Biomedical subjects

M Tsokos

Publications and source records attributed to M Tsokos.

156 records · Page 9Linked to original sources

PubMed1982

Idiopathic midline destructive disease (IMDD): a subgroup of patients with the "midline granuloma" syndrome.

"Midline granuloma syndrome" encompasses a number of specific clinicopathologic entities, such as "Wegener's granulomatosis, midline malignant reticulosis, lymphoma, nasal carcinoma and a broad spectrum of infectious diseases. In the course of studying a number of patients presenting with destructive lesions of the upper respiratory tract, 11 cases emerged as having unique clinicopathologic features. These are: 1) presence of locally destructive lesions which are always restricted to the upper respiratory tract. 2) Absence of systemic disease during a follow-up period of six months to 18 years (mean 7.3 years). On examination of repeated biopsy specimens the histopathologic picture consisted of acute and chronic inflammation with variable amounts of necrosis. Granulomata were seen in one case. Malignant or atypical cells were invariably absent. Frank vasculitis was not seen, although in five of the patients inflammatory cells in the wall of small vessels were conspicuous 4) Inability to demonstrate an infectious origin by culture or special stains. Radiation therapy has proven effective in patients with this entity, for which the term "Idiopathic Midline Destructive Disease" (IMDD) is proposed.

Adolescent↗

PubMedDate not supplied

Retinoblastoma--origin from a primitive neuroectodermal cell?

The histogenesis of retinoblastoma, the most common intraocular neoplasm of childhood, remains controversial. Previous studies have attributed the origin of the tumour to neuronal, glial or primitive stem cells of retina. In the study described here we have used immunofluorescence to search for the presence of a neuronal marker, neurone-specific enolase (NSE) and a glial marker, glial fibrillary acidic protein (GFAP), in the cells of the human retinoblastoma line Y-79 (ref. 4), before and after successful differentiation into neuronal and glial-like cells. We found that all undifferentiated cells contain both NSE and GFAP, whereas the differentiating neuronal and glial-like cells gradually lose one marker and selectively express the marker that correlates with their morphology. Our results support the notion that retinoblastoma originates from a primitive bipotential (or multipotential) neuroectodermal cell.

Cell Differentiation↗

PubMedDate not supplied

Gastrointestinal autonomic nerve tumor.

The article describes a case of gastrointestinal autonomic nerve tumor, which is histogenetically related to the gastrointestinal autonomic plexus (hence the name plexosarcoma). This rare and only recently recognized tumor of the gastrointestinal tract appears to have significant prognostic implications. This tumor cannot be diagnosed unequivocally by light microscopic and immunocytochemical examinations but shows characteristic electron microscopic features. The present case occurred as a gastric primary tumor and exhibited a light and electron microscopic picture similar to the one described in previous reports: areas of spindle-shaped and epithelioid cells, cytoplasmic processes with dense-core granules, and cytoplasmic intermediate filaments. Ultrastructural characteristics diagnostic of other gastrointestinal tumors, such as those originating from smooth muscle, Schwann cell, or endocrine cell types, were absent. Immunocytochemically, the tumor was diffusely positive for vimentin and neuron-specific enolase and focally positive for neurofilament triplet protein (NFTP) 160. Negative staining was observed for NFTP 200, S-100 protein, desmin, somatostatin, chromogranin, keratins (AE1/AE3), and glial fibrillary acidic protein. Although gastrointestinal autonomic nerve tumor has been reported to have a deceptively low-grade malignant appearance by light microscopy, it follows an aggressive clinical course. This tumor showed a much higher mitotic rate (one mitosis per high-power field) than the rates of tumors reported previously. Moreover, it occurred in a much younger patient (20 years of age) compared to previously reported cases (45 to 66 years of age), with the exception of one other case (16 years of age).

Adult↗

PubMedDate not supplied

[Differential diagnostic aspects of forensically relevant findings in the brain stem].

