Our experience with solitary fibrous tumors in the chest area.

The article reports on three patients with a solitary fibrous tumor of the chest. The first patient had a tumor in the area of the dome of the right pleural cavity which was radically resected together with the chest wall around its origin. In the second case, the tumor was attached by a vascular pedicle to the lower lobe of the right lung. This tumor was resected atypically, via thoracotomy, along with a margin of healthy lung tissue at the base of its pedicle. The last patient had a tumor of the lower lobe of the right lung, surrounding the lower pulmonary vein, which did not have a clear margin of healthy lung tissue. This finding required right lower lobectomy via posterolateral thoracotomy. The presented cases describe rare types of tumors in the chest area which at the time of detection often reach large dimensions, necessitating extensive surgical procedures. Due to the biological nature of these tumors, long-term patient follow-up is advisable.

Intrapulmonary sequestration with destructive pneumonia and life-threatening hemoptysis in an adult patient: a case report.

The article reports the case of a patient with bronchopulmonary sequestration complicated by destructive actinomycotic inflammation leading to life-threatening hemoptysis. It was an adult patient with the history of repeated right-sided pneumonia the cause of which had not been investigated in detail in the past. Only hemoptysis, which appeared as a complication, led to a closer investigation of the background of repeated right-sided pneumonia. CT scan of the chest revealed a lesion of the middle lobe of the right lung with anomalous vascularization - compatible with intralobar sequestration. Initially, conservative antibiotic treatment of pneumonia was provided at a local clinic. Embolization of the afferent vessels of the sequestrum was indicated due to persistent hemoptysis; this led to a reduction of its blood supply, proven by a follow-up CT examination of the chest. Clinically, the hemoptysis subsided. Three weeks later, the hemoptysis reocurred. The patient was acutely hospitalized at a specialized thoracic surgery department where shortly after admission, hemoptysis progressed to life-threatening hemoptea. Urgent middle lobectomy of the right lung was approached via thoracotomy to treat the source of bleeding. The case describes unrecognized bronchopulmonary sequestration as a possible cause of recurrent ipsilateral pneumonia in adulthood; additionally, it emphasizes the possible risks associated with a pathologically altered tissue microenvironment of pulmonary sequestration, and the need for surgical removal in all indicated cases.

Switchability of neoral and equoral according to Food and Drug Administration rules and regulations.

According to the US Food and Drug Administration (FDA), if a drug product contains a drug substance that is chemically identical and is delivered to the site of action at the same rate and extent as another drug product, then it is equivalent and can be substituted (switchable) for that drug product. Methods used to define bioequivalence as stated by the FDA rules (FDA 21 CFR 320, 24) are (1) pharmacokinetic (PK) studies in healthy volunteers, (2) comparative clinical trials, and (3) pharmacodynamic (PD) studies (bioactivity). We evaluated the switchability of Equoral (IVAX-USA) with Neoral (Novartis Switzerland using all FDA rules. In a single oral dose, we undertook a comparative bioavailability study of Equoral (IVAX, USA) Neoral (Novartis, USA), and Neoral (Novartis UK). The pharmacokinetics of Equoral and Neoral were determined with blood levels at 0, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 30, 36, 42, and 48 hours. The area under curve (AUC), AUC extrapolated to infinity (AUC0-inf), rate of absorption (Tmax), extent of absorption (Cmax), half time (t1/2) of Equoral and Neoral were all within the 90% confidence interval of 80% to 125% boundaries. A comparative multinational multicenter clinical trial in stable renal transplant patients included 70 patients (22 women and 48 men) of mean age of 33 years (range, 26 to 43) was performed in Turkey, Lebanon, and Pakistan. In this study the ratios of LSM and the 90% confidence intervals for the Nontransformed/Parameters (AUC0-t, AUCinf, Tmax, and Cmax) of Equoral and Neoral SGC were 98% and 95%, respectively, which are within the 80% to 125% FDA acceptance range. For immunosuppressive drugs, the site of action is the lymphocyte and the measurable response is the decrease in lymphocyte count caused by the relative concentration of the drug in the lymphocyte. In a controlled switch, fixed-dose study, both Equoral and Neoral achieved the same concentration in the lymphocytes and caused the same degree of lymphocyte count reduction. The results of the testing (bioavailability-bioequivalence, clinical studies, and pharmacodynamic-bioactivity) required by FDA for interchangeability ("switchability") of immunosuppressive agents suggests that Neoral and Equoral are switchable.

