Pulmonary xanthoma. A case report with immunohistologic study and DNA-image analysis.

A case is reported of a xanthoma of the lung in a 32-year-old asymptomatic male. Detailed roentgenographic and immunohistopathologic studies, as well as DNA-image analysis, are presented. The benign nature of this tumor is well recognised and it is generally agreed that conservative local excision with a margin of uninvolved lung is the treatment of choice. The existing literature is reviewed.

Optimal dose of omeprazole in combination with amoxicillin in eradicating H. pylori and preventing relapses in duodenal ulcer patients.

BACKGROUND/AIMS: Triple therapy schemes, based on bismuth salts, eradicate H.pylori in a high percentage of duodenal ulcer (DU) patients. However, a simple and effective regime with a low complication rate is desirable. Previous studies have shown that the combination of Omeprazole (O) with an antibiotic (most commonly Amoxycillin [A]) is effective, but the optimal dose of O in this combination is not well defined. The aim of this study therefore was to address this subject. MATERIALS AND METHODS: The following four groups of patients were studied: group I (20mg O daily + 500mg A qid, n=18), group II (20mg O bid + 500mg A qid, n=17), group III (20mg O tid + 500mg A qid, n=18), group IV (20mg O qid + 500mg A qid, n=20). Patients were treated for two weeks with the above combinations. Endoscopy was performed four weeks after stopping treatment to check for H. pylori eradication and then one year later or when symptoms suggesting relapse occurred. RESULTS: Eradication rates were as follows; group I 6/18 (33.3%), group II 10/17 (58.8%), group III 15/18 (83.3%), group IV 17/20 (85%). The highest eradication rate was achieved in group IV which was significantly higher (P<0.001) than in all the other groups except for group III. After treatment, there was a total of 48 H. pylori (-) and 25 H. pylori (+) patients in the four groups of patients studied. Relapse occurred in 20/25 (80%) of the H. pylori (+) patients and in only 2/48 (4.16%) of the H. pylori (-) patients (P<0.001). CONCLUSIONS: a) The combination of Omeprazole and Amoxycillin is effective in eradicating H. pylori. It seems that in this combination 60 or 80mg of Omeprazole is equally effective in achieving high percentages of eradication. Eradication of H. pylori with this regime prevents duodenal ulcer recurrence.

Determination of estrogen receptors in cytologic imprints of breast cancers using immunocytochemical methods.

Immunostaining of estrogen receptors (ERs) was carried out on imprints of 62 breast carcinomas using monoclonal antibodies and a sensitive immunoperoxidase technique (the Abbott ER-ICA kit). The results were compared to those obtained by the conventional biochemical analysis of cytosol proteins and to the degree of tumor differentiation. The cytologic specimens were insufficient for analysis in 6 cases; of the remaining 56 cases, 37 (66%) showed a positive ER reaction. In 51 cases with both types of ER analysis, the immunocytochemical staining of the imprints correlated strongly with the biochemical analysis in 44 cases and weakly in 3. Four cases were negative immunocytochemically and positive biochemically. Among the ductal carcinomas, well-differentiated tumors had higher percentages of ER-positive cells than did poorly differentiated tumors. These results show that the immunoperoxidase method is a highly specific and sensitive technique for the evaluation of ER content; it may be applicable to small samples of tumor tissue and may provide additional information for identifying hormonally responsive breast tumors.

Helicobacter pylori infection and gastric juice vitamin C levels. Impact of eradication.

H. pylori has recently been recognized as a novel risk factor of gastric cancer, but its precise role in gastric carcinogenesis is as yet unknown. The aim of the present study was to assess the relationship between H. pylori infection and vitamin C levels in gastric juice and also to examine whether eradication of H. pylori could have any impact on these levels. Gastric juice and plasma vitamin C levels were measured in 88 dyspeptic patients who had an upper gastrointestinal endoscopy. In the subgroup of H. pylori-positive patients, eradication was attempted with triple therapy. This subgroup was studied on two occasions, ie, before and after treatment. There were 58 H. pylori-positive and 30 -negative patients. Gastric juice vitamin C levels in H. pylori-positive patients were statistically lower (P < 0.001) than the levels in the H. pylori-negative patients. Triple therapy achieved eradication in 45 patients (77.6%) of the 58 H. pylori-positive patients. Before H. pylori was eradicated in these 45 patients gastric juice vitamin C levels were significantly (P < 0.001) lower than those after eradication, the latter being no different than the group of 30 H. pylori-negative patients. There was a significant (P < 0.001) improvement of gastritis after eradication, which paralleled the elevation of gastric juice vitamin C levels. No difference was noted in plasma vitamin C levels between H. pylori-negative and -positive patients or in the latter before and after H. pylori treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Perinatal death and thymus gland.

Three hundred (300) cases of perinatal death were autopsied and the thymus was removed for histologic examination. The histologic findings were classified into five groups: a) normal-mature thymus, b) involutional changes--"Starry sky" pattern, c) involutional changes--intense lymphocytic depletion, d) hypoplasia--aplasia, e) agenesis. The perinatal deaths were classified into five groups according to Wigglesworth's classification: 1) normally formed macerated stillborn neonates, 2) congenital malformations, 3) conditions associated with immaturity, 4) asphyxial conditions developing in labor, 5) other specific conditions (e.g. known-beta-hemolytic streptococcal infection or a fatal inborn error of metabolism). The main objective was to identify a possible correlation between sex, gestational age, birth weight, thymus weight, histologic features of the thymus and cause of death. In conclusion, a strong correlation was found between: a) weight of thymus and gestational age, b) weight of thymus and birth weight, c) weight of thymus and its histologic features, d) histologic features of thymus and cause of death, e) weight of thymus and cause of death, f) gestational age and cause of death. No correlation was found between: a) gestational age and histologic features of thymus, b) birth weight and histologic features of thymus, c) weight of thymus and sex, d) histologic features of thymus and sex, e) cause of death and sex.

Eradication of Helicobacter pylori reduces the possibility of rebleeding in peptic ulcer disease.

A close relationship has been found between Helicobacter pylori and peptic ulcer disease. Furthermore, eradication of H. pylori is associated with low recurrence rates. The aim of the present study was to examine whether eradication of H. pylori has any impact on the complications of ulcers, such as bleeding. Thirty-one patients hospitalized for duodenal ulcer bleeding, undergoing conservative treatment and with a previous history of bleeding, comprised the group studied. All patients had emergency endoscopy, and tests for H. pylori proved to be positive in all. After discharge, patients were given omeprazole 20 mg daily for 4 weeks for ulcer healing, which was achieved in all patients (100%). After this, patients were randomized to receive either omeprazole 20 mg t.i.d. alone (group O, n = 15) or the combination of omeprazole 20 mg t.i.d. + amoxicillin 500 mg q.i.d. (group O + A, n = 16) for 2 weeks. Endoscopy was performed 4 weeks after treatment ended to check for eradication of H. pylori and again when rebleeding or symptomatic relapse occurred. Groups O and O + A were similar in age, sex, smoking habits, and NSAID use. The follow-up period was 12 months for both groups. Eradication was achieved in 2 of 15 (13.3%) patients in group O and in 13 of 16 (81.3%) patients in group O + A (p < .001). Five patients rebled during follow-up. All of them belonged to group O and were patients in whom eradication had failed. In contrast, none of group O + A had rebleeding (p = 0.18).(ABSTRACT TRUNCATED AT 250 WORDS)