[Ticlopidine-associated thrombotic thrombocytopenic purpura (Morbus Moschcowitz)].

Anamnesis And Clinical Findings: A 75-year-old woman with a history of recurrent ischemic cerebral events was admitted with acute unspecific neurological symptoms and fever.

Examination: Intracerebral hemorrhage due to hypertension and antithrombotic therapy with ticlopidine was ruled out with cranial computed tomography. Laboratory findings on admission included thrombocytopenia (12/nl), renal insufficiency (serum creatinine 1.

[Primary cutaneous plasmacytoma. A case report and review of the literature].

Primary extramedullary plasmacytoma of the skin is a very rare disease; to our knowledge, only a few cases have been published in the world literature. In this paper, a patient who had a primary cutaneous plasmacytoma of the lower lip for 20 years is described. Serological, radiological and histological examinations excluded the possibility of an underlying multiple myeloma.

[Actinomycosis of the bladder].

A palpable tumour was discovered in the left lower abdomen of a 66-year-old woman with uncharacteristic lower-abdominal pain and treatment-resistant pollakisuria and stress incontinence. On ultrasound examination the tumour was about 6.0 x 2.

Effect of FOY-305 (camostate) on severe acute pancreatitis in two experimental animal models.

Two models of severe acute pancreatitis were chosen and pancreatitis induced by sodium taurocholate and by a choline-deficient ethionine-supplemented diet, to evaluate the effectiveness of FOY-305 (camostate), a new synthetic trypsin inhibitor. Prophylactic administration of FOY-305 had a significantly favorable effect on the course of the sodium taurocholate-induced disease and on the survival rate of the treated group. A beneficial effect on the amylase and lipase content in serum and ascites was found, but no effect was observed on enzyme concentration in pancreatic tissue or on the degree of histologically detectable organ destruction.

Emery-Dreifuss muscular dystrophy: disease spectrum and differential diagnosis.

We report six patients with Emery-Dreifuss muscular dystrophy (EDMD) and four patients including one female with EDMD phenotype (EDMDP). This series includes one sporadic case who had previously been reported in this journal under the diagnosis of "rigid spine syndrome" in 1977. Time of observation ranged from three to ten years.

When should treatment of acute experimental pancreatitis be started? The early phase of bile-induced acute pancreatitis.

Sodium taurocholate pancreatitis in the rat is a frequently used experimental model for evaluating therapeutical regimes in this disease. It is, however, uncertain when treatment should be started, as the early phase of this experimental model and thus the time when the pancreatitis really develops is unknown. Serum and pancreatic enzymes, as well as pancreatic morphology, were therefore studied 5, 30, and 60 min after induction of sodium taurocholate pancreatitis.

Myo-, neuro-, gastrointestinal encephalopathy (MNGIE syndrome) due to partial deficiency of cytochrome-c-oxidase. A new mitochondrial multisystem disorder.

A 42-year-old woman had a 10-year history of external ophthalmoplegia, malabsorption resulting in chronic malnutrition, muscle atrophy and polyneuropathy. Computer tomography revealed hypodensity of her cerebral white matter. A metabolic disturbance consisted of lactic acidosis after moderate glucose loads with increased excretion of hydroxybutyric and fumaric acids.

Fatal outcome of aortocoronary bypass grafting in a 62-year-old man with unsuspected coronary arteritis.

A 62-year-old man was admitted to our hospital with unstable angina. The coronary arteriography showed the occlusion of the left anterior descending artery and other stenotic lesions. The patient underwent an aortocoronary bypass operation, but unfortunately he did not survive.

Continuous intravenous infusion of elastase in normal and agranulocytic minipigs--effects on the lungs and the blood coagulation system.

In order to investigate the acute effects on lung morphology, lung function, hemodynamic and blood coagulation system, elastase (330 units (U) kg-1 h-1) was continuously infused into 16 anesthetized and mechanically ventilated minipigs. Elastase infusion induced a disturbance of blood coagulation leading to hypocoagulability, a pulmonary leukostasis, interstitial edema, a progressive respiratory failure with prompt increase in pulmonary vascular resistance, decrease in systemic vascular resistance, increased venous admixture, and increased dead space ventilation. Agranulocytosis prevented interstitial edema but not disturbances in pulmonary or hemodynamic function or hypocoagulability.

Percutaneous intracardiac direct-current shocks in dogs: arrhythmogenic potential and pathological changes.

In 12 dogs, a total of 65 direct-current (DC) shocks of 100-300 J were delivered through a standard USCI6F tripolar electrode catheter to selected sites in the heart. Severe arrhythmias were more frequent after electric shocks of high energy to the ventricles and AV-nodal or His-bundle region than after comparable shocks to the left or right atria. There was a direct relationship between the strength of the electric shocks, and the extent and severity of the injury.

Morphology of healing in vascular prostheses.

