[Hormonally-active ovarian tumors in 30 years of data (1965-1994)]. / Hormonalno aktivni tumori jajnika na tridesetogodisnjem materijalu (1965-1994).

INTRODUCTION: Authors have investigated the incidence and distribution of hormonally active ovarian tumors in a 30-year surgical material. Out of 552 ovarian tumors, there were 28 hormonally active tumors (5.07%): 18 granulosa cell tumors, 4 thecomas, 2 arrhenoblastomas, 2 malignant v. Kalden folliculomas. There were laso 2 benign tumors: ectopic adrenal ovarian tumor, and ovarian tube hydatidiform mole. They secrete estrogen and testosterone and their effects are evident: prior to puberty (Praecox pubertas), during the reproductive period, but most often in menopause. In order to make the diagnosis, when uterine hemorrhage occurs, it is necessary to perform explorative curettage, but the tumors must be surgically removed. It is necessary to perform that kind of surgery, which corresponds to the age of the woman. Recurrences may appear even 35 years later. MATERIAL AND METHODS: Hysterectomy with bilateral adnexectomy was performed in 18 (64.28%) postmenopausal women. In 4 (14.29%) women of reproductive age unilateral adnexectomy was performed, while explorative laparotomy was performed also in 4 (14.29%) women. 5-year survival in the first stage of the disease was 75% (20 women). During the first three years 5 (17.86%) women decreased in the IV stage of the disease, as well as one woman (3.57%) in the II b stage, which makes a total of 6 women (21.43%) with fatal outcome. Ovarian tumors also include hormonally active tumors which secrete female and male sex hormones, and whose effects are evident on hormonal receptors. They are divided into benign or malignant, whereas they are all potentially malignant. We differentiate two groups: 1. Feminizing mesenchymomas, which secrete female sex hormones and 2. Virilizing tumors, which secrete male sex hormones. These tumors may occur prior puberty, during the reproductive period and in the postmenopausal period--senium. They can cause minor, long-term or hemorrhages similar to menstruation, as well as hypertrophy of the myometrium. Glandular cystic hyperplasia occurs often, whereas proliferation is rare. Histopathological findings after surgery (for example of myoma) are often surprising, because they reveal hormonally active undetected ovarian tumors or glandular cystic endometrial hyperplasia. All hormonally active tumors are potentially malignant. The aim of this retrospective study was to compare our prior attitudes and interventions with newer attitudes and to make changes on behalf of our patients. RESULTS: Our investigation included 552 adnexal tumors in a 30-year material. Each woman with uterine hemorrhage had undergone explorative curettage and the material was sent for histopathological analysis. During the investigated period 28 hormonally active tumors were found: 2 benign and 26 malignant or potentially malignant tumors (Table 2). There were 18 cases (40.91%) with granulosa cell tumors, 6 cases (13.64%) with cystadenocarcinoma ovarii serosum; 3 cases (6.82%) with borderline tumors; 4 cases (9.09%) with thecoma of the ovarii. Pseudomucious adenocarcinoma was found in 2 cases (4.55%) as well as endometrial adenocarcinoma, malignant mesenchymoma, arrhenoblastoma, malignant folliculoma v. Kalden; whereas malignant teratoma was established in 1 case (2.27%), as well as anaplastic carcinoma, metastatic carcinoma--Krunberg. It is obvious that hormonally active tumors make almost half of the cases (46.43%) and occur mostly at the age of 50-59 years of age (3.4%). Out of 28 patients, 18 underwent hysterectomy and bilateral adnexectomy (64.28%); 4 (14.29%) underwent unilateral adnexectomy that is explorative laparotomy for taking bioptic samples for histological examination (14.29%). Out of 28 patients, 4 were women of reproductive age. All of them underwent adnexectomy and are alive. Hemorrhages usually occur a few years after menopausal period. In one case it occurred 35 years after menopause (arrhenoblastoma), in another 25 years after menopause due to endometrial carcinoma asso

[Helicobacter heilmanni (Gastrospirillum hominis) as a new cause of gastritis--case report]. / Helicobacter heilmanni (Gastrospirillum hominis) novi uzrocnik gastritisa--prikaz slucaja.

