Chronische infantile zentrale pontine Myelinolyse vom multifokalen Typ mit sekundären Capillarcalcinosen und Hypoxieschäden

Summary This study reports on a case of extremely chronic course of central pontine myelinolysis (multifocal type) with proliferation of glial fibres and asiderotic calcinosis of capillaries in a 2 8/12 years old girl. Since the first weeks of life there were observed periodic states of emesis, rumination and diarrhoe with hyperpyretic toxicosis, dehydration, exsiccosis, decrease in weight, cyanosis and decentralisation of circulation. Failure of drive, apathic states, statomotoric retardation, atonicastatic symptoms changing with extrapyramidal-pyramidal signs and loss of speech developed progressively since the eighth month. There were bilateral symmetrical lesions in the spinal cord, medulla, central grisea (without pallidum), cerebellum (without dentatum), and hippocampus. Glial fibres and intramural asiderotic calcinosis in the extracellular space of the vascular walls were only found in the burnt-out lesions, but not in the florid glialdystrophic demyelinated areas. The missing of Fe²⁺ in the concrements is caused by the youth of the patient. Besides the glial-dystrophic process there were fresh and old hypoxic foci in the cerebral and cerebellar cortex. It is assumed, that this burnt-out process of the multifocal-lesion-type of central pontine myelinolysis was caused by the eminently chronic course of periodic states of emesis, diarrhoe, dehydration and exsiccosis, decrease of weight, hyperpyretic toxicosis and decentralisation of circulation.

     

The Significance of Ventricular Premature Beats in the Diagnosis of Septal Infarction

Two hundred and twenty electrocardiograms containing premature ventricular beats were reviewed. Twenty of these contained premature ventricular beats of a myocardial infarction pattern, that is, one consisting of a significant Q wave followed by an R wave. A review of the case histories of these 20 patients disclosed that all 20 had angina pectoris and/or myocardial infarction. Postmortem examinations were performed in seven, and the presence of myocardial infarction was verified. In three instances, only the premature ventricular beat disclosed the myocardial infarction pattern while the normally conducted beats did not. In these three cases the postmortem examination confirmed the presence of septal infarction.     

Measurement of anti-IgA antibodies by a two-site immunoradiometric assay

To enable the detection of IgG class, anti-IgA antibodies (IgG-aIgA) and to investigate the possible occurrence of IgE class, anti-IgA antibodies (IgE-aIgA), we developed a solid phase immunoradiometric assay (IRA), which uses purified IgA coupled covalently to microcrystalline cellulose as an immunosorbent. Radiolabeled, Fc specific anti-IgG and anti-IgE antibodies were used to detect specific aIgA after incubation of test sera or controls with the immunosorbent. IgG-aIgA were detected by the IRA in 100 and 67 per cent of control sera with class specific and limited specificity aIgA. The IRA was sensitive to approximately two ng of class specific IgG-aIgA. IgG-aIgA also were detected by IRA in 7.9 per cent of sera from patients with urticarial transfusion reactions and 73 per cent of sera from patients with ataxia telangiectasia and IgA deficiency. Sera from 50 normal blood donors did not have detectable IgG-aIgA. Tests for IgE-aIgA were negative in all cases, including control sera with class specific IgG- aIgA. We conclude that the IRA is a sensitive and reproducible method for detection of class specific and limited specificity IgG-aIgA, and that IgE-aIgA do not mediate urticarial transfusion reactions.     

Rhythm-dependent role of different calcium stores in cardiac muscle: X-ray microanalysis

Under extremely different stimulation patterns such as paired-pulse stimulation, or stimulation after prolonged rest, papillary muscles of guinea-pig show differences in contraction. An early high contraction (360 ms to peak tension) results from paired stimulation at short basic stimulus interval, whereas a small “late” contraction normally occurs (550 ms to peak tension) at a stimulus interval of several minutes (rested state contraction) [Figure 1(a)]. The marked differences in the rate of rise and time to peak of tension in the two cases suggest that different calcium stores releasing calcium in a different mode could be responsible for the different pattern of contraction [1, 7].We have examined this question by looking for calcium stores involved in such states of contraction with the aid of crytotechniques and electron probe microanalysis of chemically untreated shock frozen preparations of guinea-pig papillary muscle.     

Zur Methodik der statistischen Sicherung epidemiologischer Aussagen in der Pathologie

Zusammenfassung Der Forderung erweiterter befund- und erhebungskonsistenter epidemiologischer Daten genügen die Sektionsstatistiken allein nicht mehr. Eine Zusammenführung anamnestischer, klinischer und pathologisch-anatomischer Daten unter Berücksichtigung allgemeiner Daten der Bevölkerungsstatistik bildet die Grundlage einer medizinischen Epidemiologie. Das umfangreiche Untersuchungsgut der Pathologie ist in diesem Zusammenhang in einer adäquaten statistischen Methodik kaum aufbereitet und genutzt worden. Ausgereifte morphologische Technik steht zur Verfügung. Die Möglichkeiten einer epidemiologischen Bearbeitung setzen bestimmte Überlegungen und methodische Schritte der Verbundforschung voraus.

---

Methods of statistical and epidemiological analyses in pathology

Summary Autopsy statistics alone are insuffizient nowadays to fulfill the requirements set by modern epidemiological methods. Medical epidemiology of today rests on combining and analysing data from clinical records, from clinical and pathological studies, as well as from general data of population statistics. For such combined analyses, the results provided by the extensive studies in pathology have scarcely been collected and analyzed adequately. Well-developed morphological techniques are available for use. An epidemiological study presupposes certain considerations about group research and the methods employed.

     

Cholesterol granulomas in antrochoanal polyps: a clinicopathologic study

The purpose of this study was to investigate antrochoanal polyps with cholesterol granuloma (CG), which is a granulomatous reaction to cholesterol crystals that has been precipitated in the tissue. It is usually associated with chronic middle ear disease, common in the mastoid air cells, less common in the orbit and rarely found in the paranasal sinuses. The aim of this study was to analyze the etiology and pathological findings of antrochoanal polyps associated with cholesterol granuloma. This is a retrospective study of five cases of antrochoanal polyp with cholesterol granuloma, (four males and one female between 15 and 77 years of age) who presented with nasal obstruction, rhinorhea and snoring. The cases were clinically and histologically reviewed. Four patients were treated endoscopically and one by intranasal polypectomy without endoscope. There was no recurrence during the follow-up between 24 to 36 months (mean 31.2 months). Five uncommon cases with antrochoanal polyp with cholesterol granuloma are presented. The cholesterol granulomas consist of fibrous granulation tissue containing cholesterol crystals with surrounding foreign body giant cells. The pathogenesis of antrochoanal polyp with cholesterol granuloma is unclear, and further investigations are needed.