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Biomedical subjects

W Dutz

Publications and source records attributed to W Dutz.

At least 19 recordsLinked to original sources
PubMed1991

Diagnostic sensitivity of different techniques in the diagnosis of lung tumors with the flexible fiberoptic bronchoscope. Comparison of brush biopsy, imprint cytology of forceps biopsy, and histology of forceps biopsy.

Brush and forceps biopsies were done consecutively in 186 cases of pulmonary neoplasia with a flexible fiberoptic bronchoscope guided by x-ray television fluoroscopy. Imprint and histologic sections were prepared from all forceps biopsy specimens. The three techniques were compared for their diagnostic sensitivity. As a result 84.9% of all imprints, 80.6% of brush biopsy specimens, and 62.9% of histologic sections were positive for malignancy. The sensitivity of brush biopsy specimens was independent of the location and morphology of the tumors, but the sensitivity of forceps biopsy specimens was lower in neoplasms unidentified by bronchoscopy. The sensitivity of the diagnostic accuracy when all three methods were used jointly was 97.3%, and the specificity was 100%. Agreement in the final morphologic tumor type was found in 130 of 150 cases (86.7%) by positive brush biopsy specimens, in 136 of 158 cases (86.1%) by positive imprint cytology, and in 104 of 117 cases (88.9%) by positive histology from forceps biopsy specimens. For routine bronchoscopy, all three methods should be used in combination to obtain the highest diagnostic yield.

Biopsy↗
PubMed1991

Autopsy pathology and disease patterns in Shiraz, Iran, 1960-1974.

The impact of 4300 serial autopsies performed in Shiraz, Iran, on scientific and clinical medicine is discussed. These studies in geographic pathology led to the recognition of the importance in disease patterns of persistent, life-long changes in the human immune response brought about by serious perinatal infection and/or malnutrition. Elucidation of the pathogenesis of primary upper small intestinal lymphoma serves as an example of the importance of the field of geographic pathology for the understanding of disease processes. The immune response in infantile infection with Pneumocystis carinii with interstitial plasma-cell pneumonia helped to elucidate the basic conditions and mechanisms underlying all forms of pneumocystosis. The first effective prophylaxis of pneumocystosis was thus developed. The response of the gut to different forms of nutritional deficiency and its relationship to gastroenterological cancer was also investigated.

Autopsy↗
PubMed1989

[Reform of medical education as an international trend].

The strengths and weaknesses of the present Austrian Medical Curriculum are compared with other systems. The medical curriculum is part of the educational system and must be seen in that context. The goal is the qualitative and quantitative fulfillment of the manpower needs of the health system. Graduation should follow proper practical training, not only in universities, but also in the community setting. Personal contact on all levels must complement and supersede "multiple choice" thinking. Austrian should not just follow foreign models, but lead the international reform movement in medical education.

Austria↗
PubMed1989

[The high autopsy rate in Vienna].

In 1983 34% of all persons who died in the Republic of Austria were autopsied. We examined the frequency of postmortem examinations in the capital city, Vienna, between 1983 and 1987 in view of this high overall autopsy rate. The annual autopsy rate in all 9 pathology institutes and the department of legal medicine of the University of Vienna was on average 51 to 53%. There was a slight statistically verifiable decline in 1987. The reason for this high necropsy rate is that Austrian law permits the autopsies without the consent of next of kin if it appears indicated for medical, scientific or educational reasons; further more the fact, that the chairman of the department is at the same time the coroner for the hospital. A high autopsy rate is necessary to maintain a high standard of diagnostic accuracy even in modern medicine. The diagnoses were inaccurate or incomplete in 15% of all cases. The high autopsy rate is the basis for extremely accurate mortality and morbidity statistics and provides the basis for long range public health planning. Medical students develop an insight in disease patterns, which cannot be gained in any other way. The pathology departments of Vienna introduce a new city-wide computer-supported diagnostic file system, which will provide a baseline for comparative scientific studies.

Austria↗
PubMed1989

Pneumocystis carinii infection and interstitial plasma cell pneumonia: what does history teach?

Pneumocystis carinii is a special organism that causes a variety of host reactions depending on the resistance and immune response. The disease was originally observed in premature and newborn infants, associated with interstitial plasma cell infiltrates, which lead to rapid suffocation of the infant. An understanding of all aspects of the disease and all its patterns is required in view of the worldwide epidemic of immune deficiency of various etiologies associated with the nearly ubiquitous infestation with Pneumocystis carinii.

Animals↗
PubMed1985

Immunoproliferative small intestinal disease and primary small intestinal lymphoma. Relation to alpha chain protein.

