[Morphological-functional characteristic of periarticular tissue after total hip arthroplasty: histological, cytochemical and electron microscopy aspects]. / Morfologicko-funkcná charakteristika periartikulárneho tkaniva po endoprotéze bedrového klbu: histologické, cytochemické a elektrónmikroskopické aspekty.

PURPOSE OF THE STUDY Analysis of the tissue harvested around the total hip replacement isolated from re-operated patients in order to: (1) characterize complexity of structural processes developing in the region of the total hip replacement and, (2) to define the role and significance of histological structures of this tissue, mainly in relation to implant loosening, from the viewpoint of formal and causal pathogenesis. MATERIAL AND METHODS Biopsied material isolated from periarticular tissue of re-operated patients (n=19) after THR was analyzed using the methods of light optic, fluorescent (TUNEL), and transmission electron microscopy. RESULTS Histological analysis revealed fibroproliferaive processes and epithelioid granulomatosis cell reaction around the implant with the formation of giant multinuclear syncythial (osteoclastlike) structures as a response to foreign bodies. These structures phagocyte fragments of foreign material (polyethylene particles from the implant, cement fragments). All the used methods revealed a range of regressive changes in the layers of foreign microparticles (inside giant multinuclear cells) typical of fibrinoid necrosis in collagen fibres and apoptosis. In certain cases, progressive changes as chondroid and synovial differentiation (metaplasia) were observed. DISCUSSION Total hip replacement, despite all positive aspects for patients, may cause permanent inflammatory processes in its surrounding. This may result in an extensive fibroproduction of a differently thick layer of connective tissue around the implant. An important factor of loosening of THR is probably osteoclastic resorption in the area of "bone-implant" interface, as a result of the interaction between the inflammatory mechanisms around the implant. CONCLUSION In the postoperative period, there occur fibroproliferative changes in the periarticular tissue and large population of multinuclear cells. In our view, these cells play a role in the production of wear particles from the implant and microparticles of bone tissues and bone cement. Fibroproliferative process may be considered as an immune response to the implanted foreign material.

[Choledochal cyst complication of pregnancy]. / Cysta choledochu ako komplikácia gravidity.

Authors in this case report describe rare complication of pregnancy. Ultrasound examination showed cystic lesion in abdominal cavity. It was indicated caesarean section because of deterioration of patient's condition. After the removal of foetus it was peroperative found cystic lesion in subhepatal area in right mesogastrium. Cystic lesion compressed stomach, colon transverse and loops of small intestine. After the revision of abdominal cavity and local finding surgeon detected choledochal cyst. It was resected and sutured hepaticojejunoanastomosis.

Atypical cyst of the right ductus hepaticus.

Cystic dilatation is a rare disease of extra- or intra-hepatic bile ducts. According to the literature it is an disorder accompanying other diseases rather than an independent diagnosis. In the case of smaller dimensions it is often found by coincidence because of its asymptomatic course of development. Mostly it manifests itself through abdominal pain or icterus. The authors show a case report of 14-months old patient with the finding of a cyst in the right ductus hepaticus with extraordinary dimensions (Fig. 2, Ref. 11). Full Text (Free, PDF) www.bmj.sk

[Primary hepatosplenic T-cell (gamma delta) lymphoma: morphology and immunohistochemistry in 3 cases]. / Primárny hepatosplenický T-bunkový (gamma delta) lymfóm: morfologický obraz a imunohistochemický profil troch prípadov.

We analyzed one autopsy case and two biopsy cases of primary (hepato-)splenic lymphoma, diagnosed in numerous trephine bone marrow, spleen and liver biopsies. It is a distinctive "new" type of a rare T-cell lymphoma characterized usually by rearrangement of gamma delta chains of T-cell receptor. Morphologically, the lymphoma is composed of a cytologically monotonous proliferation of small to medium sized lymphocytes, with diagnostically characteristic intrasinusoidal spread in the bone marrow, spleen and liver. The involvement of the lymph nodes is always absent. Immunohistochemically, the tumor cells expressed constant CD3 positivity and negativity for B- and myelomonocytic antigens, together with an inconstant coexpression of CD43 and CD45RO. In contrast to other and more common primary B-cell splenic lymphomas, its biological behaviour is more aggressive.

[Sequence of vascular closing mechanisms beginning post partum]. / Sekvencia cievnych uzáverových mechanizmov nastupujúcich post partum.

Ductus arteriosus, ductus venosus and umbilical vessels were studied in a group of 120 children deceased in perinatal period and 30 persons deceased at the age of 1 month till 90 years. Time sequence of evident morphological closing of vessels was analyzed. A contraction of media and proliferation of intima finished at the end of the 1st month were found in all of them except in ductus arteriosus where it finished at the end of the 3rd month. Dystrophic changes of proliferating structures were found in following months. Closing of ductus arteriosus started in an antenatal phase by pillow-like proliferation of intima. A primary thrombosis closing the vessels was extremely rare. There was not any difference between immature and hypotrophic or mature and eutrophic neonates.