Beitrage zur Pathologie最新文献

英文中文

Risk of Periprosthetic Joint Infection after Posttraumatic Hip Arthroplasty following Acetabular Fractures. 髋臼骨折后外伤性髋关节置换术后假体周围关节感染的风险。

IF 1

Beitrage zur Pathologie

Pub Date : 2023-12-01 Epub Date: 2022-05-23 DOI: 10.1055/a-1810-7379

Florian Schmidutz, Anna Janine Schreiner, Marc-Daniel Ahrend, Ulrich Stöckle, Sven Maier, Tina Histing, Philipp Hemmann

Background: Raised complication rates have been reported for total hip arthroplasty (THA) in posttraumatic hip joints after acetabular fractures with prior open reduction and internal fixation (ORIF). The present study evaluated (I) postoperative surgical site infection and the risk of early infection following THA in posttraumatic hip joints after acetabular fractures and (II) the discriminatory ability of preoperative C-reactive protein (CRP) blood levels for periprosthetic joint infection (PJI).

Materials and methods: Patients were included who had undergone THA (2014-2019) after prior ORIF, and nonsurgically treated acetabular fractures. Patients' demographics and the duration between fracture and THA implantation were assessed. Preoperative diagnostic testing (laboratory results, hip aspirations) as well as the results of intraoperative microbiological swabs and sonication were also evaluated. Postoperative complications were recorded.

Results: Sixty-seven patients (51 men/16 women) were included, with a mean age of 54.7 ± 14.0 years (range: 18.0-82.9). The mean time between acetabular fracture and THA was 13.5 ± 14.9 years (0.2-53.5). Four subgroups were classified: subgroup I (nonsurgical, n = 15), subgroup II (complete removal of osteosynthesis, n = 8), subgroup III (partial removal of osteosynthesis, n = 15), and subgroup IV (remaining osteosynthesis, n = 29). Preoperative CRP blood levels were normal. CRP levels had no discriminatory ability to predict PJI (AUC: 0.43). Positive microbiological swabs were assessed in subgroups III (n = 1) and IV (n = 2). Complications during follow-up occurred in subgroups I (one aseptic loosening [6.7%]), III (one wound revision [6.7%], two low-grade infections [13.3%]), and IV (three low-grade infections [10.3%]).

Conclusion: High infection rates were found in patients with THA after acetabular fracture with remaining implants or partial implant removal. Serum CRP alone seems to be a poor predictor. Therefore, an extensive diagnostic algorithm can help to detect an occult infection, including preoperative hip aspiration (microbiological samples and measurements of synovial CRP, WBC, and alpha-defensin levels). Intraoperative tissue samples and sonication results should be obtained during THA implantation.

背景:据报道，髋臼骨折后创伤后髋关节全髋关节置换术(THA)术前切开复位内固定(ORIF)的并发症发生率较高。本研究评估了(1)髋臼骨折后创伤后髋关节THA术后手术部位感染和早期感染的风险;(2)术前c反应蛋白(CRP)血液水平对假体周围关节感染(PJI)的鉴别能力。材料和方法:纳入先前ORIF后接受THA(2014-2019)和非手术治疗的髋臼骨折患者。评估患者的人口统计学特征和骨折与THA植入之间的时间。术前诊断测试(实验室结果，髋关节期望)以及术中微生物拭子和超声结果也进行了评估。记录术后并发症。结果:纳入67例患者(男51例，女16例)，平均年龄54.7±14.0岁(范围:18.0 ~ 82.9岁)。髋臼骨折至THA的平均时间为13.5±14.9年(0.2 ~ 53.5年)。分为四个亚组:亚组I(非手术切除，n = 15)，亚组II(完全切除骨臼，n = 8)，亚组III(部分切除骨臼，n = 15)，亚组IV(保留骨臼，n = 29)。术前血CRP水平正常。CRP水平对PJI的预测无差异(AUC: 0.43)。III亚组(n = 1)和IV亚组(n = 2)微生物拭子阳性。随访期间并发症发生在I亚组(1例无菌性松动[6.7%])、III亚组(1例伤口翻修[6.7%]、2例低度感染[13.3%])和IV亚组(3例低度感染[10.3%])。结论:髋臼骨折后剩余植入物或部分植入物取出的THA患者感染率较高。血清CRP本身似乎不是一个很好的预测指标。因此，广泛的诊断算法可以帮助检测隐性感染，包括术前髋关节抽吸(微生物样本和滑膜CRP、WBC和α -防御素水平的测量)。THA植入术中应获取术中组织标本和超声结果。

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引用次数: 0

Spindle cell lipoma (report of 2 cases and differential diagnosis) 梭形细胞脂肪瘤(附2例报告及鉴别诊断)

Beitrage zur Pathologie

Pub Date : 1977-12-01 DOI: 10.1016/S0005-8165(77)80138-8

P. Meister

“Spindle Cell Lipoma” is a benign tumor consisting of immature mesenchymal spindle cells with occasional collagen fibers, myxoid areas and lipocytes scattered throughout in varying numbers. Only focally it shows the typical appearance of a lipoma. Therefore it may be confused with liposarcoma, fibrosing lipoma, furthermore with areas of fibrous histiocytoma or nodular fasciitis showing fat infiltration.

