Biomedical subjects
Publications and source records attributed to R Fischer.
A hemorrhage from esophageal varices is a rare complication of osteomyelosclerosis. Treatment and pathogenesis of this life-threatening complication is controversial. Following splenectomy in two patients, esophageal varices and ascites disappeared. The theory of an increased portal blood flow secondary to splenomegaly is supported with these two cases.
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In 1976-1979 a total duodenopancreatectomy was employed in 18 patients with chronic relapsing pancreatitis. Indication for operation in all patients was due to pain long year lasting, and resistant to therapy efforts. Indication was also given, for we recorded in 15 patients loss of weight of 15 kg on an average, because eating was very painful for these patients. 4 patients were jaundiced, in another two patients we suspected a pancreasneoplasm preoperatively. For ten patients we observed a postoperative period without any complication, two patients died postoperatively. Later on patients were mostly affected by diabetes, which could not be controlled at all, while maldigestion could be treated easily. Therefore total duodenopancreatectomy should not be the general operative treatment in chronic pancreatitis and should rather be reserved for special cases.
CEA immune complexes and unbound CEA were preoperatively determined in 350 patients with histologically confirmed adenocarcinoma of the gastrointestinal tract. Circulating CEA immune complexes could be detected in 86 patients (25%) where an increase of tumor extension according to TNM classification was concomitant with an increasing percentage of patients with CEA immune complexes. 74/86 patients showed simultaneously pathological concentrations of unbound CEA. During postoperative surveillance the determinations of circulating CEA immune complexes could be used as prognostic criteria. In 30/50 patients with recurrent cancer CEA immune complexes were detected latest at the time of clinical diagnosis. Appearance of CEA immune complexes might contribute to characterization of the immune status of the patients. Some of the patients with widespread tumors exhibited a rapid increase of CEA immune complexes a few months before exitus (44% of the patients). Before exitus 13% of the patients again showed a greatly decreased concentration of CEA-immune complexes.
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The presence of rubella virus antigen was demonstrated by means of immunohistological methods in two cases of angioimmunoblastic lymphadenopathy. One patient had elevated serum anti rubella titer and myocarditis. These findings support the idea that angioimmunoblastic lymphadenopathy develops as a combined effect of persistent virus infection and partial immune deficiency.
Echography permits information on the shape of the kidneys and ureteral system without reference to their function, and on the perirenal tissue. This is illustrated by a typical example. Echography also provides rapid orientation in the recognition of collections of fluid in the preformed body cavities, which can rapidly bring the affected patient into a life-threatening condition, particularly in the shape of a pericardial effusion. For this reason the inclusion of echography in the investigation program in the care of patients with chronic renal insufficiency is recommended.
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Normal tissue as well as various benign and malignant lesions of the breast were histochemically examined for the presence of the Thomsen-Friedenreich (TF)-antigen. Fluorescein- or 3H-labelled peanut agglutinin was used for this purpose, a lectin that is known to have a high affinity for the TF-antigen. The occurrence of this TF-antigen seemed in all cases, even in the carcinoma lobulare in situ that is regarded as being derived from myoepithelial cells by some authors, to be associated with a secretory condition. Its presence (free and neuraminic acid covered) in normal, hyperplastic and malignant breast tissue, however, cannot be considered a specific tumour associated antigen as has been previously assumed. Furthermore the investigations have shown that the intensity of fluorescence for peanut agglutinin (PNA)-receptors was generally stronger in differentiated carcinomas than in undifferentiated carcinomas of the breast. The histochemical findings are discussed with regard to diagnostical and immunotherapeutical aspects.
Lymph node sections from 14 patients with angioimmunoblastic lymphadenopathy (AIL) were incubated with fluorescein-labeled specific antiserum against rubella virus antigen. In lymphoid cells from 11 patients intracytoplasmic rubella antigen was demonstrated. The results support the idea of a persistent virus infection in AIL.
The immediate effect of CO2-laser incision to the dorsal skin and underlying muscular tissue of rats was studied by light and electron microscopical methods. In the subcutaneous layer of skeletal muscle cells an increased susceptibility was found, resulting in distinct zones of cellular changes which are attributed mainly to thermal effects of the laser beam. The importance of these findings for the surgical application of lasers is discussed.
During the lysogenic response to infection by bacteriophage lambda, the phage-specified cII and cIII proteins provide for the coordinate establishment of repression and integration of the viral DNA. One critical regulatory function of cII/cIII is an activation of synthesis of the cI protein, the repressor that maintains lysogeny. The mechanism and site for regulation of the cI gene by cII/cIII have been a subject of controversy. The two principal hypotheses for cII/cIII action are: initiation of new RNA chains in the y region of lambda DNA just to the left of the cII gene; or antitermination of a short leader RNA (4S or oop RNA) initiated to the right of the cII gene. In an effort to distinguish between these hypotheses, we have studied the cII-mediated turn-on of cI protein synthesis in three classes of prophage deletion strains: deletions of the 4S RNA promoter but not the y region, deletions that remove both regions, and deletions that leave both intact. We find that an intact y region is required for normal regulation of the cI gene by cII, but the 4S RNA promoter is not. From experiments with other mutants, we conclude that rightward transcription from the early lytic promoter is also not necessary for positive regulation. Our results suggest that positive regulation by cII/cIII involves initiation of new RNA chains through activation of promoter sites.
Microcysts of the iris pigment epithelium have been described in association with diabetes mellitus, systemic mucopolysaccharidoses. Menkes's syndrome, and in neonates. Our study covers 68 cases obtained at necropsy. We specifically examined the iris pigment epithelium for vacuolation. We found that microcysts are more widespread than previously thought. In our series 57.3% of the cases reviewed by the light microscope showed microcysts. Of interest was the relationship of malignant neoplasm to iris pigment epithelium microcyst: 69.4% of cases with malignancy showed microcyst, whereas only 30% of the cases without neoplasms showed microcysts. Patients treated with exogenous steroid also had a raised incidence of microcysts.
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