Forty-three patients with immunoproliferative small intestinal disease and primary small intestinal lymphoma were studied prospectively. Eighteen patients in whom alpha-chain protein was detected in the serum had significantly more features of malabsorption, and disease was localized more commonly in the jejunum. In all of these patients, a diffuse lymphoplasmacytic infiltrate was found in the intestine; in three patients lymphoma was found only in mesenteric lymph nodes. Twenty-five patients with lymphoma in whom alpha-chain protein failed to be detected had significantly more features of intestinal obstruction, and disease was found more commonly in the ileum. Five of these patients had lymphoma associated with a diffuse mucosal infiltrate that was indistinguishable from the first group. In patients available for follow-up, no difference was found in cumulative survival over 30 months in the two groups, with approximately 40% mortality at 6 months.

Adolescent↗
PubMed1985

Retinyl ester retention in chronic renal failure. Further evidence for a defect in chylomicron remnant metabolism.

The metabolic remnants of triglyceride-rich lipoproteins are atherogenic in man and experimental animals. Particles resembling lipoprotein remnants have been found in plasma from patients with chronic renal failure (CRF). In this study we took advantage of the observation that retinyl esters are transported only by lipoproteins that originate in the intestine, that is, by chylomicrons (CM) and their remnants. To investigate further remnant metabolism in CRF, plasma RE were measured by reverse-phase high performance liquid chromatography in 20 non-diabetic hemodialyzed patients with CRF and 20 hospitalized non-diabetic control subjects 12-15 h after the administration of retinyl ester, 25000 IU orally. Total plasma RE were increased 3-fold in the CRF patients (P less than 0.001). Quantitative analysis of retinoids and lipids in fractions separated by unit-gravity flotation and flocculation in 3% polyvinylpyrrolidone indicated that the plasma RE were not contained among intact CM. Mean plasma retinol in CRF was also elevated consistent with previous observations and the known role of the kidney in retinol-binding protein metabolism. Although postabsorptive RE concentration was correlated positively and significantly with plasma triglyceride concentration in both groups, RE were higher in CRF patients at comparable plasma triglyceride concentrations. These data support the proposal that atherogenic lipoprotein remnants accumulate in the plasma of patients with CRF.

Adult↗
PubMed1985

Tubular dysfunctions in the diagnostic differentiation of glomerulonephritis, pyelonephritis, and diabetic nephropathy.

Concentration and acidification capability was tested in 41 patients with chronic pyelonephritis (PN), 14 patients with chronic glomerulonephritis (GN), 16 patients with diabetic nephropathy (DNP) and 12 healthy controls. Significant differences appeared between PN and GN, PN and DNP comparing a quotient between percent of normal osmolarity and percent of normal creatinine clearance. Similar results were obtained using a quotient creatinine clearance/ammonia excretion, which enabled the differentiation of PN from the other groups. The tubular functions of concentration and ammonia excretion in relation to creatinine are clinically useful in the differentiation of pyelonephritis from glomerular kidney diseases.

Ammonia↗
PubMed1981

Modification of radiation carcinogenesis by marihuana.

Male, female, and ovariectomized female Sprague-Dawley rats were irradiated with 400 rads, 150 rads, or 300 rads, respectively, of 60Co gamma rays when they were between 40 and 50 days of age. The animals were injected three times weekly with either marihuana extract or with alcohol-emulphor carrier. Comparable unirradiated groups were similarly injected. Mean survival time in males was significantly shorter in the 400 rad + marihuana group compared with the three other groups whose mean survival times did not differ. Through the 546 days that the males were observed, the total number of tumors other than fibrosarcomas was significantly greater following radiation and marihuana (22) than radiation alone (6). Fifteen of the tumors were of breast or endocrine tissues. No differences were seen in the unirradiated groups. In the females, which were observed for 635 days, the total number of breast tumors was greater with the combined treatment (38) compared with radiation alone (22). This was entirely due to a marked difference in the adenocarcinoma incidence, which was 21 (radiation + marihuana) compared with four (radiation alone). The number of adenofibromas was similar in the two groups. In the unirradiated female groups the breast adenocarcinoma incidence was eight in the marihuana group and two in the control group. Ovariectomy resulted in a lower breast tumor incidence in all groups. Nonbreast tumors were more frequent in the ovariectomized-irradiated groups. Radiation plus marihuana produced more nonbreast tumors (25) than radiation alone (17) in the ovariectomized females.

Adenocarcinoma↗
PubMed1981

Neonatal infection with mouse thymic virus: spleen and lymph node necrosis.

