[Diagnosis of the Zollinger-Ellison syndrome. I: Significance of anamnestic, clinical and laboratory examinations]. / Diagnostika Zollingerovho-Ellisonovho syndrómu I.: význam anamnestických, klinických a laboratórnych vysetrení.

The authors describe the diagnostic algorithm of Zollinger-Ellison's syndrome which proved useful in the diagnosis of 73 patients with a confirmed diagnosis. They evaluate the diagnostic validity of anamnestic and clinical data, of different examination methods and compare them with experience assembled abroad. For the diagnosis of sporadic gastrinomas the onset of the disease after the age of 40 years is important, the development of serious peptic complications (haemorrhage F-70%, M-59%, perforation M-54%, F-47%) and the presence of watery diarrhoea (41%). As to laboratory parameters they rely on high BAO values (96% > 15 mmol H+/hour and 100% > 5 mmol H+ after gastric resection. Less important is the examination of basal serum gastrin (almost 30% patients have normal or liminal values of BSG--empirically set at 100-150 pg. ml-1). The authors draw attention to the fact that patients with ZES after gastric resections may have BSG values lower than 100 pg/ml (12%). A positive secretin test has a higher validity (rise of SG by 150-200 pg. ml-1 above basal values) positive in 82.2% patients, liminally positive in 11% and negative in 6.3% patients. An even higher diagnostic value was possessed by a BAO/MAO index higher than 0.6 which was positive in 93.4% patients. At present it is not used as pentagastrin is not available. Every year they diagnose 4-6 new cases of ZES which with regard to the number of inhabitants (5 million) places Slovakia along with Denmark and Sweden among the countries with the highest detection rate (0.8-1.2 ZES cases/1 million per year).

[Deep soft-tissue leiomyoma]. / Leiomyóm hlbokých mäkkých tkanív.

Deep soft tissue leiomyomas (DSTL) are very rare. For this reason they are neither histologically, nor clinically reliably characterized, especially regarding their dignity. The authors present two cases of leiomyomas which grew from the deep soft tissue in the region of the head and perineum. Both cases involved women 43 and 63 years of age. Characteristically morphological traits, as e.g. good borderline of lesion, the presence of fibrous pseudocapsule, and classical morphologic appearance of leiomyoma were present in both cases. While in the first case the foci of dystrophic calcification within regressively altered foci of the tumour were found, the second case involved the presence of foci of myxohyalin degeneration of stroma. The first tumour contained also parts with a palisade arrangement of nuclei which gives a hint of resemblance to that of neurilemmoma. Mitoses did not exceed the HPF index of 2/10 in neither of the cases. Both cases were S-100 immunohistochemically negative, actin and human muscle actin were significantly positive, desmin was weakly or mediately positive, and vimentin significantly or mediately positive. The first case involved a clinical recurrence of a histologically verified leiomyoma after 5 years in the same location with MI being of zero value. Regarding the presented characteristics, the authors classify the described leiomyomas as DSTL. These tumours with an uncertain prognosis can metastatize despite their benign morphology. (Tab. 2, Fig. 4, Ref. 19.)

[Pathologic interpretation and clinical aspects of invasive basalioma]. / Invazívny bazalióm v interpretácii patológa a klinika.

Bioptic evaluations of basaliomas require from pathologists to perform histogenetic classification, type ascertainment, TNM system classification, as well as detection of the presence or absence of tumor elements on the margins and base of excisions. The systems of histologic type classification of basaliomas utilized by pathologists are inconsistent with the terminology used by clinicians. The presented work is aimed at correlation of the current terminology of invasive basaliomas from the view of dermatologists and pathologists. The method of retrospective study was used, namely in a 100 cases of histologically verified basaliomas followed by comparisons with clinical diagnoses and catamnestic data. Average age in male patients was 66.4 year, and 67.6 year in female patients. 11 cases of histologically ascertained types of basaliomas included two cases of invasive biological characteristics detected at control examinations after 3 months, while the margins and base of the former excisions were without tumor elements. In none of the 9 cases of clinically judged invasive basaliomas the histologic picture yielded signs of tumor invasiveness. The results imply that the clinical diagnosis of a variant of basalioma may represent information of its presupposed characteristics. An important task of a pathologist is however to notify by means of accurate ascertainment of the histologic variant in cases of morpheaphorm and fibroepithelial basalioma the possible invasive character of the particular tumor. (Tab. 4, Ref. 14.)

Carcinoma of the colon after ureterosigmoidostomy and trigonosigmoidostomy for exstrophy of the bladder.

Two cases of adenocarcinoma of the colon developing 28 and 33 years after ureterosigmoidostomy and trigonosigmoidostomy are described. The mechanisms of neoplastic transformation and the clinical implications are discussed.

[Crohn's disease of the stomach]. / Crohnova choroba zalúdka.

The authors describe the incidence of Crohn's disease at an uncommon site the stomach--in a 40-year-old man. With regard to the steadily increasing incidence of the disease, it is important to consider its presence also in uncommon sites in the gastrointestinal tract. The establishment of the diagnosis must be comprehensive, as even histological examination of endobioptic specimens or resected portions need not be unequivocal from the diagnostic aspect.

[Biometric data of normotrophic neonates]. / Niektoré biometrické dáta normotrófnych novorodencov.

Gestation age of a neonate could be estimated approximately by a pathologist according to some macroscopical features. In addition to the weight of large organs the authors studied weight of other organs and some biometrical data in a group of 84 normotrophic neonates. Regressive analysis gave information about the growth trend of organs; compared with tables it enabled to find out the growth retardation of a neonate or his single organ. The span of fingers represented a precise statistical figure for the estimation of gestation age in addition to the weight of organs.

[Evaluation of the mucosal surface relief of the small intestine in neonates]. / Hodnotenie sliznicného reliéfu tenkého creva u novorodencov.

Immature neonates have slim thread-like villi of uniform length. More matured children have rougher villi with initial club-like expansion of the tip. Later there is a triangular broadening at the base of villi and at last tongue-shaped villi occur. They develop quickly in early days of life of an immature child and simultaneously with broader square villi and crest-like formations. This phenomenon is far more expressed in immature neonates than in matured ones.

Coeliac disease in monozygotic twin girls. Synchronous presentation.

A pair of monozygotic twin girls with coeliac disease is reported. The diagnosis was made on clinical and biochemical evidence of malabsorption, characteristic histological findings, and clinical, biochemical, and histological response to gluten elimination. Monozygosity was established on finding a single placenta at birth, exact similarity of physical appearance, similar blood group, and histocompatibility antigens, and negative reaction in mixed lymphocyte culture. This is one of six well documented cases of coeliac disease in monozygotic twins and may throw light on the importance of genetic and environmental factors in the causation and expression of the disease.