“梭形细胞脂肪瘤”是一种良性肿瘤，由未成熟的间充质梭形细胞组成，偶有胶原纤维、黏液样区和不同数量的脂肪细胞散布在各处。仅局部表现脂肪瘤的典型表现。因此，它可能与脂肪肉瘤、纤维化脂肪瘤混淆，甚至与纤维组织细胞瘤或结节性筋膜炎的脂肪浸润区混淆。

引用次数: 9

On the lysosomal function of juxtaglomerular granules 肾小球旁颗粒溶酶体功能的探讨

Beitrage zur Pathologie

Pub Date : 1977-12-01 DOI: 10.1016/S0005-8165(77)80134-0

M. Cantin , Y. Desormeaux, S. Benchimol

The presence of acid phosphatase, β-glucuronidase and aryl sulfatase in juxtaglomerular cell granules (JGG) as well as the uptake and concentration of certain low molecular weight dyes by these granules have repeatedly suggested that they are akin to lysosomes. In the present experiments, rats were injected with three substances of widely different molecular weight and physicochemical properties - sucrose, iron sorbitol-citric acid complex (Jectofer) and horseradish peroxidase - that are well known to selectively concentrate in renal tubular cell lysosomes. None of these substances was found to enter the JGG to any significant degree, although both sucrose and Jectofer were evident in juxtaglomerular cells. Contrary to previous reports, thorium dioxide (Thorotrast) particles were not detected in the JGG after parenteral injection. These results indicate that JGG do not possess any significant lysosomal function and raise the question of the role of hydrolytic enzymes in the physiology of these granules.

小球旁细胞颗粒(JGG)中酸性磷酸酶、β-葡萄糖醛酸酶和芳基硫酸酯酶的存在，以及这些颗粒对某些低分子量染料的摄取和浓度，一再表明它们类似于溶酶体。在本实验中，给大鼠注射了三种分子量和理化性质差别很大的物质——蔗糖、山梨醇-柠檬酸铁络合物(Jectofer)和辣根过氧化物酶，这三种物质众所周知可以选择性地集中在肾小管细胞溶酶体中。这些物质均未被发现以任何显著程度进入JGG，尽管在肾小球旁细胞中可见蔗糖和Jectofer。与先前的报道相反，在静脉注射后的JGG中未检测到二氧化钍(Thorotrast)颗粒。这些结果表明，JGG不具有任何显著的溶酶体功能，并提出了水解酶在这些颗粒生理学中的作用的问题。

引用次数: 5

Morphological alterations and focal deficiency of the histochemical activity of acid and alkaline nucleases in rat liver after chronic administration of phenobarbital 慢性给药苯巴比妥后大鼠肝脏酸性和碱性核酸酶组织化学活性的形态学改变和局灶性缺陷

Beitrage zur Pathologie

Pub Date : 1977-12-01 DOI: 10.1016/S0005-8165(77)80137-6

L. Fort , H.S. Taper, J.M. Brucher

Chronic oral administration of phenobarbital (up to 16 months) did not produce any neoplastic foci or nodules in the liver of male Wistar rats. Decrease of glycogen content and cytoplasmic alterations probably indicating S.E.R. hypertrophy were observed in the hepatocytes localized predominantly in the centrilobular areas of rats after chronic phenobarbital treatment. This treatment induced small foci of alkaline DNAse and RNAse deficient liver cells in the initial stages of the experiment. Acid DNAse and RNAse deficient zones increased in liver parenchyma since the third month of chronic administration of phenobarbital. At later stages of the experiment (7 to 16 months) they concerned in some cases more than 50% of liver parenchyma. The hyperbasophilia and the intensity of methylgreen-pyronin staining which, most probably, indicated the accumulation of nucleic acids also increased progressively with phenobarbital administration in similarly distributed irregular zones. These zones had predominant centrilobular localization.

It was suggested that such zonal deficiency of acid nuclease activity might be involved in tumor-promoting action of phenobarbital when separately administered in rats after hepatocarcinogen treatment.

