Morphological and immunohistochemical studies of normal adrenal gland

Morphologically and functionally distincts from each other, the two different types of endocrine tissue that constitute the adrenal gland, the medulla and the cortex, could have influence on the endocrine activity of each one, i.e., there might be regulatory mechanisms exercised by some products released from each of these two areas to the other one. Besides these findings, there are evidences of the presence of cells from the adrenal cortex within the medulla area and vice versa. Twenty-one cases without clinical evidence of endocrine disease were selected for morphological study of the adrenal tissue and to verify their immunoreactivity for hormones, intermediate filaments and neuroendocrine peptides. All cases were histologically classified as normal. Chromogranin was recognized in 20 cases only in medullary region. Synaptophysin was identified in the medullary area in 9 cases. S-100 protein was observed in all cases in both medullary and cortex areas. Immunoreactivity to cytokeratins was found in 14 cases. Vimentin showed focal positivity in 5 normal cortex areas and ACTH reactivity was present in only one case. Positivity for FSH was observed (one case in medulla and two in cortex), possibly due to antibody specificty. D-11 positivity was found in the cortex region in 18 cases. Further studies should be conducted in order to establish the utility of these findings, since presence of hormone or hormone-like sustance secreting cells could induce local paracrine stimulation.

Later complications on diabetic patients: nephropathies in necropsy material

The purpose of the present study was to analyze in detail the kidney lesions of diabetic patients. Revision of the histopathologic aspects of this nephropathy was performed, seeking to approach the pathophysiology of its formation. In 200 consecutive necropsies of cadavers of diabetic patients examined at the Pathology Department of the Medical School of the Säo Paulo University, some degree of nephropathy was found in 158 cases. The slides from parffin sections of these cases were reviewed according to a morphologic protocol previously established. Diffuse, nodular and mixed glomerulosclerosis were encountered in 42.2 per cent, 21.5 per cent and 5.7 per cent respectively. Subvcapsular drop and exudative lesion appeared in 12,7 per cent and 15.2 per cent of the cases. We also encoutered arteriosclerosis in 81.6 per cent, arteriolosclerosis in 88.6 per cent, necrotizing papillitis in 11.4 per cent and acute and chronic pyelonephritis in 23.4 per cent and 20.9 per cent respectively. We concluded that glomerular and vascular hyalin alterations were the most frequent findings in diabetic patients

Study in necropsy material of "cause-specific mortality" in diabetics, in São Paulo-Brasil

Specific causes of death in diabetic patients was studied in retrospective work from necropsies performed at the Medicine School of the University of São Paulo from 1931 until 1989. From 145,043 necropsies, 813 indexed cases were found: 449 females (55.2) and 364 males (44.8). The race ratio of patients was: 584 (71.8) white, 208 (25.6) negro and 21 (2.6) asiatic. The predominant age of death incidence was between the fifth and sixth decades. The main causes reported were infections (42.68), coma (12.79), neurologic involvement (11.56) and cardiac diseases (11.07); indeterminate causes of death were related in 7.4 of cases. Our results differ from the others of literature mainly in two points: the high prevalence of infectious diseases and the proportional low incidence of cardiopathies. We concluded that, in our casuistic, infectious diseases in diabetic patients represent an important cause of death establishing important clinical parameters for their care.

Biópsia endomiocárdica em cardiopatas chagásicos crônicos: um estudo, na necrópsia, para aferiçäo diagnóstica / Endomyocardial biopsy in chronical Chagas heart diseases: a study, in necropsy for diagnosis

Uma média de quatro fragmentos, medindo aproximadamente 3 mm**2, foram retirados do septo ventricular direito em regiöes superior, média e inferior, tomando-se como referencial o sulco interventricular, em pacientes falecidos em conseqüência da cardiopatia chagásica crônica. Os fragmentos foram corados pela hematoxilina-eosina e estudados à microscopatia óptica. Três observadores diferentes analisaram os fragmentos sem conhecimento prévio do diagnóstico. Os dados obtidos foram comparados com os diagnósticos encontrados em fragmentos de tamanho habitual obtidos na necrópsia em cada regiäo do septo onde se "biopsiou" e das paredes livres do ventrículo esquerdo e direito. Obtivemos correlaçäo entre os diagnósticos em 100% dos casos. Analisando-se a miocardite obtivemos que 21,35% dos fragmentos de tamanho equivalente ao obtido pelo método das biópsias näo apresentaram correlaçäo quantitativa com aqueles de tamanho habitualmente a necrópsia. Concluímos que a biópsia endomiocárdica é de grande sensibilidade para o diagnóstico de cardiopatia chagásica, mormente a miocardite, quando forem encontradas alteraçöes no material. Em caso negativo contudo näo é possível negar a existência do processo inflamatório