including polarization, thioflavine, fluorescence, immunofluorescence staining, and electron microscopy, revealed an amyloidoma, which consisted of broad appositionally grown amyloid deposits surrounded by some plasma cells, monocytic or foreign body cell types. The massive accumulations, often associated not only with blood vessels or perivascular collagenous fibers but also lying in the cerebral tissue not unlike senile plaques in the cortical gray matter corresponded to gradually growing masses as seen in the repeated CT scans. This unique lesion in the brain of a patient who did not show any evidence of systemic disorder, seems to confirm that the spontaneous tumor-like amyloid, which gave an immunofluorescent staining mainly with anti-IgM, is a special variant of primary amyloidosis (amyloid L) or of so-called paramyloid.

Amyloid↗
PubMed1981

Late-onset metachromatic leukodystrophy: diagnostic problems elucidated by a case report.

A 20-year-old female had psychiatric symptoms of organic brain disease for five years but without clinical or neurophysiological signs of polyneuropathy. Late-onset metachromatic leukodystrophy was confirmed by finding severely reduced arylsulfatase A activity in her urine and leukocytes, marked excretion of sulfatides in the urine and the presence of lysosomal residual bodies in a sural nerve biopsy. This case report emphasizes the need to screen patients with early onset dementia of unknown origin or atypical hebephrenia, who are often confined to mental institutions early in the course of their disease.

Adult↗
PubMed1981

Eccrine sweat glands are not innervated in hereditary sensory neuropathy type IV. An electron-microscopic study.

The ultrastructural study of a skin biopsy in a patient afflicted with hereditary sensory neuropathy type IV (congenital insensitivity to pain with anhidrosis) did not reveal any unmyelinated axons or axonal terminals around eccrine sweat glands but only processes, partially covered by a basement membrane and therefore resembling Schwann cell processes. The absence of such unmyelinated axons in close proximity to eccrine sweat glands where they normally occur appears to be the morphological equivalent to the anhidrosis and also corresponds to the deficiency of unmyelinated axons in the sural nerve of the same patient, as previously reported.

Basement Membrane↗
PubMed1981

Fingerprint profiles in lymphocytic vacuoles of mucopolysaccharidoses I-H, II, III-A, and III-B.

Fingerprint (FP) profiles in vacuolated lymphocytes of mucopolysaccharidoses I-H, II, III-A, and III-B are a numerically rare, but possibly consistent finding as they have not been seen in vacuolated lymphocytes of other non-neuronal lipofuscinosis (NCL) lysosomal diseases. Their nosologic significance is not clear, but they may be as non-specific as tubular inclusions in lymphocytes and they are identical to those FP profiles seen in juvenile NCL.

Humans↗
PubMed1981

Congenital myopathy with cytoplasmic bodies.

Since early infancy, a 15-year-old girl had suffered from an apparently static neuromuscular disorder that chiefly afflicted her proximal muscles but did not spare her distal ones. Her CPK values had repeatedly been mildly elevated and her electromyogram had been considered "myopathic". There were no similar neuromuscular disorders in the family. Quadriceps muscle biopsy showed a type I myofiber predominance of 96%, this girl's muscle disease represented "congenital myopathy with cytoplasmic bodies" as cytoplasmic bodies were recently reported in other sporadic and hereditary neuromuscular disorders of unknown origin.

Adolescent↗
PubMed1981

Neuromyopathy and vitamin E deficiency in man.

A 12-year-old boy, born of a consanguineous marriage, had ataxia, sensory neuropathy, generalized muscle hypotrophy and a lower serum vitamin E level. Two of his relatives had died of a clinically similar disorder in their late adolescence. Morphologically, his striated muscle fibers and Schwann cells of his sural nerve contained numerous autofluorescent acid phosphatase-positive lipopigments which, by electron microscopy, consisted of a finely granular matrix surrounded by a trilaminar membrane. These lysosomal lipopigments were similar to those observed in muscle fibers of a patient afflicted with abeta-lipoproteinemia. They probably represent the morphological sequelae of long-standing vitamin E deficiency in this child, the extract origin of which has not been fully elucidated.

Child↗
PubMed1981

Bulbar palsy with Rosenthal fiber formation in the medulla of a 15-year-old girl. Localized form of Alexander's disease?

A 15-year-old girl died of a long-standing bulbar palsy that had caused difficult swallowing since early infancy. She was severely malnourished and retarded in growth. Morphologically, the clinical symptoms corresponded to a circumscribed lesion in the enlarged medulla (mega-medulla) that consisted of proliferation of astrocytes, incomplete demyelination, perivascular infiltrates and abundant formation of Rosenthal fibers. Rosenthal fibers were also present in the subpial medullary region where inflammation and astrocytic proliferation were largely absent. This patient's disorder appears to be a localized form of alexander's disease because macrencephaly, Rosenthal fiber formation and leukodystrophy of the cerebral hemispheres and cerebellum were absent. The morphological spectrum of Alexander's disease may now comprise diffuse and localized forms both of adulthood and children.

Adolescent↗
PubMed1980

Dense core vesicles in the desmoplastic variant of cerebral neuroblastoma.

A desmoplastic primary cerebral neuroblastoma originating in the frontal lobe of a boy who died at the age of 6 years contained dense core vesicles within the cytoplasm of neoplastic cells as evidence of neuronal differentiation. Sarcomatous transformation had occurred at the time of recurrence. At autopsy, he also had cerebrospinal and extraneural metastases.

Autopsy↗
PubMed1980

Ultrastructurally abnormal mitochondria in the pituitary oncocytoma.

