[Perforating and ruptured trichilemmal cyst with metaplastic ossification]. / Perforierende rupturierte Trichilemmalzyste mit metaplastischer Ossifikation.

Trichilemmal cysts can occur as multiple scalp lesions and may have a familial history. Metaplastic ossification, as seen in several traumatic, inflammatory or neoplastic conditions, however, seems to be an exceedingly rare event in trichilemmal cysts and might be associated with previous rupture.

[Frequency of histopathological heart findings in representative autopsy material. An epidemiological contribution to quality assurance]. / Häufigkeit histopathologischer Herzbefunde im repräsentativen Autopsiegut. Ein epidemiologischer Beitrag zur Qualitätssicherung.

Only few representative autopsy studies can be found about the frequency of histopathological alterations of the myocardium. One reason, no doubt, is the low rate of abductions. Based on 1,073 autopsies made during 1987 and 1987, a macroscopically inconspicuous region of the left-ventricular myocardium was analysed light-microscopically in addition to the other histological investigations. Slightly more than one half (53%) of them revealed a severe coronary sclerosis, especially with advanced age. Still more frequent was an interstitial fibrosis of the myocardium (71.5%). Surprising was the proportion of an uncharacteristic focal fibroplastic carditis of 24.8% and of lymphocyte pericarditis of 8.9%. Only rarely was there observed an acute, exudatively fibrinous pericarditis. Fibroses of the endocardium were found histologically in 177 cases (16.5%). More frequent than expected was the light-microscopic detection of myocarditis (4.7%). Surprising as well was a high frequency of amyloidoses of the heart muscle (12.8%), especially from the 60th year of age on. The study has underlined once again the value of autopsy and, in particular, the importance of additional, targetted histological organ investigations for a high level of epidemiological knowledge and quality assurance.

[Autopsy in peri- and neonatology--an essential step in quality control. Data on autopsy frequency in Saxony]. / Die Autopsie in der Peri- und Neonatologie--ein unverzichtbarer Schritt bei der Qualitätskontrolle. Erhebungen zur Sektionsfrequenz in Sachsen.

In the framework of a general quality assurance compaign the working group for peri- and neonatology at the General Medical Council of Saxony has investigated the frequency, conclusiveness and development of autopsies in Saxony between 1992 and 1997/98. There were observable different autopsy rates depending on the degree of neonate maturity. Thus, the autopsy rate of stillbirths having birth weights from 500 to 999 g amounted to 79.7%, and that of stillbirths above 1000 g birth weight to only 59.4%. The abduction rate of neonates dying before day 7 of life was 65.7%. It is remarkable that the abduction rates declines from 79.1 to 62.9% in all weight classes of premature and full-term neonates from 1992 to 1997. The possible reasons for the decline of autopsies and the problems emerging for quality assurance are discussed.

[Pathology of inflammatory diseases of the central nervous system--an autopsy analysis 1967-1988]. / Pathologie der entzündlichen Erkrankungen des ZNS--eine Obduktionsanalyse der Jahre 1967-1988.

This paper deals with investigations of CNS-inflammations based on 23,338 autopsies in the period from 1967 to 1988. Inflammatory CNS-findings were observed in 210 cases (0.9 per cent). Their etiology was caused bacterially in 66 per cent and viral infections were found in 20 per cent. Additionally multiple sclerosis appeared in 14 per cent of all CNS-inflammations. The meningitis dominated among the bacterial infections and the leukencephalitis and nekrotizing polioencephalitis of Herpes type among the viral inflammations. The histological classification of the nonbacterial inflammations was difficult or impossible in 9 per cent. A clinical diagnosis was established only in 70 per cent of all cases. Especially babies and patients at the age about 60 or 70 were involved.

[Neuropathology of hypertensive encephalopathy]. / Die Neuropathologie der hypertonischen Enzephalopathie.

An account is given of hypertensive encephalopathy on the basis of neurohistological studies into 54 brains, with additional reference being made to autopsies. Vasculopathy of peripheral arteries and arterioles along with thickening of vascular walls, change of media, and lumen stenosis were primarily recorded by means of optical light and electron microscopy. A difference of more than seven per cent was found to exist between wall thicknesses of arterioles in hypertensive brains, on the one hand, and those in normotensive brains, on the other. Vessels with thickened walls were not rigid but were rather capable of dilation just as under normotensive conditions. Their inner diameters, however, were below normal. Vascular wall fibrosis, to which little attention had been given in the past, was repeatedly recordable from the venous and capillary systems. Impairment of the endothelial barrier function was quite often recorded, with lipid deposits being incorporated in peripheral arterioles and capillaries. No relevance to pathogenesis can be reliably attributed at present to detection of IgG in the arterial system. Microinfarction, micro-haemorrhage as well as disseminated damage to nerve cells are recordable from roughly one third of all hypertensive brains and are primarily located in brain stem ganglia. Demyelinisation and cerebral oedema are quite infrequent. High-protein cerebral oedema was found in some rare cases. Hypertensive encephalopathy should be considered as a nosological entity in which morphological and clinical phenomena are not always correlated to each other.

[Hypertonic central nervous system complications from the viewpoint of the pathologist]. / Die hypertonischen zentralnervösen Komplikationen aus der Sicht des Pathologen.

Based on 2130 autopsies with a hypertension it is reported on the hypertensive CNS-lesions. The frequency of encephalomalacia was 12%. By 9.7% was founded brain haemorrhages. The relapse rate of haemorrhages was about 5%. The encephalomalacia existed by way of secondary finding in 24.7%, and the haemorrhage in 2.2%. The investigations showed an important arteriosclerosis by 39.8% in haemorrhages and by 51.6% in brain infarct. It was remarkable by the hypertensive brain haemorrhages a dominant right hemisphere.