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Biomedical subjects

K Geboes

Publications and source records attributed to K Geboes.

At least 181 records · Page 10Linked to original sources
PubMed1992

The innervation of the lymphoid tissue at the ileocolonic transition: an enzyme and immunohistochemical study.

Using enzyme and immunohistochemical methods on whole-mount preparations and cryostat sections, a morphologic and semiquantitative study was performed of the nervous tissue in the appendix and the ileum (areas with and without Peyer's patches) of the rabbit. The plexus submucous externus (Meissner) consists of a network of small ganglia, vaguely associated with the vascular submucosal plexus. From the nerve cell bodies, cell processes occasionally penetrate the lymphoid follicles at the junction between the mucosa and the submucosa while other extensions form a dense plexus in the lamina propria of the mucosa. No nerve fibers are present in the dome of the follicles. The plexus submucous internus (Henle), consisting of large cell bodies and large processes, closely follows the blood vessels. The numeration of the nerve fibers of the submucosal plexus endorses the histological finding that the appendix is a richly innervated lymphoid organ. In addition, the plexus myentericus (Auerbach) of the appendix is a network of small meshes, while in the ileum, in the area of Peyer's patches, the same plexus is composed of a network with large meshes. These differences point to a higher density of innervation in the appendix. Yet a specialized anatomic distribution of the innervation of lymphoepithelial structures cannot be demonstrated.

Animals↗
PubMed1992

Granulomatous gastritis and Whipple's disease.

Granulomatous gastritis is an uncommon morphological diagnosis. An etiopathogenetic diagnosis can be reached only by combining the morphological examination with clinical and laboratory investigations. The diagnosis of Whipple's disease in our patient was based upon a classical clinical picture and upon the likewise classical morphological appearance of the small intestinal mucosal biopsy. To our knowledge, this case report is the first to describe granulomatous gastritis in a patient with Whipple's disease.

Gastritis↗
PubMed1992

Zenker's diverticulum: is a myotomy of the cricopharyngeus useful? How long should it be?

In a series of 100 consecutive patients surgically treated for Zenker's diverticulum (ZD) biopsy specimens were taken at the level of the cricopharyngeal muscle in 62 patients and also at the level of the striated muscle wall of the cervical esophagus in 10 patients. Contractility, pathological enzymo- and immunohistochemical characteristics were studied in comparison with a group of 15 controls. Obvious pathological findings were noted in 95% of the ZD specimens as compared with the control specimens. These pathological changes, although somewhat less pronounced, were also documented in the biopsy specimens taken at the level of the striated cervical muscle wall. The findings were judged important enough to justify a long extramucosal myotomy of the cricopharyngeal muscle and cervical esophagus as an essential step in the treatment of ZD. The treatment of choice in this series was a diverticulopexy and a four to five centimeter long extramucosal myotomy, starting from the cricopharyngeal muscle and extending downwards into the striated muscle wall of the cervical esophagus. Excellent or very good results were obtained in 96% of the patients with respect to diverticulum-related symptoms.

Adult↗
PubMed1991

Conventional X-ray examination in esophageal cancer: an opinion.

Double contrast is the best radiological technique for the detection of small esophageal cancer. Gastrografin is indicated when a blind mediastinal fistula is suspected; in cases of choking or suspicion of a fistula with the airways, a low osmotic hydrosoluble Iodium compound must be used. Conventional radiology and endoscopy are complementary techniques for the detection of esophageal cancer, as some lesions may be missed or misinterpreted by both. The need for endoscopic biopsy being incontestable for diagnostic confirmation and characterization, radiology presents some advantages over classic esophagoscopy for preoperative and the general pretherapeutic staging of esophageal carcinoma: assessment of topographical relation with the surrounding organs is possible and with the upper esophageal sphincter is easier; appreciation of tumoral extension along the longitudinal axis (tumor length, gastric invasion) remains mostly possible even in cases of severe stenosis; tumoral extension along the transverse axis (kinking, fistula) may be evaluated; detection of a second tumor or concomitant pathology distally from a stenosing tumor is mostly possible; moreover radiology is important before starting radiotherapy; and finally, previous radiology may reduce the (small) risk of endoscopic perforation. Radiology is indispensable or indicated in the posttherapeutic follow-up of esophageal carcinoma, as well after surgery as after endoscopic interventions, radiotherapy or chemotherapy.

Diatrizoate Meglumine↗
PubMed1991

Inflammatory disorders of the esophagus.

