Immunohistochemical detection of the hMLH1 and hMSH2 proteins in hereditary non-polyposis colon cancer and sporadic colon cancer.

Defects in DNA mismatch repair system are involved in carcinogenesis of sporadic and inherited human cancers. We assessed the feasibility of using immunohistochemistry to detect tumors with DNA mismatch repair deficiency. We analyzed 81 samples (74 colon cancers (CC), 1 colon dysplasia and 6 extracolonic cancers) for hMLH1 and hMSH2 protein expression, microsatellite instability (MSI) and/or mutational analysis. A meta-analysis of the published data on immunohistochemistry of hMLH1/hMSH2 proteins was performed. Sensitivity and specificity of the method was calculated. Twenty four of 29 tumors from hMLH1/hMSH2 mutation carriers and 10 of 13 sporadic high frequency MSI tumors lost one of the proteins. None of the 42 tumors with stable microsatellites or low frequency MSI lost the proteins. Based on literature review of 49 publications on colorectal cancer, hMLH1 immunohistochemistry was able to detect 136 of 154 tumors from hMLH1 germline mutation carriers (the sensitivity of 88.3% [95%CI, 85.8-90.8%]), hMSH2 immunohistochemistry detected 99 of 109 tumors from hMSH2 mutation carriers (the sensitivity of 90.8% [95%CI, 88.5-93.1%]), and hMLH1/hMSH2 immunohistochemistry identified 1262 of 1382 tumors with high-frequency microsatellite instability not correlated with mutational analysis (the sensitivity of 91.3% [95%CI, 90.4-92.2%]). The specificity of the method was 99.4% (95%CI, 99.2-99.6%). In conclusion, immunohistochemistry of hMLH1 and hMSH2 proteins is a useful method to predict the presence of mismatch repair deficiency, although its sensitivity is lower than that of MSI analysis.

[EBV-positive Hodgkin's lymphoma in children under 10 years]. / EBV pozitivní prípady Hodgkinova lymfomu u detí do deseti roku.

The number of EBV-positive child patients with HL varies in different countries and regions. In developing countries the number of child patients with this disease is higher than in the patient population of economically advanced countries. The authors examined 24 patients under 10 years with Hodgkin's lymphoma. Twenty patients were males, four females. In ten cases according to histological examination type II of HL was involved--nodular sclerosis (7 boys, 3 girls). In 14 instances the authors detected the mixed cellularity type (13 boys and 1 girl). EBV positivity was assessed immunohistologically by means of the antibody against LMP-1 and EBER-1 by the method of in situ hybridization. In 20 EBV positive HL 18 boys and 2 girls were affected. EBV positivity was proved in 83%. The marked intersexual difference in different EBV positive HL has not been explained unequivocally so far. The authors proved, that 14 EBV positive HL were type III--mixed cellularity. In 6 cases the type of nodular sclerosis was involved. The authors assume that marked positivity of child patients is associated with the initial massive EBV infection. EBV positive tumour cells are to a considerable extent removed by the immune apparatus and thus in the second and third decade EBV negative patients predominate.

Titanium-nickel shape memory clamps in small bone surgery.

The therapeutic applications of titanium-nickel (TiNi) shape memory clamps with optimized structural characteristics for fixation of small bone fragments in 64 patients are presented. Our fixative makes compressive stabilization possible and enables a patient to start rehabilitation very soon after surgery. The supporting splint immobilization never exceeded 12 days. Three aspects were studied: bone union, wound healing problems and histology. Non-union occurred in 4 patients treated with only one fixative. Two clamps implanted in non-parallel planes seem to be advisable to exclude the need for longer immobilization. Neither toxic manifestation nor episodes of an allergic reaction occurred. No suppuration appeared when a heat stimulus was supplied by using a contact resistance heater. Histological evaluation of the tissue covering the implants in 22 patients did not reveal any adverse reaction. Our study suggests that by using TiNi clamps in an appropriate way, satisfactory outcomes could be achieved with respect to both biofunctionality and biocompatibility.

[Imaging of focal nodular hyperplasia in static scintigraphy of the liver using 99mTc colloid]. / Obraz fokální nodulární hyperplázie pri statické scintigrafii jater 99mTc koloidem.

A case of focal nodular hyperplasia of the liver is reported and its scintigraphic picture is presented. In the authors' experience and in accordance with available literary sources, Tc-99m-sulfur colloid scintigraphy is to be considered the crucial noninvasive examination approach revealing the pathologico-anatomical substrate of this asymptomatic hepatic lesion which may mimic severe focal disease of the liver.

[Pathomorphologic findings after catheterization]. / Patomorfologické nálezy po kanylacích.

Thrombosis and its complications were studied in a group of 110 autopsies of patients who had had a subclavian vein cannulation. A unique complete obliteration of vena cava superior was found in connection with cannulation thrombosis related to the cause of death. A mycotic septicaemia occurred in two cases. "Floated-off cannules" were presented in five cases.

[Intravascular sclerosing bronchioloalveolar tumor]. / Intravaskulární sklerózující bronchioloalveolární nádor.

A case of ISBAT in a 42 year old woman was described. Tumour consisted of two foci in the right lung found incidentally during x-ray examination. Discussion introduced modern views on its denotation and pathogenesis resulting from the latest electron microscopical and immunological studies.

[Congenital aneurysm of the aortic sinus of Valsalva]. / Kongenitálni aneurysma Valsalvova sinu aorty.

In a 25-years-old man following a virus of short duration, cardiac dyspnea developed and within ten days following the onset of the disease, the patient died with manifestations of heart failure. A congenital aneurysm of the sinus of Valsalva was found at the post-mortem accompanied by a double perforation into the right atrium. In accordance with the literature, this finding is considered to be rather rare. The malformation was associated with a fenestration of the aortic and the pulmonary valves.