[Significance of autopsy. Continuous evaluation of autopsy findings by internists]. / Bedeutung der Autopsie. Fortlaufende internistische Wertung von Autopsieergebnissen.

To continuously monitor the impact of autopsy results, a short questionnaire was forwarded with each list of autopsy diagnoses to the clinician who had requested the autopsy. This continuous feedback between clinician and pathologist reveals unsolved problems and provides the opportunity for their interdisciplinary evaluation. The 1188 autopsies were done from 1980 to 1984 at the Institute of Pathology for the Medical Clinic, Cantonal Hospital, Lucerne, an acute-care medical teaching hospital department containing about 200 beds. The autopsy rate was 52% for in-hospital deaths. The clinician deemed that about 9/10 of all autopsies had confirmed his diagnosis. About 3/4 of all autopsies disclosed previously unknown and clinically important findings. Major discrepancies between clinical diagnosis and autopsy findings were noted in about 10% of all autopsies. Further, in approximately 1/10 of all autopsies the findings were considered to be of potential therapeutic relevance had they been known before death. The results confirm the relevance of autopsy for the practice of controlled clinical medicine based on objective criteria.

[Hemangio-endothelioma of the liver (case report) (author's transl)]. / Das infantile Hämangio-Endotheliom (Fallbeschreibung).

The infantile hemangio-endothelioma (IHE) of the liver, a rare neoplasm, may lead the clinician and the surgeon to suspect the presence of a malignant tumor, whereas histologic examination often reveals a benign condition; our case report illustrates this discrepancy in a 3 1/2-month-old girl suffering from multiple nodules in the liver. Conservative steroid treatment resulted in a marked reduction in tumor size; the girl is in good health more than two years after diagnosis. More than 80% of hepatic IHE are diagnosed during the first six months of life. Hepatomegaly, congestive heart failure and hemangiomas of the skin combine to the classic symptomatic triad. Since the mortality is high in untreated cases, early diagnosis is of importance. IHE may regress spontaneously. Therefore, conservative therapy, such as steroid medication and treatment of the secondary, tumor-induced complications appear indicated. Alternatively, embolization and/or resection of the tumor may be considered. Signs of cardiac or hepatic insufficiency at diagnosis and a low degree of histologic differentiation are of unfavorable prognostic significance.

[Megalocytic interstitial nephritis. A contribution to the differential diagnosis of the large insufficient kidney]. / Grosszellige interstitielle Nephritis. Ein Beitrag zur Differentialdiagnose der grossen insuffizienten Niere.

After a female patient had presented with advanced renal failure, bilateral enormous increase in kidney size radiologically, urinary tract infection (E. coli) and septicemia, autopsy disclosed megalocytic interstitial nephritis (MIN). Clinical and pathological differentiation from renal parenchymal malakoplakia (RPM) is discussed. A literature survey of 15 cases of MIN and 35 observations of RPM points to certain differences between the two entities, i.e. an increased incidence of bilateral pathology in MIN, mor frequent extrarenal localizations in RPM, absent Michaelis-Gutmann bodies and a predominantly cortical distribution in MIN. The similarities, however, suggest that the two conditions might represent different stages of one and the same disease process.

[Experiences with homologous umbilical cord veins in vascular reconstructive surgery]. / Erfahrungen mit homologen Nabelschnurvenen in der gefässrekonstruktiven Chirurgie.

12 homologous umbilical cord veins prepared according to the method of MINDICH from February to November 1978 were used as either femoro-femoral or femoro-popliteal bypass. 6 of the 12 implanted umbilical veins after an average of 4 months were still open and showed good results, whereas 4 were blocked by thrombosis due to bad outflow conditions or dissection. On two implants that had had to be removed, histological examinations were used, and these showed a destruction of the graft's wall. In contrast to the advantages of their problem-free availability and good technical suitability stands the destruction of these grafts observed by us and hence the questionable nature of tenacity in the receiver. Further experiences of longer duration dealing with this interesting subject of vascular substitute are needed.

Reading capacity in cases of 'cured' strabismic amblyopia.

Fifty cases of cured amblyopia were examined in relation to distance vision, near vision, and reading capacity. Occlusion had been abandoned at age 8; the examination was made at age 12. Although linear vision for distance and near was full, reading capacity was markedly impaired. In order to prevent this 'reading amblyopia', sneaking-out or tapering-off occlusion with alternating calibrated filters is continued until the child can read fluently with each eye.

[Intravascular uterine leiomyomatosis]. / Intravaskuläre Leiomyomatose des Uterus.

Intravascular (intravenous) leiomyomatosis is a rare uterine neoplasm. The unusual growth and extension of histologically benign smooth muscle tumors in vascular channels of uterus and pelvis are cardinal features of the disease. The course of the affection has been benign in the majority of the cases reported in the literature. Clinical and pathologic aspects are briefly evaluated in the context of an example of intravascular leiomyomatosis in a 30-year-old woman.