[Gas exchange in localized pneumopathies. Effects of posture].
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Humans↗
Biomedical subjects
M Wolff
Publications and source records attributed to M Wolff.
Use of the India ink immuno-reaction for the rapid detection of enteric pathogens in two area of Nigeria.
The India-ink Immuno-reaction (IIR) was used as a simple, convenient procedure for the detection of carriers of enteric organisms in an unselected sample of patients attending a mission clinic at Kubacha in a remote area of Kaduna State, northern Nigeria. To assess the reliability of this procedure in difficult working conditions a similar population from the same clinic was subsequently examined by routine bacteriological culture techniques. Because of a temporary shortage of suitable anti-sera we were unable also to examine specimens from this second group by IIR. A further group of patients attending the out-patients clinic of the General Hospital in Kaduna with symptoms of acute enteric disease was investigated using both IIR and routine culture. Proportionally more positive results were obtained from Salmonellae, Shigellae and Vibrios with IIR than with routine culture. A larger scale controlled survey is desirable to evaluate the procedure further.
Adult↗
Mucin-like changes in keloids.
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Granuloma↗
Tubular carcinoma of the breast. Clinical pathologic correlations based on 100 cases.
One hundred tubular carcinomas were reviewed, analyzed and compared with previously reported studies in the literature. Our cases were subdivided into five groups, according to the proportion of the carcinoma which was tubular. In the case of pure or almost pure tubular carcinomas (76% or more), tumor size was small, no metastases were found, no recurrences developed, and there were no deaths attributable to the carcinoma. As the proportion of the carcinoma which was tubular decreased, the size and biologic aggressiveness of the tumor increased; this it is likely that tubular carcinoma may represent an early form of carcinoma. A right-sided preponderance was found of the "pure tubular" carcinomas; and lesions of the central sector of the breast were rare in all five groups. The incidence of bilateral cancer was greater than that expected for breast cancer in general and included three patients with bilateral tubular carcinomas. On the basis of our findings, we suggest that lesions which are composed 90% or more of tubular carcinoma may be treated by simple mastectomy, and that axillary dissection is not necessary. For all carcinomas with a lower proportion of tubular elements, at least total mastectomy and axillary dissection are indicated, although the safest treatment probably is radical mastectomy.
Adenocarcinoma↗
Thymic abnormalities: antigen or antibody? Response to thymectomy in myasthenia gravis.
The therapeutic value of thymectomy for myasthenia is still questioned although it retains an important place among management modalities that strive for sustained remission. Questions derive from uncertainty as to appropriate timing, variable extent of resection and quantitation of response. Forty-seven patients, followed one to seven years, underwent an extended transsternal or combined transcervical-transsternal procedure with anterior mediastinal exenteration. Sixteen have been in complete remission from six months to six years, four are asymptomatic on occasional pyridostigmine and eight are significantly improved. Evaluation of thymic pathology (hyperplasic, involuted areas, and thymoma) included a search for thymic myoid cells by fluorescence cytochemistry. Antibodies to acetylcholine receptor present in 38 of 43, decreased post-operatively to normal in four, by 50% to 80% in 14, by 20 to 50% in three and were unchanged in 14. Most remissions occurred in young women with noninvoluted hyperplastic glands and variably high anti-AChR titers which dropped toward normal in seven of 15. These results encourage us to utilize this procedure routinely.
Adolescent↗
Use of the electrohydraulic lithotriptor in the biliary tree in dogs.
The electrohydraulic lithotriptor, a machine which breaks up stones by generating a hydraulic shock wave, was assessed as a means of facilitating percutaneous extraction of biliary calculi. Tissue exposed to the lithotriptor showed no mucosal damage when studied histologically; however, round-cell infiltration was seen in one dog, raising the possibility of long-term stricture formation. Eighty per cent of the calculi could be fragmented with the lithotriptor. The application and limitations of the system are discussed.
Animals↗
Fibromatosis of the breast.
