Biomedical subjects
Publications and source records attributed to G Pizov.
An unusual case of reversible reactive amyloidosis (AA) is described. A patient in the course of lobar pneumonia developed acute transient nephrotic syndrome and renal failure. Renal and liver biopsy showed amyloidosis and positive immunohistochemistry stains for amyloid A protein. The nephrotic syndrome resolved completely following 6 months of colchicine treatment and the urine is protein free after 6 years of follow-up.
We studied 196 radical prostatectomy cases performed for clinical stage B prostate cancer with capsular penetration; in all cases seminal vesicles and lymph nodes were free of tumor. The mean followup in patients who showed no evidence of progression was 5 years. Focal capsular penetration was seen in 93 cases. There was no difference in progression in this group, irrespective of whether margins were negative or positive. High grade tumors (Gleason score 7 or more) had a significantly higher risk of progression compared to lower grade tumors (p = 0.0002). Established capsular penetration was seen in 103 tumors. Cancers with established capsular penetration had a higher risk of progression than those with focal capsular penetration. Established capsular penetration tumors were stratified into 3 groups with increasing risks of progression: 1) margins were negative and grade was low, 2) margins were positive or grade was high yet both adverse features were not present or 3) margins were positive and grade was high. The differences in progression among these 3 groups were statistically significant. Because of the negligible influence of positive margins in patients with focal capsular penetration the status of capsular margins should not influence the decision on whether to administer immediate postoperative adjuvant therapy. To evaluate the efficacy of adjuvant therapy following radical prostatectomy, tumors with capsular penetration should be stratified into groups having similar risks of progression according to the extent of capsular penetration, surgical margins of resection and grade.
Small intestinal biopsies are part of the routine evaluation of children with chronic diarrhea and malabsorption, and are commonly performed via suction capsule. Because this technique entails x-ray exposure, longer procedure time, and technical failures, most small intestinal biopsies in adults are currently obtained via endoscopy. Endoscopy is believed to yield morphologically inferior specimens, and, therefore, its use for obtaining small intestinal biopsies in children has remained limited. The histological adequacy of biopsy specimens obtained in 30 children by endoscopy and in 30 children by suction capsule was compared. Biopsies were assessed for quality of orientation, size (length and depth), presence of Brunner's glands and crush artifact, and for the ability to confirm or exclude a mucosal abnormality. Small intestinal biopsies obtained via endoscopy were shown to yield tissue specimens that are histologically comparable to those obtained by suction capsule, and that are equally suitable for interpretation.
The cytogenetic evaluation of prostatic adenocarcinoma has shown no consistent cytogenetic abnormalities. Despite manipulation of culture conditions, the majority of low-stage, untreated prostatic adenocarcinomas show a normal karyotype. We have performed cytogenetic analysis on eight primary prostate adenocarcinomas, using several control measures to increase the probability that any normal karyotype was derived from neoplastic cells rather than accompanying normal cells. Tumors were grown in media that encourages epithelial growth; DNA ploidy studies were performed before and after tissue culture; and immunohistochemical confirmation of the prostatic and epithelial nature of the cells was done following culture. Percentage of tumor on tissue sections adjacent to those submitted for culture was > 75% in all cases. Seven of eight cases were evaluable, and six cases showed no clonal abnormalities and were diploid. One tumor showed a population of tetraploid cells, without structural abnormalities. Three additional tumors showed evidence of tetraploidy by DNA analysis. One case showed nonclonal marker chromosomes and was aneuploid. This patient was pathologic Stage D. We conclude that the majority of prostatic adenocarcinomas at their inception may not show routinely detectable cytogenetic abnormalities. However, tetraploidy may play a role in the evolution of prostatic adenocarcinoma.
Using image cytometry and a video planimetry unit, various deoxyribonucleic acid (DNA) measurements, nuclear size and shape factors, and Gleason grade were correlated with capsular penetration, seminal vesicle invasion and lymph node involvement in 113 radical prostatectomy specimens. Percentage of nondiploid cells was the best DNA measurement and standard deviation of nuclear area was the best size measurement correlating with capsular penetration. However, stepwise regression analysis demonstrated that Gleason grade was the only independent predictor of capsular penetration. The only parameter that independently predicted seminal vesicle invasion in a stepwise regression analysis was percentage of tetraploid cells. The mode of optical density was the best DNA measurement for predicting lymph node involvement, although stepwise regression analysis found that Gleason grade was the only independent predictor. DNA ploidy was not as predictive of pathological stage. In summary, DNA measurements and nuclear morphometry performed on smears offered relatively little additional prediction of pathological stage over that of Gleason grade.
