Autolysosomes in Alzheimer's disease and their possible role in its pathogenesis. An ultrastructural study.

In 10 cases of senile dementia of Alzheimer's type (AD) a systematic post-mortem ultrastructural analysis was performed. Attention was paid mainly to the presence of autolysosomes in the neuropil of the brain cortex. Autolysosomes appeared as osmiophilic dense bodies (DB) which originated in synaptic terminals and peripheral nerve-cell processes. DBs contained sequestrated cellular material wrapped by pinched off, invaginated cell membrane. DB were very frequent also in fields where no senile plaques (SP) and/or nerve-cell processes with paired helical filaments (PHF) were present. Abnormal fermentative degradation of DBs and their possible negative influence on the plasmatic flow in nerve-cell processes is discussed.

[Morphological changes in the brain in schizophrenia]. / Morfologické zmeny v mozku u schizofrenie.

In 1975-1985 in the mental hospital in Dobrany died 225 patients with chronic schizophrenia. The author presents the causes of death confirmed by necropsy. In all the brain was examined by a light microscope. Ordinary microscopy revealed that in chronic schizophrenia at the age above 65 years Alzheimer's disease is six times more frequent than in the case-records of the mentally healthy population. Electron microscopic examination performed in 22 cases of schizophrenia revealed changes on the synapses at all examined sites of the cerebral cortex--i.e. aggregations of synaptic vesicles. The most probable cause of aggregation of synaptic vesicles could be an impaired "immunological interaction" between synaptic vesicles which from the physiological aspect have at least three types of origin. The findings are supplemented also by data on the function of neurotransmitters and neuropeptides in the physiology and pathology of cerebral functions. The author draws attention to research focused on immunological reactivity in schizophrenia. During electron microscopic examination artefacts caused by premortal agony were eliminated as well as those caused by post-mortem changes and tissue fixation. As controls the author examined the cerebral cortex of five subjects who did not suffer from mental disease. The author also submits a of morphological incorporation of synapses in the structure of the cerebral cortex of five subjects who did not suffer from mental disease. The author to the possible relation to clinical manifestations of the disease.

Ultrastructure of cortical synapses in the brain of schizophrenics.

The autopsy was performed in 225 cases of chronic schizophrenia. In 44 cases examination of the brain by light microscope revealed changes typical of Alzheimer's disease. The increased risk for the development of Alzheimer's disease in chronic schizophrenia is pointed out. In 8 schizophrenics where death occurred suddenly and unexpectedly electronmicroscopy of brain was carried out. Clusters of a great number of synaptic vesicles were found in presynaptic knobs in the brain cortex of the schizophrenics but not in the controls; the postmortal origin and/or fixation artefact origin of the clusters were excluded. The possible "immunologic dependent" clustering of synaptic vesicles is discussed. The new "modul concept" in the structure of the brain cortex is used to make the role of synapses in the mental process more clear.

[Etiology and therapy of cholecystitis and cholelithiasis]. / Beitrag zur Atiologie und Therapie der Cholezystitis und Cholelithiasis.

Microscopic examinations of 1,000 ectomized gallbladders in patients with acute acalculous as well as calculous cholecystitides render possible a morphologic definition of the changes which are responsible for the beginning of a disease of the biliary duct. The cases in question are oedema, haemorrhages and necroses in the wall of the gall-bladder. These changes are evoked by pathologic angioneurotic reactions which take place in the supply area of the cystic artery during the gall colic. As their sequelae gallstones develop as was shown by the microscopic examinations of the fluid content of the operated gall-bladders and the gallstones. Changes in the wall of the gall-bladder in chronic cholecystitis are reparable processes of lesions which develop during the gall attack. The triggering moments of the pathological angioneurotic reaction are suggested in an allergic diathesis, neurovegetative lability and in psychic and physical stress factors, based on the examinations of 50 patients. In order to prevent a development of changes in the biliary duct antihistaminics were used. These had a surprisingly favourable therapeutic effect in heavy as well as weaker gall colics. The findings were compared with the hitherto got knowledge about etiology and therapy of the diseases of the biliary duct. A therapy with antihistaminics is recommended for the prevention of gallstones.

Morphology of cholecystitis and gallstone formation.

One thousand gallbladders received from cholecystectomies were analyzed microscopically. Regarding the clinical symptoms the morphological signs of acute and chronic cholecystitis were established. Microscopic changes typical of acute cholecystitis were oedema, haemorrhage and necrosis; and of chronic cholecystitis, sclerosis, presence of haemosiderin pigment and scars. The initial injury of the gallbladder is caused by an angioneurotic reaction (vasospasm and vasodilation) taking place in the bed of the cystic artery during the biliary colic. Acute lesions in the gallbladder are the result of a stress-reaction which takes place in the wall of the biliary tract. Microscopic analysis of the content of removed gallbladder displayed the beginning of gallstone formation. The gallstones are considered a secondary complication of processes which occur in the gallbladder wall during biliary colic. The succession of separate factors which have a role in cholecystitis and cholelithiasis are specified. A new therapeutic approach, treatment with antihistaminics is proposed, to block the angioneurotic reaction and to prevent the progression of biliary tract disease and the formation of gallstones.

Aortic dystrophy: a cause of hypertrophic cardiomyopathy of obscure origin.

Cardiac hypertrophy of obscure origin, with or without features of congestive heart failure, is a relatively common finding at autopsy. A primary abnormality of cardiac muscle has usually been considered the basis of this condition. This paper proposes that the basic pathologic process does not affect the myocardium, but rather the ascending aorta. This "aortic dystrophy" is characterized grossly by diffuse ectasia of the ascending aorta, and microscopically by typical histologic features. The hypertrophy of the left heart appears to be work hypertrophy secondary to increased volume of the ascending aorta and reduced elastic recoil of the aortic wall following ventricular systole. The disorder in "idopathic" cardiac hypertrophy with aortic dystrophy is heritable (mendelian dominant), also affects the skeleton, and can be demonstrated in relatives. Dissecting aneurysm of the aorta is an alternative manifestation of aortic dystrophy, and may occur in families or in patients with "idiopathic" cardiac hypertrophy.