[Myocardial infarction in the young - our results and experience]. / Infarkt myokardu v mladom veku - nase výsledky a skúsenosti.

AIMS: Coronary artery disease in young adults is important task of contemporary cardiology. Presented our results experience and opinion were obtained by our long term investigation of myocardial infarction in young patients under 40 years. METHODS: Two sets of patients were examined - 78 patients (74 men, 4 women) hospitalised in pretrombolytic era in prospective 8 years follow up (1984-1992) and 39 patients (35 men, 4 women) admitted during period 2000-2010 analysed retrospective. RESULTS: Myocardial infarction in young age belongs roughly to two different groups with considerable overlap in pathogenetic mechanisms: 1. angiographycally normal coronary arteries or unilocular nonsignificant atherosclerotic stenosis (less 50%) in 25-30% with thrombotic occlusion of one infarct related artery probably with substantial vasospastic component. Patients were younger (average 31.7 ± 3.7 years), dominant risk factors smoking, hyperlipidemia, excessive physical and emotional stress. Disease course and prognosis are favourable. 2. premature accelerated atherosclerosis with significant (more 50%) in 70-75 % often multivessel affection. Pts were significantly older (average 35.8 ± 2.6 years; < 0.001) bad risk factors profile, worse clinical course and poor long-term prognosis. CONCLUSIONS: Study of myocardial infarction in young adults indicates: great role of risk factors, mainly smoking, hyperlipidemia, family history and type A behaviour, hostility with participation of low education level and social inequality (unemployment). Noticeable are hypercoagulable states and trauma. Dominancy of men (90-95%). Prognosis depends on age, extend of coronary atherosclerosis and residual cardiac function. Disease picture has not been changed during last 30 years. Aggressive control over risk factors is unavoidable. Current requirement is to evaluate impact of modern treatment strategy on long-term survival. Key words: coronary artery disease - myocardial infarction at young age.

Expression pattern of anti-apoptotic protein survivin in dysplastic nevi.

UNLABELLED: The anti-apoptotic protein survivin was detected in a panel of 27 dysplastic nevi. From each representative paraffin block 4 mm sections were cut and stained with anti-survivin antibody (DAKO, Clone 12C4). In each section, the labeling intensity, the subcellular location of survivin antigen, the percentage of labeled cells and the degree of dysplasia were assessed. Survivin was present in 23 out of 27 cases (85.2%), but absent in 4/27 cases (14.8%). Positive staining was confined to the cytoplasm (C) of nevus cells only in 18 cases (66.7%), while cytoplasmic as well as nuclear positivity (NC) was found in 5 cases (18.5%). In no case solely nuclear staining could be seen. Furthermore, in 4 out of 5 cases (80%) with NC staining, severe dysplasia was found. Our data point at usefulness of survivin staining, otherwise rarely performed in dysplastic nevi. We confirm the importance of nuclear location of the survivin antigen, which may be helpful for assessing the possible progression to melanoma. KEYWORDS: survivin, immunohistochemistry, nevi, dysplasia, melanoma.

Effects of Mg-ATP on the flavonoid production in the Scutellaria baicalensis Georgii suspension cultures.

This work focused on the cultivation of S. baicalensis Georgii in vitro cultures and on the possibilities of increasing the production of secondary metabolites in these cultures. The aim of the Sstudy was to determine whether the baicalin transport through vacuolar membrane is dependent on the presence of Mg-ATP. Our results showed that Mg-ATP had a significant effect on the ratio of baicalin and baicalein content and on the transport speed of these flavonoids. Therefore, the transport mechanism for baicalin are probably some of the MRP proteins which are the subfamily of the ABC transporte

Kaposi's sarcoma - still an enigma.