Esophagitis is a very common disorder. The etiology cna be highly variable and is not always clear from the biopsy. The main microscopic inflammatory lesions are located in the epithelium. They consist of an increase in inflammatory cells, either polymorphs or mononuclear cells, or both. They are associated with architectural mucosal changes. It is often difficult or impossible to distinguish reflux esophagitis from drug-induced or viral esophagitis. Yet some microscopic patterns are characteristic and provide information on the etiology of the lesions.

Biopsy↗
PubMed1990

Expression of MHC class II antigens and immunoglobulin M by the corneal epithelial cells in herpetic keratitis.

The corneal buttons obtained from 4 patients with active epithelial and stromal herpetic keratitis were studied with routine microscopy and immunohistochemistry. We used an immunoperoxidase technique with monoclonal antibodies directed against Langerhans cells, lymphocyte subsets, MHC products and immunoglobulins A, G, M and D. The epithelium and stroma contained an inflammatory infiltrate composed of polymorpho-nuclear leukocytes, dendritic cells, B-lymphocytes and T-lymphocytes (helper/inducer and suppressor/cytotoxic subsets). The epithelial cells of all the corneal buttons expressed MHC class II antigens. IgM was bound to the membrane of the epithelial cells in 3 specimens. HSV antigenic material was localized in the epithelial cells and in the stromal keratocytes by a direct immunofluorescence technique. Our data suggest that cell-mediated as well as antibody-mediated immune responses are involved, with a possible role for an autoimmune mechanism in the pathogenesis of this condition.

Adult↗
PubMed1990

The immunopathology of Schistosoma mansoni granulomas in human colonic schistosomiasis.

The immunopathology of Schistosoma mansoni infection was studied in colonic biopsies obtained from 14 patients with established schistosomiasis. The characteristic lesions of this parasitic infection are mainly induced by the presence of living eggs in the tissue. Different types of lesions can be present simultaneously. The earliest lesions contain T-lymphocytes as well as accessory cells around living eggs. They transform into granulomas composed of eosinophils, T-lymphocytes, a few B-lymphocytes and large mononuclear cells expressing major histocompatibility (MHC) class II antigens. These cells are also Mac 387 positive. This means that they are monocytes/macrophages freshly recruited from the blood. In other, probably older, granulomas, MHC class II positive cells tend to disappear and the centrally located multinucleated giant cells are negative for antibodies directed against MHC class II antigens. It appears thus that the composition of the granulomas in schistosomiasis is variable. The lesions may have characteristics of cell-mediated immunity and/or of a foreign-body reaction. Contrary to what is often seen in Crohn's disease or intestinal tuberculosis no major hyperplasia of the lymphoid tissue is observed in the colon in association with S. mansoni infection.

Adolescent↗
PubMed1990

Predictability of the postoperative course of Crohn's disease.

Eighty-nine patients who had been treated by ileal resection for Crohn's disease between 1979 and 1984 were included in a prospective cohort follow up to study the natural course of early postoperative lesions. Recurrent lesions were observed endoscopically in the neoterminal ileum within 1 year of surgery in 73% of the patients, although only 20% of the patients had symptoms. Three years after surgery, the endoscopic recurrence rate had increased to 85% and symptomatic recurrence occurred in 34%. The ultimate course of the disease was best predicted by the severity of the early postoperative lesions, as observed at ileoscopy. Clinical parameters that influenced outcome were preoperative disease activity, the indication for surgery, and the number of surgical resections. When patients were stratified for preoperative disease activity, the severity of lesions found at endoscopy remained a strong predictive factor for symptomatic recurrence. In 22 other patients submitted to "curative" ileal resection and ileocolonic anastomosis, the segment to be used as neoterminal ileum was carefully examined during surgery, and two large biopsies were taken before making the anastomosis. An ileoscopy was performed 6 months after surgery. Although all patients had a macroscopically normal neoterminal ileum and 19 had entirely normal biopsies at the time of surgery, 21 patients were found at ileoscopy to have developed ileitis involving a 15-cm segment (range, 4-30 cm), and 20 had unequivocal microscopic lesions on biopsies. These studies suggest that early lesions in the neoterminal ileum after Crohn's resection do not originate from microscopic inflammation present in this bowel segment at the time of surgery. The early postoperative lesions in the neoterminal ileum seem to be a suitable model to study the pathogenesis of Crohn's disease and also to evaluate new therapeutic modalities, either to prevent development of these early lesions or to treat progressive recurrence.