长期口服苯巴比妥(长达16个月)不会在雄性Wistar大鼠的肝脏中产生任何肿瘤灶或结节。慢性苯巴比妥治疗后，大鼠小叶中心区肝细胞糖原含量降低，胞质改变，可能提示S.E.R.肥厚。在实验的初始阶段，这种处理诱导了碱性DNAse和RNAse缺陷肝细胞的小灶。慢性服用苯巴比妥3个月后，肝实质酸性DNAse和RNAse缺陷区增加。在实验后期(7至16个月)，他们在某些情况下关注超过50%的肝实质。嗜碱性细胞增多和甲基绿-吡咯蛋白染色的强度，很可能表明核酸的积累也随着苯巴比妥在类似分布的不规则区逐渐增加。这些区域以小叶中心为主。提示，大鼠肝癌治疗后单独给予苯巴比妥时，核酸酶活性的这种区域性缺失可能参与了苯巴比妥促瘤作用。

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引用次数: 8

The Technique of Death Masks Making 死亡面具的制作技术

Beitrage zur Pathologie

Pub Date : 1977-12-01 DOI: 10.1016/S0005-8165(77)80139-X

H.H. Jansen , P. Leist

In taking death-masks two different techniques are used. In the technique using a plaster matrix the plaster mash is brought on the face. When the plaster-cast has dried it is filled with plaster mash. Later the matrix is removed in order to lay open the mask. In the technique using a plastic matrix the plastic powder Palgat is brought on the face after mixing it rapidly with icewater until it appears pappy. After that a layer of several centimeters of plaster mash follows in order to stabilize the delicate plastic matrix. Likewise the matrix is filled with plaster mash. The mask can be furnished with a collar and a fixation and the surface can be prepared. The skin relief of the face is reproduced finer using the cast of a plastic matrix.

在制作死亡面具时使用了两种不同的技术。在使用石膏基质的技术中，石膏泥被带到脸上。石膏模型干了以后，就填上石膏泥。随后，移除矩阵以打开掩模。在使用塑料基质的技术中，在与冰水快速混合后，将塑料粉末Palgat涂在脸上，直到它看起来像乳头状。之后，一层几厘米厚的石膏泥紧随其后，以稳定脆弱的塑料基质。同样，基质中填充石膏泥。所述面罩可配有项圈和固定物，并可制备表面。使用塑料基质的铸件，面部的皮肤浮雕被复制得更精细。

引用次数: 2

Effect of hemoglobin loads on the function and morphology of ischémic kidneys in the rat 血红蛋白负荷对大鼠缺血肾功能和形态的影响

Beitrage zur Pathologie

Pub Date : 1977-12-01 DOI: 10.1016/S0005-8165(77)80135-2

G.E. Schubert , R. Ochs, A. Haupt

Male Wistar rats were used to investigate the effects of stromafree hemoglobin (200 mg Hb/100 g body weights, i.v. as a 16.4% solution) on kidney function and morphology.

Ischemia of the kidney was induced by bilateral clamping of the renal pedicle. The most severe disturbances of kidney function occurred in kidneys damaged by ischemia during the peak of Hb excretion; endogenous creatinine clearance decreased to 5%) of control values, serum creatinine concentration rose 6 times as high as control values, and Hb excretion in the urine was reduced. Kidney damage after Hb loading and ischemia was more severe than damage caused by ischemia alone. These results demonstrate that the vulnerability of kidneys to damage by ischemia is increased by Hb loading.

以雄性Wistar大鼠为研究对象，观察基质血红蛋白(200mg Hb/ 100g体重，静脉注射16.4%溶液)对肾脏功能和形态的影响。双侧夹持肾蒂引起肾缺血。肾功能紊乱最严重的发生在Hb排泄高峰时的缺血损伤肾脏;内源性肌酐清除率降至控制值的5%，血清肌酐浓度上升至控制值的6倍，尿中Hb排泄减少。Hb负荷和缺血对肾脏的损害比单纯缺血对肾脏的损害更严重。这些结果表明，Hb负荷增加了肾脏对缺血损伤的易感性。

引用次数: 1

Form and structure of cell nuclei in growing and hypertrophied human hearts 生长和肥大的人类心脏中细胞核的形态和结构

Beitrage zur Pathologie

Pub Date : 1977-12-01 DOI: 10.1016/S0005-8165(77)80136-4

C.P. Adler , A. Hartz, W. Sandritter

Tissue portions were taken from eight different places in the right and left ventricle from 17 autopsied human hearts (fetuses, children, adults, hypertrophied and atrophic hearts), and sectioned and smear preparations were obtained and stained after Feulgen. Twenty-eight light microscopic features of heart muscle nuclei were identified, and their percent frequency in individual hearts was obtained.

