Histological evaluation of multiple testicular biopsies helping assisted reproduction.

Because of the fall in population in Europe, the evaluation of causes of male infertility is becoming more and more important. Testicular biopsy is a useful method of examination in the area of assisted reproduction. Testicular biopsies of 85 infertile males were evaluated histologically. According to the sperm count, 31 patients had azoospermia, 22 oligo-astheno-teratozoospermia (OATS), 29 oligozoospermia, and 3 astheno-teratozoospermia. The biopsies were carried out by atraumatic microsurgery. Samples were taken from the upper inner and lower outer quadrant of both sides. Bouin-fixed, paraffin-embedded blocks were cut and HE slides examined. Samples taken from azoospermic patients showed atrophy, maturation arrest, normal histology or Sertoli cell-only syndrome. Oligozoospermic patients presented maturation arrest, hypospermatogenesis or normal histology. In the OATS group maturation arrest hypospermatogenesis and atrophy were found. The spermatogram groups showed significant correlation with the homogeneity of the spermatogenesis. The sperm count alone is not sufficient in assessing spermatogenesis. Four samples give more adequate information than just one, because spermatogenesis is not homogeneous in the testis. After evaluating diagnostic biopsies, tissue for TESE can be taken from the most appropriate location in the testis.

[Parvovirus B19 infection in hydrops fetalis]. / Parvovírus B19-infekció foetalis hydropsban.

In a retrospective study from 210 foetal autopsies carried out in a period between 1992 and 1999 fifteen hydropic foetuses were found. The cause of the hydrops was shown to be Rh incompatibility in one case only. The cause of hydrops was not discernible in one case. In the others pathological examination clarified the cause and pathomechanism of non-immune hydrops. One isolated cystic hygroma, one monochorionic twin pregnancy with twin to twin transfusion, one case of sacrococcygeal teratoma and 4 cases of congenital heart diseases were reported. Postmortem interphase cytogenetic examination showed X0 monosomy in 2 cases. In further 4 foetuses pathognomic viral inclusions in the proerythroblasts raised the probability of parvovirus B19 infection what was confirmed by immunohistochemistry and electronmicroscopic examination. The occurrence of the parvovirus B19 associated cases of foetal hydrops was shown to be higher (4/15) in this series than in the literature. The accumulation of cases in 1998 is suggestive of an outbreak. The prenatal diagnostic implications and the attempts on further management are also discussed.

Cholesterol-dependent clustering of IL-2Ralpha and its colocalization with HLA and CD48 on T lymphoma cells suggest their functional association with lipid rafts.

Immunogold staining and electron microscopy show that IL-2 receptor alpha-subunits exhibit nonrandom surface distribution on human T lymphoma cells. Analysis of interparticle distances reveals that this clustering on the scale of a few hundred nanometers is independent of the presence of IL-2 and of the expression of the IL-2R beta-subunit. Clustering of IL-2Ralpha is confirmed by confocal microscopy, yielding the same average cluster size, approximately 600-800 nm, as electron microscopy. HLA class I and II and CD48 molecules also form clusters of the same size. Disruption of cholesterol-rich lipid rafts with filipin or depletion of membrane cholesterol with methyl-beta-cyclodextrin results in the blurring of cluster boundaries and an apparent dispersion of clusters for all four proteins. Interestingly, the transferrin receptor, which is thought to be located outside lipid rafts, exhibits clusters that are only 300 nm in size and are less affected by modifying the membrane cholesterol content. Furthermore, transferrin receptor clusters hardly colocalize with IL-2Ralpha, HLA, and CD48 molecules (crosscorrelation coefficient is 0.05), whereas IL-2Ralpha colocalizes with both HLA and CD48 (crosscorrelation coefficient is between 0.37 and 0.46). This coclustering is confirmed by electron microscopy. The submicron clusters of IL-2Ralpha chains and their coclustering with HLA and CD48, presumably associated with lipid rafts, could underlie the efficiency of signaling in lymphoid cells.

Testicular biopsy helping assisted reproduction.

Authors have performed testis biopsy on 21 male patients according to the predesigned protocol. The biopsy has been carried out from scrotal excision, with the exposure of both testis with microsurgical method. The results have been evaluated according to the spermogram groups. Correlation of FSH values and histological appearance of both testis was analyzed. Their method and experiences have been evaluated the effectiveness of assisted reproduction.

Compact growth of Staphylococcus haemolyticus in soft agar is not due to hydrophobic interaction between the cocci.