Mouse thymic virus (TA) is a naturally occurring herpesvirus of laboratory and wild mice, which produces massive thymic necrosis when inoculated into newborn mice. Our histopathological study showed necrosis not only of the thymus but also of the spleen and lymph nodes which was noticeable by day 7 and complete by day 14. Both spleen and lymph nodes regenerated to an almost normal histological pattern by day 70. The results show that TA infects multiple lymphoid tissues causing massive necrosis in all, and is not limited to a single site, the thymus. TA infection was found to be a persistent herpesvirus infection in both the lymph nodes and spleen. During the period of acute infection, as necrosis increased, the response of cell suspensions of lymph nodes to the T cell mitogens concanavalin A and phytohaemagglutinin was virtually non-existent. Activity returned to normal as the histological repair progressed.

Animals↗
PubMed1979

Pneumatosis cystoides intestinalis in Iran.

Nineteen cases of pneumatosis cystoides intestinalis all affecting adults and all involving the small intestine have been collected in two centres of Iran (Shiraz and Tehran) over a 20 year period, the pathological findings being divided into three groups: pure submucosal, combined submucosal and subserosal, and pure subserosal cysts. Experimental PCI was produced in cadavers using high pressure oxygen insuflation of the lungs, thus lending support to the theory that it has a mechanical origin. Other theories of aetiology include tumour, nutritional deficiencies, gas-forming organisms, alveolar rupture, and acid-base disturbance. In most of the cases presented high intraluminal pressure produced by obstruction appeared to force intraluminal gas through a breach in the mucosa into either the lymphatics or perivascular tissue to produce PCI. It is concluded that the aetiology in the vast majority of adult cases is mechanical in nature and that bacteria seem to play very little part, unlike their role in the PCI of infants.

Adult↗
PubMed1979

Gastrointestinal mucosa and primary gastrointestinal lymphoma.

The primary gastrointestinal lymphomas in Shiraz, Iran, and Richmond, Virginia, USA were compared. Upper duodenojejunal lymphoma is always associated with atrophy of the surrounding nonlymphomatous mucosa, plasma cell infiltration and formation of lymph follicles. This is frequently linked to repeated gastroenteritis leading to mucosal atrophy, mutation of plasma cell precursors and secretion of alpha-heavy-chain. Gastrointestinal lymphoma in the USA and other industrialized countries is found in the stomach, where it is accompanied by superficial perifoveolar plasma cell gastritis of the surrounding mucosa, or in the performed lymphoid tissue of the ileocolon, surrounded usually by normal mucosa. A hypothesis for the pathogenesis of the different types of primary gastrointestinal lymphoma, considering the geographic distribution, and mucosal and immunologic antecedents, is presented.

Adult↗
PubMed1979

[Automatic regeneration of capillary dialysers].

First results of an automatically working regeneration apparatus for capillary dialysators in 200 dialyses allow the on an average tenfold use of the dialysator CDAK 4. In this case a reduction of the effective surface to 70% of the initial value must be taken into bargain. Pyrogenic reactions or bacterial contamination of the regenerated dialysators were not taken into consideration. This method is recommended as transitional solution up to the industrial production of cheap dialysators for a single use.

Kidneys, Artificial↗
PubMed1979

Immune disturbances after severe enteritis during the first six months of life.

Infants with severe enteritis and associated prolonged thymic atrophy during the first six months of life showed persistent cell-mediated immune deficiency between the ages of three and five years. Experimental investigations show that early intrauterine and extrauterine stress may lead to permanent cell-mediated immune deficiency and an imbalanced immune response. Trends in disease frequency among different population groups may be influenced in part by the immunity of the host.

Animals↗
PubMed1979

Epidemiologic studies of gastric carcinoma: comparison between Iranians and two racial groups in the USA.

Gastric carcinoma in 226 cases from the two major racial groups--black and white--in Richmond, VA, USA, and in 75 cases from Shiraz, Iran, were studied. The age at onset and the ratio of intestinal to diffuse gastric carcinoma were compared with those for the high- and low-risk groups from Colombia. Poor socioeconomic conditions are directly related to intestinalization of the gastric mucosa and onset of carcinoma at a relatively young age. In Shiraz, the peak incidence of lymphoma, including intestinal lymphoma, is in the third decade of life; for esophageal carcinoma, it is in the fourth decade, and for gastric carcinoma, in the fifth. Comparison of this age distribution with induction times of neoplasia in immunosuppressed patients supports the suggestion of a common cocarcinogenic factor acting early in infancy. In Richmond, the ratio of intestinal to diffuse carcinoma for the black population is consistently higher than for the white. This difference has increased recently due to a more rapid decline in incidence of intestinal-type gastric carcinoma in the white population than in the black.

Aged↗