[Experimental modeling of nucleoprotein disposal disorders in systemic lupus erythematosus].

The objective of this research was to adapt the experimental model simulating the nucleoprotein disposal disorders in systemic lupus erythematosus (SLE) for further study of its extracorporeal correction, as well as to assess validity of the model by short-term experiment. Twenty to female Wistar rats were intraperitoneally injected with the chromatin-containing extract from bovine liver followed by intravenous administration of anti-DNA antibodies derived from SLE patients. After these procedures plasma concentrations of anti-dsDNA, circulating immune complexes and DNA became sharply increased, together with distinct elevation of leukocytes. On the contrary, changes in erythrocytes, platelets, total protein concentration, creatinine, asparagine and alanine aminotransferase activities, as well as blood coagulation time were changed insignificantly. Using direct immunofluorescence of cryosections, we detected human IgG deposition in rat kidneys treated in accordance with the simulation protocol. Thus, our model reproduces essential DNA disposal disorders in SLE without any animal death or the life-threatening changes in examined markers during short-term experiment.

[Extracorporeal treatment of nucleoprotein disposal disorders using the systemic lupus erythematosus model: evaluation of efficacy and safety in a short-term simulated experiment].

Efficacy and safety of the extracorporeal blood perfusion through DNase I- and C1q-containing magnetic beads have been evaluated using the experimental model simulating the nucleoprotein disposal disorders in systemic lupus erythematosus (SLE). The study was performed using 20 rats in which the essential impairments of nucleoprotein catabolism typical for SLE were modeled. The animals were randomized into the experimental group and the placebo perfusion control group. Rats of the experimental group were characterized by the statistically significant reduction of increased levels of circulating immune complexes and plasma DNA as well as diminished levels of plasma creatinine and kidney IgG deposition as compared with placebo controls. During short-term experiment there were neither animal deaths nor substantial blood cell destruction and hepatotoxicity signs.

[OSTEOPOROSIS IN MEN: CURRENT ISSUES].

Analysis of outpatients male patients aimed at Bone Density Measurement (Dual-Energy X-Ray Absorptiometry) during 2013. The study shows that men are sent to the examination for osteoporosis nearly 20 times less than women, while in men older than 60 years the decrease in bone mineral density was observed in more than 85% of cases. The identified violations of mineralization of bone tissue in men in different age periods and the main reason for referral for examination were analyzed.

[Prognostic value of leptin level detection in industrial workers suffering from osteoarthrosis in Volgograd].

Study of 130 osteoarthrosis patients revealed high serum level of leptin in 42 (32.3 %) patients including 9 males and 33 females. Osteoarthrosis patients with high serum leptin level are characterized by more severe course of the disease.

[Detecting adiponectin in industrial workers having inflammatory diseases of joints].

Examination of 55 patients with rheumatoid arthritis revealed low serum level of adiponektin in 25.4 % of the patients. Patients with low serum level of adiponektin demonstrate such symptoms set as: increased activity degree on DAS28 (II-III activity grade), high level of antibodies to citrullinated vimentin, advanced and late stages of the disease, severe X-ray changes.

[Efficiency of unsaponifiable compounds of soya beans and avocado in health care personnel with osteoarthrosis in Volgograd].

The authors used immunoenzyme method to assess level of oxydated low density lipoproteins (o-LDL) in 130 patients with osteoarthrosis. High serum level of o-LDL was seen in 60% of the patients with osteoarthrosis. 40 patients with osteoarthrosis were treated by unsaponifiable compounds of soya beans and avocado (Piaskledin, Expanscience, France)--dose of 300 mg daily, over 3 months. The treatment resulted in good effect in the patients with high level of o-LDL (over 168 ng/ml).

Emulsive polymerization as a method of enzyme modification preserving biological properties of nanostructures.