Vascular grafts differ in shape and size, material, mode of construction, and porosity. The latter was found to be of great importance with respect to tissue response of the host to the graft. The first reaction of the host after implantation represents the phase of exsudation.

Spontaneous hemodynamic improvement or stabilization and associated biopsy findings in patients with congestive cardiomyopathy.

The hemodynamic courses of 56 patients with congestive cardiomyopathy (CCM) were investigated. Fourteen patients died within 24 months after diagnosis. The hemodynamic courses of the remaining 42 patients were investigated in subsequent examinations by determination of left ventricular ejection fraction (LVEF), mean pulmonary arterial pressure at maximal workload, and peak systolic pressure/end-systolic volume index.

[Electrophysiologic findings in patients with Kearns-Sayre syndrome--report on 2 cases].

The Kearns-Sayre syndrome is identified by the triad of progressive external ophthalmoplegia, atypical pigmentary retinopathy, and conduction disturbances. In addition, clinical manifestations may include mental retardation, sensorineural deafness, cerebellar ataxia, and facial and peripheral muscle weakness. Morphologic alterations in skeletal muscle may be characterized by ragged-red fibers.

[Right ventricular inflow tract obstruction in primary non-Hodgkin lymphoma of the heart].

An unusual case of non-Hodgkin lymphoma (centroblastic B-cell type) is described presenting with severe tricuspid stenosis due to a large right atrial intracavitary tumor mass obstructing the tricuspid orifice. The clinical picture of cardiogenic shock was relieved by surgical removal of the greater part of the tumor mass from the right atrium.

Rupture of a thoracic aortic aneurysm after prosthetic bypass from the ascending aorta to the descending aorta in a case of congenital aortic arch hypoplasia.

An unusual case of a successfully operated ruptured thoracic aneurysm of the aorta with bleeding into the atelectatic pulmonary left lower lobe and acute occlusion of the prosthesis in a 28-year-old woman is reported. The underlying disease was congenital aortic arch hypoplasia still present following implantation of a prosthetic bypass from the ascending aorta to the descending aorta performed in 1963.

[The heart in the elderly. Pathology: macroscopic and light microscopy findings in the heart].

The average heart weight increases up to the 9th decade. An existence of senile atrophy is not confirmed. Various morphological abnormalities of the heart in the elderly can be found during the course of life--polypathy of the heart.

Meningiomas in a male fetus from a hormonally dysequilibrated mother.

Congenital multiple meningiomas in a male fetus of 37 cm length are reported. The tumor was histologically a highly vascular meningioma. An unbalanced level of hormones before and at the beginning of the mother's pregnancy could be ascertained, which resulted in gestational abnormality.

[Value of 2-dimensional echocardiography in the diagnosis of infectious endocarditis].

Cross sectional and simultaneous M-mode echocardiograms were performed on 15 consecutive patients with infective endocarditis, 14 of whom had pre-existing cardiac lesions. Patients were divided into two groups based on the presence or absence of echocardiographically detected vegetative lesions. In 10 out of 15 patients vegetations were present (66%): aortic valve 5, mitral valve 1, tricuspid valve 1, both aortic and mitral valves 1 and left ventricular endocardium associated with aortic valve lesion 2.

[Surgical treatment of congenital abnormalities of the right heart].

The surgical treatment of complex congenital malformations of the right heart is described and discussed with regard to the following heart diseases: tetralogy of Fallot (FT), transposition of the great arteries (TGA), tricuspid atresia (TA), single ventricle (SV). The results of the patient material of Goettingen were focused on the right ventricular function. With reference of the FT-correction a residue pulmonary stenosis is considered to be better tolerated than a residual pulmonary insufficiency.

[Classical form of Kaposi sarcoma: immunology and interferon therapy].

T-lymphocytes and their subsets were determined in three patients with classical Kaposi's sarcoma. A reduction of pan-T-lymphocytes, including both a reduction of T-helper and T-suppressor cells, was found in one patient. None of the patients showed a reduction of the T-helper/T-suppressor cell ratio, as described in the lymphadenopathic disseminated type of Kaposi's sarcoma.

[Occlusion of the right coronary artery with acute right heart infarct and cardiogenic shock].

In a 42-year-old patient with an acute inferior infarction the right coronary artery was recanalised by intracoronary streptokinase 4 hours after the onset of symptoms. In spite of early reperfusion the patient developed an extensive myocardial infarction and died three days later from cardiogenic shock. Autopsy revealed an almost complete necrosis of the right ventricle including the inferior interventricular septum and the adjacent left ventricular wall.

[Primary angiosarcoma of the heart--3 case reports and a review of the literature].

Three cases of primary angiosarcoma of the heart diagnosed intra vitam are reported. A review of the literature with 118 described cases is given, with special reference to localization, clinical symptoms, diagnostic procedures, and prognosis. Modern diagnostic procedures make it possible to diagnose cardiac tumors in the living patient, but prognosis remains poor.