Gastric hyalinization as a possible consequence of corrosive injury.

We report a case of gastric obstruction due to hyalinization of the antrum. The endoscopic appearance of the lesion was suggestive of Crohn's disease or gastric neoplasm. Biopsy showed pseudopolypous gastritis with ulceration and fibroid granulation. Surgery was carried out to relieve the obstruction. Examination of the resected specimen showed massive hyalinization of all layers of the antral wall with circular collagenous infiltration and a normal duodenal bulb. The question of hyaloid gastritis as a unique entity is raised. Subsequently, information from the patient revealed the cause: voluntary acid ingestion causing corrosive injury.

[Metastasis in metastasis]. / Attét az áttétben.

Double metachron neoplasm was found in a 75 year-old man by the authors, myxoid chondrosarcoma as primer neoplasm of the right leg, and cecum adenocarcinoma. In the centre of myxoid chondrosarcoma's metastasis of the lung adenocarcinoma metastasis occurred. Metastasis in metastasis is a histological rarity.

Intrastromal corneal ring, a new refractive surgical technique to decrease myopia. Experimental and clinical results.

From among the wide range of keratorefractive operations, the authors applied the intrastromal corneal ring (ICR) technique to treat myopia. The results of operations performed on dogs' eyes were evaluated using slit lamp investigations, cornea topography and histological investigations. In the possession of favourable results, this kind of operation was successfully performed on three patients suffering from expressed unilateral myopia, too. The desired optical results (10.0 dioptres) proved to be permanent 3-10 months after surgery and were demonstrated by the patients' visual acuity as well as cornea topographic examinations. The surrounding of the PMMA ring situated intrastromally and the substance of the cornea remained calm and clear, respectively. The authors think that the ICR technique can successfully be applied in the treatment of myopia similarly to refractive surgical interventions such as radial keratotomy (RK) and excimer laser photorefractive keratectomy (PRK), which are widely used methods these days.

Dose-response comparisons of five lung surfactant factor (LSF) preparations in an animal model of adult respiratory distress syndrome (ARDS).

1. We have examined the effects of five different lung surfactant factor (LSF) preparations in the rat lung lavage model. In this model repetitive lung lavage leads to lung injury with some similarities to adult respiratory distress syndrome with poor gas exchange and protein leakage into the alveolar spaces. These pathological sequelae can be reversed by LSF instillation soon after lavage. 2. The tested LSF preparations were: two bovine: Survanta and Alveofact: two synthetic: Exosurf and a protein-free phospholipid based LSF (PL-LSF) and one Recombinant LSF at doses of 25, 50 and 100 mg kg-1 body weight and an untreated control group. 3. Tracheotomized rats (10-12 per dose) were pressure-controlled ventilated (Siemens Servo Ventilator 900C) with 100% oxygen at a respiratory rate of 30 breaths min-1, inspiration expiration ratio of 1:2, peak inspiratory pressure (PIP) of 28 cmH2O at positive end-expiratory pressure (PEEP) of 8 cmH2O. Two hours after LSF administration, PEEP and in parallel PIP was reduced from 8 to 6 (1st reduction), from 6 to 3 (2nd reduction) and from 3 to 0 cmH2O (3rd reduction). 4. Partial arterial oxygen pressure (PaO2, mmHg) at 5 min and 120 min after LSF administration and during the 2nd PEEP reduction (PaO2(PEEP23/3)) were used for statistical comparison. All LSF preparations caused a dose-dependent increase for the PaO2(120'), whereas during the 2nd PEEP reduction only bovine and recombinant LSF exhibited dose-dependency. Exosurf did not increase PaO2 after administration of the highest dose. At the highest dose Exosurf exerted no further improvement but rather a tendency to relapse. The bovine and the Recombinant LSF are superior to both synthetic LSFpreparations.5. In this animal model and under the described specific ventilatory settings, even between bovine LSFpreparations there are detectable differences that are pronounced when compared to synthetic LSFwithout any surfactant proteins. We conclude that the difference between bovine and synthetic LSFpreparations can be overcome by addition of the surfactant protein C.

[Eosinophilic leukemia: a rare form of Philadelphia chromosome negative chronic myeloid leukemia?]. / Eosinophil leukaemia: a Philadelphia chromosoma negatív krónikus myeloid leukaemia ritka formája?

Eosinophil leukaemia is a rare and poorly defined entity characterized by neoplastic proliferation of eosinophil cell line. This form of the hypereosinophilic state is considered to be a variant form of CML, although as a diseases entity is not generally accepted. A history of a patients is reported, whose clinical course is thought to fulfill the requirements of eosinophil leukaemia. On the basis of the initial results (pathological lymphogram, eosinophilia, Ph-negativity) lymphogranulomatosis was suspected and explorative laparotomy was performed. However, only marked eosinophilic infiltration of the spleen was detected. After splenectomy his disease was stable without treatment for six months when his leukocytosis and eosinophilia increased. Despite the administration of hydroxyurea the leukocyte count exceeded 100 x 10(9)/l (eosinophil cells 70%), and the bone marrow revealed massive (80%) eosinophilic infiltration. Neither Ph-chromosome, nor cabl and bcr gen rearrangement were demonstrated, but the expression and amplification of c-myc oncogene indicated disease progression. Interferon therapy produced long-term clinical and haematological improvement, but blastic transformation was developed in the second year of his disease. Autopsy showed multiple organ involvement characteristic of CML, but no marked eosinophilic infiltration was found. The feature of this case suggest that eosinophil leukaemia might represent an uncommon form of Ph-negative CML.