The pharmacokinetics of equoral versus neoral in stable renal transplant patients: a multinational multicenter study.

We studied the pharmacokinetics (PKs) of the new generic cyclosporine formulation, Equoral capsules, after the switch from original formulation Neoral capsules in stable renal transplant patients. The study was carried out in accordance with the basic principles defined in the US 21 CFR Part 312.20 and the principles of the Declaration of Helsinki. The study included clinically stable first renal transplant patients maintained on cyclosporine with no rejection episode during the past 6 months. Hematology, biochemistry, and urine chemistry were determined on day 7, and day 21. The patients were all switched to Neoral (lot number 416MFD0601) on day 0 when the first sparse sampling PK was performed. On day 14 a 12-hour PK profile included predose, 30 minutes; 1 hour; 1 hour 30 minutes; 2 hours; 3 hours; 4 hours; 5 hours; 6 hours; 8 hours; 10-hours and 12-hour samples. Cyclosporine levels were determined using a CYA kit (Abbott TDx). On day 15 the patients were switched from Neoral capsules to Equoral capsules (lot 5T111014) at an equivalent dosage (mg/mg). The second sparse sampling PK was performed on day 21 and a 12-hour PK was performed on day 28. On the morning of day 29 patients were switched from Equoral capsules to Neoral capsules at an equivalent dosage (mg/mg). Additional concentrations were measured on days -7, 18, and 35. Safety parameters were monitored at each visit. The pharmacokinetics of both formulations were equivalent. The mean AUC for Neoral and Equoral was 2856 and 2892, respectively. The ratios of LSM and the 90% confidence intervals for the in-transformed parameters (AUC o-t, AUC inf, and Cmax) of Equoral and Neoral SGC were 98% and 95%, respectively, suggesting that Equoral and Neoral SGC are bioequivalent.

Expression of p53 protein in tissues and organs of human and mouse embryo.

The expression of p53 was demonstrated in the cells of some tissues in the various stages of human embryo development. The distribution of this protein correlates in some cases with sites of higher proliferative activity as demonstrated by PCNA/cyclin detection. It is necessary to prove whether the p53 protein participates in the regulation of cell division, or it is the aberrant expression of unfunctional p53 which is induced in sites of higher proliferation by feed back regulatory mechanism.

Ultrastructure of mice Leydig cells at chronic lead intoxication.

In the present paper we report on the study of the ultrastructure of Leydig cells of male mice after application of various doses of Pb(NO3)2 in drinking water for 2, 3, 4, 5, 7, 9 and 11 weeks. The increasing dose and time interval lead to formation of numerous concentric lamellar systems, accumulation of fatty vacuoles, vacuolization of mitochondria, pronounced surface differentiation, and changed shape of the nucleus of Leydig cells. The ultrastructural picture corresponded with an enhanced metabolic activity in some cells; in other cells dystrophic changes were observed in other. In addition to that, some cells were found that are considered by us to be an intermediary stage between the nondifferentiated mesenchymal cells and the fully functional Leydig cells.

Effect of physical load on the platelet function and ultrastructure in patients with ischemic heart disease.

