Biomedical subjects

W Feiden

Publications and source records attributed to W Feiden.

97 records · Page 6Linked to original sources

PubMedDate not supplied

CMV encephalitis during ganciclovir therapy of CMV retinitis.

An AIDS patient with cytomegalovirus (CMV) retinitis was treated with ganciclovir (10 mg/kg) for four days followed by 5 mg/kg for 69 days. Clinically, CMV retinitis improved during therapy. Two weeks after induction of therapy, the patient became increasingly disoriented, and died 78 days after admission. Microscopically, a necrotizing encephalitis with characteristic cytomegalic cells with intranuclear inclusion bodies was observed. We conclude that ganciclovir therapy did not prevent development or progression of CMV encephalitis in the doses used.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Cerebroretinal vasculopathy and leukoencephalopathy mimicking a brain tumor. Report of two early-onset cases with Fanconi's anemia-like phenotypes suggesting an autosomal-recessive inheritance pattern.

We report two sisters affected with a unique disorder characterized by recurrent space-occupying brain lesions and retinal vasculopathy since their early twenties. Affection status was associated with abnormalities characteristic of Fanconi's anemia, i.e. aplastic anemia, microcephaly, short stature, an unusual face and pigmentation abnormalities of skin. In cytogenetic analyses performed in childhood signs of chromosome fragility or any chromosomal aberration were lacking. Histopathological examination of brain biopsy samples in both cases demonstrated identical histomorphological features of an unusual occlusive vasculopathy with multilayered basement membranes and coagulation necroses which were confined to the white matter. A veno-occlusive retinopathy with neovascularization attributed to progressive visual loss. One of the sisters died at an age of just 24 years, the other is now 27 years old. Unlike any other published cases of hereditary cerebroretinal vasculopathy, the sisters' complex early-onset vaso-occlusive CNS-/eye-disease seems to be genetically associated with their Fanconi's anemia-like phenotypes and is suggested to constitute an autosomal-recessive variant. Patchy white matter calcifications, an incidental finding in either of the affected sisters, may represent preclinical manifestation of disease onset in childhood.

Adult↗

PubMedDate not supplied

Xanthogranuloma of the Erdheim-Chester type within the sellar region: case report.

Manifestations of Erdheim-Chester disease in the central nervous system are very rare. Cases with localization in the retroorbital space, hypothalamic area and posterior pituitary as well as intracerebral lesions are known. In our neurosurgical unit, a 51-year-old male patient with a history of hypophyseal insufficiency and visual deficits underwent surgery for a pituitary lesion. Histological and immunohistochemical examination revealed a xanthogranulomatous lesion composed of very large CD68-positive foam cells with small nuclei and some Touton-like giant cells, histiocytes, as well as loci with small lymphocytes and isolated eosinophilic granuolcytes, embedded in fibrotic tissue. Based on these findings, the histological diagnosis was a xanthogranuloma of the Erdheim-Chester type.

Granuloma↗

PubMedDate not supplied

Automated nuclear segmentation in the determination of the Ki-67 labeling index in meningiomas.

