Morphology of tracheal scar after resection with CO2-laser and high-frequency cutting loop. A study in normal pigs.

In 6 pigs a bronchoscopical resection of the tracheal mucosa was performed using CO2-laser on one side, and an electric high-frequency cutting loop (ECL) on the other. The pigs were sacrificed 3 months later. On macroscopic examination the tracheal mucosa appeared almost normal on the laser-resected side, while severe deformation was seen after ECL treatment. Microscopically the respiratory epithelium had regenerated irrespective of the instrument used. After laser resection the subepithelial tissue had a normal width and consisted of collagen fibrils with few vessels and sparse fragmented elastic tissue. The cartilage showed necrosis and pericellular fibrosis. The scar tissue after ECL was a broad cellular and richly vascularized connective tissue. The content of elastic fibres was markedly greater than after laser resection. The cartilage showed small irregular necroses lined by pyknotic nuclei. In neither case had the gland regenerated. Both CO2-laser and ECL caused severe (but not identical) damage to the tissue, clearly visible after 3 months. However, the deformation caused by ECL was not seen at the laser-resected sites, which makes the laser technique seem preferable--where economy permits.

Familial centronuclear myopathy: a clinical and pathological study.

A congenital myotubular myopathy in a family is presented. An elderly woman, her daughter and her granddaughter showed the characteristic clinical and histological pattern of the disease. It is still a matter of debate whether the disease is of myopathic or neuropathic origin. The similarity of the muscle fibre with a myotube of the fetus might point towards an arrest of the maturation after 20th week of gestation perhaps caused by a lack of a trophic factor from the motor nerve.

Nasal Schneiderian papillomas: a study of 83 cases.

Nasal Schneiderian papillomas are unique lesions involving the mucosa of the nasal cavity and paranasal sinuses. Most often epidermoid in histological appearance, they favour 2 sites: the septum and the lateral wall of the nasal cavity. The medical literature on these tumours contains a plethora of contradictions concerning the nomenclature and no less than 54 separate designations are used. The synonyms are discussed and the term Schneiderian papilloma is proposed as the most suitable alternative. This study includes 83 patients with Schneiderian papillomas in whom the history, clinical and radiological findings, treatment procedures, pathological sections, recurrences, and associated malignancies were analyzed. Histological and clinical features were not helpful in predicting recurrence, but the recurrence rate was related to the treatment modalities; with 17% recurrences using an extranasal approach (lateral rhinotomy) and 59% using intranasal approach with limited excision. Schneiderian papillomas were associated with squamous cell carcinoma in 7 patients. Simultaneous papilloma and carcinoma were demonstrated in 4 patients at presentation (5%) and subsequently developing carcinoma in 3 patients (4%). As recurrences are frequent after inadequate removal and as association with maligancies may occur in both septal and lateral wall papillomas, radical aggressive surgery, thorough histological examination of the entire specimen, and careful follow-up are advocated.

An evaluation of gliomas of the anterior visual pathways. A 10-year survey.

Thirteen cases of the childhood type of optic glioma from a 10-year period were studied. Particular attention was paid to the pre-operative neuro-ophthalmological and radiological findings. The patients all underwent explorative craniotomy when biopsy specimens were removed for histopathological study. Post-operative radiotherapy was given in 12 cases. In the follow-up period five patients showed deterioration of visual function, three patients showed unchanged visual function, and one patient showed improved visual function. In the remaining four patients, visual function could not be adequately determined. Three patients died in the course of the follow-up period. Retrospectively it was possible, on a histopathological basis, to divide the patients into three groups. It is suggested that the future management of these patients should consist of explorative craniotomy with diagnostic biopsy. Radiotherapy should be confined to selected cases, as only a minority of optic gliomas are radiosensitive.

Ultrastructure of muscle biopsies in recent, short-term and long-term juvenile diabetes.

Muscle biopsies from juvenile diabetics were studied by electron microscopy and the results correlated to earlier published light microscopical abnormalities of the same biopsies. A total of 32 striated muscle biopsies from 29 juvenile recent, short-term and long-term diabetes were examined. The ages ranged from 16 to 43 years with a diabetes duration from 1 week to 32 years. The material was compared with biopsies from healthy persons of the same ages. The electron microscopy revealed degenerative changes of the striated muscle fibres which signify a neurogenic atrophy. No myopathic alterations were found. The capillaries in both the recent and long-term diabetics showed an extremely pronounced pinocytosis indicating an increased metabolic activity. In the long-term group the intramuscular capillaries both from upper and lower extremities displayed a definitely thickened basement membrane. In the recent and short-term group the capillary wall alterations were debatable. The motor end plate in the recent diabetics revealed minimal alterations. Contrary to this the long-term group showed severe alterations with occasional disappearance of the nerve fibres.