Biomedical subjects
Publications and source records attributed to P Meister.
"Spindle Cell Limpoma" is a benign tumor consisting of immature mesenchymal spindle cells with occasional collagen fibers, myxoid areas and lipocytes scattered throughout in varying numbers. Only focally it shows the typical appearance of a lipoma. Therefore it may be confused with liposarcoma, fibrosing lipoma, furthermore with areas of fibrous histiocytoma or nodular fasciitis showing fat infiltration.
Ligation of Stenon's duct represents a possibility for treatment of chronic-recurrent parotitis. This procedure leads to an atrophy of the gland parenchyma. In one case, observed by us as a complication of this method ligation of the duct was followed by the formation of a great parotid gland cyst. Under respect of this casuistic report, possibilities are discussed to prevent similar and other complications. They consist in the section of the preganglionic fibers of the tympanic plexus respectively in a simultaneous radiation therapy of the diseased gland.
A case of bilateral intrauterine torsion of the spermatic cord is reported. The possibility of an intrauterin origin is given by observations in newborn infants. The head symptoms are scrotal swelling, flush and induration. Already a suspected torsion of the spermatic cord justifies immediate surgery as the germinative and interstitial cells are irreversibly damaged after very short time. The obstetrician is obliged to diagnose these pre- or perinatally originated torsions and to arrange immediate surgery.
The case is pointing to two remarkable facts: 1. Sjögren's syndrome may also be proceeding--without demonstrating any inflammatory rheumatic symptoms--with an isolated pulmonary fibrosis, as it had been evident in another case mentioned. 2. In certain circumstances, it may be considerably difficult to differentiate, with reliable certainty, the morphological changes in the salivary gland from those of a malignant lymphoma. Besides, also in literature there are reports concerning malignant degeneration turning into malignant lymphomata [1,8] in cases of Sjögren's syndrome.
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Electromanometric studies were performed in a serie of 149 chronically constipated children. One third of the cases showed manometrically an organic and spincter achalasia. In the other two thirds the constipation was functional or psychogenic. In 73 patients a sphincter myotomy was performed. In 50 of these cases the histology of the internal anal sphincter taken by biopsy revealed a close relationship to the electromanometric results. Patients electromanometrically diagnosed at having an organic cause of the achalasia showed histologically in all except one, severe chronic inflammation, fibrosis, hyperplasia of the smooth muscle, or an absence of the ganglion cells in the upper part of the sphincter muscle. In 17 cases with a functional or psychogenic cause only one showed histopathologic findings. Of the 73 patients who were operated upon, 66 had excellent results. In 7 cases encopresis and constipation persisted. The reasons for this are discussed. Pre- and postoperative electromanometric measurements were performed in 30 children, postoperative measurements alone in 59 others. The most important electromanometrically criteria in evaluating the results of the sphincteromyotomy are normalisation of the anorectal pressure profile and the return of regular anorectal fluctuations. Signs of incontinence could not be observed.
Subepithelial changes in hyperplasia of the laryngeal mucosa consist in edema and cellular inflammatory reaction. 150 cases of epithelial hyperplasia without atypia have been investigated histologically in regard to these subepithelial changes. The cases were subdivided into 3 categories, according to the degree of hyperplasia. The degree of inflammatory reaction in the subepithelial compartment also was classfied into 3 groups. A, B and C. There was evidence of a positive correlation between the increase in the epithelial hyperplasia and the increase of a positive correlation between the increase in the inflammatory process in the subepithelial layer. It could not be decided, which one of these two pathological changes was primary and which secondary. The therapy, however, should aim at both, epithelial proliferation, as well as, subepithelial inflammation.
A prospective study with regard to a cytostatic drugs combination treatment, partly synchronized and carried out in team work, of advanced ovarian carcinoma is being accomplished at the II. Women's Clinic of the University of Munich. The team consists of one oncologically orientated internal specialist, one radiotherapist, and one surgeon. The therapeutic procedure should be discussed; a report is given about the experiences gained so far in 41 patients, i.e. until May 1st, 1975.
A report is given on a case of proliferative myositis in a 75 year old woman. By fine structural analysis it can be shown, that the characteristic giant cells in proliferative myositis are mesenchymal cells with an intensive protein metabolism. They can be compared to fibroblasts; for a myogenic origin of these cells we found noevidence. Furthermore, various stages in the development and function of the proliferating cells were observed, by which the course of the disease can be expalined.
In a prospective study 148 consecutive patients with biopsyproved acute viral hepatitis were observed serially and followed for 5 years. They were divided into three groups on the basis of being treated with high or low doses of gamma globulin and compared with a control group, not treated. As the efficacy of gamma globulin for the prophylaxis or modification of infectious hepatitis has been well documented by many investigators during the past 25 years, we were interested in evaluating the therapeutic effect of gamma globulin on the course of viral hepatitis. The purpose of the study was to determine the comparative efficacy of various doses of gamma globulin in preventing complications and in influencing the severity and the length of time of acute viral hepatitis and in preventing the development of chronic hepatitis and cirrhosis. For controlling the clinical, biochemical and histopathologic course 12 functional parameters were repeatedly measured under stable clinical conditions and 3--12 liver biopsies were performed in an individual patient using the Menghini needle with an intercostal approach. During the 5-year trial an overall of 825 liver biopsis were performed with this 148 patients. We conclude from this study, that in about 80% of patients with acute viral hepatitis recovery is complete, but takes several month's. A protracted course of 4 month's duration until recovery was found in 45 patients (30,4%), persistent hepatitis with recovery after 1--4 years duration occurred in 37 patients (25%), global liver necrosis with hepatic coma in 3 (2,3%), chronic hepatitis in 22 (14,8%), 8 of them as chronic aggressive hepatitis and cirrhosis in 3 (2,3%). The study demonstrated no therapeutic efficacy of gamma globulin in modifying the course or preventing complications of both AuAg+ and AuAg-neg. acute viral hepatitis in man. There was no striking difference in the groups treated with various doses of gamma globulin compared with a control group.
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20 samples of human cortical bone removed from the subtrochanteric region after introchanteric femoral osteotomies with subsequent fixation by a blade plate were examined for studies of the phenomenon of cancellous transformation. Previous experiments with animals can be confirmed. A dilatation of Haver's canals in the direction from endosteum peripherally becomes apparent. This quantitative loss of cortical density is associated with a loss of mineral density. Under polarisation and scanning microscopy a derangement of collagen fibrils usually arranged in an oriented fashion can be shown. The loss of mechanical properties is discussed in connection with the derangement of orientation of collagen fibrils.
Following attacks of maxillary sinusitis and pneumonia ocular signs (epiphora and diplopia) developed in a 39-years-old female patient. An ulceration of the skin over the left lacrimal sac with destruction of the lacrimal bone gave way to a fistula to the nose; and simultaneously a left sclerokeratitis developed. Later a similar fistula on the right side occured together with destruction of the nasal bones, left phthisis bulbi and skin ulcerations on the lower lid. Histologically there was a non-specific chronic inflammation compatible with the diagnosis granuloma gangraenescens nasi ("progressive lethal ulceration of the nose") but no evidence for Wegeners granulomatosis. Under immunosuppressive therapy the condition improved and the patient was able to return to work.
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