[Diverticular disease. Pathology and clinical aspects based on 368 autopsy cases]. / Die Divertikelkrankheit. Pathologie und Klinik anhand von 368 Sektionsfällen.

There were found 368 cases (4.5 percent) of diverticulosis of the intestine based on 8124 autopsies in the years of 1979 till 1988 with regard to their localisation, complications and accompanied diseases. In 174 of 368 cases clinical files could be examined and integrated in the evaluation. Sigmoid diverticula were most frequently followed from duodenal diverticula chiefly in the immediate vicinity of the "Papilla of Vateri". Constipation, stomachache, haemorrhoids and spasm of the anal sphincter were typical complaints. One during lifetime known diverticulosis was noted only approximately half on the autopsy application as a second disease. The autopsy results a complication of diverticula (mostly with a peritonitis) in 39 percent as the primary cause of death. Most frequently complication was a diverticulitis (in 16.8 percent refer to the total number). Arteriosclerosis, hypertension and/or diabetes (so called "civilization diseases") were in the main accompanied diseases, which were found too. Surgical intervention took place principal under suspicion of malignoma or as an "acute abdomen". Non-characteristic complaints (protraction by the physician) and the ignorance of the illness among the population (protraction by the patients) are disadvantageous to the identification of the diverticulosis. Because the diverticulosis as a disease of the economic developed countries represents a growing problem ought to direct more attention to prevention, which consists in application of food rich in ballast-substances and the treatment of the constipation.

[The effect of fixation, dehydration and polymethacrylate imbedding on the results of immuno- and enzymehistochemical studies on lymphatic tissue and bone marrow]. / Einfluss der Fixation, Dehydrierung und Polymethacrylateinbettung auf die Ergebnisse immun- und enzymhistochemischer Untersuchungen am lymphatischen Gewebe und Knochenmark.

The influence of formaldehyde fixation, dehydration and polymethacrylate embedding on the results of immunofluorescence staining of immunoglobulin and enzymehistochemical demonstration of hydrolases, especially acid phosphatase and alpha-naphthylacetate esterase in human tonsils and bone marrow were studied. The best results were achieved by using 2% formaldehyde and 5% sucrose in 0.02 M phosphate buffer (ph 7.4) for fixation and ethyleneglycol monobutylether for dehydration. The procedures were carried out at 4 degrees C. For tissue embedding we used the commercially available polymethacrylate Kalloplast R. The polymerisation was carried out at -20 degrees C for 18 hours. This method permits a good preservation of morphological details and the survival of antigenic determinants and enzyme activity. Trypsin, pepsin and alpha-chymotrypsin were used to "unmask" the antigenic determinants in methacrylate sections. Trypsin and alpha-chymotrypsin revealed comparable results, but because of better practicability we used alpha-chymotrypsin. Using the described fixation, dehydration and embedding procedures it was possible to demonstrate both intracellular immunoglobulins (gamma, alpha and mu heavy chains; kappa and lambda light chains) and surface-bound immunoglobulins (mu and delta heavy chains; kappa and lambda light chains). Comparable results were achieved in human bone marrow biopsies. The results of histochemical demonstration of both enzymes were better in bone marrow sections than in that of the tonsils. We think, that the presented method is suitable in the diagnosis of myelo- and lymphoproliferative disorders on both the bone marrow and lymphatic tissue.

[Immuno- and enzymehistochemical studies of methacrylate-embedded biopsy material, especially iliac crest biopsies]. / Immun- und enzymhistochemische Untersuchungen von methacrylat-eingebettetem Biopsiematerial, insbesondere von Beckenkammbiopsien.

Immunohistochemical and histochemical methods are increasingly used and their application in surgical pathology is obvious. Especially we used these methods on bone marrow core biopsies. Optimal and comparable results have been obtained by using different methods after halving the biopsy cores longitudinally and/or transversally. The two halves were used for cytologic imprints. Two parts of the biopsy cores were embedded in polymethacrylate at low temperature (-20 degrees C). The methacrylate-embedded biopsy part for routine histology was fixed in Schaffer's solution (methanol-formalin-fixative). The methacrylate-embedded undecalcified section of 4 microns may be stained by most stains commonly employed in routine histopathology after removal of the plastic. The sections are virtually free of artefacts such as shrinkage and swelling in the light microscope. The second methacrylate-embedded part of biopsy cores was fixed in 2% paraformaldehyde with 5% sucrose in 0.02 M phosphate buffer (pH 7.4) and dehydrated in ethyleneglycolmonobutylether. All procedures were carried out at 4 degrees C. This method permits the use of immunohistochemical and histochemical procedures. The immunohistochemistry was carried out at sections of 4 microns after removal of the plastic with methoxide and use of proteolytic enzyme (0.1% alpha-chymotrypsin) to unmask antigens in sections. Surface and intracellular immunoglobulins were very well detected with the indirect FITC method. The histochemical procedures are carried out at sections of 7-8 microns after removal of plastic with xylene and toluol. The sections were incubated for specific esterase and nonspecific esterases, acid and alkaline phosphatase and then examined by light microscopy. A third part of biopsy cores may be immediately frozen, and cryostat sections are stained and evaluated for rapid diagnosis and used for immunohistologic analysis with mono- and polyclonal antibodies (FITC method) and/or histochemical investigations. Imprints of biopsy cores are evaluated for cytological, cytochemical and/or immunocytological analysis with mono- and polyclonal antibodies (FITC method). The cryostat sections and the imprints are fixed for all methods with 2% paraformaldehyde and 5% sucrose in PBS (0.02 M, pH 7.4) at 4 degrees C for 30 minutes. The best diagnostic results were obtained in the myelo- and lymphoproliferative disorders using the combination of methods described here. Examples were demonstrated.