Kaposi's sarcoma (KS) is an unusual neoplasm that has proved to be an enigma in many ways since its original description in 1872. KS, a vascular tumour that is otherwise rare, is at present the most common neoplasm in patients with AIDS. The lesions contain spindle cells that share features with endothelial cells and smooth muscle cells and are in all likelihood primitive mesenchymal cells that can form vascular channels. These cells are monoclonal in origin indicating therefore that KS is a neoplasm. The presence of a novel type of human herpes virus, KS herpesvirus (KSHV) also called human herpesvirus type 8 (HHV8) in KS lesions support a viral ethiology. KS may be mistaken in the skin for an inflammatory or other lesion, thus skin biopsy is important for correct diagnosis, with the use of immunohistochemistry or molecular biology if needed. Radiation or interferon alpha dominate in the therapeutic approaches.

Multiple cutaneous metastases as the first sign of lung cancer in a patient with well-differentiated papillary transitional cell carcinoma of the urinary bladder.

A case of multiple, cutaneous metastases as the first sign of lung cancer in a patient with well-differentiated, papillary, transitional cell carcinoma of the urinary bladder is presented. In the left clavicular region were two, sharply demarcated, dark red tumors measuring 3 and 2 cm in diameter with a history of rapid growth and intermittent spontaneous bleeding. Thorough examination of the patient revealed 16 additional skin lesions, which were dark red macules and papules, 2-3 mm in diameter, situated on the left side of the chest. The skin biopsy material (tumors, macular and papular lesions) was studied using histological and immunohistochemical techniques and showed intact epidermis and massive dermal and subcutaneous metastatic involvement by a small cell carcinoma with neuroendocrine differentiation most likely originating in the lung.

[Juvenile hyaline fibromatosis]. / Juvenilná hyalínová fibromatóza.

BACKGROUND: Juvenile hyaline fibromatosis is a sporadic hereditary disease with autosomal recessive mode of inheritance, characterized by the presence of nodules and tumours in the skin and soft tissues and gingival hyperplasia. The majority of patients are growth retarded, suffer from joint disorders, contractures, osteolytic lesions and have a positive family history. The disease most frequently occurs in children, but may be diagnosed also in adults. Since 1873, when the disease was described by Murray, only a few cases were introduced in the literature. THE AIM AND THE BASIS OF THE STUDY: To present the clinical pattern of a patient diagnosed at the age of 28 and describe also the histopathological, immunohistological and electron-microscopic findings of excisions from the lesions. METHODS: The pathologist in cooperation with clinicians from several disciplines established the diagnosis on the basis of typical histopathological picture and additional immunohistological tests not yet introduced in the literature. RESULTS: Tumorous lesions contained hyaline structureless matrix often with chondroid or even osteoid metaplasia, calcium salts. The matrix contained numerous fibroblastoid-like cells with eosinophilic cytoplasm, oval nucleus and often pericytoplasmic halo. ELMI investigation revealed dilated cisternae of rough endoplasmic reticulum and hypertrophic Golgi apparatus. Sporadically were particles with calcium salts density detected. Immunohistochemical tests revealed the expression of vimentin, alfa1-antitrypsin and alfa1-antichymotripsin by the tumorous cells. CONCLUSION: The authors presented an extremely sporadic childhood disease in an adult. The results are in accordance with the data from the literature. Immunohistochemical picture of "cementicles" has not yet been introduced in the available literature. (Fig. 12, Ref. 25.)

Phaeohyphomycosis due to Alternaria spp. and Phaeosclera dematioides: a histopathological study.

A case of phaeohyphomycosis caused by strains of both Alternaria spp. and Phaeosclera dematioides is presented. The biopsy material was studied using histological, immunohistochemical and transmission electron microscopy techniques. The agent's dematiaceous mycelia are composed of thick-walled hyphae, branched and unbranched, with terminal vesicular formations. All the described structures occur alone or in chains within multinuclear giant foreign body-type cells or invading an abscess. Also present are budding forms. Immunostaining of histiocytic inflammatory cells in either. diffuse or granulomatous infiltrates revealed cytoplasmic positivity for lysozyme and Ki-MIP antibody. The lymphocytic infiltrates of the upper corium show predominantly small T lymphocytes (CD3 and CD45RO positive) and absence of CD20-positive B cells. Plasma cells occurring within the infiltrates of the deeper parts show polyclonal expression of both Ig light chains.