The aggregability of the blood platelets and their ultrastructure were examined during the bicycle exercise test in 20 patients with ischemic heart disease and stable angina pectoris. In 8 patients with unequivocally positive exercise test a significant increment of stimulated aggregation from 58.2 (CV7%) to 71.2 (13.6%) resulted in comparison with a group of patients who did not fulfilled criteria of exercise testing. In this group the aggregability dropped from 56.0 (5%) to 38.7 (8.4%) eventually. No changes in a diameter and shape were observed during the exercise test was positive the amount of granules decreased. It is considered to be an indirect proof of the functional changes in thrombocytes during a certain rise in aggregability.

Toxic effect of lead of mice testicles after its administration with drinking water.

The experiments were carried out with male mice of the strain CBA x C57BL/10. Lead dinitrate was added to drinking water to obtain the final lead concentration of 0.05 g/l. The material was removed on the 1st, 2nd, 3rd, 4th and 5th week. Testicles were removed fixed in the mixture of neutral formol and 3% K2Cr2O7. Tissue samples were processed by routine procedure and stained with HE and PAS. A relative volume proportion of seminiferous tubules and of interstitial tissue of the testicles was determined by the method of point counting. The first changes in the germinal epithelium of seminiferous tubules were found on the 2nd week after the application. Atypical cells varying in size up to large multinuclear cells were present. With a prolonged time of exposition they multiplied and various dystrophic changes up to disintegration of cells of the germinal epithelium occurred. The experimental groups showed (compared to controls) an increased volume of interstitial tissue. A prolonged exposition led to a marked enlargement of the interstitial tissue.

Morphological study of the effect of abdominal compression on acute intestinal radiation syndrome. I. Local irradiation with 14 Gy.

The effect of abdominal compression on acute intestinal radiation syndrome in rats was studied morphologically using light microscopic and histochemical methods. It was confirmed that the method of abdominal compression introduced by Svoboda et al. does not induce either acute or later changes (until 11 months) of the structure of abdominal cavity organs. The structure of intestinal mucosa of rats exposed to local irradiation of the abdomen with 14 Gy of gamma radiation from a Co60 source with or without abdominal compression was quite different with respect to acute changes. Ischemia of the intestine wall protects stem cells of intestine epithelium and subsequently allows a rapid and pronounced regeneration of radiation injury.

Morphological study of the effect of abdominal compression on acute intestinal radiation syndrome. II. Local irradiation with 30 Gy.

The radioprotective effect of abdominal compression introduced by Svoboda et al. on rats exposed to local irradiation of the abdomen with 30 Gy was studied using light microscopic and histochemical methods. Irradiation combined with abdominal compression does not lead to the development of typical radiation alterations of intestinal mucosa. The protected animals retained normal structure of intestinal and colon mucosa, and unchanged epithelium with typical enzymatic equipment. Local differences in protective effect may be due to various degree of ischemization of intestinal tract.

Early pyeloplasty for idiopathic hydronephrosis.

Evaluation has been made of a total of 272 patients who underwent surgery for hydronephrosis at the Department of Urology, Faculty Hospital in Olomouc, from 1979 to 1983. On the whole 221 (81%) pyeloplasties and 51 (19%) nephrectomies were performed. Five grades of hydronephrotic nephropathy were distinguished according to their significance. The clinical evaluation was based mainly on the results of excretory urography. The five grades of hydronephrosis were also characterized on the basis of the histological and electron-microscopical patterns and perioperational bioptic findings. Besides the dystrophic changes, seen on the tubular system of the kidney were morphological signs of regeneration, viz. the incidence of differentiated, pale "regeneration cells". However, in advanced stages of hydronephrosis, also these cells are subject to dystrophy making the hydronephrotic changes in the kidney irreversible. On the basis of the histological and clinical findings in correlation with the results of pyeloplasty the authors recommend to operate upon patients with Grades I-II hydronephrosis.

Postirradiation changes in small intestine mucosa of piglets selectively decontaminated by peroral antibiotics.

