Cathepsin H expression distinguishes oncocytomas from renal cell carcinomas.

BACKGROUND: Because the differential diagnosis of oncocytoma and renal cell carcinoma lacks specificity, new methods supporting correct diagnostic decisions are welcome. MATERIAL AND METHODS: Sixteen cases of renal oncocytoma, and 16 sex-, age-, and stage- matched controls of renal cell carcinoma (T1-2N0M0) were studied. The minimum follow up exceeded ten years. There were no deaths due to neoplasm among oncocytomas, but 4 patient died with metastatic disease among cancer patients. Immunohistochemical staining for cathepsin H was quantified by 3 histoscores. The histoscores evaluated: 1) even cytoplasmic staining of neoplastic cells, 2) granular staining, or 3) total staining. RESULTS: 100% distinction was possible with the even cytoplasmic staining score. Total staining distinguished 87.5%, and granular staining 25% of neoplasms. CAM 5.2 cytokeratin, or vimentin distinguished 84.4% or 56.6% of these tumors, respectively. CONCLUSIONS: Cathepsin H histoscore on even cytoplasmic immunostaining is an excellent method for the distinction of oncocytomas and renal cell carcinomas.

Nuclear morphometry in differential diagnosis of renal oncocytoma and renal cell carcinoma.

PURPOSE: Morphometric distinction of renal oncocytoma and renal cell carcinoma was attempted. MATERIALS AND METHODS: Nuclear morphometric measurements were done from sections of 16 histologically diagnosed renal oncocytomas and renal cell carcinoma controls (grade 1 or 2, stage T1 to 2N0M0). RESULTS: Oncocytomas could be distinguished from carcinomas on the basis of nuclear morphometry in more than 80% of the cases. Especially, the shape descriptors (form factors) were significantly different between oncocytomas and carcinomas. CONCLUSIONS: Morphometrically determined nuclear shape descriptors can be used to support diagnostic decisions in problematic cases.

Contact lenses in hypoxia.

Seven women with soft contact lenses were examined during a 4 h period in a decompression chamber. The atmospheric pressure was lowered from the normal value of 1000 millibars (750 mmHg) to 560 millibars (420 mmHg), which corresponds to the altitude of 4000 m above sea level. The humidity, temperature, percentage of carbon acid and illumination were attempted to be kept even. Five test subjects developed subjective, and all the 7 also developed objective eye symptoms. It was concluded that hypoxia itself may cause eye discomfort for aircraft passengers with contact lenses. The most serious objective findings were corneal erosions in 3 and opacities of corneal stroma in 5 test persons. The control group without contact lenses did not develop any symptoms during the test.

The significance of low atmospheric pressure on the eyes with reference to soft contact lenses.

Many aircraft passengers wearing contact lenses have complained about visual disturbances, tearing and smarting of the eyes. This kind of discomfort has been named jet-set disease. The literature on this subject has been reviewed. Also my own study is reported. In that study seven test persons were examined during four hours in a decompression chamber. The atmospheric pressure was lowered to 560 millibars , which corresponds to an altitude of 4,000 metres. All test persons wore soft contact lenses. Objective symptoms were verified in four eyes after one hour and in all 14 eyes after three hours. The most serious objective findings were corneal erosions in 4 and opacities of corneal stroma in 10 eyes. The two investigators who did not wear contact lenses remained without both subjective and objective symptoms.

Corticosteroid injection of chalazia.

Corticosteroid (triamcinolone acetonide) injection of chalazion intralesionally is an effective, easy and a safe method. Perfect recovery was achieved in 88% of 24 chalazion cases (22 patients). Most of them were cured with a single injection. The steroid therapy is most effective when the chalazion has not been secondarily infected. If this has already happened surgery is the method of choice. If the steroid injections are limited only to common non-infected chalazia, the results will be excellent in about 100% of the cases. This treatment may be recommended especially for children and persons with allergy to local anaesthetics. It is particularly suitable for chalazia located close to the lacrimal punctum. Because of its simplicity, efficiency and almost non-existent risks, this method should also be convenient to physicians other than ophthalmologists.

On the microwave exposure.

During the last decades the use of microwaves has been common in the industry, medicine, household and armed forces. According to the literature microwaves may especially cause lens opacities and other serious health disturbances. The authors of this paper examined 121 radar workers, but nothing was found which could be connected to microwaves. For example, the amount of lens opacities had correlation only to the age of the patients, but not to the exposure time of microwaves. The exposure duration varied from 0 to 28 years and the age of the patients between 18 and 59 years.

On the significance of heterophoria for stereoscopic vision.

This study was undertaken to explain the possible correlation between heterophoria and stereopsis because, in the literature, there are different opinions. The subjects were 806 recruits. They were trained as rangefinder men, of whom a perfect stereopsis is required. The permitted maximal limits of heterophoria were 1 prism diopter (PrD) vertically, of esophoria 5 PrD, and of exophoria 6 PrD. Soldiers wit abnormal stereopsis, myopia, hyperopia more than 1.75, or astigmatism over 0.50 diopters, were omitted. The heterophoria was tested with Herschel's prism to 5 m distance. The stereoscopic vision was investigated using Pulfrich's device and the so-called three-needle test. No statistically significant correlation could be demonstrated between heterophoria and the degree of stereopsis. Surprisingly, it could be noticed that persons with esopheria finshed Pulfrich's test more quickly than those with exophoria. This difference was statistically highly significant. In the three-needle test, the results had the same trend. This might have some importance to rangefinder men and to pilots if it can be confirmed in the military practice.

Heterophoria--its influence on stereopsis and the importance of cycloplegia in refraction testing of pilot applicants.

Heterophoria, its influence on stereopsis, and the importance of cycloplegia in refraction testing of pilot applicants were studied. Distant heterophoria was found in 94.5-100% while near heterophoria was found in 86.9-98.1% of the cases, depending on the test used. Hyperphoria of over 1 prism diopter was extremely rare. No statistically significant correlation between distant heterophoria and the degree of stereopsis could be demonstrated at a range of up to at least 6 prism diopters. Cycloplegia induced a mean difference of +0.75 diopter in refraction before and during cycloplegia. Eight percent of the applicants failed because of refractive errors (spherical extremes, -0.75 diopter and +4.50 diopters; cylindrical extreme, 1.25 diopters). It is concluded that stereopsis does not seem to be affected much by heterophoria within moderate limits, and that cycloplegia in refraction testing of young pilot applicants must be considered relatively important.