Because of the extreme dense accumulation of vital structures (compared with other regions of the central nervous system), in the brainstem even small lesions may cause serious clinical symptoms. Judging the forensic relevance of macroscopically visible lesions requires the knowledge of the respective possible diagnosis. As shown in three case reports (67 years, teleangiectasis; 35 years, cavernoma; 49 years, secondary hemorrhage following trauma) this demands apart from the knowledge of the normal and pathological anatomy of the brainstem always the use of histological methods.

Accidents↗

PubMedDate not supplied

[Postmortem dog bites after sexually motivated homicide with multiple stab wounds--differential diagnostic aspects].

The body of a 20-year-old woman that had undergone significant putrefaction was found lying on the bed of her apartment in a supine position. The legs were straddled and apart from a T-shirt, she was naked. The inner side of the right thigh showed a circumscribed 20 cm x 40 cm defect exposing the underlying muscles. The wound margin was ragged and superficial scratch-type abrasions were found in the vicinity of the injury margin. The investigating police officers classified the injuries to be caused postmortem by a crossbreed dog that was inside the apartment. No other signs of external force were found on the body at the death scene and due to the previous history of the deceased, a drug death was assumed. Autopsy revealed 13 vital stab wounds in the neck and aspiration of blood in the lungs as well as signs of manual strangulation. The observed coincidence of injuries due to postmortem animal depredation and stab wounds, although in different localization, can be regarded as a rare entity in the light of the literature. The morphological appearance of traumatic injuries due to other causes can be modified by the simultaneous presence of postmortem injuries caused by animals and difficulties can arise concerning the differential diagnosis especially under poor conditions (e.g. advanced putrefaction) at the death scene.

Adult↗

PubMedDate not supplied

[Postmortem bite injuries cause by a domestic cat].

A 70-year-old farmer was found dead in front of a barn. The emergency doctor did not note any significant findings at the external examination of the body. When the corpse was picked up by the undertaker, he noticed facial injuries. Several domestic cats were strolling around the barn at this time. External examination by a forensic pathologist revealed both sharp and crenated wound margins around the removed ear with punctured stabs adjacent to the mutilation. Further small perforating but not mutilating skin lesions were found also on other parts of the face. Given the typical morphology of the skin lesions and the observation of cats at the death scene, it is concluded that the injuries were inflicted by at least one domestic cat. In the forensic literature, reports on depredation of human corpses by cats are rare. To our knowledge, this is the first case report of outdoor cat depredation in the early postmortem interval. The case shows that domestic cats feed on human corpse even if other food is available.

Aged↗

PubMedDate not supplied

[Suicidal electrocution using timers. Case reports and review of the literature].

Suicidal electrocution using a time switch is relatively rare. Based on two cases from the authors' own forensic material and seven cases from literature peculiarities regarding the concomitant intake of medicines (benzodiazepines) and alcohol are discussed and comments are made how to proceed in the criminal and forensic investigation of such cases.

Adult↗

PubMedDate not supplied

[Self-mutilation in men--injury pattern and motivation].

6 cases of self-inflicted injuries in male individuals are reported. The age of the affected men was between 15 and 46 years whereas the younger age predominated. Alleged incidents were robberies in 3 cases, rape in one case, violation in custody in one case and an assault originating in personal motives in one case. In 4 cases, the typical injury pattern of self-infliction was present showing parallel course and superficiality of the wounds in areas accessable by the persons's own hands. In 2 cases, atypical injuries (i.e. deep cuts and massive signs of strangulation respectively) were found. However, in most cases, the underlying motive was to gain affection. An autoerotic accident was tried to be disguised in one case. Profit was the leading motive in another case.

Adolescent↗

PubMedDate not supplied

Control of retinoblastoma cell growth by differentiating agents: current work and future directions.

