Biomedical subjects
W Dutz
Publications and source records attributed to W Dutz.
[Roentgenologic observations in small bowel lymphoma (author's transl)].
A comparison of the reontgenologic pattern of 100 cases of lymphoma of the small bowel with the clinical and pathological findings revealed three basic types: 1. The primary lymphoma with malabsorption, in which the classical tumor signs of the lymphoma are accompanied by signs of sprue in the nonlymphomatous mucosa. The disease is most severe in the duodenum and jejunum and less so in the ileal mucosa. The neoplasia is most frequently located in the upper small bowel. Severe diarrhoea, weightloss and clubbing are clinical signs. Th;is pattern is seen in the socalled "Mediterranean lymphoma" or in lymphoma associated with poorly controlled gluten sprue. 2. The primary ileocaecal lymphoma, in which the associated mucosa is usually normal. 3. The secondary lymphoma of the small bowel following disseminated lymphoma, which can not be differentiated from a stage 4 primary lymphoma of the gut. Distention and separation of the bowel loops by enlarged mesenteric lymphnodes always indicates a stage 3 or stage 4 advanced lymphoma.
Immunoproliferative small intestinal disease with duodenojejunal lymphoma: radiologic changes.
The radiologic changes in 1090 cases of lymphoma of the small bowel were analyzed and correlated with the pathologic findings. The material was collected in Iran, a high incidence area for immunoproliferative small bowel disease (IPSID). Of 100 cases of primary intestinal lymphoma associated with IPSID, 48 involved the duodenum and upper jejunum. They were associated with a characteristic spruelike radiologic pattern of the nonlymphomatous segments of the gut, the intensity of which decreased distally. However, the radiologic features of the lymphoma associated with IPSID were identical with those described in other forms of primary small intestinal lymphoma, regardless of histologic type or the presence and absence of alpha-heavy chain secretion.
Mycotic urinary tract infection in pyelonephritic patients.
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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.
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.
[En bloc perfusion of donor kidneys--a report on 2 1/2 years' experience].
The methodology of the extracorporal en-bloc-perfusion of donor kidneys is described. After an application of nearly three years its advantages are explained and clearly confirmed on the basis of very good functional results after transplantation of kidneys preserved in such a way.
[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.
Geographic pathology of the gastrointestinal tract. Preface.
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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.
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.
On the therapy of urolithiasis in chronic renal failure.
A resigning attitude in respect to patients suffering from nephrolithiasis and manifest renal failure is not justified anymore in view of the advances in diagnosis and therapy. During the period 1964-1975, at the urological clinic of the hospital Friedrichshain 188 patients suffering from nephrolithiasis and renal failure have been treated: 120 surgically and 68 conservatively. The operative-therapeutical conception is outlined. The pre- and postoperative hemodialysis therapy is described in detail and the different indications of hemodialysis according to the stage of renal failure are elaborated. Tabulated data demonstrate the fate of all surgically treated patients.
Myxomas of the paraoral--oral soft tissues.
Fifteen cases of soft-tissue myxoma of the paraoral-oral structures have been presented. Eleven cases were garnered from an extensive review of the literature, and four previously unreported cases are described. The myxomas were slow-growing, insidious, infiltrative tumors which occurred in all age groups, with an average patient age of 38 years. Most frequent locations were the cheek, floor of the mouth, and palate. The lesions were present from 2 weeks to 6 years prior to treatment. In this series all the myxomas were treated by surgical excision, with no evidence of recurrences or metastases. The recommended therapy is surgical resection with adequate margins. Other myxomatous lesions which may mimic a myxoma are mentioned.
Analysis of lymphocyte receptors (B and T cells).
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[Immunologic development disorders and disease incidence].
Interference with any organ system during development leads to permanent damage. Severe disease or starvation during the first four months of extrauterine life lead to a persistent deficiency of cell mediated immunity, which changes the life expectancy and later disease patterns in population groups. Severe intercurrent disease, starvation or trauma later in life lower cell mediated immunity only temporarily.
Long-term haemodialysis-an enhancing factor for cadaveric graft survival.
In 220 consecutive cadaveric kidney transplants, graft survival in patients dialysed for a period of two years or longer was significantly greater than in those dialysed for less than two years. More blood transfusions were received and the formation of HLA antibodies was greater in the group dialysed for more than two years. A positive cross match was the basis for excluding 21% of the HLA positive patients from transplantation during a one year period of observation. When these same HLA positive patients had more than two subsequent opportunities for donor-recipient selection the exclusion rate dropped to 2%. The longer period of dialysis with more blood transfusions had a favourable influence on cadaveric graft survival whereas the formation of HLA antibodies had a negative influence. Even in HLA positive patients graft survival was better in the long-term dialysis group when compared with the group dialysed for a shorter period. These results suggest that longer dialysis with more blood transfusions represents an enhancing factor for cadaveric kidney grafts.
[Preparation of the patient for kidney transplantation].
1. Before the kidney transplantation the renal insufficient patient should be tended in a chronic dialysis program, because only in this way all possibilities of the prolongation of his life are treated fully and favourable presuppositions can be provided for success of the transplantation. 2. The age of the patients above 50 years and a bad clinical condition are the most important risk factors for a kidney transplantation. Both of them must be avoided, if possible. 3. Part of the preparation of the transplantation is the rehabilitation of the patient. It has the following priorities in diagnostic and therapeutic relation: a) sanitation of the infection b) correction of complications of the terminal kidney insufficiency c) normalization of the function of the respiratory system and gastrointestinal tract and of the cardiovascular system.
Roentgenologic changes in pulmonary echinococcosis.
Radiologic changes seen in 420 cases of pulmonary echinococcosis are discussed. Criteria for early diagnosis of complicated, infected or ruptured cysts are described. The role and limitations of radiology in approaching the diagnosis of advanced stages of infected hydatid cysts of the lung are emphasized.