Morphologiai es igazsagugyi orvosi szemle最新文献

The frightening increase in alcoholism presents for the general practitioner complex and not always objectively assessable problems. The fact that alcoholics are liable to some not directly alcohol-related diseases, such as suppurative septic processes (primarily pneumonias), tuberculosis, ulceration and its complications, traumatic lesions cannot be enough stressed. Clinical diagnostic data are most unfavourable. The reason of this is the wrong medical attitude explaining all complaints on the basis of prevailing alcoholism.

As a routine fixative calcium-acetate-formol is recommended causing no tissue shrinkage, haemolysis, formaldehyde pigments and having an almost neutral pH. Due to the formation of insoluble calcium salts it preserves fatty acids and water-soluble urates and makes them withstanding to paraffin embedding. If completed with methylene blue this solution is also suitable for an improved fixation of acidic glycosaminoglycans.

A case of ochronosis is reported which caused no clinical symptoms and was recognized during postmortem. The diagnosis was verified by histological and chemical examinations. In the family of the deceased no alcaptonuria occurred. With decreasing isolation of the Czechoslovak mountain villages this disease is expected to become sporadic.

Of malignancies occurring in bones, metastatic tumours are the most frequent. Due to the increase of mean life span and to other factors the incidence of tumours is growing. Nevertheless, survival chances of patients suffering from tumours are also improving due to advance in diagnostics and to the application of complex therapy. These trends have substantially increased the number of recognized and manageable bone metastases. In general, life expectations of a tumour-patient are determined by the metastases therefore, the question of diagnostics and management of bone metastases is worth of special attention. Authors have performed a clinicopathological survey of patients of the past eight years who have suffered fracture due to bone metastases and were treated surgically. In one-third of the patients the primary tumour was unknown at the time of the fracture. On the basis of the histological pattern the detection of the parent-organ, particularly in adenocarcinomas, was not possible. Independently from the radiological appearance of the metastasis simultaneous osteogenesis and osteolysis were histologically observed.

Authors have studied the morphology of 10 human planocellular bronchus carcinoma xenografts parallel with that of the donor tumour. The expression of cytokeratin, epithelial membrane antigen and carcinoembryonic tumour markers was also studied and compared. The histological structure and marker expression of xenografts did not change as compared to the donor tissue. Tumour cells were characterized by cytokeratin rather than epithelial membrane antigen. Carcinoembryonic antigen positivity occurred mainly in well-differentiated tumours. The cellular heterogeneity of human planocellular bronchus carcinomas was found to occur also in xenograft tumours.

Authors have verified during the postmortem of a 60-year-old woman, in addition to clinically manifested vascularly and parenchymally decompensated cirrhosis a small hepatocellular carcinoma with signs of vascularization. The patient received since four years pyridinolcarbamate (Prodectin) because of obliterating peripheral arteriosclerosis. During treatment, icterus occurred the drug-induced nature of which was proved by the provocation-test. Owing to the known hepatotoxic effect of pyridinolcarbamate the question must be raised concerning a possible causal relationship between the acute hepatic damage having occurred four years ago and the cirrhosis and cancer observed in the autopsy material. The reporting of this case was aimed at drawing attention to such a possibility.

In the cytoplasm and nucleus of granulated tumour-cells S-100 protein and neuro-specific enolase were immunohistochemically detected supporting the Schwann-cell origin of the tumour. This was suggested also by electron microscopic findings.

Author has studied in 5 needle-biopsy and 25 autopsy samples the wall unevennesses of the glomerular capillary loops developing in kidney amyloidosis. In all cases subepithelial spikes consisting of parallel amyloid fibres were observed. In half of the cases, similar structures occurred also subendothelially. In silver-stained preparations they were readily identified by their increased argyrophilia. In all cases nodular features composed of irregular amyloid fibres were subendothelially present resulting in a considerable narrowing of the lumen. The spikes and nodules causing the unevenness of the basement membrane are of diagnostic value in glomerular amyloidosis.

An experimental protocol is proposed for the differentiation of calcium-hydrogen-phosphate, tri-calcium-phosphate, calcium-oxalate, calcium-urate and fatty acidic calcium. For tissue fixation calcium acetate-formaldehyde is recommended in which fatty acids and earth-metal urates form insoluble calcium-salts which can be demonstrated in paraffin sections.

Authors describe in 2 cases of type 3 mesangiocapillary glomerulonephritis the typical histological, pathological and clinical features of the disease. It is considered to be an ultrastructural variant of mesangiocapillary glomerulonephritis accompanied by focal subepithelial deposits reminiscent of membraneous glomerulonephritis. As the background of immune-complex deposition the increase of capillary permeability observed often in diabetes mellitus is discussed. On the basis of its more benign course this pattern is thought to be a separate subtype.