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Biomedical subjects

W Lang

Publications and source records attributed to W Lang.

At least 289 records · Page 16Linked to original sources

[Heterosexual transmission of the acquired immunodeficiency syndrome (AIDS)].

A man who, only in 1979 and on a few occasions, had homosexual contacts, transmitted AIDS virus HTLV-III in 1980 and 1981 to two previously healthy women who did not belong to any AIDS risk group. One of them now has an early form of AIDS, while the other died of AIDS in its full form and her child, born in 1983, has fairly far progressed early symptoms of AIDS. Serum antibodies against HTLV-III were demonstrated in all four subjects.

Acquired Immunodeficiency Syndrome↗

Cytology and distribution in normal human cerebral cortex of neurons immunoreactive with antisera against neuropeptide Y.

The frontal, parietal, and temporal cortices in normal human brains (Brodmann areas 10, 7a, 7b, and 21) are well endowed with numerous neurons, identifiable by immunoreactivity with antisera against the 36-amino acid brain peptide neuropeptide Y (NPY). These neurons with rare exception are small, intracortical, nonspiny neurons, 12-20 microns in somatic size, with long slender dendrites and exuberant axon plexuses exhibiting finely beaded varicosities. The cells are rarest in layers I and II, are found with frequency in the lower cortical layers (IV-VI) and in significant numbers in the subcortical white matter. Within the cortex the axonal plexuses of these peptide neurons rise straight up into the upper cortical layers or descend deep into the white matter. In layers I and II, numerous other lengthy axons, some possibly of extracortical afferent origin, run along the pial surface at right angles to the axial ones running perpendicular to the cortex. This endowment of peptide neurons and their processes forms a rich network in the cerebral cortex, relating with one another in complex fashion within palisades of terminals as well as with the other cortical neurons not labeled by these methods. It remains to be shown what functions these NPY neurons have individually and in their remarkable networks, and how they are altered in neurological disease.

Aged↗

Cortical neurons immunoreactive with antisera against neuropeptide Y are altered in Alzheimer's-type dementia.

Neurons identified by their immunoreactivity with antisera against neuropeptide Y (NPY) were studied in three selected areas of the cerebral cortex in brains from controls and in senile dementia of the Alzheimer type (ATD). Changes were more profound in temporal cortex than in parietal cortex, and more severe in parietal cortex than in frontal cortex, paralleling the severity of neuritic plaque formation and incidence of neurofibrillary tangles in these regions. NPY-i neurons became distorted, with enlarged misshapen cell somata and reduced, thickened, and gnarled dendrites. There was a sharp reduction in the extensiveness and delicacy of the axonal plexus; the reorganized axons were haphazard compared to the normal symmetry of these fibers. Besides the alteration in form and sizes, there were also appreciably fewer cells. Nevertheless, the NPY population is not eliminated. Double-label studies of NPY-i and thioflavin indicate that NPY-i fibers can participate in neuritic plaque formation although not all neuritic plaques contained NPY-i axons and not all NPY-i axons were associated with plaques. The surviving NPY cells were evident in all cortices examined, thus giving rise to the speculation that these peptide neurons may have unusual survival and reorganization potential even in terminal neurological disease.

Aged↗

Neuropsychological and neuroendocrinological disturbances associated with extracerebral cysts of the anterior and middle cranial fossa.

In ten adult patients various clinical signs and symptoms led to the diagnosis of an arachnoid cyst in the anterior and middle cranial fossa. In this study a functional relationship between these cysts and disturbances of higher cognitive processes is described. In addition, neuroendocrinological impairment were caused by arachnoid cysts reaching into the suprasellar cistern. Considering the short medical history of our patients we presumed the disturbances not to be primary, but rather secondary, caused by an expansion of the cysts' volume.

Adult↗

Progressive diffuse leukoencephalopathy in patients with acquired immune deficiency syndrome (AIDS).

