[Quantitative and qualitative findings in endomyocardial biopsies from patients with and without hypertension]. / Quantitative und qualitative Befunde an Endomyokardbioptaten bei Patienten mit und ohne Hypertonie.

Histological and morphometric investigations were made of left-ventricular endomyocardial bioptates which had been obtained from 19 male patients with so-called latent cardiomyopathy as well as from 21 patients with positively verified hypertension and with angiographically excluded coronary artery sclerosis. The patients were additionally divided in two cohorts according to the weight of the left ventricle below and above 170 g. Inflammatory and ischaemic conditions were, above all, histologically recorded from the first group, while microangiopathy was more frequent in the second. Aspects relating to differential diagnosis and possible relationship between microangiopathy and hypertension were discussed in some detail. Endomyocardial biopsy appears to be justified for patients with hypertension (and also for those with so-called latent cardiomyopathy), if other heart diseases are to be ruled out. Subjective perception of hypertension of myocardial cells was compared to measured myocardial cell diameters. Hypertension of myocardial cells was subjectively overestimated in roughly 50% of all cases. Such subjective overestimation did not necessarily lead to histological diagnosis of hypertension. The conclusion was suggested that subjective assessment of hypertension was sufficient for routine checks. No relationship was found to exist between the weight of the left ventricle or presence of hypertension, on the one hand, and diameter of myocardial cells or volume fraction of the interstitium, on the other.

[Morphologic findings in dilated cardiomyopathy]. / Morphologische Befunde bei dilatativer Kardiomyopathie.

For the morphological characterization of the architecture of the myocardium in dilatative cardiomyopathy hearts of deceased persons as well as after heart transplantation (explanted hearts) were investigated morphologically and histomorphometrically. Thereby could be stated that the cardiomegaly which accompanies this picture of the disease is caused by hypertrophy, increase of the number of collagenous fibres and dilatation of the ventricles. The morphometric investigations made evident that not all cells of the myocardium in the same way participate in the hypertrophy. As a result of the qualitative and quantitative morphological investigations could be stated that in the dilatative cardiomyopathy a particular form of the cardiac insufficiency is concerned which is characterized by an irreversible change of the architecture of the myocardium.

[Actinic keratoses--sequelae of long-term PUVA therapy]. / Aktinische Keratosen--Folgen einer PUVA-Langzeittherapie.

Multiple actinic keratoses occurred on skin regions that were not exposed to the sun in one (0.15%) of 672 psoriasis patients receiving long term PUVA treatment after receiving a cumulative UVA dose of 883 J/cm2. Apart from skin type II, no risk factors were found. Besides clinical signs of chronic, light-induced skin damage, there were minor indications of epidermal dystrophy. Acantholysis was abnormally common in the regions affected by actinic keratosis.

[Fibrotic fraction and myocardial cell diameter in latent cardiomyopathy]. / Fibroseanteil und Herzmuskelzelldurchmesser bei latenter Cardiomyopathie.

100 left-ventricular endomyocardial biopsies of 32 patients were studied by means of morphometric and histological methods. No differences were found between patients with normal left ventricular end-diastolic pressure (LVEDP) and with increased LVEDP in the mean diameter of heart muscle cells, the distribution parameters coefficient of variation and kurtosis, and the volume density of the connective tissue. These patients did not show pathological findings of the other functional parameters and the coronary arteries. Statistically significant differences had been proved between patients with different histological diagnosis (post-myocarditic state, chronic-ischemic heart disease) with respect to the mean diameter of the myocytes (p less than 0.001) and the kurtosis of the distribution of myocytes' diameter (p less than 0.05).

[Craniopharyngioma in a fetus]. / Kraniopharyngiom bei einem Feten.

Intrauterine sonography reveals pathological enlargement of the head and an abnormal intracranial mass in a fetus (25th week of gestation). Birth induction results in a stillborn female child (weight 1,590 g; length 35 cm; head circumference 32 cm). The supratentorial space is almost totally occupied by a craniopharyngioma, measuring 8 cm in diameter.

[Pathologico-anatomical peculiarities of ischemic heart disease in females]. / Pathologisch-anatomische Besonderheiten der ischämischen Herzkrankheit bei Frauen.

In 364 women who died of myocardial infarction, autopsy was performed to assess the extent of chronic ischemic heart disease. The mean age at the time of death at 70.5 years was higher than that of men who died of myocardial infarction; only 4% of the women were less than 50 years of age. In all cases, there were severe arteriosclerotic changes in all coronary arteries. Three-forths of the patients had luminal narrowing of more than 50%, one-forth less than 50%. Accordingly, with respect to morphology, for acute myocardial infarction as cause of death, there were no differences between the sexes. The muscle mass averaging 440 g was less than that reported for comparable studies in men. In 59 women less than 50 years of age with complaints consistent with angina pectoris and angiographically-documented normal coronary arteries, left ventricular biopsies were examined for evidence of chronic ischemic heart disease. In ten patients changes in the terminal vascular beds were found which were considered to be compatible with small vessel disease and in 19 patients there were microscars and a fibrotic pattern as seen in chronic ischemic heart disease. Twelve patients had scarring and fibrosis similar to that seen after myocarditis and 18 patients had a round-cell myocarditis without evidence of involvement of the terminal vascular beds. Thus, heart muscle biopsies appear to be of value in the diagnosis of changes in peripheral arterial beds.

[North American blastomycosis]. / Nordamerikanische Blastomykose.

We report the case of an African patient with North American blastomycosis. The clinical and mycological results and presented and the therapy explained.

[125I]LDL uptake in rabbit arteries perfused in situ. Effect of HDL on intact and de-endothelialized vessels.

The uptake of [125I]LDL by rabbit abdominal and thoracic aortae, and carotid arteries perfused in situ was studied. [125I]LDL uptake in vessels with intact endothelial covering was saturable, Ca2+, Mg2+-dependent and was inhibited by a 100-fold excess of LDL and HDL, on the average by 30% and 60%, respectively. In de-endothelialized vessels [125I]LDL uptake increased by approximately 3-fold, and was not reduced in the presence of excess of unlabeled LDL and HDL.

[African histoplasmosis]. / Afrikanische Histoplasmose.

This is a case report of two patients who suffered from African histoplasmosis. Clinical, histological, and mycological characteristics, and the treatment are described.