OBJECTIVE: Assessing the Ki-67 labeling index (LI) is laborious and time consuming. Therefore, an automated computer-based method was developed, which is able to identify and analyze immunolabeled and hematoxylin-stained nuclei in digital images of routine immunohistochemical slides. MATERIAL AND METHODS: The method is based on a plugin for the public domain image analysis software ImageJ, which runs on every operating system (free download at http://rsb.info.nih.gov/ij/). Percentage of Ki-67 immunostained nuclei were determined in 5 high power fields (x40) of immunostained slides (DAB detection technique, hematoxylin counterstain) of 20 Grade I, 20 Grade II, and 10 Grade III meningiomas conventionally by two independent investigators and automatically, respectively. The time effort was measured for each counting procedure. RESULTS: Enumerating conventionally or automatically did not reveal any significant differences in the mean labeling indices. Ki-67 LIs discriminated sufficiently between meningiomas of Grade I (median 1.7% Investigator 1 and 1.5% Investigator 2 vs. 1.5% automatically), Grade II (7.6%, 8% vs. 7.3%), and Grade III meningiomas (22%, 21% vs. 22%). The computer-based results correlated very closely with those obtained by manual counting (correlation coefficient = 0.98). The mean time effort for counting procedure per image was 374 s (130 s-435 s) for the conventional and 11 s (7 s-12 s) for the automated method. CONCLUSIONS: The described method can reliably assess the Ki-67 LI much faster than conventional enumerating. The computerized method has the advantages of objectivity, accuracy, repeatability, and ease of use. There is no request for special stains nor special image acquiring systems. The plugin can be downloaded at the "Morphometrie" section of http://www.uniklinikum-saarland.de/neuropathologie.

Biomarkers, Tumor↗

PubMedDate not supplied

Rabies encephalitis: immunohistochemical investigations.

Three cases of human rabies encephalitis were studied immunohistochemically using a specific antiserum to rabies ribonucleoprotein (RNP) and the peroxidase-antiperoxidase method. In this way, RNP could be specifically demonstrated in all cerebral regions and the spinal cord with a predilection for virus attack on the diencephalon and the brain stem according to the clinical course of the disease, and possibly reflecting the phenomenon of pathoclisis. Virus antigen was mainly present in the nerve cell bodies and processes, and in glial cells, especially in the interfascicular oligodendroglia, which seems to be a route of rabies virus infection in the later course of this fatal disease. Immunohistochemically, virus antigen was not limited to the Negri bodies: it was also traceable in the cytoplasm. Altogether, many more virus infected cells were established by immunostaining than were to be expected by the presence of Negri bodies in hematoxylin-eosin stained sections.

Adult↗

PubMedDate not supplied

An electronic tutorial of neurosurgical pathology--application of multi-media in clinical pathology.

We present an electronic tutorial of neurosurgical pathology developed for standard MS-DOS-computers. No additional software requirements are necessary. Digital pictures are displayed on the computer screen in Super-VGA quality. The user interface allows a dialogue between the pathologist and the engine. The dialogue component consists of scroll bar menus with lists of possible suggestions and answers. For each case the user is supplied with the basic clinical information and a set of representative pictures of the histological specimens. In some cases radiographs and CT-images are available. During the consultation session both routine and special staining methods are available on request. If the user proposes a wrong diagnosis the system offers a commentary. The presented cases are part of a teaching series developed for residents in neuropathology.

Computer-Assisted Instruction↗

PubMedDate not supplied

Characterization of intermediate type (WHO "atypical") meningiomas.

The intermediate type meningioma (formerly "meningioma variant with signs of increased proliferation activity"; WHO "atypical" meningioma) represents a meningioma group the mean Ki-67 index and the recurrence rate of which lie between those of the ordinary and the anaplastic type [Kolles et al. 1995]. In the study cited (n = 160) the percentage of recurrences was 9% in the common, 29% in the intermediate, and 50% in the anaplastic type. The present study focuses on 49 subsequently diagnosed meningiomas of the intermediate type. Apart from certain histopathological features, the most important independent factors associated with recurrence were Ki-67 indices covering the 95% confidence interval between 3.7% and 4.9%. At the light-microscopic level, however, meningiomas in general, and especially those supposed to belong to the intermediate type, are highly variable in tissue architecture and do, in contrast to the anaplastic type, not display frank histological features of anaplasia. Morphologically, the growth pattern of solid ("syncytial") sheets, micronecroses, and large distinct nucleoli are suspicious. Cytogenetically, independent of the loss of one chromosome 22, it has been shown that terminal loss of the short arm of one chromosome 1 (1p-) or complete loss of this chromosome were useful additional indicators of meningioma progression.

Adult↗