Two adult patients with acquired immune deficiency syndrome (AIDS) presented with psycho-organic symptoms produced by an extensive cerebral and cerebellar leukoencephalopathy. Diffuse loss of myelin and axons with reactive astrocytosis and distinctive multinucleated giant cells were prominent in the deep white matter, but less so in the subcortical white matter and in compact myelinated pathways. Bilateral involvement of the centrum semiovale produced distal Wallerian degeneration of the descending pyramidal tracts, which in one patient correlated with progressive paraparesis and bladder dysfunction. Although there were morphological indications of cytomegalovirus infection and immunohistochemical evidence of papovavirus antigens, the neuropathology did not resemble that usually associated with infection by these opportunistic agents. The possibility is entertained that the progressive diffuse leukoencephalopathy (PDL) in these patients was directly related to infection with human T-cell lymphotropic virus (HTLV-III/LAV), the etiologic agent of AIDS.

Acquired Immunodeficiency Syndrome↗

Primary malignant hepatic tumours in childhood.

Twenty-four cases of hepatoblastoma, 14 cases of hepatocellular carcinoma and three cases of malignant mesenchymoma out of a total of 54 primary liver tumours were studied by light microscopy and immunohistochemistry. A remarkable finding in one case of hepatoblastoma and one case of hepatocellular carcinoma was a sarcoid-like reaction in the tumour tissue. Three cases of hepatoblastoma presented a macrotrabecular pattern. Among hepatocellular carcinomas, three cases corresponded to the fibrolamellar variant. By immunohistochemistry, the proportion of cases with positive staining for alpha 1-fetoprotein was higher in hepatoblastoma than in hepatocellular carcinoma. HBs-antigen could be demonstrated in non-neoplastic liver cells in two cases of hepatocellular carcinoma, but not in the tumour cells. No strong correlation between histological pattern and prognosis could be established in hepatoblastoma. However, there was a tendency to more aggressive biological behavior in cases with pronounced mitotic activity. The number of mitoses in hepatoblastoma varied widely. As in previous studies, patients with the fibrolamellar variant of hepatocellular carcinoma fared better than those with the classical type of this tumour. Prognosis in malignant mesenchymoma was not as poor as suggested from previous studies.

Carcinoma, Hepatocellular↗

[Operative indications and surgical procedure in iodine-induced hyperthyroidism].

Clinical course, indications for surgical treatment, and results of treatment in 8 female patients with iodine induced thyrotoxicosis (IIT) are reported. The diagnosis of IIT could be established in all patients by a) clinical hyperthyroidism, b) increased T3 and T4 serum concentrations, and c) previous iodine contamination. Sources of iodine were radiographic contrast agents for urography (n = 4), oral cholecystography (n = 3), intravenous cholangiography (n = 1), phlebography (n = 1), and cranial computer tomography (n = 1). The onset of hyperthyroidism occurred 1-8 weeks after iodine exposure. Indications for surgical treatment of IIT were: 1. autonomous nodular goiter (n = 6), and 2. iodine exacerbation of preexisting thyrotoxicosis in patients with Graves' disease (n = 2). Corresponding to the different pathogenesis of autonomous and immunogenetic goiter the following surgical treatment is recommended: Enucleation of solitary autonomous adenomas or unilateral lobectomy in case of large adenomas, subtotal bilateral lobectomy in toxic multinodular goiter or, preferentially, unilateral lobectomy combined with subtotal resection of the contralateral thyroid lobe; "Near-total" thyroidectomy in Graves' immunopathy.

Adult↗

[Thyroid cytology].

The fine needle aspiration cytology of the thyroid represents a valuable aid for clinical decisions besides scintigraphy and sonography if representative cellular material is available. False diagnoses of malignancy may be totally avoided whereas a relatively high percentage of malignant tumours escapes the cytological diagnosis mostly as a consequence of insufficient puncture. For the intraoperative decision concerning the extent of resection, imprint cytology shows better results than frozen sections at least for follicular tumours.

Adenocarcinoma↗

Fine needle aspiration biopsy in the diagnosis of intraocular cancer. Cytologic-histologic correlations.