The proposed method of emulsive polymerization provides the possibility of modifying and obtaining insoluble forms of superoxide dismutase (SOD), glutathione reductase, and streptolysin-O preserving nanoobjects (conformationally active centers and antigenic determinants) in their native states. Apart from enzymatic and immunological properties, the samples acquired some new features: resistance to high temperature, resistance to 3 M KCNS solution and buffer solutions with high concentration of hydrogen ions, and resistance to preserving solutions. Magnetic properties provide the possibility of simplifying enzyme-linked immunosorbent and immunofluorescence assays. In addition, sensitivity of these assays was by an order of magnitude higher and the specificity fully preserved. Taking all the facts into account, we prepared agents for long-term and repeated use. Due to preserved enzymatic properties, insoluble forms of SOD and glutathione reductase can be considered as a tool for correction of peroxide-antioxidant balance and associated immunological abnormalities.

Recurrent mucinous carcinoma of skin mimicking primary mucinous carcinoma of parotid gland: a diagnostic pitfall.

A case of a 63-year-old man with a swelling lasting 2 years in the left infraauricular area is reported. Examination by fine needle aspiration cytology raised suspicion of mucoepidermoid or adenoid cystic carcinoma of the parotid gland and an excision was recommended. The lateral parotidectomy specimen showed a poorly circumscribed gelatinous tumor measuring 15 mm in diameter within the parotid gland tissue. Microscopically, the lesion featured large pools of mucin containing clusters of tumor cells with little atypia and low mitotic activity. Immunohistochemically, the tumor cells showed expression of epithelial markers and of both estrogen and progesterone receptors. Left lateral neck dissection revealed massive lymphogenous dissemination of the tumor. Retrospective analysis of a skin biopsy from the same anatomic area performed 8 years prior to parotid neoplasm displayed a tumor with identical microscopic appearance and immunohistochemical profile (additionally performed) which was, however, misdiagnosed as a benign lesion. The diagnosis of recurrent primary mucinous carcinoma of the skin infiltrating the parotid gland was established. The patient underwent radiotherapy and has been 3 years free of disease. The differential diagnostics of this rare tumor is discussed.

[Extrapleural solitary fibrous tumor mimicking lateral neck cyst--a case report]. / Extrapleurální solitární fibrózní tumor napodobující laterální krcní cystu--kazuistika.

A 62-year-old man was referred to the Department of Dentistry because of ultrasonographic finding of "cystoid lesion with relationship to right parotid gland". During operation, a tumor mass without any relationship to parotid gland but attached to the right internal carotid artery was found. Grossly, the tumor was well circumscribed, spheric, measuring 40 mm in diameter; it was of solid, firm appearance and tan-to-white color on cross section. Microscopically, the tumor cells were round to spindle-shaped with vesicular nuclei and eosinophilic cytoplasm, arranged in fascicular pattern. Immunohistochemically, the cells expressed vimentin, CD 34, smooth muscle actin, and bcl-2 protein. On the basis of microscopical appearance and results of immunohistochemistry, the diagnosis of solitary fibrous tumor (cellular variant) was established. One year after resection, the patient is free of disease. A new concept of this uncommon mesenchymal tumor is discussed.

Low grade myofibroblastic sarcoma of tongue: a case report.

A case of a 24-year-old woman with a 6 weeks lasting nodule of the right margin of the tongue is described. The nodule was 20 mm in diameter and showed surface ulceration. The diagnosis of low grade myofibroblastic sarcoma was supported by histological, immunohistochemical and electronmicroscopic examination. Although the tumor resection was not complete, the patient is free of disease 1 year after operation. The differential diagnostics of low grade myofibroblastic sarcoma is discussed.

[Prenatal detection of congenital mezoblastic nephroma]. / Prenatální záchyt kongenitálního mezoblastického nefromu.

TYPE OF STUDY: Case report. SETTING: Department of Gynecology and Obstetrics, Department of Radiology, Department of Pathology, Department of Medical Genetics, Charles University Hospital, Hradec Králové. METHODS: The autors report a case of renal tumor in a fetus at 33 weeks of gestation detected by means of ultrasonography and magnetic resonance imaging. The pregnancy course was complicated by polyhydramnios. The female infant was born vaginally at 37 weeks of gestation. Postnatal nephrectomy confirmed prenatal diagnostic presumption - congenital mezoblastic nephroma. At follow-up at 12 months of age, the infant had no evidence of the disease. CONCLUSION: Detection of renal tumor in a fetus is rare. Congenital mezoblastic nephroma with the favourable prognosis is most probable diagnosis. Prenatal detection enables the prevention of complications (prematurity prevention, detection of the developing cardial decompensation and fetal hydrops) with the planning of labour and postnatal management.