We have reviewed the Columbia-Presbyterian Hospital experience with fibromatosis of the breast, a most uncommon lesion that frequently mimics carcinoma. Very few examples of this rare lesion have been reported previously, and the lack of follow-up data has made it difficult to evaluate treatment. Five patients were cared for at the Columbia Presbyterian Medical Center and an additional 12 patients were reviewed after slides were sent for consultation. Complete clinical information and follow-up data were obtained in a total of 13 patients, three of whom had recurrences. There were no histologic features that served to distinguish those patients who had a recurrence from those who did not. While there were no recurrences when adequate excision was carried out, it is worth noting that we found one instance of spontaneous regression as well as two patients who did well despite the fact that tumor was found at the margin of the specimen. The results of this review suggest that the major problem facing the surgeon, once the diagnosis has been made, relates to the difficulty in defining the extent of the tumor in the breast. Careful orientation of the specimen and repeated use of frozen sections should make it possible to perform a complete excision and, at the same time, remove a minimum amount of breast tissue. Since fibromatosis is a benign process, the cosmetic impact of surgical therapy certainly deserves careful consideration.
Adolescent↗
Heterotopic gastric epithelium in the head and neck region.
Heterotopic gastric epithelium in the head and neck area is a little-known entity, unsuspected by clinician and pathologist alike. We have reviewed the literature and discovered 14 cases of this entity. While previous reviews of the subject have, unfortunately, included reports of cases with heterotopic intestinal epithelium, our study addresses itself to separating the two. Five new cases of gastric heterotopia are reported in 3 female and 2 male patients ranging in age from 2 1/2 weeks to 70 years. Three cystic lesions occurred in the floor of the mouth, while 2 small nudular lesions were found in the region of the larynx. The larger lesions caused obstructive symptoms. An error in embryogenesis is the only plausible explanation for such heterotopic elements as gastric fundic, antral, and mucous neck types of epithelium, often associated with a partial muscularis mucosae, in the head and neck region. Treatment consists of surgical extirpation.
Adult↗
Colorectal carcinoma 15 years after the diagnosis of perianal Paget disease.
We report a patient with perianal Paget disease who developed a colorectal carcinoma fifteen years later, complicated by pseudomyxoma peritoneal. While perianal Paget disease is often associated with underlying carcinomas noted at the time of the diagnosis, we suggest that perianal Paget disease may also predispose to the future development of colorectal cancer.
Anus Diseases↗
Prostate cancer mimicking malignant lymphoma.
We report three patients evaluated on a medical service for lymphoma-like signs and symptoms. Although none had prostate or bone symptomatology, all three were found to have metastatic prostate cancer. These cases emphasize the propensity of prostate cancer to metastasize to lymph nodes as well as bones. Diagnostic and therapeutic implications are discussed.
Adenocarcinoma↗
Intussusception with incarceration of a cystadenoma of the appendix: case report and review of the complications of appendiceal adenomas.
Fifty benign epithelial neoplasms were encountered during the examination of more than 30,000 appendectomy specimens in the Laboratory of Surgical Pathology, Columbia University. In 44 cases, the neoplasms were papillary cystadenomas; in 11 of these cases, there were complications, all thought to have been caused by abnormal accumulations of mucus. We have reported a unique case of an incarcerated intussusception, and attempted to explain the pathogenesis of this unusual complication. We have also summarized the existing medical literature on the subject of intussusception of adenomatous lesions of the appendix.
Adenolymphoma↗
Branchiogenic carcinoma -- fact or fallacy?
The ongoing debate concerning the existence of malignant transformation of branchial cleft cysts has been analyzed, with the aid of previous reports and reviews in the literature. Six new cases are presented and illustrated. These occurred in 4 male and 2 female patients, having an average age of 60 years. Two of the lesions were within the parotid salivary gland. The longest period of survival was 3 1/2 years. New criteria for the acceptability of tumors as primary branchiogenic cancers are proposed. We believe that, using these strict criteria, rare examples of primary branchiogenic carcinomas do exist; their treatment should include whide local excision, followed by ipsilateral radical neck dissection.
Aged↗
Pulmonary metastases (with admixed epithelial elements) from smooth muscle neoplasms. Report of nine cases, including three males.
