Biomedical subjects
Publications and source records attributed to L Peychl.
The pathogenicity of coagulase-negative staphylococci was shown in two patients--one died on bacterial endocarditis, the second was a diabetic woman after gastroectomy.
Histology of ulcus durum with regional simple lymphadenitis and of condyloma latum was presented. Inflammatory lymphoplasmocytic infiltration included eosinophilic leukocytes in both cases. Syphilitic granulomatous lymphadenitis with conspicuous productive perilymphadenitis has been lasting about 1 month. Treponemas in histological section were found only in condyloma latum.
In a prospective study (1961-1972) the incidence of rheumatic fever (RF), development of rheumatic heart disease (RHD) and penicillin prophylaxis efficacy were investigated in 300 000 children and 70 000 adults. Only patients whose index attack met the modified Jones' criteria were included; all were enrolled in a prophylaxis programme (i. m. benzathine-penicillin). The RF incidence decreased from an initial 61.2 attacks per 100 000 in children and 42.9 in adults to below 10 by 1969 and remained low thereafter. In total, 541 children (209 with carditis) and 176 adults (108 with carditis) were followed up for 5.5 years (average) after an index attack. At final examination, no valvular involvement was detected where previous attacks had been without clinical carditis. Patients studied from time of the primary attack with carditis (211) had a very favorable prognosis: only up to 3.5% had developed a moderate to severe heart lesion by the end of the study. However, of 68 adult patients followed up only from the time of recurrence with carditis and often having had a prolonged rheumatic history: 23.5% had a moderate to severe heart lesion and a further 20.6% had died of RHD by the end of the study. Prophylaxis efficacy calculated as a cumulative attack-recurrence rate per 100 patients and over a 5-year interval was 2.72 in protected as against 64.75 in unprotected children (mostly failing to comply with prophylaxis); in adults, the respective values were 1.3 and 24.92. The prevalence of serious residual RHD may be expected to decrease substantially in the future, starting with the younger age groups.
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A postmortem examination of a 60 year old female patient proved the presence of fibrosarcoma of the head of pancreas. The tumour first became manifest through an accidentally diagnosed pulmonary metastasis two years before death. 14 weeks before death, the patient had been operated on for a metastasis in the brain. Jaundice lasted 10 weeks.
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A primary pulmonary lymphoma associated with paraproteinemia was observed in a man aged 73. Histologically, the tumour was classed as lymphoplasmocytic lymphoma. No metastases were disclosed at autopsy.
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The authors present their personal experience with common histological methods for amyloid demonstration. For practical use, they recommend staining with Congo Red followed by differentiation in alkaline alcohol and another method using staining with a 2% solution of Saturn Red in 1% NaCl. The latter method permits to differentiate between amyloid and hyalin without employing polarized light.
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