It has become clear over the last few years that malignant transformation for several tumors results from failure of embryonic tissue to properly differentiate and activation of a mechanism which triggers uncontrolled cellular proliferation. Retinoblastoma fits this pattern, in that early inactivation of regulatory genes leads to proliferation of cells that are arrested in a primitive stage of development. Cultured Y-79 human retinoblastoma cells, however, can be induced to differentiate to a more "normal" stage in development through the use of several naturally occurring agents, such as butyrate, cyclic AMP, and retinoic acid. These agents cause reversible growth inhibition (e.g., retinoic acid) or result in cell death (e.g., butyrate). Proteins translated from mRNAs isolated from Y-79 cells are dramatically altered by all the above substances. Thus, alteration in transcriptional activity and changes in macromolecular synthesis can lead to the transition of rapidly growing, non-differentiated retinoblastoma cells to a non-proliferating, more differentiated state. The changes of the mRNA species induced with the various agents we have utilized, supports the hypothesis that differentiation and growth inhibition in Y-79 cells are programmed genetic events which can be controlled at least in vitro. Screening and testing of differentiating agents could be clinically useful for the treatment of retinoblastoma as well as for better understanding the biological control mechanisms involved in tumor growth.

Butyrates↗

PubMedDate not supplied

Bcl2 and p53 protein expression in metastatic carcinoma of unknown primary origin: biological and clinical implications. A Hellenic Co-operative Oncology Group study.

We have previously shown that metastatic carcinomas of unknown primary site overexpress several tumor markers as well as the products of the oncogenes c-myc, ras and c-erbB2. We analyzed the tissue expression of the protein products of the apoptosis modulation genes p53 and bcl-2 in 47 CUP cases. Formalin-fixed, paraffin embedded tumor specimens were stained with commercially available antibodies to p53 (DO7) and bcl-2 after antigen retrieval by the microwave method. Staining was evaluated by intensity (1+ to 3+), percentage of positive cells (1-100%), and the 'intensity times percentage' product defined as the immunoreactivity index with values ranging from 0 to 300. Immunoreactivity index values higher than 150 were considered to characterize protein over-expression. Expression of p53 was identified in 70.2% of tumors while 53% of them showed a high immunoreactivity index. Bcl-2 expression was detected in 65% of tumors and overexpressed in 40%. Overexpression of both proteins was detected in 20% of tumors. The detection of either protein was not associated with any of the major clinicopathological variables studied. Nevertheless, a trend towards a more favourable response to platin based chemotherapy was seen in the cases that showed a strong expression of both proteins, when analysed by immunoreactivity index and percentage of positive cells. We conclude that CUP overexpress at a high percentage the p53 and the bcl2 proteins. The observed weak association of strong expression of these proteins with response to platin-based chemotherapy deserves further evaluation in the CUP setting.

Adenocarcinoma↗

PubMedDate not supplied

[Expert assessment of coital injuries from the forensic medicine viewpoint].

A 38-year-old woman was transmitted to hospital with profuse vaginal bleeding. The origin of the vaginal injuries (resulting from "normal" sexual intercourse vs. use of instruments for manipulation in the vagina) was obscure. The wound pattern is presented and the literature on the subject is reviewed with special reference to predisposing factors and genesis of coital injuries. Concerning the wound pattern, reflecting a blunt trauma, a manipulation with a (so far unknown) instrument, but also with finger or hand could not be proved with the required certainty. In the presented case the origin of the vaginal injuries from "normal" sexual intercourse as described by the accused man could not be excluded.

Adult↗

PubMedDate not supplied

[Death in the milieu of homeless persons. A comparative retrospective analysis of an autopsy sample of different regional population structures (Middle Hessia/Hamburg)].

For an evaluation concerning different regional population and community characteristics, 23 fatalities of homeless individuals were selected from the current autopsy series of the Institutes of Legal Medicine of Giessen/Germany and Hamburg/Germany from 1990 to 1996. The outcome of this retrospective analysis enables to overcome the deficiency of knowledge of causes, manners and circumstances of death among homeless individuals.

Accidents↗