It was hypothesized that the formation of compact colony in soft-agar both in the presence and absence of serum, characteristic mainly for strains of the species Staphylococcus haemolyticus among coagulase-negative staphylococci [Szúcs et al. Acta Microbiologica Hungarica 40:181-189 (1993)] was due to hydrophobic interaction between cocci. The effect of a number of surface active agents on this phenomenon was examined. Neither 0.1% and 1%. Tween-80 nor 5% and 10% ethylene glycol and polyethylene glycol nor 0.1%-4% trypsin influenced the colony morphology in soft-agar prepared in modified Staphylococcus 110 broth. Bovine lactoferrin and apolactoferrin at concentrations of 0.1%-0.4% made compact colonies transient to diffuse ones. Thus, cocci are not adhered to each other in compact ball-like colonies by hydrophobic interaction or trypsin-sensitive proteins. It is possible that still unknown polysaccharide-binding proteins or other trypsin-resistant proteins are responsible for the formation of compact colonies by Staphylococcus haemolyticus in soft-agar.

[Sonographic volumetry of the thyroid]. / Sonographische Schilddrüsen-volumetrie.

The utility of ultrasound volumetry of the thyroid is discussed on the basis of 414 different examinations. Analysis of the possible errors in calculations and the importance of the experience as well as practice are emphasized. According to the results of the cadaver studies, the difference between the in situ size and the size of the removed thyroid is explained by the changes of the blood, lymph and colloid flows after stasis. The preliminary data on the thyroid volume values in a randomized population pattern may serve as a model for a wide-ranging study aimed at the determination of the normal value in Hungary. Different volume values in the two phases of the menstruation period draw the attention to the effect of the female sex hormones on the thyroid volume, a factor that has to be considered in follow-up studies of female thyroid patients. Ultrasound volumetry is an indispensable method for the correct estimation of the thyroid volume changes in the course of suppressive treatment.

[Unity of diagnostic pathology, continuing education and research at our institute]. / A diagnosztikus pathológiai, továbbképzö és kutató munka egységéröl intézetünkben.

Authors give a brief view on the activity in Institute of Pathology and Histopathology of Post-graduate University of Medicine. In its frame, close relation of diagnostic, post-graduate education and research activity is illustrated by examples of different fields (intestinal, cardiac, vascular system, respiratory tract, organ of locomotion, urological diseases, electronmicroscopic tumor diagnostics, endocrinology). Importance of modern morphological methods and their place both in practical and scientific activity are dealt with.

45,X streak gonad syndrome associated with bilateral 'burnt out' gonadoblastoma.

A 28-year-old woman with well-developed female secondary sexual characteristics, secondary amenorrhea, short stature and a few somatic anomalies of streak gonad syndrome who had bilateral 'burnt out' gonadoblastoma associated with 45,X karyotype is reported. Although the exact source of steroid production in the present case could not be defined, it seems probable that the tumor once secreted steroid hormones which were responsible for the development of the female secondary sexual characteristics. At the time of diagnosis there was no evidence of hormonal activity of the tumor. Cases of gonadoblastoma without Y chromosome are reviewed. The diagnostic difficulties encountered in patients with gonadoblastoma not associated with Y chromosome are discussed.

Correlation of electrocardiologic and pathologic findings in 100 cases of Q wave and non-Q wave myocardial infarction.

Of 100 cases of acute myocardial infarction as shown on autopsy, 55 cases were transmural infarcts and 45 were subendocardial. Pathologic Q waves appeared in 67% of the cases of transmural infarct and in 30% of subendocardial infarct. In transmural infarcts, Q wave infarcts occurred twice as frequently as non-Q wave infarcts. In the cases of subendocardial infarcts just the opposite was observed: non-Q wave infarcts had double the frequency of Q wave infarcts. In spite of this, when a myocardial infarct is characterized strictly by electrocardiology, it should be described by only the accurate terminology of Q wave infarct or non-Q wave infarct. To distinguish with certitude between subendocardial infarct and transmural myocardial infarct on the basis of the ECG does not seem possible. Q wave infarct as "transmural" and non-Q wave infarct as "subendocardial" does not correspond to the pathologic evidence.

[Varicosities as a result of acquired non-traumatic arteriovenous fistulas]. / Varicosités par fistule artério-veineuse acquise non traumatique.