[Study of malignant melanoma using 1H-nuclear magnetic resonance spectroscopy]. / Stúdium malígneho melanómu 1H-spektroskopiou nukleánej magnetickej rezonancie.

1H-nuclear magnetic resonance spectroscopy was used to study malignant melanoma extract. The aim of this work was to study low molecular weight metabolites soluble in water, which can be helpful for a more detailed understanding of tumor metabolism with a view to using this knowledge for diagnosis. The authors found in a well distinguished spectrum the presence of numerous low molecular weight metabolites such as glutamate, glutamine, choline, inositol, creatine, phosphocreatine, phosphocholine, glucose, acetate, alanine, lactate. It is necessary to correlate these in-vitro findings with a study of the above mentioned metabolites in-vivo. Malignant melanoma is appropriate for this investigative and diagnostic technique because of its superficial localization. (Fig. 1, Ref. 18.)

[Morphologic study of mastocytes from skin biopsies in patients with non-systemic and systemic mastocytosis]. / Morfologická stúdia mastocytov z kozných biopsií pacientov s nesystémovou a systémovou mastocytózou.

The authors describe morphologic changes in mastocytes in the picture of transmission electron microscopy (TEM) and skin changes in patients with urticaria pigmentosa (7 causes) and systemic mastocytosis (2 causes). The presented study analyzes the changes in the cellular membrane and cytoplasmic processes, intracytoplasmic membrane structures, mitochondria, granules, and nuclei of mastocytes in patients with systemic mastocytosis. The authors evaluate these cells as being atypical, respectively immature. The study discusses the malignization of these states. (Tab. 2, Fig. 8, Ref. 16.)

Generalized melanosis with malignant melanoma metastasizing to skin--a pathological study with S-100 protein and HMB-45.

A patient with primary malignant melanoma localized to the right gluteal region is described. Four years later and after intercurrent influenza, disseminated metastases of malignant melanoma to the skin occurred. After a further 6 months melanodermia developed and lasted until the death of the patient (6 months later). Autopsy revealed melanosis of the visceral organs. Histology taken from internal organs using S-100 protein and HMB-45 melanoma methods confirmed metastases of malignant melanoma to the skin, oral cavity, palatal tonsils, nasal and nasopharyngeal mucosae, lungs, myocardium and brain. The authors discuss the mechanism of melanosis--a rare sign in patients with metastasizing malignant melanoma.

A study of possible causal relations between squamous cell carcinoma of the penis and carcinoma of the cervix uteri.

The authors investigated 26 regular sexual female partners of 24 men with squamous cell carcinoma of the penis. Neoplasms were diagnosed in 6 (23.1%) of the total of 26 women. STDs were found in 6 (23.1%) women. In 2 the cytologic findings on the cervix were classified as PAP III (PAP IIIa-CIN I, PAP IIIb-CIN III). Squamous cell carcinoma of the uterine cervix was found in 2 women (1 case PAP IV-CIN III; 1 case PAP V-suggestive of invasive carcinoma). Endometrial adenoacanthoma, mammary adenocarcinoma, squamous cell carcinoma of the right hand and non-Hodgkin's malignant lymphoma (centroblastic) were found in 1 case each.

Squamous cell carcinoma of the penis. Analysis of 24 cases.

The authors evaluated retrospectively 24 cases of spinocellular carcinoma of the penis, trying to detect aetiological carcinogenic factors of the disease. Phimosis persisting since childhood was reported by ten men, whereby in five of them circumcision was performed during puberty. The duration of symptoms up to the time of biopsy and histological verification of differentiated spinocellular carcinoma of the penis varied from one month to thirteen years. Eight patients (33.3%) belonged to category T1, 8 (33.3%) to T2 and 8 (33.3%) to T3. Fifteen tumours (62.5%) were G1, 5 (20.8%) G2 and 4 (16.7%) G3. In 5 men print cytology was negative.