Renal oncocytoma with invasive histopathologic features -  case report.

BACKGROUND: Renal oncocytoma is an uncommon tumor, classified as a benign renal neoplasm in the World Health Organisation classification of renal tumours. Despite it there were described several reports with invasive histopathologic features. CASE REPORT: We describe a case of renal oncocytoma with bizzare cells and invasion of renal sinus fat tissue. We performed immunohistochemical analysis of the case and a review of relevant literature. CONCLUSION: In order to set up the right dia-gnosis the perfect co- operation of clinicians and pathologists is necessary. In our opinion, in accordance with other authors, the renal oncocytomas should be considered as having a very low rather than no malignant potential, in spite of clinically benign behavior, supplementing a hypothesis, whether renal oncocytomas may be considered as a precancerous lesion of chromophobe carcinoma.

Sentinel lymph node radiolocalization and biopsy in oral cavity and oropharynx mucosal squamous cell carcinoma.

OBJECTIVES: The aims of the study were to assess our feasibility and accuracy of sentinel lymph node radiolocalization in patients with squamous cell carcinoma of the oral cavity and oropharynx, and to determine whether the pathology of the sentinel node reflected regional disease. MATERIAL AND METHODS: Patients preoperatively underwent lymphoscintigraphy after peritumoral injection of a 99m Tc labeled radiocolloid. After perioperative gamma probe radiolocalization of the sentinel lymph nodes, elective neck dissection was performed. The histopathological examination of the sentinel nodes and other nodes of neck dissection specimen were compared. RESULTS: Detection of sentinel lymph nodes by lymphoscintigraphy was feasible in all 12 patients. Also localization with a handheld gamma probe was successful in all patients. Forty sentinel nodes and 276 non-sentinel nodes were histopathologically examined. Occult metastases were confirmed in 7 sentinel nodes (4 patients). There was no false negative sentinel lymph node in our series. CONCLUSION: Identification of the sentinel lymph node in patients with squamous cell carcinoma of the oral cavity and oropharynx is technically feasible and accurate. This method shows to be able to predict occult metastases and select patients who would benefit from neck dissection (Fig. 1, Tab. 2, Ref. 28). Full Text in free PDF www.bmj.sk.

Two types of cardiovascular autonomic regulatory responses to the war.

In war, many people are not directly hurt, but they feel fear of various intensities for a long time. The response of the cardiovascular autonomic system to these conditions, produced by the bombardment of Yugoslav cities by NATO for 78 days in spring 1999, was investigated. A group of 12 active medical professionals was examined 1 and 5 weeks after the beginning of bombardment and 10 days after the end of bombardment by spectral analysis of heart rate variability. Two types of cardiovascular autonomic responses emerged. One type included a fast reaction and then adaptation; the increased activity of symphaticus compared to parasymphaticus in the beginning of war was followed by a balance of these activities after 1 month and a small increase immediately after the end of bombardment. The other type did not show an increased activity of symphaticus compared to parasymphaticus during the war, but at the end of bombardment the prevalence of vagal tone was observed.

[Patient compliance with drug therapy in temporal arteritis]. / Observance médicamenteuse dans la maladie de Horton.

OBJECTIVE: To evaluate patient compliance with drug therapy in temporal arteritis and to determine the characteristics of compliant or non-compliant patients. METHODS: Inpatients and outpatients from an Internal Medicine Unit were interviewed. Compliance with drug dosage and administration time was assessed with a questionnaire for the following drugs: glucocorticoids, calcium, vitamin D, diphosphonates (prevention of glucocorticoid-induced osteoporosis). RESULTS: Forty-nine patients were interviewed (61% female, mean age = 73.7 years). Glucocorticoids were prescribed to 96% of the patients, calcium and vitamin D to 86% and diphosphonates to 49%. Compliance with drug therapy was 87%, 60%, 68% and 51%, respectively, for all treatments. It was independent from the disease duration. Male were more compliant than female (P = 0.012). CONCLUSION: Half of the patients with temporal arteritis are non-compliant with drug therapy. The questionnaire is simple. It can be used in everyday clinical practice to study and improve patient compliance.

[Acute metabolic cataract as a first manifestation of IDDM in an adolescent girl]. / Akut metabolikus cataracta, mint az 1-es típusú diabetes elsö tünete serdülókorú lányban.

The authors present a case report of a 13.5 yrs old girl. The first manifestation of her diabetes was the sudden decrease of her vision due to bilateral cataract. There was no report of perinatal of actual infection, previous trauma, radiation exposure or drug consumption. She was hypermetropic, for that she regularly underwent ophthalmological examination, including fundoscopy. In the patient's history the usual presenting signs of diabetes i.e. weight loss, polyuria, polydipsia, weakness were absent. Upon admission in the hospital, blood sugar was 32.3 mmol/l, HbAIC 12.3%. After correction of her mild ketoacidosis and controlling her elevated serum glucose level she undervent bilateral cataract phacoemulsification, and artificial lens implant on day 14th and 58th. The patient regained her previous visual acuity, while her diabetes was controlled with 0.83 IU/kg/day of insulin. In the Hungarian literature the authors did not find any similar case. In the literature 22 similar cases were described.

Mucinous tubular and spindle cell carcinoma with Fuhrman nuclear grade 3: a histological, immunohistochemical, ultrastructural and FISH study.

Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney generally shows low nuclear grade. MTSCC with high nuclear grade is relatively rare. In this article, we report two cases of MTSCC with Fuhrman grade 3. One case occurred in a 57-year-old Japanese female and the second case in a 49-year-old Caucasian female. Histologically, the tumors were composed of neoplastic cells with cuboidal or columnar and spindle morphology, and Fuhrman nuclear grade 3. The myxoid stroma was also observed. This stroma was positive for Alcian blue stain. Immunohistochemically, neoplastic cells of both cases were positive for AMACR, but negative for CD10 and RCC Ma. Ultrastructurally, tumorous cells of one case contained numerous mitochondria. In FISH analysis, many neoplastic cells of both cases demonstrated monosomy of chromosomes 15 and 22 and disomy of chromosomes 7 and 17. One of the two patients died of respiratory failure due to pleuritis carcinomatosa 48 months postoperatively. Finally, the pathologist should recognize that high grade MTSCC exists despite its rare frequency. FISH analysis may be helpful in establishing the diagnosis of this entity. Furthermore, we present the first report of a patient with MTSCC dying of distant metastasis.

Evaluation of a novel kit for the rapid detection of extended-spectrum beta-lactamases.

Since a method of rapidly detecting extended-spectrum beta-lactamase (ESBL) production in gram-negative isolates from patients with severe infection is urgently required, the present study of a novel commercial kit was conducted. The Cica-Beta Test I (Kanto Chemical, Tokyo, Japan) is designed for the rapid detection of ESBL in gram-negative bacteria directly from isolated colonies in a 15-min protocol. In this study, a total of 304 strains of Klebsiella spp., Escherichia coli and Proteus mirabilis were tested using the novel kit and the phenotypic confirmatory disk test using cefotaxime and ceftazidime with and without clavulanate. The kit showed 95.5 and 98.1% sensitivity and specificity, respectively, as compared to the disk test, and thus proved to be an appropriate tool for the rapid detection of ESBL.

Effect of gamma-irradiation on microtubule assembly in vitro.

Microtubular protein was exposed to gamma-radiation from 500 to 1000 Gy, Within that dose range its polymerization ability was decreased by 20-60 per cent when samples were irradiated in assembled state, and by 40-75 per cent when irradiated in unassembled state. Microtubules assembled from irradiated subunits were shorter and of more uniform lengths than control microtubules. For the dose of 1000 Gy the mean length and its standard deviation were reduced to about one-half of the values of the control.

Fast disassembly of microtubules induced by Mg2+ or Ca2+.

The extent and rate of disassembly of microtubules induced by the addition of high concentrations of magnesium and calcium have been measured. At 25 degrees C, the rate constant for microtubule disassembly increases more than ten-fold on increasing [Mg2+] from 4.0 to 20 mM. The process is even more sensitive to [Ca2+], showing similar enhancement on increasing [Ca2+] from 0.5 to 8 mM. Electron microscopy indicates that the disassembly is an end-dependent process. Complete microtubule disassembly occurs at concentrations in excess of 10 and 2 mM for Mg2+ and Ca2+, respectively; this suggests the importance of binding to weak sites for both ions. The sensitivity to ionic composition explains the wide variations in the published values for k-, under varying conditions. The results indicate the potential range of microtubule disassembly rates which may be encountered under different conditions in vitro and in vivo. The highest values of k- (ca. 3000 s-1) would imply microtubule shortening rates in excess of 100 um per minute.

A model of the pH-dependence of the number of oxygen-linked chloride binding sites in hemoglobin.

A model is presented of the pH-dependence of the number of oxygen-linked chloride binding sites established by nuclear magnetic resonance quadrupole-relaxation studies on various mutant and chemically modified hemoglobins. The predictions of the model are in good qualitative agreement with the measured pH-dependences of the linewidth of the 35Cl- NMR signal. The obtained agreement implies that more chloride is bound to oxygenated than to deoxygenated hemoglobin.

Double and single exponential kinetics of microtubule assembly in vitro.

The kinetics of the microtubule protein assembly were studied in Mes buffer, pH 6.6, at 28 degrees C. The assembly under above conditions follow a kinetic expression containing two exponential terms. The observed two rate constants depend on protein concentration, and are on the order of 10(-2) sec-1 and 10(-3) sec-1. When CaCl2 is added to the system in low concentration, the kinetic expression becomes single exponential. The observed rate constant is independent of protein concentration and its value is 5 X 10(-3) sec-1. It is concluded that the double exponential kinetics correspond to favorable assembly conditions, probably to a high extent of nucleation, whereas the single exponential kinetics correspond to favorable assembly conditions, probably to a high extent of nucleation, whereas the single exponential kinetics is a slower process which occur under hindered assembly conditions.

Cross-modal plasticity of the corticothalamic circuits in rats enucleated on the first postnatal day.

Reorganization of the reciprocal corticothalamic connections was studied as a possible anatomical substrate of the cross-modal compensation of the missing visual input of the visual cortex by somatosensory-evoked activities in neonatally enucleated rats. The use of quantitative retrograde tract-tracing techniques revealed that the contribution of the lateral posterior thalamic nucleus (LP) is significantly increased following enucleation, while that of the dorsolateral geniculate and the lateral dorsal nuclei is decreased in the thalamocortical afferentation of a region in visual cortical area 17. In contrast with the control rats, a dense terminal arborization of afferents was labelled in the LP after the injection of anterograde tracer into the barrel cortex of the enucleated rats. The injection of anterograde tracer into the visual cortex also demonstrated a massive afferentation into the LP of the enucleated rats. Visual and somatosensory corticothalamic afferents exhibited similar ultrastructural features in the LP after enucleation, but their synaptic organizations differed as regards the diameter of the postsynaptic dendrites. Taken together with the previous observations, these results suggest a central role for the LP in the transmission of the somatosensory-evoked activities to the visual cortex after early blindness.