[Visual cortex infarct as a cause of homonymous hemianopsia following malar bone reposition].
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Biomedical subjects
Publications and source records attributed to H von Domarus.
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We report five cases of metastasizing basal cell carcinoma. The incidence of metastases in all patients with basal cell carcinomas who had surgery in the same period was 0.1%. There was no squamous differentiation in the histology of any of the primary lesions, but we found some squamous differentiation in a late recurrence in one patient and in the metastases in two patients. All other histologic features were identical in both the primary tumor and in the metastases. Perineural spread and blood vessel invasion were evident in the primary tumor and/or recurrence of three of the five patients and may be important pointers to possible recurrence and metastasis. Of 205 cases of metastasizing basal cell carcinomas mentioned in the literature, we accepted and evaluated 170 cases of tumors of the skin with histologic proof of metastasis. The male-to-female ratio was 2:1, median age at onset of primary tumor, 45 years, median interval between onset of tumor and first sign of metastasis, 9 years, median age at first sign of metastasis, 59 years, and median survival after first sign of metastasis, only 8 months. The site of the primary tumors is similar to that in nonmetastasizing basal cell carcinoma. Metastatic spread is most often to lymph nodes, lungs, and bones with lymphogenic and hematogenic spread equally frequent. Age or sex of the patient seemed to have no influence on survival or way of metastatic spread. As metastasis of basal cell carcinoma is extremely rare (1 in 1,000 to 35,000), many authors sought or postulated histologic "degeneration" into a squamous cell carcinoma, but no such unequivocal evidence has ever been found. Areas of squamous differentiation were reported in less than 15% of both primary and metastatic lesions of metastasizing basal cell carcinoma. The mode of metastatic spread and the characteristics of the histology make it rather unlikely that metastasis of a basal cell carcinoma is due to a change toward squamous cell carcinoma.
Trisomy 1 embryos in mice are smaller in all dimensions, showing a developmental retardation as compared with euploid mice. Very rarely the trisomic embryos develop a typical hypotelorism with holoprosencephalon and missing olfactory nerves. Corneal distances, angles between the optic nerves and further microscopic examination showed no intermediate forms between the trisomy 1 embryos and the rare trisomy 1 embryo with hypotelorism. There seems to be a threshold, beyond which the major developmental derangement occurred. This is an experimental model showing parallels to the occasional varying phenotypes in human trisomies.
In a series of 43 impalement injuries of the palate, 8 lesions were located in the dangerous peritonsillar area. All cases healed uneventfully. Posttraumatic thrombosis of the carotid artery as described in the literature seems to be very rare among such lesions. The spontaneous healing potential even of a perforating gap in the hard palate is so enormous that comparison with the healing in the cleft palate patient reveals a lack of healing capacity for this area in the latter.
Size and weight of embryos can differ according to the location in the uterine horn. In these experiments the source of teratogenesis was within the individual trisomy-1 embryos, producing either euploid or trisomic embryos in a given position in the uterus. We therefore used the embryo and not the litter as a statistical sampling unit. In our opinion a nested analysis of variance is the most appropriate method to assess a position effect of embryos in this model. We were unable to show a position effect on gestational days 13 and 14. There was a significant difference though, among litters. We were able to show that further investigations of trisomy-1 embryos, in particular morphometric studies, are not complicated by a position effect. A position effect as described by several authors should be assessed for every new teratogenic model. The methods described here provide a reasonable vehicle for similar studies.
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According to Bhaskar and Lilly, experimental results with rat tongues indicated that trauma is the cause of the rare eosinophilic granuloma of the human tongue. On the basis of similar experimental investigations, we consider this conclusion to be incorrect. In our opinion, the etiology of eosinophilic granuloma of the tongue as that of other eosinophilic granulomas in man is still unknown.
Aluminium foil has been found to be an extremely useful and painless way of dressing wounds prior to delayed skin grafting. However, it is not recommended for use on skin-graft donor sites as it delays epithelial healing.
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