82 patients with telangiectasias of the lower extremities near the knee were examined. At the level of these telangiectasias, it was possible to hear, with the Doppler, an arterial pulse and the histological examination showed that the telangiectasias were secondary to an arterio-venous fistula. Since this shunt is not an important one, we feel that this is a micro-fistula. In most cases, telangiectasias appear at puberty or during delivery in young women. The clinical picture is not univocal and its manifestations are more less obvious. Such an arterio-venous disease is neither congenital nor traumatic; we believe it has a special origin, corresponding to an abnormal functioning of normal cutaneous arterio-venous shunts.

A study of free radicals in paraffin embedded and deparaffinized human heart muscle tissue using electron spin resonance (ESR).

Free radicals (spectroscopic splitting factor; g factor = 2.003-2.005) were investigated in formol-fixed, paraffin embedded heart-muscle tissue sections using electron spin resonance (ESR) spectra. Changes in signal amplitude, g factor and line width were registered during deparaffinization, chloroform-methanol extraction, vapour treatment and bromination. An attempt was made to identify the source of the ESR signals by a correlation between the signal amplitude and number of fluorescent and/or Sudan-black-positive granules counted in the tissue sections. An increase in signal amplitude, g value and line narrowing were characteristic of the ascorbyl radical after deparafinization in air. Vapour treatment revelated that the broader signal has lower g factor, a characteristic that is tentatively assigned to oxidized lipids. The bromination resistant minor fraction of free radical centres with small g factor might be associated with the pigment content of the samples.

Hypoadrenia following adrenal venography in Cushing's disease.

Three patients with Cushing's disease are reported. In two patients the hyperfunction of the adrenal glands ceased following selective adrenal venography, moreover hypoadrenia has developed. In the third case necrosis following venography was proved by surgery and confirmed by histology. Regarding the therapeutic possibilities of Cushing's disease the use of this diagnostic procedure is taken into consideration but not recommended.

[Oral contraceptives and liver tumors]. / Az orális fogamzásgátlók és májdaganat.

PIP: The case is described of a 36-year old female patient who developed a benign hepatic cell adenoma after having taken oral contraceptives (OCs) for several years. The tumor, which was situated on the central part of the right lobe, because of disintegration and hemorrhage broke through to the surface and caused a massive subcapsular hemorrhage. After subtotal hepatectomy the patient recovered uneventfully, and has remained symptom-free since that time. As far as is known, this was the 2nd successful subtotal hepatectomy in Hungary. The authors review the literature on the relationship between OCs and liver tumors. They call attention to the rapidly increasing occurrence, in Hungary, of these tumors, and to a tendency to life-threatening hemorrhages, which in the majority of cases require extensive hepatic resection. They describe various possibilities and methods of surgical care.^ieng

Radiation pancreatitis: a necropsy study.

The responses of the normal pancrease to radiation administered to the abdomen, sacro-iliac joints and thoraco-lumbal vertebrae was studied in necropsy material. Changes were observed in every case. They consisted of vascular damage, oedema, fibrosis and inflammatory cell infiltration of the interstitial tissue. There were changes affecting the secretory cells of the pancreatic glands and the epithelial lining of the intercalated ducts. Hyalinization of the islets of Langerhans was seen and there were scattered foci of necrosis. It is suggested that the type of histological changes may be correlated with the duration of survival after the exposure to radiation. The normal pancreas shows considerable damages on exposure to radiotherapy, but owing to its large reserve capacity clinical manifestations of the damage are infrequent

Muscle spindles in rheumatoid arthritis. An ultrastructural study.

Ultrastructural features of muscle spindles were studied in biopsy material from 100 patients suffering from classical rheumatoid arthritis. Thickening of the outer capsule, increased amount of extracellular ground substance within the inner capsule, and marked thickening of the basement membrane of capillary blood vessels supplying the muscle spindles were observed. Chronic inflammatory cells and macrophages were present within the spindles. Changes affecting the intrafusal muscle fibres were also seen. They were manifest as atrophy and degeneration of the intrafusal muscle fibres, absence of the specialised junctional complexes, and of the intercellular bridges, microladders and satellite cells. It is suggested that the changes affecting the intrafusal muscle fibres are probably secondary. Damage to the myelinated nerves was present, while the sensory and motor nerve endings were well preserved.

Primary carcinoid tumor of testis.

A case of pure, primary testicular carcinoid tumor in a forty-four-year-old male is reported. The patient presented with painless testicular enlargement, and testicular tumor was diagnosed. Orchiectomy was performed, and histology revealed a primary argentaffinoma. The patient is well and symptom free two years after diagnosis.