This study pertains to an entity characterized by the presence of multiple intrapulmonary nodules, which consist of an admixture of bundles of well-differentiated smooth muscle cells and epithelial-lined spaces. These lesions have been frequently interpreted as a variant of hamartomas. However, in this review of the literature, and careful analysis of nine cases of this entity, we concluded that they should be considered metastases from smooth muscle tumors which incorporate some structures of mature lung parenchyma as they slowly expand. We affirm that the designation "fibroeliomyomatous hamartoma" should be discarded. Our cases occurred in six female and three male patients. In all but one female the primary source for lung metastases was uterus, while the male patients had primary lesions in the saphenous vein, diaphragm, and soft tissues. These lung lesions increase in size and number and are potentially fatal, though this may take many years. Even though the smooth muscle cells of the lung nodules appear bland on light microscopy, we were always able to demonstrate mitotic activity; electron microscopy indicated immaturity of the cells. For these reasons, we believe the tumors to represent metastatic leiomyosarcomas.
Adult↗
Microfibrillar collagen hemostat: a new transcatheter embolization agent.
Nine patients underwent transcatheter embolization with a suspension of microfibrillar collagen hemostat (MCH). Four of the patients had large vascular renal tumors, and two had bleeding bladder carcinomas. There was one case each of bleeding rectal tumor, bleeding esophageal varices, and arteriovenous malformation of the shoulder. MCH was highly thrombogenic and could be injected through very small catheters. It was highly effective as an occlusive agent and was able to penetrate the small end-arteries of a lesion. Its main disadvantage is that if normal tissues are inadvertently embolized, there is a risk of ischemic complication.
Adult↗
[Adenylate cyclase and guanylate cyclase activity in the isolated kidney glomerulus of the rat].
Isolated rat renal glomeruli contain an adenylate cyclase system and guanylate cyclase system. Adenylate cyclase was strikingly activated by purified parathyroid hormone, epinephrine, prostaglandin I2 and histamine. The demonstration of PTH activated adenylate cyclase in glomeruli raises the possibility of a role of this hormone in regulation of glomerular filtration rate. Guanylate cyclase was strikingly activated by CA2+, nitrate derivatives such as sodium nitroprusside. Its role remained still unknown.
Adenylyl Cyclases↗
The endoscopy corner: reversible ischemic colitis--correlation of colonoscopic and pathologic changes.
Ischemic colitis is a well described complication following distal aortic replacement. The diagnosis is typically made by correlating clinical signs such as the occurrence of abdominal pain and bloody diarrhea with supporting radiographic changes. In this report, the diagnosis of ischemic colitis was confirmed on the basis of colonoscopic and associated histopathological findings. Colonoscopy is a useful technic in establishing the diagnosis of ischemic colitis, especially in patients whose clinical condition makes barium enema not feasible.
Aged↗
The clinical, radiologic, and pathologic characterization of benign hepatic neoplasms. Alleged association with oral contraceptives.
Poor histopathologic documentation and confusing terminology have caused focal nodular hyperplasia (FNH) and liver cell adenoma (LCA) to be categorized together as "benign hepatomas." FNH and LCA are distinguishable grossly, microscopically, and ultrastructurally. In a majority of instances they may be differentiated by combined angiography and liver scan: FNH is hypervascular and exhibits normal uptake on scan whereas LCA is hypovascular and cold on scan. FNH almost always follows a benign course, rarely undergoing hemorrhagic necrosis and rupture. FNH does not possess malignant potential; the prognosis, even if unexcised, is excellent. Resection is indicated only if FNH is symptomatic. LCA often ruptures and its malignant potential remains uncertain; the prognosis is guarded and resection is indicated. The literature reported association between FNH and oral contraceptives is anecdotal. However, the recent marked increase in the incidence of LCA's, their almost exclusive occurrence in young women, and the consistent hormonal history strongly suggests an association between oral contraceptive use and LCA's, although here too, statistical evidence is lacking. Prognostic and therapeutic considerations mandate that a clear distinction be made between FNH and LCA.
Adolescent↗