The role of gastric mucosal dysplasia in the development of gastric carcinoma.

It is widely acknowledged that most stomach carcinomas developed from dysplastic lesions of gastric mucosa. They can be found in known precancerous conditions as chronic gastritis, gastric adenoma, giant rugal hypertrophy, chronic peptic ulcer, gastric stump after partial resection and pernicious anemia. Several grading systems of gastric dysplasia have been suggested. Nagayo's or the ISGGC classification was applied to 367 biopsy specimens of 258 patients between 1979-1995. The frequency of moderate and severe dysplasia was 0,84% regarding all gastric endoscopies in the same period of time. Follow-up studies were performed in 56 cases in a period of 1 7 ys. In this group cancer developed during 14 patients. The authors' recommendation is to follow up the patients gastric dysplasia for least 10 ys after with diagnosis.

Investigation of effect of lesser curvature seromyotomy of the stomach in animal experiments.

The effectiveness of seromyotomy of the lesser curvature of the stomach--the simplified version of proximal selective vagotomy--was investigated in eleven dogs. Decreased acid secretion was proved with congo red test and pH measuring by glass electrode. No significant damage to the motor function of the stomach was found with scintigraphy. Histological examinations revealed neurofibre degeneration peripherally to the seromyotomy line after peripheral vagotomy and vacuolar degeneration in the ganglion cells and amputation neuromas in the seromyotomy line.

[Correlation between neonatal mortality and hyperinsulinema]. / A neonatális morbiditás és a hyperinsulinaemia kapcsolata.

The authors investigated the correlation among the severity of maternal diabetes, the tight control of the maternal blood glucose concentration and the neonatal morbidity. Umbilical cord insulin level were measured in 115 newborns, 40 of them have diabetic mother. There were significant different in the serum insulin level between the low and high morbidity group. The authors suggest the importance of the tight blood glucose control during pregnancy, the diagnostic value of cardiological ultrasound to decrease the neonatal morbidity.

[Insulin concentration in amniotic fluid in mid-term pregnancy]. / A magzatvíz inzulintartalma középidös terhességben.

Insulin concentrations of 284 amniotic fluid samples were assessed, obtained from pregnant women by genetic amniocentesis between the 16-18 gestational weeks. The indication of amniocentesis was either advanced maternal age (> 35 years) or high risk genetic history. The amniotic fluid insulin concentration (mean +/- SD) was found 3.8 +/- 3.0 microIU/ml. The insulin concentration in 4.3% of all pregnant women was higher than the mean value +2 SD (9.8 microIU/ml) which represents individual pathological value, characteristic for gestational diabetes. Our data suggest that one part of gestational diabetes might be detected between the 16-18 gestational weeks, therefore we propose an earlier screening as the usual one. At institutes where the possibility of genetic amniocentesis is given the determination of insulin level in amniotic fluid may be reasonable. We could analyze the outcome of 230 pregnancies analysed. A close correlation was found between the amniotic fluid insulin concentration and birthweights of female newborns. It could not found such correlation at male newborn. A more careful screening test for gestational diabetes should be performed at mothers with female fetuses.

Papova viruses and recurrent laryngeal papillomatosis.

The pathogenesis of larynx papillomas has been a challenge of medical science for a long time. Both clinical observations and electronmicroscopical examinations have made it possible to establish the viral origin. Final evidence, however, has been achieved only by complicated immunohistochemical investigations. The Papova viruses--types 6 and/or 11--can be detected with in situ hybridization polymerase chain reaction amplification. HPV can be positivity demonstrated not only from visible papillomas but--in significant percentage--in neighboring healthy-looking mucous membranes. It may reveal the inadequacies of removal of lesions and the need for adjuvant therapy. To make treatment more effective we have developed a therapeutic regimen that combines CO2 laser microsurgery with immunostimulants.

[The effect of lesser curve seromyotomy of the stomach in animal experiments]. / A gyomron végzett kisgörbületi seromyotomia hatásának vizsgálata állatkísérletekben.

The authors investigated the efficiency of the seromyotomy of the lesser curvature of the stomach in 11 dogs. Reduction of the acid production was verified by glass electrode pH measuring of the gastric mucosa. Scintigraphic examination showed that the operation did not damage the motor function (motility) of the stomach. The fact of peripheral vagotomy was established by histological examination: degeneration of nerve fibres was detected on the peripheral side of the line of the seromyotomy, vacuolar degeneration was found in the cells of parasympathetic ganglions, and amputation neurinomas were shown in the line of the seromyotomy.

Investigation of premalignant lesions of larynx epithelium with histoautoradiography and HPV-assay.

The histological evaluation of precancerous alterations of larynx epithelium is, in transitional cases, very difficult. The differentiation of harmless metaplasia, hyperplasia and keratosis from abnormal proliferation depends on the pathologist's training and experience. Fine diagnostic lines separate the different grades of dysplastic epithelial alterations. The tritiated thymidine, 3H-TdR, labelling and histoautoradiographic procedure of biopsy specimens taken from the larynx provide the possibility to recognise the DNA synthetiser cells. The number, location and distribution of 3H-TdR labelled cells in the epithelial layers help us to distinguish with clarity the growth activity, the degree of dysplasia. After 3 weeks' exposition time of sections prepared by photoemulsion and stained with haematoxilin-eosin, the result can be assessed. In addition to histoautoradiography HPV-assay was applied, as HPV may play a role in the pathogenesis of laryngeal preneoplastic alterations.

Synovial sarcoma of the hypopharynx in an 11-year-old boy: treatment by partial supraglottic laryngopharyngectomy.

Synovial sarcoma in an extra-articular location is a very rare tumor, particularly in relation to childhood tumors. We report our experiences with an 11-year-old boy who suffered from swallowing difficulties caused by a polypoid tumor of the hypopharynx. Biopsy demonstrated a fusocellular carcinoma, while the epithelial components showed cytokeratin and neuron-specific enolase positivity. A correct final diagnosis could only be established by the histology of the surgical preparation following partial laryngopharyngectomy. The presence of spindle cells associated with glandular-like ones proved the synovial character of the tumor. The spindle cells were negative for epithelial marker but were positive for vimentin. S-100 protein positivity could only be demonstrated in the nerve elements encapsulated in the tumor. Ultrastructural examinations confirmed the presence of the different cell types. The spindle cells were rich in intermediate fibers, as demonstrated by electron microscopy.