BACKGROUND: Development of fibrosis characterizes chronic pancreatitis. As it results from deposition of extracellular matrix (ECM) proteins such as hyaluronan (HA) or laminin, the release of these ECM components into blood or pancreatic secretion may be enhanced during the course of chronic pancreatitis. PATIENTS, MATERIAL AND METHODS: Using immunoassays for HA and laminin, the concentration for these ECM components was measured in pancreatic juice and serum samples from 20 patients with and 20 patients without chronic pancreatitis. Pancreatic calculi of varying size and weight obtained from 13 patients with chronic pancreatitis were also examined for the content of ECM components. Tissue samples from normal pancreas and those showing chronic pancreatitis were investigated immunocytochemically with an antibody to HA synthetase (HAS). RESULTS: After stimulation with secretin high levels of ECM components were found in the initial washout period in chronic pancreatitis patients as well as in controls. HA levels, however, were seen seven times higher in patients with chronic pancreatitis (mean +/- SEM; 734 +/- 301 vs. 95 +/- 15 microg/l; p < 0.01). Serum HA levels correlated with the duration of chronic pancreatitis and with the levels of HA in pancreatic juice. HA and laminin were detected in the supernatants of pancreatic calculi (laminin 0.70 +/- 0.30 U/l; HA 275 +/- 85 microg/l). Immunocytochemically, strong staining for HAS was found in the duct epithelium and in centroacinar cells of chronic pancreatitis specimens. CONCLUSION: Demonstration of increased amounts of HA in pancreatic juice of chronic pancreatitis patients stimulated with secretin suggests enhanced production of this ECM component in the chronically inflamed pancreas. The source of HA appears to be the pancreatic ductal epithelium.

Calculi↗

PubMedDate not supplied

Electron microscopic detection of copper in the liver of two patients with morbus Wilson by EELS and EDX.

A 20-year-old male patient with morbus Wilson was liver transplanted because of terminal failure of liver function. The explanted liver showed a strong macronodular cirrhosis as typically seen in Wilson disease. There were visible granular accumulations in the hepatocytes after the rubeanic acid or rhodanine method for histochemical detection of copper. The electron microscopic studies on ultrathin sections revealed numerous electron-dense lysosomes and residual bodies. The elemental analysis in transmission electron microscope (TEM) with electron energy loss spectroscopy (EELS) and in scanning electron microscope (SEM) with energy dispersive x-ray analysis (EDX) showed copper-specific signals of electron-dense accumulations inside these dark lysosomes and residual bodies. In a second case, Wilson disease was diagnosed after autopsy of a 31-year-old patient by liver electron microscopy and EELS; strong electron-dense lysosomes and residual bodies with positive copper signals were found inside hepatocytes. For negative control, hepatocytes with iron accumulation after idiopathic hemochromatosis and liver cirrhosis were also analyzed by EELS in TEM, which showed strong iron, but only a few or no copper signals. Atomic absorption spectroscopy (AAS) in 16 liver samples of healthy and cirrhotic liver revealed only in both cases of Wilson disease a strong increased copper concentration higher than 100 microg Cu/g. The electron microscopic detection of copper-containing hepatocytic lysosomes is helpful for the diagnosis of early stages of Wilson disease in addition to the quantification of hepatic copper by AAS.

Adult↗

PubMedDate not supplied

Primary malignant melanoma of the cervix uteri: a case report of a rare tumor.

We present a case of malignant melanoma of the uterine cervix by focussing on the pathological and immunohistochemical studies that were done to confirm the diagnosis. A 67-year-old postmenopausal women suffering from vaginal bleeding was diagnosed with a polypous tumor at the uterine cervix. The histological diagnosis of a biopsy was pleomorphic malignant melanoma. Colpohysterectomy with bilateral adnexectomy, inguinal and pelvic lymphonodectomy was performed. The tumor was examined by histological and immunohistochemical methods. Multiple atypical cells (PAP V) were found in the cytological examination. The histological preparation showed partly atypical parvicellular, partly solid clear cellular tissue. The immunohistochemical staining reaction with pancytokeratin, LCA, estrogen- and progesterone- receptor was negative. A positive reaction was found on vimentin, S-100 and HMB-45. Thirty percent of the nuclei showed a positive reaction on the proliferation marker MIB1. The tumor was finally diagnosed as a primary pleomorphic malignant melanoma of the portio-vaginal border with satellite metastases into the vaginal wall and tumor thickness 2 mm. The value of immunohistochemical examination enabled us to make the diagnosis of a malignant melanoma of an unusual localisation at the cervix.

Aged↗

PubMedDate not supplied

Vaginal metastasis of lung cancer: a case report.

BACKGROUND: Lung cancer is the second most common malignant tumor, with increasing incidence in the female population. The most frequent metastatic sites are the regional lymph nodes and surrounding areas as well as liver, adrenal gland, bones and brain. Metastases in the vagina of primary lung cancer have not been previously reported. CASE REPORT: Lung cancer was diagnosed in a 67-year-old, postmenopausal woman. Two years following partial lung resection (right apical lobe, R0-resection, CR), the patient complained of increasing problems with urination. A suspect tumor was identified with palpation and confirmed sonographically. Histological and immunohistochemical examinations of a vaginal excisional biopsy revealed metastatic adenocarcinoma, with the staining reactivity as primary lung neoplasm. Anterior exenteration was performed. CONCLUSION: Some cases of vaginal metastases from extragenital tumors have been previously reported. This is the first report of vaginal metastases from primary lung cancer. We suggest that adenocarcinoma especially tend to form metastases in the female genital tract. The present case emphasizes that, in women with unclear symptoms and findings in the small pelvis (e.g. urination problems, suspect vaginal tumor), the formation of such metastases should be taken into account.

Aged↗

PubMedDate not supplied

[The results of using plasmapheresis in the acute rejection reaction after kidney transplants].

We report about the results of plasmapheresis treatment of acute vascular rejection in patients after renal transplantation and compare this group of cadaveric-kidney recipients with another group of patients with acute vascular rejection that got only treatment with intensified immunosuppression (cyclophosphamide). The retrospective study was provided in a non-randomized form with 27 patients in the combined plasmapheresis-cyclophosphamide group and 31 patients in the cyclophosphamide group. The advantages and disadvantages of plasmapheresis treatment in acute rejection periods are discussed. Special attention is given to infectious complications in the early posttransplant period.

Evaluation Studies as Topic↗