Fine needle aspiration biopsy was used as an investigational procedure in the evaluation of 71 eyes harboring a suspected intraocular malignancy between January 8, 1981, and January 21, 1983. Twenty-seven of these 71 biopsies were performed prior to any treatment as a diagnostic procedure and the others were performed following enucleation or tumor excision to provide specimens for cytologic-histologic correlation. The histologic findings confirmed the cytologic diagnosis of malignancy or benignancy in 94.3% of the 53 cases in which a corresponding tissue specimen was available for histologic evaluation. None of the eight eyes with a cytologically confirmed diagnosis of malignancy that were managed conservatively following the biopsy has experienced visual loss attributable to the biopsy. There have been no instances of documented needle tract seeding by tumor cells or orbital tumor recurrence to date in the 27 cases in which diagnostic fine needle aspiration biopsy had been performed prior to treatment.

Biopsy, Needle↗

Theiler's virus encephalomyelitis is unaffected by treatment with myelin components.

Treatment of SJL/J mice with myelin components prior to infection with Theiler's picornavirus did not effect the development of inflammatory demyelinating lesions characteristic of Theiler's mouse encephalomyelitis. These results suggest that the pathogenesis of this disease differs from experimental autoimmune encephalomyelitis, which can be suppressed by such a treatment.

Animals↗

Comparison of histology and immunohistochemistry with thyroglobulin serum levels and radioiodine uptake in recurrences and metastases of differentiated thyroid carcinomas.

The importance of lightmicroscopical and immunohistochemical features of 38 recurrent differentiated thyroid carcinomas (27 papillary carcinomas (PC), 11 follicular carcinomas (FC] for post-operative serum thyroglobulin (TG) concentrations was analysed in regard to pre-operative serum TG levels with tumour type, histological and cytological differentiation, volume fraction of TG synthesizing tumour cells (TG immunohistomorphometry), tumour volume and radioiodine uptake (RIU). Serum TG concentrations increased with tumour size and the number of TG synthesizing tumour cells (r = 0.5). PC and FC did not differ in their volume proportions of TG synthesizing tumour cells, while TG serum levels in FC significantly exceeded those of PC of similar size. The low TG serum levels found in PC might be explained by a specific defect in thyroglobulin secretion. Carcinomas with partial or total cytologic metaplasia (e.g. oxyphilic carcinomas) had low volume proportions of TG synthesizing cells and low serum TG levels. Thirteen of the 38 differentiated carcinomas (34.2%) showed both high TG serum levels and positive RIU, 17 (44.7%) disclosed only elevated TG serum levels and 6 (15.8%) a positive RIU. In two cases (5.3%) TG serum levels were not elevated and RIU's were negative. TG immunostaining was positive in all 38 cases. In summary, TG serum levels depend on the following morphologic factors in differentiated thyroid carcinomas: 1) Number of TG synthesizing tumour cells, 2) Mode of TG secretion and 3) Cytological differentiation of the tumour cells. Serum TG levels did not predict total body iodine scan.

Adolescent↗

[Heart transplantation in cardiomyopathy].

Within the spectrum of presently accepted candidates for heart transplantation, end-stage heart failure in dilated cardiomyopathy has become the principle indication. Although several indicators of poor prognosis have been specified, the decision for heart transplantation is primarily made on clinical grounds. Expected long-term survival after transplantation is 60 to 80% at one year and more than 50% at five years. Since July, 1983, 50 patients underwent orthotopic heart transplantation, 38 of whom had been suffering from dilated cardiomyopathy. Ages ranged from nine to 54 years with a mean of 40 years. At present, 38 patients are alive, 34 are discharged from hospital, 14 have returned to work or school. Physical capacity and cardiac function are normal. There was no difference between the cardiomyopathy patients and the coronary artery disease patients with respect to rate and severity of rejection episodes, infection and long-term findings. Heart transplantation is considered a promising routine treatment for end-stage heart failure in particular in younger patients with dilated cardiomyopathy.

Adolescent↗

Timing function of the frontal cortex in sequential motor and learning tasks.