[Quantitative pathomorphological findings in chronic glomerulonephritis at autopsy: characterization of the grade of renal insufficiency for correlation studies]. / Quantitative pathomorphologische Befunde der chronischen Glomerulonephritis im Sektionsmaterial zur Charakterisierung des Niereninsuffizienzgrades für Korrelationsuntersuchungen.

The investigation is based on 49 autopsies at which chronic glomerulonephritis (GN) was found. The glomerular findings were classified by the WHO classification of renal diseases. The ratio of kidney weight (g) to body height (cm) gave a constitutional kidney index which correlated with the degree of global and segmental (more than 50%) sclerosis of glomeruli in chronic GN (diffuse intracapillary type). The negative correlative coefficient from simple linear regression was rho = -0.606. Chronic GN was then further subdivided into four groups which mutually correlate: diffuse sclerosing GN (so-called end-stage kidney). Index: 0.27 g/cm; diffuse sclerosing GN (over 80% glomerular sclerosis). Index: 0.49 g/cm; diffuse proliferative and extensive sclerosing GN (more than 50% and less than 80% sclerosis) Index: 0.59 g/cm; diffuse proliferative and mild to moderate sclerosing GN (less than 50% sclerosing). Index: 0.93 g/cm. The indices of the diffuse extracapillary GN were high in comparison with diffuse intracapillary GN. The kidney index of diffuse extracapillary proliferative and extensive sclerosing GN with over 80% fibrous crescents was 0.78 g/cm. Index of diffuse extracapillary proliferative and mild to moderate sclerosing GN, mostly epithelial and fibro-epithelial, few fibrous crescents was 1.30 g/cm. The mean values of the indices for normal kidneys were (males) 0.78-0.81 g/cm and (females) 0.73-0.75 g/cm (age: 20-60 years). These results may be used for correlative investigations with morphometric parameters of renal osteopathy.

[Classification of primary bone tumors]. / Zur Klassifikation primär ossärer Geschwülste.

An expanded classification for bone tumors is presented based on the well known international classification as well as earlier systems. The current status and future trends in this area are discussed.

[Pathological anatomy and histology as well as pathogenesis of leg thickness in piglets]. / Pathologische Anatomie und Histologie sowie Pathogenese der Dickbeinigkeit der Ferkel.

Leg thickness in piglets was found to be an autosomal recessive defect resulting in a primary developmental disturbance of the periosteal and connective components of the soft tissues of the fore- and, less frequently, hindlegs. Histologically there is periosteal thickening with periosteal proliferation of woven bone spiculae and also of myxoid elements of the soft tissue between bone and skin. Similar entities are not known in the human literature. Analogies with human hereditary congenital elephantiasis and pes equinovarus are incorrect.

[Chordoid sarcoma of the urinary bladder]. / Beitrag zum chordoiden Sarkom der Harnblase.

A case report of a chordoid sarcoma of the urinary bladder of an 81 years old man is presented. After the first description of the extraskeletal chordoid sarcoma in 1948, this is the first report of the tumor of the urinary bladder.

[Benign fibrous histiocytoma of bone (author's transl)]. / Benignes fibröses Histiozytom des Knochens.

A case report is presented of a large cystic lesion of the proximal end of the left femur in a 66 years old man which is classified as a benign fibrous histiocytoma of bone. After the first description of the malignant fibrous histiocytoma of bone in 1972, this is the first report of the benign type of this tumor.

[Bone fluorosis]. / Beitrag zur Knochenfluorose.

It is reported on a 80-year-old man with a pronounced bone fluorosis which was ascertained by X-ray findngs, dissection, and determination of the fluor content of the bones. Since there was no professional flour exposition a so-called neighbourhood fluorosis was to be assumed. It was caused by an already naturally increased fluor content of drinking water, which was essentially increased by the sewage of a fluor plant. In addition to this an increased fluor emission was present, since the patient has lived for more than 30 years in the nearest environment of the plant. By suitable measures the prescribed values of the fluor content of drinking water and of the fluor emission have to be kept.

[General classification, diagnostic standards, and therapeutic suggestions for malignant bone tumours (author's transl)]. / Allgemeine Klassifikation, Diagnostikstandards und Therapieempfehlungen primär maligner Knochentumoren.

The nomenclature of bone tumours as elaborated by a WHO expert group is presented and compared with own experience. Based on these data as well as those collected in the bone tumour centre at Dresden, diagnostic and therapeutic standards are recommended.

[Diagnostics and therapy of benign bone tumours (author's transl)]. / Diagnostik und Therapie benigner Knochentumoren.

The diagnosis of benign bone tumours must be confirmed histologically; only in rare cases this can be omitted. After having identified the kind of tumour, a specific therapy must be established, covering a wide range, like excochleation as well as amputation. Malignant degeneration and high rates of relapse are possible.

[Bone tumour register and therapeutic centres (author's transl)]. / Zur weiteren Optimierung der Diagnostik und Therapie durch Knochentumoren-Register und Behandlungszentren.

This report deals with bone tumour centres in Dresden and Cottbus (G.D.R.). The data registered were computerized. A reference centre as suggested by the WHO is described with respect to the tumours of bones.