Differential expression of ABH histo-blood group antigens and LAMPs in infantile hemangioma.

Although infantile hemangioma (IH) are the most common tumors of infancy, the mechanism of their proliferation and involution remains vague. Proliferation, differentiation and death of endothelial cells are the basic processes involved in their pathobiology. Here we hypothesize that the glycoconjugates ABH histo-blood group antigens (HBGA) and lysosome-associated membrane proteins (LAMPs) might be implied in both the differentiation and death of endothelial cells during vascular remodeling in IH. Proliferating and involuting IH were examined immunohistochemically for HGBA and LAMP expression together with vWF and CD31. Proliferative and apoptotic indices were determined. LAMPs were found in immature endothelium of proliferating IH. In involution an increased number of immunopositive cells stained with higher intensity was detected. The enhanced expression might be associated with augmented autophagy required for tissue remodeling during tumor involution. HBGA presented an opposite pattern of expression--they stained intensely the endothelium of mature capillaries, while the immature ones were positive for vWF. The presence of HBGA in endothelial cells of IH may be related to the differentiation process only, as well as to endothelial adhesion and angiogenesis. Novel evidence for differential expression of HBGA and LAMPs in proliferative and involutive phases of IH is presented.

Intraductal aspiration cytology and galactography for nipple discharge.

The objective of this study was to assess the diagnostic value of preoperative cytology and galactography in women with nipple discharge using a simple intraductal aspiration method. From May 1997 to February 2002, 172 patients with unilateral, spontaneous nipple discharge without palpable masses underwent intraductal aspiration cytology followed by galactography. Major duct excision was performed in 133 of 155 successful cases. Pathological findings showed solitary papilloma in 65 cases, breast cancer in 16 cases, fibrocystic disease in 17 cases, papillomatosis in 12 cases, ductal hyperplasia in 11 cases, and finally, duct ectasia in 12 cases. Our results showed sensitivity of 75.0% and 68.8%, specificity of 86.3% and 62.4%, and overall accuracy of 85.1% and 63.2%, respectively, for cytological analysis and galactography. This suggests that the intraductal aspiration method for preoperative cytology and galactography is a minimally invasive and well-tolerated procedure that seems to be useful in differentiating between benign and malignant lesions in patients with unilateral, spontaneous nipple discharge.

[Hepatoid adenocarcinoma of the lung: a case report]. / Sluchai na khepatoiden adenokartsinom na beliia drob.

A case of a 71-year-old man with dyspnea attacks, weight loss and astheno-adynamia syndrome is presented. A 7.7 x 6.4 cm well-delineated tumor is found intraoperatively in the superior lobe of the left lung towards the posterior mediastinum. The tumor cells resemble hepatocytes histologically and show expression for alpha-fetoprotein. Diagnosis primary hepatoid lung adenocarcinoma is made. Pericellular basal membrane-like material is found on electron microscopy. A clinico-morphological discussion regarding the biological behavior and prognosis of this rare tumor is presented.

In situ hybridization determination of the heterophagocytic origin of type 2B prostate epithelial lipochrome pigment granules: histochemical and ultrastructural correlates.

UNLABELLED: Morphologically, polymorphic prostatic lipochrome pigment has been classified and subclassified in the last few years. Type 2B lipochrome pigment granules (LPGs) are frequently found in prostatic epithelium in patients who had died of AIDS. Intensive apoptosis is observed in the same epithelium which lends support to the hypothesis of heterophagocytic (apoptotic) origin of type 2B pigment granules. Detection of nuclear chromatin material is necessary for the differentiation of an autophagosomal from a heterophagosomal structure in the cellular cytoplasm. OBJECT OF THE STUDY: Application of in situ hybridization (ISH) for elucidating the origin of subtype 2B LPGs in the prostate epithelial cells of patients who had died of AIDS. METHODS: ISH was used on routine necropsic prostate epithelial samples from three patients who had died of AIDS. A DNA probe raised against total human DNA was employed. RESULTS: Multiple hybridization signals were detected in type 2B LPGs which shows the presence of nuclear material in those structures. The chromatin material localized to the periphery of pigment granules. CONCLUSION: Type 2B LPGs have a heterophagocytic origin and represent phagocytosed apoptotic bodies in the phase of phagolysosomal degradation. They can be used as a morphologic tissue marker of intensive epithelial apoptosis.

Incipient perisinusoidal fibrosis in an adult patient with Dubin-Johnson syndrome.

The present paper describes a rare case of incipient perisinusoidal fibrosis of perihepatocellular type occurring in the Dubin-Johnson syndrome in a 63-year-old patient operated on six months previously for chronic calculous cholecystitis. The source of collagen formation was the activated sinusoidal Ito cells. Excluding chronic virus hepatitis and reactive cholecystic hepatitis, we believe that the fibrosis in this patient can be associated with the relatively old age of the patient and the duration of the disease.