There was performed light microscopic and morphometric comparison of changes in the intestinal mucosa structure after the irradiation of the lower part of body by radiation 60Co in a dose of 12 Gy, observed the third day after irradiation in piglets kept under conventional conditions and the fifth, the fifteenth and the twentieth days after irradiation in piglets kept under the conditions of selective decontamination by peroral antibiotics. The non-irradiated animals kept conventionally as well as under the conditions of decontamination served as controls. The estimation was performed on transverse slices of the cranial part of jejunum and of the caudal part of ileum. The slices were stained by the method hematoxylin-eosin. The drawings prepared with the help of the projective microscope Pictoval were used for measuring on the apparatus for the quantitative analysis of image MOP AM 03. A markedly lower damage of the intestinal mucosa was evidenced in piglets selectively decontaminated by peroral antibiotics. In the studied time intervals after irradiation in a dose of 12 Gy, the epithelial cover of mucosa, the crypt epithelium and the general outline of mucosa are much better maintained. The favourable effect of the selective decontamination on the maintenance and regeneration of the mucosa of jejunum and ileum is confirmed by a range of morphometric parameters.

Acute radiation sickness--morphology of CNS syndrome.

The present treatise is a report on the study of morphologic changes induced in the brain of laboratory animals by the exposure to supralethal doses of ionizing radiation. The review of literature summarizes the basic current findings on the interaction between biological objects and ionizing radiation. Principal attention is then paid to literary data describing the morphological changes in the single components of the central nervous system after irradiation. There is a detailed account primarily of what has so far been known on the structure of the blood-brain barrier and its individual, morphologically observable components. What the exploration of literature shows is that problems concerning the morphologic changes following supralethal irradiation have hitherto been paid but little attention. The scarce publications on this topic mostly offer contradicting conclusions. Most of the experiments were made with conventional female rats supplied by the firm Velaz. The animals were exposed to 60Co gamma radiation doses within the range of 15 to 960 Gy. The material for study was sampled in the intervals from 15 min to 6 days after the irradiation had ended. Similar experiments, though on a smaller scale, were carried out with mice, rabbits and dogs. The tissue samples were treated in current methods for the purposes of light microscopy, electron microscopy and histochemistry. The light microscopical pattern of morphological changes during the first hours is dominated by the signs of a cerebral edema. The nerve cells show symptoms of acute swelling. There are small hemorrhages near some of the capillaries. In later periods, the nerve cells assume the nature of pyknomorphous neurons. The degree in which the changes are expressed however varies considerably. Dystrophic changes were also found for glial cells. Small hemorrhages are dispersed over all the areas of the brain. There are persisting signs of brain edema with dilated perivascular and pericellular spaces. The activities of the following enzymes were studied in histochemical examinations: acetylcholinesterase (ACE), nonspecific cholinesterase (CE), alkaline phosphatase (AP), acid phosphatase (AcP), ATP splitting enzyme (ATP), thiamine pyrophosphatase (TPP), glycero-3-phosphate dehydrogenase (GPDH), succinodehydrogenase (SDH), acid nonspecific esterase (AE). A phase progress of activity changes was found for AP, CE, and ACE in the blood capillaries of the brain cortex after the exposure to the radiation doses of 50 to 200 Gy. The irradiation was first followed by elevation of their activity and then, in the intervals of 4 to 24 hours after irradiation, by a drop in their activity below the level obtained for the control animals.(ABSTRACT TRUNCATED AT 400 WORDS)

Ultrastructure of human granulosa cells obtained from follicular fluid aspirates.

Samples of the granulosa cells obtained from a punctured human preovulatory follicles stimulated for in vitro fertilization purposes were studied by means of light and electron microscopic methods. Early and late preluteinized granulosa cells were characterized by the presence of high amount of pale and homogeneous lipid droplets, moderate accumulation of glycogene and progressive development of smooth endoplasmic reticulum. A new type of granulosa cell containing dense-cored granules with fine granular contents of a secretory nature was identified in this material and discussed in comparison with some earlier published indications of its possible existence.