Actuarial Analysis↗
PubMed1990

Pre-operative radiological diagnosis of acute necrotizing enteritis in systemic lupus erythematodes.

Acute abdominal complications of systemic lupus erythematodes requiring laparatomy are not frequent. A 30-year-old man with systemic lupus erythematodes developed a necrotizing enteritis of the small bowel with pneumatosis intestinalis. Only one case of intestinal vasculitis associated with systemic lupus erythematodes has previously been reported. Presence of intramural gas in the small bowel and of gas in the portal vein was detected on plain abdominal film and confirmed by subsequent CT examination. Since corticosteroids often mask the severity of the disease, radiological evaluation is essential to the overall management of the patient with intestinal vasculitis. Due to the observed radiological signs, emergency laparotomy was performed. Histologic examination revealed necrotizing enteritis due to vasculitis.

Adult↗
PubMed1989

Primary malignant fibrous histiocytoma of the esophagus.

A 59-year-old man was admitted to the hospital for dysphagia and fever. Esophagogram and upper gastrointestinal endoscopy revealed a polypoid mass in the midesophagus. Subtotal esophagectomy, cervical esophagogastrostomy, and lymph node dissection were performed. The histological diagnosis of the tumor was malignant fibrous histiocytoma. An area of severe epithelial dysplasia was found in the esophageal mucosa 3 cm under the tumor.

Esophageal Neoplasms↗
PubMed1989

Risk factors which determine the long term outcome of Neodymium-YAG laser palliation of colorectal carcinoma.

We have analysed the long term results of YAG laser palliation for incurable colorectal carcinoma in 88 patients. Although initial palliation was achieved in 82%, good palliation could only be maintained in 51% and 41% of patients surviving 6 months and 12 months respectively. The relative inefficacy of YAG laser therapy for palliation of rectal cancer is due to the failure to control extraluminal tumour growth, complications of YAG laser therapy and the poor general condition of these elderly patients. Factors influencing the efficacy of palliation, besides life expectancy, included T classification, and length of the neoplastic stricture. Treatment-related mortality due to perforation was 2.3%. YAG laser therapy, applied as the sole therapeutic modality, is effective for short term palliation of incurable colorectal carcinoma, but is not adequate for long term palliation in most patients. Trials should be conducted to study the effect of combined treatment (e.g. laser + radiotherapy) on palliation.

Aged↗
PubMed1989

Immunopathological study of vernal keratoconjunctivitis.

The in situ immune reaction occurring in the conjunctival tissues of patients with vernal keratoconjunctivitis was studied using immunohistochemical techniques and a panel of monoclonal and polyclonal antibodies. Our data point to a complex immunopathogenesis of the disease. The anaphylactic response was demonstrated by the presence of many eosinophils and mast cells showing membranous IgE staining in the epithelial and stromal inflammatory infiltrate. IgE+ plasma cells were rare or absent in the conjunctival tissues and around the acini of accessory lacrimal glands, suggesting that IgE is not produced locally in the conjunctival tissues. A humoral immune response was evidenced by the presence of small B-lymphoid follicles, scattered B-lymphocytes, and many plasma cells in the stromal inflammatory infiltrate. IgA+ and IgG+ plasma cells were of more or less equal numbers and outnumbered IgM+ plasma cells. The majority of plasma cells around the acini of accessory lacrimal glands were IgA+. A role played by cell-mediated immunity was evident from the presence of scattered stromal T-lymphocytes and many dendritic cells in the epithelium and stroma. Some stromal dendritic cells carried IgE on their surfaces.

Adolescent↗
PubMed1989

The bioenergetics of mitochondria after cryopreservation.

The functional characteristics of rat liver mitochondria after cryopreservation with and without the addition of the cryoprotectant dimethyl sulfoxide (Me2SO) were evaluated. As criteria of functional integrity, polarographic measurements of substrate-linked oxygen consumption and luminescent assay of adenosine triphosphate (ATP) synthesis were considered before and after cryopreservation. The results demonstrated that mitochondrial damage after freezing was indicated by the polarographic studies but was not evident when ATP synthesis was considered. Me2SO present during cryopreservation was partially protective for mitochondrial substrate-linked oxygen consumption; however, simple exposure to and dilution from Me2SO effected some changes in mitochondrial function.

Adenosine Triphosphate↗