A pituitary adenoma in a 67-year-old man was characterized by abundant mitochondria and identified as an oncocytoma, which clinically and histologically appeared as a chromophobe adenoma. In addition to the numerous mitochondria within the neoplastic cells, structurally abnormal mitochondria were also present. Compared with other pituitary oncocytomas reported in the literature, abnormally structured mitochondria appear rare among the mitochondrial population of pituitary oncocytomas.

Adenoma↗
PubMed1980

A form of congenital muscular dystrophy.

Five children, between 2 and 10 years old, 3 boys and 2 girls, two of them siblings, showed mild clinical and morphological congenital muscular dystrophy. Neuromuscular signs and symptoms being present from birth or early infancy, aggravated only insignificantly during the course of the disease. Three patients developed right ventricular hypertrophy after the age of 9 years, of whom 2 died of cardiac failure at the age of 11 years. There was probably no cardiomyopathy; pulmonary hypertension of unclear range or slightly elevated. The EMG showed abnormal but non-specific features. A myopathic fiber diameter spectrum, intrafascicular fat cells and mild endomysial fibrosis as well as insufficient fiber typing and type I predominance were prominent in histopathological findings. Ultrastructurally, abnormal myofibers were present in each biopsy although the fine structural pathology was non-specific. The families of the patients came from a genetic isolate in the North-Eastern region of the Federal Republic of Germany. The first 4 patients were genetically related to each other by several links among their families dated back over the last 3 centuries. The fifth patient came from the same area, but unequivocal familial linkage could not be established. An autosomal recessive mode of inheritance is suggested for this congenital muscular dystrophy.

Child↗
PubMed1980

Ultrastructural pathology of skin biopsy and fibroblast enzyme studies in a case of GM2-gangliosidosis with deficient hexosaminidase A and thermolabile hexosaminidase B.

A 2 year-old non-Jewish boy had muscle hypertonia, a black cherry spot, dementia, and seizures. His skin biopsy showed membranous cytoplasmic bodies in axonal terminals and zebra body-like inclusions in Schwann cells. Biochemically, a deficiency of Hex A and two separate Hex B peaks indicated a type 1 (B variant, Tay Sachs) like subvariant of GM2-gangliosidosis.

Axons↗
PubMed1980

Rectal biopsy findings in infantile neuroaxonal dystrophy.

A 21-month-old boy with a family history of parental consanguinity and two siblings having died of a progressive neurological disorder was investigated for a neurometabolic disease because of recent loss of gait and lack of intellectual progress. While a lysosomal disease could not be verified, his clinical findings were compatible with infantile neuroaxonal dystrophy, the diagnosis of which was electron microscopically established by demonstrating typical enlarged axonal terminals in rectal biopsy tissue.

Axons↗
PubMed1980

Confirmation of virtual unmyelinated fiber absence in hereditary sensory neuropathy type IV.

Sural nerves from two unrelated young boys were virtually without unmyelinated fibers (UFs). Small myelinated fibers (MFs) may also have been slightly reduced in number. Since no degeneration or regeneration is observed, UF absence is assumed to be congenital, due to either lack of neuron formation or to premature degeneration. The main clinical features of this inherited sensory neuropathy (previously identified by us as type IV) are the inherited nature and abnormality of nociception, of sweating, and of thermal regulation associated with mild mental retardation. Our findings confirm the congenital absence of UFs of cutaneous nerves in cases such as these and provide further evidence that this disorder has a different natural history and pathology than do the other three types of hereditary sensory neuropathy.

Humans↗
PubMed1980

Adult metachromatic leukodystrophy. III. Clinical course, final stages and first biochemical results.

Continuing the previously published clinical development of a case of adult metachromatic leukodystrophy (MLD), we now describe the terminal phase and death (at 46 years of age) of our patient. The final phase was characterized clinically by progression of generalized peripheral neuropathy, advanced extrapyramidal and pyramidal tract symptomatology, dementia and brainstem dysfunction. First biochemical results show a moderate relative increase (3- to 5-fold) of sulfatides in the frontal lobe white matter but not in the cortex. The analysis of fatty acids in total lipid extract shows a decrease of long-chained fatty acids in favor of short-chained fatty acids, this change is more pronounced in white matter in the cortex. The clinical course and biochemical results are discussed in relation to previous cases analyzed by us. Epidemiological aspects especially emphasize routine serach for MLD amongst patients with neuropsychiatric symptomatology showing unusual psychoses, presenile dementias or unspecific disturbance of motor coordination possibly with electroneurographic evidence of peripheral neuropathy.

Age Factors↗
PubMed1980

Adult metachromatic leukodystrophy. IV. Ultrastructural studies on the central and peripheral nervous system.

Ultrastructural studies on the central and peripheral nervous system of 2 patients with adult onset metachromatic leukodystrophy (MLD), dead at the ages of 46 and 51 years, showed MLD-specific inclusions, tufaceous and prismatic structures, a wide spectrum of membranous arrangements within lysosomal residual bodies, and the intimate admixture of sulfatides and other membranous material with lipopigments. Oligodendrocytes and Schwann cells were foremost affected but membranous inclusions could also be verified in neuronal perikarya and astrocytes. The varying ultrastructural spectrum of lysosomal residual bodies in adult onset MLD and the association with lipopigments, chiefly in nerve cells, exceed the fine structural observations on late infantile and juvenile MLD and may reflect morphological differences between these subtypes of MLD that are also known from clinical and biochemical observations.

Adipose Tissue↗