The studies showed:

1.
Heart muscle nuclei in fetal hearts and in hearts soon after birth show a compact, rounded form in cross section. During childhood heart growth, the nuclei become more and more angular and develop pointed or bizarre projections. In marked heart hypertrophy, almost all heart muscle nuclei assume a bizarre shape and have pointed projections. Compact nuclei are encountered only very occasionally.
2.
In longitudinal section, 80% of heart muscle nuclei in fetal hearts have an oval shape, 20%) are rectangular with rounded corners. During childhood heart growth, the nuclei are angular, and the corners frequently form a point. The smaller edges of the nuclei are cleft. Hypertrophied hearts again show more rounded nuclei.
3.
The external nuclear membrane during childhood heart growth is either smooth or mildly wavy, in contrast to adult heart nuclei which are grooved. Heart hypertrophy again shows predominantly smooth nuclear membranes.
4.
The internal structure of myocardial nuclei (heterochromatin) is granular in the fetal and perinatal periods, whereas it is predominantly netlike in structure during childhood growth phase. Heterochromatin is exclusively coarsely granular in normal, adult hearts, but again finely distributed in a net-like fashion in hypertrophied hearts. Myocardial nuclei from fetuses and children typically show large, round bodies, representing compact DNA aggregates (chromocenters). These are encountered only as isolated findings in normal, adult hearts and in hypertrophied hearts.
5.
The length of heart muscle nuclei remains constant at 9.8 μm during physiologic heart growth, and increases during heart hypertrophy to a mean of 19.2 μm.
6.
Approximately 10% of heart muscle cells from all hearts contain double nuclei and nuclear sequences. The morphological findings of these multinucleate heart muscle cells suggest amitotic nuclear division and nuclear increase.

Shape and structural alterations in heart muscle nuclei permit conclusions to be drawn on the one hand regarding the functional status of the heart muscle, and on the other hand regarding the growth process of the myocardium in physiological heart growth and in pathologic heart hypertrophy. Morphologic evidence is given for a

从17例尸体解剖的人心脏(胎儿、儿童、成人、肥厚心脏和萎缩心脏)右、左心室8个不同部位取组织切片，经Feulgen染色，取切片和涂片。确定了28个心肌核的光镜特征，并获得了它们在个体心脏中的百分比频率。研究表明:1。胎儿心脏和出生后不久心脏的心肌核在横切面上呈致密的圆形。在儿童期心脏生长过程中，细胞核变得越来越有棱角，并形成尖状或奇异的突起。在明显的心脏肥厚中，几乎所有的心肌核都呈奇异形状并有尖状突起。致密核只在非常偶然的情况下出现。纵切面上，80%的胎心心肌核呈椭圆形，20%的胎心肌核呈圆角矩形。在儿童时期心脏生长，核呈角状，角常形成一个点。细胞核较小的边缘是裂的。肥大的心脏再次显示更圆的细胞核。儿童期心脏生长的外核膜是光滑的或轻微的波浪形的，而成人的细胞核则是沟槽状的。心脏肥大再次以光滑的核膜为主。心肌细胞核的内部结构(异染色质)在胎儿和围产期是颗粒状的，而在儿童期主要是网状结构。异染色质在正常的成人心脏中呈粗颗粒状，但在肥厚的心脏中又以网状的方式精细分布。胎儿和儿童的心肌核通常显示大而圆的体，代表致密的DNA聚集体(色心)。这些只在正常、成人心脏和肥大的心脏中单独发现。心肌核的长度在心脏生理性生长期间保持在9.8 μm，在心脏肥厚期间增加到19.2 μm。所有心脏中大约10%的心肌细胞含有双核和核序列。这些多核心肌细胞的形态学表现为无丝分裂和核增加。心肌核的形状和结构改变一方面可以得出心肌功能状态的结论，另一方面可以得出心肌在心脏生理性生长和病理性肥大中的生长过程的结论。形态学证据表明，无丝分裂是肥厚性心脏数量核增生的原因。

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引用次数: 12

Studies on the tubular ferritin-uptake in the kidneys of Goldblatt-hypertensive rats 高血压大鼠肾小管铁蛋白摄取的研究

Beitrage zur Pathologie

Pub Date : 1977-12-01 DOI: 10.1016/S0005-8165(77)80133-9

M. Szokol , M.B. Soltész

Ferritin deposition in the tubular epithelial cells developing after intravenous ferritin injection was investigated in the kidneys of 25 Goldblatt hypertensive rats and of 10 normotensive controls. The phenomenon was detected only in the hypertensive animals. Light microscopic and planimetric data indicate an increased permeability of the glomerular filter and contradict a degenerative damage of the tubular epithelial cells as a primary cause. Ferritin after having crossed the glomerular filter is partly reabsorbed by the tubular epithelium and partly excreted by the urine. The high iron content of the urine and the ferritin detected electrophoretically in it also proves this explanation.