The timing aspects of human frontal lobe function are discussed in the light of the results of three experiments on movement-related cerebral potentials. Experiment I is based on use of a sequential tracking task and experiment II a motor learning task; experiment III deals with frontal hemispheric specialisation by comparing self-initiated writing and drawing. The Bereitschaftspotential (BP) preceding voluntary movement is maximum over the supplementary motor area (SMA) for all movements, including finger, toe, speech, and eye movements, regardless of each movement's different localisation in the brain, e.g., motor cortex, temporal lobe, or midbrain. The assumption that all motor events are governed by the primary (rolandic) motor cortex is erroneous. The motor system is widely decentralised. It is only when this decentralization is recognized that the close temporal association between the onset of all movements and the preceding Bereitschaftspotential in the SMA can be understood. A plausible explanation would be that the SMA decides on the starting time of all the various movements. The frontal function of motivation is not a single entity but has several subfunctions. It has to decide what to do, how to do and when to do. The latter is probably the task of the SMA. A comparison of different motivational situations makes this clear. In the usual BP paradigm, such as self-initiated simple finger or eye movements, only the SMA becomes active among all the frontal areas. If, however, motivation is required to modify motor programs in motor learning, as it is in experiment II, the entire convexity of the frontal lobe shows a large surface-negative potential, the amplitude of which reveals a significant positive correlation with the success in learning. On the other hand, in experiment I, which uses a manual pursuit-movement task requiring attention to unpredictable changes in stimulus direction but providing a fixed time for these changes (so that their timing is foreseeable), the SMA shows anticipatory behaviour; it takes the form of a large negative potential which ceases 0.5 s prior to the end of the directed-attention potential over parietooccipital areas. In other words, in this special situation, where the SMA can anticipate the onset of movement, it seems to delegate the final execution of the movement to the cortical area most specialised for it, in this case the parietooccipital cortex. The supervision of the tasks concerning what to do and how to do may be provided mainly by the orbital cortex and the frontolateral cortex, respectively (Kleist 1934).(ABSTRACT TRUNCATED AT 400 WORDS)

Cerebral Cortex↗

[Case report of florid trichinosis in otorhinolaryngology].

A 61-year-old male patient who contracted an acute trichinosis infection 39 years ago presented himself with swellings of the floor of the mouth, the tongue and the cheeks. Histological examination of two surgical specimens showed florid trichinosis. No malignant tumor was detectable. We had no indication of a new infection. Mebendazol (= Vermox), Thiabendazol (= Minzolum) and Prednison were used for management.

Cheek↗

[Differential nuclear medicine diagnosis of intrahepatic space-occupying diseases].

The use of ultrasonography has led to an increase of symptom-free carriers of intrahepatic masses. Whereas follicular nodular hyperplasia and haemangioma does not require further treatment, all other tumours should be resected. In a prospective study involving 81 patients with intrahepatic masses the value of nuclear medical methods for such a differentiation was assessed. In 21 out of 23 patients with follicular nodular hyperplasia and in 17 out of 18 cases of haemangioma a correct classification was achieved. In addition, all 3 adenomas and 36 out of 37 malignant tumours could be attributed correctly. Sequential and blood pool scanning of the liver as non-invasive methods thus permit differential diagnosis of intrahepatic masses with sufficient accuracy.

Diagnosis, Differential↗

Alkaline haematin D-575, a new tool for the determination of haemoglobin as an alternative to the cyanhaemiglobin method. I. Description of the method.

A new method for the rapid and accurate measurement of haemoglobin has been developed as an alternative to the conventional cyanhaemiglobin method. This method is based on the conversion of all haeme, haemoglobin, and haemiglobin species into a stable end product by an alkaline solution of a non-ionic detergent ('AHD reagent'). The reaction product, designated as alkaline haematin D-575, is extremely stable and shows a characteristic absorption peak at 575 nm. As compared to the cyanhaemiglobin method, the determination of haemoglobin by alkaline haematin D-575 offers several advantages such as (1) extreme stability of the AHD reagent and the conversion product, (2) decreased conversion time of all haemoglobin species into the end product, (3) decreased amounts of plasma and cell errors, and errors caused by delayed conversion of carboxy- and fetal haemoglobins, and (4) standardisation by a primary standard (purified crystalline chlorohaemin).

Heme↗