Thymoma--a retrospective study of 48 cases

Of the 48 thymomas operated on between 1968 and 1985 50% were associated with myasthenia gravis, in 25% diagnosis was made due to accidental X-ray findings. In the staging according to Masaoka et al. [10] the following distribution was noted: I:22, II:5, III:18, IV:3. The 5-year survival rate of the 37 curatively resected patients was 78.5% (stage I: 88.6%, stage III: 55.6%). No stage III patient with residual tumor survived more than 2 years. Predominantly epithelial tumors had a significantly worse prognosis as compared to those with lymphocytic predominance. None of the 4 patients with category II thymoma survived more than 15 months. Association with myasthenia proved to have a negative prognostic influence in stage I and II patients. Frequency of local recurrences and metastases is documented. The value of irradiation and chemotherapy is discussed.     

Supravalvular pulmonary stenosis following anatomic correction of transposition of great vessels: report of a successful balloon dilatation

Primary anatomical repair of TGA has several theoretical advantages over conventional atrial baffle techniques. However, one of the most common postoperative complications of the new technique is the development of an obstruction at the arterial anastomosis to the pulmonary artery (PA). A supravalvular pulmonary stenosis developed progressively over the first months after an arterial switch operation of a simple TGA in a newborn infant. The diagnosis was easily performed by Doppler-echocardiographic follow-up studies. Hemodynamic assessment by cardiac catheterization performed when the patient was five months old revealed a systolic gradient of 76 mm Hg at the arterial anastomosis. Percutaneous balloon angioplasty was successfully performed.     

Sequential Flow Cytometry and Fluorescence In Situ Hybridization for the Study of Formalin-Fixed, Paraffin-Embedded Breast Cancer Cells

Both flow cytometry and fluorescence in situ hybridization (FISH) are useful techniques in the analysis of cancer tissues. When the two are used in the study of the same specimens, they are usually performed in parallel, separately. This is problematic where there is a scarcity of material, making completion of both studies impossible. Fluorescence in situ hybridization procedures that will utilize excess material discarded from flow cytometry would be advantageous. The present report describes an optimized protocol for performing sequential flow cytometry and FISH using formalin-fixed paraffin-embedded archival material. Although breast cancer tissues were used in this initial study, the protocol is applicable to other cancer tissues as well.     

Veränderungen von Mäusenieren nach experimenteller Infektion mit Mucambo-Virus

Summary The purpose of this study was to determine whether autoimmune nephritis in rats affects subsequent generations. Moreover, it was planned to study the nature of the changes in the kidneys in subsequent generations of rats. In these experiments eight generations of rats were investigated. The first five generations were immunized with a mixture of -Streptococcus hemolyticus with an emulsion of renal cortical substance; the rats were given from 4 to 8 injections. After the fifth generation the animals were not immunized, but their nephritis was considerably more pronounced than in their parents. In the 6th and 8th generations there was a sharp rise in the number of animals that died, mainly pregnant rats and newborns. In the course of the experiments, the animals were found to have hypertension, elevated blood nitrogen and proteinuria. A morphological investigation of the rats of the 6th, 7th, and 8th generations that were not immunized, but were born of immunized parents, revealed membranous-proliferative glomerulonephritis, which according to its clinical course and morphological data resembled the nephrotic syndrome the mixed type of human glomerulonephritis.

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Zusammenfassung Die Untersuchungen über den Generationswandel der Autoimmunnephritis der Ratte erstreckten sich über 8 Generationen. Bei den ersten 5 Generationen wurde durch eine 4–8malige Injektion einer Mischung aus beta-hämolytischen Streptokokken mit einer Emulsion aus Nierenrindengewebe eine Immunnephritis erzeugt. Die Ratten der 6. bis 8. Generation erhielten keine immunisierenden Injektionen. Trotzdem kam es in der 6. und 8. Generation zu einem akuten Anstieg der Spontantodesrate besonders unter den graviden und neugeborenen Versuchstieren. Klinisch führte die Immun-Nephritis zu einem Blutdruckanstieg, einer Proteinurie und Erhöhung des Harnstoffes. Histologisch entsprachen die Nierenbefunde der 6.–8. Generation einer membranösen proliferativen Glomerulonephritis.

     

238. Die Ausflu?bahn des rechten Ventrikels (RVOT) nach Korrektur der Fallot'schen Tetralogie (FT)

Zusammenfassung Die Rekonstruktion des RVOT wird bei der FT durch die Anatomie bestimmt, sie zwingt zu Infundibulektomie, transanulärem Patch oder Conduit. Seit 1970 wurden 259 Patienten einer FT-Korrektur unterzogen. In den letzten 3 Jahren sank die Frühletalität von 16 auf 5% durch Verminderung transanulärer Patches von 75 auf 35%, wobei ein P_RV/LV<0,7 in 82 und ein P_RVOT-PA <30 mm Hg in 87% erreicht wurde. Das Management verminderte den negativen Einfluß der Pulmonalklappeninsuffizienz, eines hohen P_RV/LV und P_RVOT-PA auf die Funktion des RV, Verlauf und Letalität obwohl das Alter als Median von 6,9 auf 3,7 Jahre gesenkt wurde.     

Reduced joint count indices in the evaluation of rheumatoid arthritis

Two types of summary measures of joint disease were evaluated in 2 controlled clinical trials in rheumatoid arthritis patients. One measure was based solely on the clinical/biologic judgment approach; the other combined this methodology with statistical approaches using reliability and factor analyses. "Signal joint" indices, summarizing disease activity in 2-5 key joints, were found to be insensitive to deterioriation of nonsignal joints. Therefore, they are not recommended as replacements for the complete articular survey in rheumatoid arthritis. A reduced version of the complete articular survey was found to be desirable based on its validity, reliability, accuracy, precision, and sensitivity to active drugs. Its sensitivity can be slightly higher or lower than that of the full joint survey.     

Bilateral obstruction of the ureters as a complication of iliac aneurysms

A case of bilateral obstruction of the ureters secondary to iliac aneurysms is reported. While perianeurysmal fibrosis in so-called "inflammatory" aneurysms causes the obstruction in most cases, this is a report on a case of compression of both ureters by huge aneurysms without inflammatory reaction. Recurrent back pain of urinary type is the first symptom in 75% of the cases. Ultrasonography shows hydronephrosis and deviation of the ureters as well as the aneurysms. Intravenous pyelography, angiography and CT-scan are necessary to show the real size of the ureters and the aneurysm. Treatment of choice is resection of the aneurysm and replacement by a prosthesis. Ureterolysis may be necessary if the ureters are enveloped by perianeurysmal fibrosis.