We compared mean nuclear size and mean nuclear shape (nuclear roundness) on Feulgen-stained smears from 113 cases of prostatic carcinoma analyzed by DynaCELL system at x 100 magnification versus CAS system at x 40 where DNA can be assessed simultaneously. Correlation coefficients were 0.67 for size and -0.07 for shape. A subgroup of cases were compared at x 40 versus x 100 on the CAS system by two observers: The correlation for size ranged 0.47 to 0.49, with correlations for shape ranging from -0.19 to 0.54. In this subgroup at x 100 magnification, the correlation between CAS and DynaCELL was 0.32 for size and 0.07 for shape. At x 100 magnification on the CAS system, intraobserver correlation was 0.58 for size and 0.37 for shape with interobserver correlations of 0.36 for size and -0.05 for shape. At x 40 on the CAS system, intraobserver correlation was 0.42 for size and 0.72 for shape, with interobserver correlations of 0.06 for size and 0.45 for shape. This study shows that in comparison to video planimetry of prostatic cancer nuclei, which has been shown to have a high inter- and intraobserver correlation, the CAS 200 system provided accurate measurements of size yet not shape. Intra- and interobserver correlations were suboptimal with CAS, showing better results at x 100 for size and x 40 for shape. These results in part reflect the relative narrow range of size and shape in prostate cancer in comparison to other tumors, and the use of Feulgen smears where nuclear RNA is not stained or measured by the CAS system, potentially leading to artifactually irregular shapes.
Heparin was found to inhibit the DNA binding of antibodies eluted from kidneys of both humans and MRL-lpr/lpr mice with systemic lupus erythematosus. Treatment of MRL-lpr/lpr mice with low doses of heparin significantly inhibited renal damage. These results suggest that low-dose heparin might be useful in preventing renal damage in patients with lupus nephritis.
A survey on cystic meningiomas is given based upon the analysis of 85 cases in the literature and an additional three of our own. In these three cases the computerized tomography appearance led to an incorrect preoperative diagnosis of necrotic glioma or metastatic lesion. The tumours were totally removed and the definitive diagnosis of meningioma was histologically confirmed. In reviewing the literature, we found 85 cases of intracranial meningiomas with cystic changes reported. Their pathological and radiological findings are discussed.
Five cases of persistent neonatal hyperinsulinemic hypoglycemia (PNHH) were studied by a combined immunofluorescent and Feulgen technique under a computerized microscope which was used to measure the area and absorbance of beta cell nuclei. An increase of 16% was found in the nuclear area and absorbance of the beta cells in PNHH cases, in comparison with age-matched control cases. A smaller increase (9%) was found in nuclear area and absorbance of non-endocrine ductal cells in PNHH cases. In all PNHH and control cases, higher values of nuclear area and absorbance were found for beta cells in the islets of Langerhans than for nesidioblasts. The increase in average size of beta cell nuclei in PNHH can be used as a morphologic criterion for diagnosis in these cases. The increased absorbance of the nuclei stained with the Feulgen reaction is the morphologic expression of polyploidy, and has a correlation to the metabolic activity of beta cells in this disorder. We conclude that, in contrast to the normal postnatal developmental process of nesidioblastosis, nesidiodysplasia is a well-defined histologic entity, manifested by an increase of beta cell nuclear size and its DNA content.
Degradation of, and tissue reaction elicited by a series of polyethylene oxide (PEO)/polylactic acid (PLA) PELA block copolymers were studied in vitro and in vivo. In particular, the effect of pH, temperature and enzymatic activity was addressed. The mass loss was faster, the more basic the media, while, expectedly, PELA copolymers degraded faster with the higher temperature. The addition of an enzyme (carboxylic ester hydrolase) had no effect. The degradation process strongly affected the mechanical properties of the materials under investigation, the elongation at break dropping drastically after two days of degradation. After seven days, only gross observation of the extensively degraded samples was possible. The in vivo studies compared the tissue reaction elicited by various PELA copolymers to that evoked by PLA. Evaluation of tissue reaction observed with a PELA sample after sterilization with gamma radiation showed acute inflammation with considerable dispersion of the material, 12 days after implantation. The granulomatous reaction observed with PELA copolymers after ethylene oxide sterilization was identical to the reaction observed with PLA.
A 46-month-old boy with a four-day history of pain and swelling over the right posterior ilium was thought to have acute osteomyelitis on the basis of a normal pelvic x-ray, markedly increased scintigraphic activity in the right ilium, and a mildly elevated sedimentation rate. At surgery, no signs of osteomyelitis were found, and biopsy revealed osteolytic osteogenic sarcoma. This is the youngest child with osteogenic sarcoma of the pelvic reported in the literature.
Explore the source record for details and available documents.
We report a case of amyloidoma of a peripheral cervical nerve situated in the right anterior aspect of the neck. Such a localization has not been previously described, to the best of our knowledge.
We describe an unusual case of acute septal myocardial infarction in a heart transplant recipient. The clinical presentation was most suggestive of acute rejection; the correct diagnosis was first made by endomyocardial biopsy and was then verified by coronary angiography. Acute myocardial infarction should be included in the differential diagnosis of acute rejection after heart transplantation and included among the possible diagnoses made by endomyocardial biopsy in these patients.