Scoliosis in rhythmic gymnasts.

STUDY DESIGN: An anamnestic, clinical, radiographic study of 100 girls actively engaged in rhythmic gymnastics was performed in an attempt to explain the higher incidence and the specific features of scoliosis in rhythmic gymnastic trainees. OBJECTIVES: To analyze the anthropometry, the regimen of motion and dieting, the specificity of training in rhythmic gymnastics, and the growth and maturing of the trainees, and to outline the characteristics of the scoliotic curves observed. An etiologic hypothesis for this specific subgroup of scoliosis is proposed. SUMMARY OF BACKGROUND DATA: The etiology of scoliosis remains unknown in most cases despite extensive research. In the current classifications, no separate type of sports-associated scoliosis is suggested. METHODS: The examinations included anamnesis, weight and height measurements, growth and maturing data, eating regimen, general and back status, duration, intensity, and specific elements of rhythmic gymnastic training. Radiographs were taken in all the patients with suspected scoliosis. The results obtained were compared with the parameters of normal girls not involved in sports. RESULTS: A 10-fold higher incidence of scoliosis was found in rhythmic gymnastic trainees (12%) than in their normal coevals (1.1%). Delay in menarche and generalized joint laxity are common in rhythmic gymnastic trainees. The authors observed a significant physical loading with the persistently repeated asymmetric stress on the growing spine associated with the nature of rhythmic gymnastics. Some specific features of scoliosis related to rhythmic gymnastics were found also. CONCLUSIONS: This study identified a separate scoliotic entity associated with rhythmic gymnastics. The results strongly suggest the important etiologic role of a "dangerous triad": generalized joint laxity, delayed maturity, and asymmetric spinal loading.

Thoracolumbar distraction fractures in advanced pregnancy: a contribution of two case reports.

Thoracolumbar trauma in pregnant women is an important topic, though rarely discussed in the pertinent literature. Two consecutive cases of thoracolumbar distraction injuries in advanced pregnancy are presented. Conservative treatment failed in both cases; surgical management was necessary on a delayed basis using compression instrumentation. The similar features of the pattern of injury in the two patients suggest a cushioning effect of the gravid uterus. A theoretical analysis of the pathomechanics is carried out in an attempt to explain the specificity of flexion-distraction injuries in victims in an advanced stage of pregnancy. The authors suggest that the spine pivots about the fetus, and so is injured more in tension than in compression. The damage is mainly to soft-tissue structures, while anterior column compression and axial loading are less important.

Differential diagnosis of Kikuchi's disease and systemic lupus erythematosus lymphadenopathy: clinicopathologic algorithm.

The authors have described the first case of Kikuchi's disease in Bulgaria. The present study gives the clinicopathologic algorithm compiled by them to make the correct diagnosis and differentiate Kikuchi's disease from systemic lupus erythematosus lymphadenopathy.

An autopsy study of the prostate in acquired immunodeficiency syndrome: evidence for excessive apoptosis and intracytoplasmic epithelial inclusions.

We describe a combination of epithelial cell apoptosis and intracytoplasmic inclusions in prostatic epithelium in 6 patients who died from the acquired immunodeficiency syndrome. Two different types of apoptosis were detected: simple cell shrinkage and exploding glandular cells. No intracellular or extracellular viral particles were detected, either ultrastructurally or immunohistochemically. Intracytoplasmic inclusions are apoptotic bodies in a state of degradation and in close association with lipofuscin. The cell degeneration we observed confirms the theory that increased apoptotic cell depletion is responsible for weight loss in the acquired immunodeficiency syndrome. In the prostate itself, the combination of excessive apoptosis and active phagosomal digestion of apoptotic bodies presents a "human model" of postcastration rat ventral prostate, under the conditions of severe immune deficiency.

[The triple diagnosis of breast diseases]. / Troina diagnostika na zaboliavaniiata na mlechnata zhleza.

The aim of the study is to assess the data of clinical, mammographic, cytological and triple diagnosis of breast diseases. 188 patients are included in the study. The hystological findings are as follow: 58 patients with carcinoma and 130 with benign diseases. The coincidence of the exams are: 1. clinical examination--109 benign and 46 with carcinoma 2. mammography--114 for the benign group and 51 with carcinoma 3. cytology of FNB--104 to 40 4. triple diagnosis--118 to 40 The best method of diagnosis, according to our study, is the triple method.

Simultaneous fracture of the femur and the femoral stem following total hip replacement. A case report.

We describe an apparently unique case of simultaneous fracture of the femoral component of a hip replacement and of the adjacent femur. No similar case has been published in the literature. We suggest a five step plan of operative management.