[Diverticulitis appendicis vermiformis--a case review and literature overview]. / Diverticulitis appendicis vermiformis--kazuistika a prehl'ad literatúry.

BACKGROUND: Diverticulosis and diverticulitis of appendix vermiformis is a rare diagnosis with incidency of 0.004-2%. Because of intermittent pain and atypical problems patients with diverticulitis are surgically intervened later as patients with simplex appendicitis. Complications in regard to perforation of appendix are more frequent in 27% in diverticulitis and mortality of consequent peritonitis is 30 times higher than in simplex appendicitis. PATIENTS: Authors present 0.1% incidency of diverticulitis of appendix in the group of 1496 patients with appendicitis. The case involved a man and a woman (age 59 and 61). In clinical picture predominated pain with the duration of two and three days with maximum in right lower abdomen. Patients showed no febrility, one of them had anorexia and constipation, one of them suffered from diarrhea. Mantrels score reached 5 and 7 points. In laboratory parameters elevated inflammatory markers (Leu: 1.5 x 10(9)/l, 11.44 x 10(9)l; CRP: 182 mg/l, 96.3 mg/l) were detected. Ultrasonographic examination determined the diagnosis of subacute appendicitis in one case, a perforation of sigmoid diverticle in the second case. Appendectomy was performed in both patients, there was a finding of gangrenous and phlegmonous appendicitis. In both patients, a correct diagnosis of diverticulitis was determined only through histopathological examination. CONCLUSION: Clinical and laboratory examinations did not showed a difference between progress of disease of diverticulitis and simplex appendicitis. In comparison to a control group, only a higher CRP was determined and also a 35 years higher age average. In neither case did the USG examination determine the exact diagnose. Urgent surgical operation prevented frequent complications presented in the literature.

[Chronic wound as a precancerosis (Ulcus marjolini--Marjolin's ulcer)--a case review]. / Chronická rana ako prekanceróza (Marjolinov ulkus).

Marjolin's ulcer is defined as a tumor arising from a chronic wound, scar or chronic inflammation. Commonly, it is histologically diagnosed as a squamous cell carcinoma or a basocellular carcinoma. Its management includes its excisioning including a sufficient circumferential rim and histological examination of the sentinel lymphnode. The authors present a case review of a 51-year-old male with a history of a sacral decubitus, treated for over 40 years. The patient was hospitalized to cover the defect with a skin flap. During the hospitalization, histological examinations of his inguinal lymphnodes and subsequent wound granulations were performed with an identical finding of a squamous cell carcinoma. Based on the findings, the Marjolin's ulcer was diagnosed. The patient underwent the first series of chemotherapy. However, the patient's condition deteriotated. He exited 24 days following establishment of the diagnosis. The aim of this study is to highlight one of the most dangerous complications of chronic wounds. Marjolin's ulcer is a diagnosis, which must be considered in any chronic wound of any etiology, persisting for over 3 months.

[Pulmonary thromboembolism over a 25-year period in data from the Institute of Pathology of the P.J. Safarik Medical School in Kosice]. / Výskyt plúcnej trombembólie v materiáloch Ustavu patológie Lekárskej fakulty Univerzity P. J. Safárika v Kosiciach v odstupe stvrt'storocí.

Based on a review of archival autopsy protocols an analysis of the frequency of pulmonary thrombembolism in consecutive autopsy material is presented. The study interval for the analysis was oriented to the period between the years 1949-2000. Our analysis has shown a gradual progression of incidence of pulmonary thrombembolism, as demonstrated in relative figures. The applied preventive measures against the development of thrombosis during hospitalization have not substantially contributed to decreasing its frequency, what is not in accord with some recent observations from other countries.

[Multiple intracranial and intraspinal meningiomas in the neurocristopathy (phacomatosis) type of neurofibromatosis]. / Mnohopocetné intrakraniálne a intraspinálne meningiómy v rámci neurokristopatie (fakomatózy) typu neurofibromatózy.

Presentation of a case of a "central type" neurofibromatosis in a 56-year old woman, clinically diagnosed erroneously as multiple sclerosis with a 20 years long course. Disturbances of hearing, walking, sight, sensitivity, incontinentia, intracranial hypertension and headache represented the main symptoms. More than 120 intracranial and tens of intraspinal meningiomas represented the leading postmortem finding. In a lesser frequency spinal plexiform neurofibromas and schwannomas were also found. The death was attributed to aspiration purulent bronchopneumonia. Various types of meningioma were seen microscopically, including secretory type and a type with amyloid. Immunostaining was positive with S-100 protein and EMA. Negative expression was found with vimentin, CEA, smooth muscle actin, estrogen and progesterone receptors, amyloid A and cytokeratins. With regard to the presence or absence of key morphological features the presented case was placed according to Sobol et al. (29) into the seventh category of neurofibromatosis (NF7).

[Subacute morphologic changes in the heart after radiofrequency ablation in the area of the atrioventricular junction]. / Subakútne morfologické zmeny na srdci po rádiofrekvencnej ablácii v oblasti átrioventrikulárnej junkcie.

Catheter ablation of the atrioventricular (AV) junction for due to refractory supraventricular tachycardias by means of the radiofrequency (RF) current is at present an accepted and widespread mode of therapy. Although pathomorphological findings of the early postablative period are well documented in animals, only few data are available on pathological postablative changes in humans. In this paper we present the necropsy findings in a woman who suddenly died 25 days after RF ablation of AV junction. In this case the ablative procedure has caused subendocardial necrosis revealing signs of advanced organisation with deposits of lipofuscin and haemosiderin. We have also found the necrosis of fat tissue in the vicinity of the tricuspid anulus in the stage of advanced resorption. The recent complication was the thrombotic occlusion of a small branch of coronary artery in the right atrial posterior wall causing a nonextensive acute infarction. We conclude that our findings are in agreement with the literature data on morphologic similarity of ablative lesions and reparative processes in experimental models and clinical practice. (Fig. 4, Ref. 8.)