[Apoptosis of urothelial carcinoma cells]. / Apoptóza u bunek uroteliálního karcinomu.

BACKGROUND: Programmed cells death, apoptosis, is a physiological, genetically controlled mechanism. It represents the fate of the majority of cells formed during the somatic development and during the next life of most of the creatures. In the article, data from the study of urothelial carcinoma cells are presented and compared with histochemical analysis. METHODS AND RESULTS: During 1999 to 2002 native urine samples of 36 of patients with the verified urothelial carcinoma were studied. Nine patients had tumors of grade II, 27 patients had tumors of grade III. Urine samples were analysed by flow cytometry and the data obtained were compared with tumor gradients. In our cohort the zero apoptotic activity was found in 32 patients (88.9%). In four patients with preserved apoptosis the tumors were of grade III. CONCLUSIONS: Lack of apoptosis of the tumor cells was the dominant sign in our sample. The premise of existing apoptosis in tumors of the lower grade contrary to the higher one was not confirmed when apoptosis was found in four tumors of the grade III. When the tumor grading was compared, apoptosis was less active in the group of tumors with the highest histopathologic grading. Values expressing the direct relation between apoptosis and the histopathologic grading were obtained.

Apoptosis and regression of embryonic mesenchyme in the development of the middle ear spaces.

Apoptosis was studied using temporal bones from three fetuses representing different times of gestation and from three neonates. Paraffin-embedded sections 20-microm thick were studied using the terminal deoxynucleotide transferase-mediated dUTP nick-end labeling method based on 3'-end-labeling of fragmented DNA. Phenotyping of the immune cells was performed using regular monoclonal antibodies. In the bone marrow the granulocyte series dominated and the number of cells in the macrophage series was noticeably fewer, with apoptotic cells occurring in both. In the embryonic mesenchyme, solitary apoptotic cells occurred in all locations in both the fetuses and neonates. Apoptosis is a basic factor in the regression of embryonal mesenchyme, but may not be preprogrammed. Basic scientific data obtained from modified tissue cultures show that mechanical forces cause cells to switch between different genetic programs. It is suggested that the act of swallowing causes periodic changes in the amniotic fluid pressure and provides the necessary force for regression of the mesenchyme by apoptosis.

Residual mesenchyme in the middle ear cavity of the newborn with malformation of the kidney.

Microscopic sections of 37 temporal bones from 22 foetuses were examined, five with renal agenesis, six with Potter's sequence without renal agenesis and two with mild kidney pathology. Every tenth section containing the stapes were used for measuring the volume of mesenchymal tissue in the middle ear cavity. At 5% significance level, foetuses with serious renal pathology had more mesenchymal tissue in the middle ear cavity than a control group of nine foetuses with no renal or urinary tract abnormality.

Acute purulent thyroiditis with retropharyngeal and retrotracheal abscesses.

An unusual case of acute purulent thyroiditis in a 45-year-old man forming a large abscess in the left lobe of the thyroid gland is described. It perforated the capsule at the posterior wall of the thyroid, causing extensive retropharyngeal and retrotracheal abscesses. The patient was treated with broad-spectrum antibiotics and surgical excision of the infected tissues. He has remained well one year after the operation.

[Pneumatosis cystoides intestinalis as a cause of obstructive ileus]. / Pneumatosis cystoides intestinalis jako prícina obstrukcního ileu.

The authors present the case-history of a 83-year-old patient hospitalized and operated on account of ileus caused by pneumatosis cystoides intestinalis. In the discussion the authors pay attention to the etiology, pathogenesis, clinical picture and possible treatment of this disease.

[Synovial metaplasia around breast implants]. / Synoviální metaplazie kolem mamárních implantátu.

