Biomedical subjects
Publications and source records attributed to G Mikuz.
Acute idiopathic fatty liver of pregnancy was observed in a 34-year-old patient. Mother and child survived this complication which has happened in only 10% of the 69 histologically verified cases. On the basis of coagulation studies it may be assumed that consumption coagulopathy had been present initially. This could be pathogenetically relevant in the development of fatty liver of pregnancy.
(1) Histiocytosis-X can manifest itself in virtually every organ, but in gynecology it is an absolute curiosity. (2) Differential diagnosis must exclude specific and nonspecific ulcerations and granulations such as syphilis, tuberculosis, Boeck's disease, and also neoplastic processes like lymphomas, sarcomas, carcinomas, and malignant diseases of the hemopoietic system. (3) The diagnosis by light microscopy alone, as in our case, may be insufficient; therefore, electron microscopy should be used. As soon as the diagnosis is confirmed histologically, an extensive examination of all organs is necessary in order to establish an exact prognosis and an optimal plan of therapy. (4) Because of the unknown etiology of histiocytosis-X, a causal treatment is not yet possible. In spite of this, with a symptomatic, individualized therapy by means of excision, low-dose irradiation and cytotoxic agents a 5-year survival of 90% was obtained for the patients. (5) Because of its rarity and multidisciplinary character, histiocytosis-X is a challenge to interdisciplinary and interregional cooperation. Though not being a malignoma in the strict sense, diagnosis, therapy, and in part prognosis are not essentially different from a malignant disease.
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A 20-year-old labourer, employed in the metal powder industry, developed increasing shortness of breath and serious urge to cough after 2 1/4 years of exposition to cobalt and tungsten carbide powder. On admission 9 months later pulmonary changes were demonstrated radiographically indicating hard-metal-dust lung. Detailed clinical assessment including transpleural biopsy and lingula resection as well as histochemical investigations and follow-up observations permitted access to the pathogenesis and morphology of the disease. By introduction of steroid treatment, before conclusion of diagnostic steps, limitation of the inflammatory primary reaction was possible inasmuch as loss of pulmonary function could be arrested despite massive, histologically verified, tendency for fibrosis.
Material obtained from 58 breast carcinomas was subjected to comparative morphometric and DNA-cytophotometric analysis. The results of DNA analysis were compared with the WHO grading, size of nuclei and size of nucleoli. The large and heterogeneous group of grade II carcinomas could be defined more exactly by means of DNA cytophotometry than it is possible by histological grading. The size both of the nucleus and the nucleoli represent very important cytological hallmarks of proliferation. Carcinomas with big nuclei and prominent nucleoli showed a significantly more marked degree of proliferation than carcinomas without such cytological features.
Ultrastructural features of a papillary mesothelioma arising in a hydrocele-sack are reported. The tumour cells presented numerous microvilli, desmosomes, basement membranes and abundant bundles of microfilaments, which all are hallmarks of mesotheliomas. The predominant cell type was the "clear epithelial cell", but transitional cells and degenerative forms (foamy cells) were also found. The morphology and differential diagnosis of mesothelial tumours arising in the tunica vaginalis propria testis are discussed.
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An approach was made to replace the subjective evaluation of human sperm morphology by an objective method applicable in routine laboratories. 20 patients out of infertile marriages (G2 and G3) were compared with 10 normal, fertile men (G1). Two different methods were used. Highly developed instruments and techniques were used in method 1, and cheap and simple ones, designed for routine laboratories, in method 2. Head area, circumference, length, and maximal midpiece width of 100 spermatozoa/subject were determined by a semi-automatic image analysis system. Head variation and average midpiece width were clearly bigger in G2 and G3 than in G1. As a result, formulae were developed, determining the pathological alteration of sperm head and midpiece for the individual semen. In addition, an objective classification into different sperm types was elaborated. Using the developed formulae, results of methods 1 and 2 are well in agreement. Thus, method 2 is recommended for routine laboratories, allowing an objective and reproducible morphology determination within 30 min.
In 22 patients with T3-4, N0-3, Mo squamous cell cancer of the head and neck (classification UICC 1979), who were treated with induction chemotherapy before surgical resection and postoperative radiotherapy, a comparative histopathologic examination of the prechemotherapy biopsy specimens and serial sections of the surgical specimens was performed. Chemotherapy consisted of 3 cycles every 3 weeks. On the first day of each cycle methotrexate (20 mg/m2) and 15 bleomycin, on the second day cis-diamminodichloroplatinum (60 mg/m2) and from day 3-8 15 mg bleomycin was given daily in a 6 hour infusion. Histopathologic grading of the prechemotherapy biopsies separated well from moderately well and from low differentiated squamous cell carcinoma. In addition the type of tumor growth - solid organoid or diffus reticular - and the mode of invasion were examined. The surgical specimens showed characteristic morphologic changes dependent on the quantity of the remaining tumor. Many tumor residues consisted of solid organoid well-differentiated carcinoma only. After good tumor response to chemotherapy tumor nests typically showed central cystic changes, which resembled pseudoglandular squamous cell carcinoma in cases with tendency towards keratinization or adenoid "basalioma", rarely solid "basalioma", if no tendency towards keratinization was found. Very small tumor nests in abundant local fibrotic tissue merely consisted of undifferentiated cells with absence of differentiated cells. In cases with tendency towards keratinization undifferentiated cells sometimes built one layer - complete or incomplete - around big foci of keratinization. The type of tumor growth - solid organoid or diffuse reticular - and the grade of differentiation showed marked accentuation after chemotherapy.
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Breast cancer is the most common cause of cancer death in women. The probability of being cured of this disease is below 50%. However, for certain stages of disease prognosis can be improved by the application of modern therapeutic strategies. The present paper deals firstly with the relationship between prognosis, staging, and tumour cell characteristics (receptor status and cell kinetic findings). Thereafter, selection and efficacy of cytotoxic chemotherapy and endocrine treatment is discussed and related to the prognostic different entities. The current therapeutic regimen of our group is outlined.
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Prior endometrial biopsies were studied for evaluation of the relationship between hyperplastic endometrial changes and the development of endometrial cancer. Our findings were: A trend for the histologic diagnosis to be more severe in the reexamination. Endometrial hyperplasia preceeded cancer in 20 out of 21 cases. The severe hyperplastic lesions were found 1 to 6 years prior to the diagnosis of endometrial cancer.
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A malignant histiocytoma of the left talus is described. The patient was introduced to our hospital because of an infected recidivation of a partly exstirpated tumor. It is classified as a metastasis of a malignant melanoma. The final histologic diagnosis could be proved by the original slides. The exarticulation of the knee was followed by chemotherapy.
Late results were determined for 42 patients who had undergone detorsion and fixation for unilateral testicular torsion in the prepubertal and pubertal age. Exocrine and endocrine function for the testes was determined in 30 patients who had reached postpuberal age. Patients who underwent detorsion and fixation 8 hours or less after the onset of symptoms had normal-sized testicles and only slight changes in testicular morphology. When treatment was delayed and detorsion was done more than 8 hours later a marked decrease was observed in testicular size. The exocrine function in patients with torsion was reduced. The semen quality, as judged by 2 semen analyses, was normal in 15 patients, doubtful in 3 and pathological in 12. Even when detorsion was done 4 hours or less after the onset of symptoms the exocrine function of the testes was normal in only 50 per cent of the cases. In patients with doubtful and pathological sperm analyses higher follicle-stimulating and luteinizing hormone levels were observed.