INTRODUCTION: During the course of research into Helicobacter pylori, further microorganisms colonizing the gastric mucosa have been detected. The large spiral-shaped bacteria deviating from Helicobacter pylori was originally described by Dent. The bacteria was initially named Gastrospirillum hominis, but after sequencing of 16S rRNA it was classified as Helicobacter and named Helicobacter Heilmannii in honour of the pathologist Prof. Dr. Konrad Heilmann. We report two additional cases. CASE REPORTS: In 1997 at the Department of Pathology of General Hospital in Senta 268 gastric biopsies (151 male, 117 female), average age of 50.4 were analyzed. Helicobacter pylori was identified in 176 biopsies (65.7%). Helicobacter Heilmannii was found in two cases (0.74%). The clinical details were as follows: Case 1. A 32-year-old male complained of dyspepsia. Esophagogastroduodenoscopy disclosed hyperemia and scattered erosions in the lower third of stomach. Case 2. a 55-year-old female was admitted at the hospital with lumbar pain, loss of appetite and body weight. Esophagogastroduodenoscopy findings were normal. The patient lived in rural household in contact with various domestic animals. In the biopsy specimens of both cases in the antral gastric mucosa large bacteria resembling a corkscrew were found, 6-10 microns length, consisting of 5-9 regular tight spiral. The bacteria were midly eosinophilic and Gram negative. The bacteria stained strongly with the Warthin-Starry silver stain, and with Giemsa stain. The distribution of Helicobacter Heilmannii was patchy in the central zones of the gastric pits, deep or more superficial including the foveolar opening on the mucosal surface. A mild degree of chronic gastritis characterized both cases, with, focally active inflammation and lymphoid aggregates. None of biopsies had atrophy, intestinal metaplasia or epithelial damage. There was a symptomatic improvement after a 4-week course with triple therapy (H2 antagonist & metronidazole & amoxycillin). After treatment rebiopsy specimens displayed mild chronic gastritis and no spiral organisms. CONCLUSION: Our reported cases are the first described cases of gastritis caused by Helicobacter Heilmannii in our region with successful eradication after therapy. Morphologically similar bacteria have been found in the stomachs of domestic animals. It is a general opinion that Helicobacter Heilmannii is characteristic for animals but it is occasionally transmitted to humans.

[Characteristics of colonic carcinoma in our material]. / Karakteristike karcinoma debelog creva na nasem materijalu.

By analyzing the characteristics of colonic carcinoma on the ten-year material of the Department for pathology of the Senta Hospital we came to a conclusion that this disease has a greater part in the mortality structure of the region along the river Tisa in relation to the Vojvodina average. Some morphologically prognostic elements (the tumor type, the intensity of peritumoral lymphocytic infiltration) do not show any significant deviations from literature facts, while tumor differentiation, the type of invasion and grading according to Dukes indicate a less favorable situation in our surroundings. An attempt was made to evidence the relation between colonic adenoma and carcinoma on the basis of classic morphology and the presence of nucleolar organizers. Our results indicate the insufficient discovering of precancerous states and early stadiums of colonic cancer in our surroundings.

[Results of laryngo-microscopic examinations over a 10-year period at the ORL Department of the Senta Hospital]. / Rezultati laringomikroskopskih ispitivanja na desetogodisnjem materijalu ORL odeljenja bolnice u Senti.

In the period from 1980-1989, 199 laryngomicroscopical examinations were conducted at our department. There were 20 cases of laryngeal carcinoma, 55 cases of keratosis with the presence of dysplasia in 21.8%, as well as 19 papillomas in adult individuals. In our material keratoses appear a few years before the onset of laryngeal carcinoma in an average statistical distribution. With one exception, the carcinomas were detected before the appearance of metastases. Our data indicate the exceptional benefit of laryngomicroscopy in the detection of precancerous lesions and carcinoma of the larynx.