[Ulcerative colitis associated with pyoderma gangrenosum]. / Pyoderma gangrenosummal járó colitis ulcerosa.

The authors present a 42-year-old man's case in whom the onset of chronic ulcerative colitis and pyoderma gangrenosum was simultaneous. Pyoderma gangrenosum began as bullae on his chest and lower limb. The main symptoms were fever, anaemia, hypoproteinaemia beyond the skin lesions, and the abdominal symptoms characterizing chronic ulcerative colitis were absent. The thorough internal check-up and the micribiologic and histologic examinations of the skin disorders made clear that the lesions mentioned were the skin symptoms of a systemic disease. Sulfasalazin and prednisolone therapy of the underlying disease and the local non-specific treatment of the cutaneous lesions resulted together in the patient's rapid improvement. The authors give a brief review of pyoderma gangrenosum and of the connection between pyoderma gangrenosum and chronic ulcerative colitis.

Cytophotometric investigations on atypical epithelial cells of the human seminal vesicle.

Normal seminal vesicles were studied histologically in 80, and by Feulgen's cytophotometric method in 10 autopsied cases (males, 44-82 years of age). In every case large, hyperchromatic nuclei were found. By cytophotometry euploid polyploid atypia was also shown in every case, which is characteristic of benign hormonal dysplasia.

Clinical analysis of patients with non-Hodgkin's lymphomas (1965-1985).

Clinical and histopathological data of 307 patients with non-Hodgkin's lymphoma (NHL) was reviewed applying the Kiel histopathologic classification scheme and the Ann Arbor clinical and pathologic staging system. The first group included 74 patients who were diagnosed as having lympho- and reticulosarcomas during the 1965-1974 period. The case histories and histological diagnoses of these patients were retrospectively reevaluated. These patients were given orthovoltic irradiation and single agent chemotherapy. The second group included 233 patients who were entered into a prospective study from 1975 onwards. These patients were given combined polychemotherapeutical regimes. The comparative investigation has shown that the proportion of the low and high grade NHLs were the same in the groups. The administration of the new chemotherapeutical regimes did not influence significantly the survival of NHL patients.

Bizarre leiomyoma of the prostate.

Obstruction of the urethra, caused by a prostatic tumour necessitated prostatectomy in a 49-yr-old man. Histology revealed a moderately cellular and vascular tumour with marked cellular atypia. After a follow-up for three years, the results of both the clinical investigations and prostatic needle biopsy were negative. Thus the original opinion of malignant prostatic mesenchymal tumour was revised, resulting in the diagnosis of bizarre leiomyoma. Subsequently the smooth muscle cell origin and the benign nature of the tumour were demonstrated by electron microscopy and Feulgen-cytophotometry, respectively. This is the first prostatic bizarre leiomyoma in which malignancy was excluded by demonstrating euploid polyploidy. This case also calls the attention to the need of more sophisticated methods in everyday diagnostic pathology.

BCG immunostimulation in primary pulmonary cancer (a clinical, immunological and radiological study).

The authors reported the results of a clinical, radiological and immunological study of 147 primary pulmonary cancer cases who were immunostimulated with BCG vaccine over a period of three years between 01.01.76 and 31.12.78. Compared with the same number and stage of cancerous patients treated with the same cytostatic drugs and/or surgically without BCG immunostimulation, the survival rate of the immunostimulated group was higher than that of the control group. The radiological picture did not change during the study time in 45% of the patients, regression was observed in 34%, and progression in 21% in the Stage I vaccinated group, while in the control Stage I group regression was only noticed in 21%, and progression was observed in 50%. In the Stage II vaccinated group regression was noted in 48%, in the control group in 23%. No favourable changes were noted in Stage III groups, neither in the vaccinated nor in the nonvaccinated cases. The more favourable prognosis of the immunostimulated group was reflected in the results of the skin tests and in the cellular and humoral immunological responses too. The modification of the BCG immunostimulated pulmonary cancer patients gives a statistically significant prolongation of survival time and a beneficial improvement of life quality and expectation.

Malignant fibrous histiocytoma of the mediastinum.

A case of malignant fibrous histiocytoma in the right postero-superior mediastinum in a 43-year-old male patient is presented. He was operated on and a part of the tumor including the infiltrated second segment of the lung was resected. At reoperation, the great vessels were found infiltrated by the tumor and radical exstirpation could not be carried out. The patient died 4 months after discovery of his disease due to further growth of the tumor. This case is the fifth malignant fibrous histiocytoma of the mediastinum described in the world literature.