研究了25只Goldblatt高血压大鼠和10只正常血压对照组肾小管上皮细胞内铁蛋白沉积的变化。这种现象仅在高血压动物中发现。光镜和平面测量数据显示肾小球滤过器通透性增加，与小管上皮细胞退行性损伤是主要原因相矛盾。铁蛋白穿过肾小球滤过后，部分被小管上皮重新吸收，部分由尿液排出。尿液中的高铁含量和电泳检测到的铁蛋白也证明了这一解释。

引用次数: 2

Morphology of Mouse Epidermal Cells in Vitro: A Scanning Electron Microscopy Study 小鼠表皮细胞体外形态的扫描电镜研究

Beitrage zur Pathologie

Pub Date : 1977-10-01 DOI: 10.1016/S0005-8165(77)80091-7

K. Elgjo , R. Fölling Elgjo , H. Hennings

Scanning electron microscopy of isolated epidermal cells from newborn mice grown in vitro showed that the cultures consisted of several morphologically different types of cells. Young cultures had many smooth, round cells while older cultures contained more cells with rough or ruffled surface and a varying number of flat, irregular cells. Probably, the various cell types corresponded to different stages of differentation (keratinization). Cultures that were grown in the presence of retinyl acetate (12.5 μg/ml) had more round and smooth cells after several days in vitro than the controls. This could indicate that retinyl acetate delayed or altered cell differentiation. Scanning electron microscopy of the cultures consistently showed that the cells were situated at different layers. The apparent monolayer seen by phase contrast microscopy therefore seems to be an optical phenomenon due to projection of the cells onto the same plane.

体外培养的新生小鼠表皮细胞的扫描电镜显示，培养物由几种形态不同的细胞组成。年轻的培养物有许多光滑的圆形细胞，而较老的培养物含有更多粗糙或褶皱表面的细胞和不同数量的扁平、不规则细胞。可能，不同的细胞类型对应于不同的分化阶段(角化)。体外培养几天后，在视黄酯(12.5 μg/ml)存在下培养的细胞比对照组更圆、更光滑。这可能表明醋酸视黄酯延缓或改变了细胞分化。培养物的扫描电镜一致显示细胞位于不同的层。因此，通过相衬显微镜观察到的明显单层似乎是由于细胞在同一平面上的投影而产生的光学现象。

引用次数: 1

Occurrence of Myofibroblasts in the Different Phases of Morbus Dupuytren (Dupuytren's Contracture) 肌成纤维细胞在Dupuytren挛缩不同时期的发生

Beitrage zur Pathologie

Pub Date : 1977-10-01 DOI: 10.1016/S0005-8165(77)80095-4

J.M. Gokel , G. Hübner

Twenty-one surgically removed specimens of Morbus Dupuytren (M. D.) were studied by light and electron microscopy. The cell type observed in the proliferative phase shows the basic ultrastructural features of fibroblasts, while the majority of the cells in the involutional phase resemble myofibroblasts. Myofibroblasts exhibit ultrastructural characteristics of both smooth muscle cells and fibroblasts and are said to behave functionally like smooth muscle cells. In the residual phase, typical fibrocytes of connective tissue are found. These findings confirm the concept that fibroblasts are capable of converting into myofibroblasts and demonstrate that myofibroblasts represent an intermediate cell type of transitional cellular differentiation. The significance of myofibroblasts for the development of the contracture in M. D. is discussed.

本文采用光镜和电子显微镜对21例手术切除的Dupuytren Morbus (m.d.)标本进行了研究。增生期的细胞类型显示成纤维细胞的基本超微结构特征，而复复期的大多数细胞类似于肌成纤维细胞。肌成纤维细胞具有平滑肌细胞和成纤维细胞的超微结构特征，其功能与平滑肌细胞相似。残余期可见典型的结缔组织纤维细胞。这些发现证实了成纤维细胞能够转化为肌成纤维细胞的概念，并证明肌成纤维细胞代表了过渡细胞分化的中间细胞类型。本文讨论了肌成纤维细胞在m.d.挛缩发生中的意义。

引用次数: 35

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