Three cases of the periprosthetic breast capsules showing typical features of synovial metaplasia are presented. The histological picture is characterized by the presence of cellular layer mimicking synovial membrane. These elements are devoid of basement membrane, otherwise, nevertheless, they strongly resemble single- or multilayered epithelium. Focally, the differentiation towards giant multinucleated cells is noted. Immunohistochemical profile, as well as the ultrastructure of the cells, confirms their histiocytic origin with advanced differentiation towards elements of the synovial membrane. These histological features are referred to as synovial or synovial-like metaplasia. They are found in considerable fraction of textured breast implant capsules. The pathogenesis remains uncertain; however, similar picture was observed in other locations in association with prolonged or repeated action of mechanical forces. Thus, movement of the implant in situ is the most probable trigger of synovial metaplasia.

Temporal bone findings in trisomy 18 and 21 syndromes.

The temporal bones from fetuses with known autosomal trisomy syndromes were examined histopathologically after spontaneous or induced abortions. Fetal ages dated from the 17th to the 24th week of pregnancy. In all, 17 temporal bones from nine fetuses were studied and included seven cases of Down's syndrome and two of Edwards' syndrome. Temporal bones from fetuses with Down's syndrome had more abnormalities of the external and middle ears than of the inner ear. The bones from the fetuses with Edwards' syndrome showed abnormalities of the external or middle ear and retarded development of the inner ear (failed ossification of the otic capsule and unformed organ of Corti).

[Subacute thrombosis of the abdominal aorta with suprarenal involvement and successful treatment with pharmacomechanical fibrinolysis]. / Subakutní trombóza brisní aorty suprarenálne zasahující, úspesne lécená farmakomechanickou fibrinolýzou.

In a 43-year-old patient with Ebstein's anomaly and a history of acute myocardial infarction by means of duplex ultrasonography and aortography the diagnosis of thrombotic occlusion of the a aorta was established, starting above the insertion of the renal arteries and reaching as far as the bifurcation of the aorta and the common iliac arteries. In the clinical picture dominated complete anuria with uraemia and marked hyperkaliaemia as a result of ischaemic affection of the extremities due to thrombosis of the aorta; at the onset of hospitalization also left ventricular failure with hyperhydration and later also signs of the hyperviscous syndrome. The latter developed after repeated haemofiltrations which led to a rise of the originally high haemoglobin and haemotocrit values a result of a righ-left shunt in Ebstein's anomaly. After improvement of the clinical condition local fibrinolytic treatment of the aortal thrombosis with urokinase (total dose 2,160,000 u. administered within 24 hours) was provided. The thrombus with a total length of 13.5 cm was dissolved except for a residual portion of 10 mm located in the area of insertion of the right renal artery. After dissolution of the thrombus it proved possible to restore the blood flow into the left kidney a and lower extremities, but not into the right kidney because of the residual thrombus. Seventy-two hours after terminated fibrinolysis - and after 31 days of anuria - the diuresis was restored and after a polyuric stage normalization of mineral, urea levels was restored and the creatinine value was slightly above the upper normal range. Concurrently with fibrinolytic therapy angioplasty of the aorta was carried out and a stent was placed on the left iliac artery. The clinical condition of the patient was improving, the patient started to mount stairs. Death occurred suddenly and the cause was cardiac failure due to very serious congenital heart disease.

[Isolated leukemic infiltration of the iris]. / Izolovaná leukemická infiltrace duhovky.

A boy 3 1/2 years old with the diagnosis acute lymphoblastic leukemia, in stage of high malignity, came to the Eye clinic in Hradec Králové. The clinical and haematological findings showed the remission of the illness but a leukemic infiltration with hypopyon had arised. The diagnosis has been done selon the clinic image of the eye and selon the ultrasound examination. The histologic finding showed also an infiltration of chorioidea, iris and ciliary body, an infiltration in the nuchal region, in the spleen and in testicles. The isolated leukemic infiltration of the iris can be the first sign of a relapse and is an indication to begin a relevant therapy.