Overexpression of p53 and MDM2 proteins in cervical neoplasia.

Sixteen methacarn-fixed and paraffin-embedded cervical squamous lesions were examined using monoclonal antibodies to p53 and MDM2 in order to compare the expression of both proteins in cervical neoplasia. Standard avidin-biotin or streptavidin-biotin immunoperoxidase techniques were employed. The results show that the overexpression of both proteins takes place in a meaningful proportion of cervical neoplastic lesions. The expression of either protein is not very frequent in CIN 1 and 2. The overexpression of either p53 (9/12) or MDM2 (4/10) proteins was recorded in the group of more advanced lesions, their level fluctuating from 10% to 60% positive cells. The results suggest the possibility of an interaction of the p53 and MDM2 proteins in some cases of cervical neoplasia.

Inhalation injury.

Inhalation injury is an acute insult of the respiratory tract, caused by steam or toxic inhalants. A suspicion of inhalation trauma (closed-space exposure, facial burns, etc.) is an indication for an immediate endotracheal intubation. Precise objective case history is also very important point for making the diagnosis. Up-to-date methods of examination in case suspicion of inhalation injury are described in our contribution. The main therapeutical points are mentioned as well.

[Central pontine myelinolysis]. / Centrální pontinní myelinolýza.

The authors describe a case of central pontine myelinolysis in a 43-year-old female alcoholic, confirmed by post-mortem examination, as for technical reasons in lifetime neither CT nor MR examinations could be made. Despite the relatively scarce incidence of the disease, as mentioned in the literature, this possibility must be taken into consideration in particular in young alcoholics.

[Peroperative cytologic diagnosis]. / Peroperacní cytologické vysetrení.

Author performed intraoperative cytology of 236 pneumomediastinal processes, 251 mammary and 45 other focal lesions. He used fine needle asperation or scraping of pathological tissue and hematoxylin-eosin staining of smears. Diagnosis of pulmomediastinal processes was reliable in carcinomas, chondrohartomas, and polymorphocellular sarcomas. Unreliability as to biological behaviour was found in identification of low grade malignant mesenchymal tumours which needed histology. Cytokeratin expression verified the diagnosis of thymoma from routine staining and enabled cytological and histological identification of extensive bronchioloalveolar epithelial hyperplasia associated with specific and unspecific inflammations or marginally with primary as well as secondary epithelial and mesenchymal malignant tumours and melanomas. Intraoperative cytology of mammary lesions succeeded in identification of nonmalignant processes and of 94 from 97 carcinomas (remaining 3 having been left for histology). As a rule, intraoperative cytology yielded a prompt information about investigated process' nature which was necessary for defining the extent of surgery, further information was completed by histology.

[The cytology laboratory of the 2d Institute of Pathology and Anatomy in Brno (present status, perspectives, problems)]. / Cytologická laborator II. patologicko-anatomického ústavu v Brne (soucasnost, perspektivy, problematika).

The laboratory was engaged in exfoliative cytology, mainly of sputa and investigated 1450 hospitalized patients and 1410 smokers in a screening campaign during the last year. Another programme included cytology of bronchoscopical materials (2480 patients a year), fine needle aspiration cytology (550 patients), and peroperation cytology, mostly pulmonary and mammary (125 patients). A limited number of exfoliative and bronchoscopical materials could have been examined in correlation with the number of medical technologists for screening and preliminary evaluation. The laboratory shared immunochemical facilities and computerized registration of results with the others in the Institute. For future, the laboratory reckons with an increase of aspirations taken by visualization methods and with development of special technologies of material processing and evaluation.

[The diagnostic significance of cytological and histological examination of secretions, washout materials, catheterization and brush biopsy materials in the diagnosis of malignant bronchopulmonary diseases]. / Diagnostický význam cytologických a histologických vysetrení sekretu, výplachu, katetrizacních a sterových biopsií v diagnostice maligních bronchopulmonálních onemocnení

Referring to their group of 325 patients examined by means of all-around endobronchial biopsy material withdrawal the authors present the results of cytological and histological diagnosis. Endobronchially material obtained by direct aspiration of bronchial secretions, by wash-outs, and by catheterization and brush biopsy represents, particularly in peripheral localizations, a significant and often decisive contribution to the objectivization of malignant affections. The authors present and discuss morphological criteria of malignity derived from endobronchially obtained material processed by the method of cytoblocks stressing, at the same time, the possibility of an accurate localization of the pathological process down to the particular segment involved.

[Use of bronchoalveolar lavage in the diagnosis of pulmonary complications in immunocompromised patients]. / Vyuzití bronchoalveolární laváze pro diagnostiku plicních komplikací u nemocných s porusenou imunitou.

The authors examined, using bronchoalveolar lavage, 70 immunocompromised patients with pulmonary complications. The bronchoalveolar fluid was subjected to cytological and microbiological examination. The examination was not associated with any serious undesirable side effects, not even in patients who were in a serious general condition. Based on the examination the treatment was changed in 83% of the patients and the correctness of treatment was confirmed in 7% of the patients. In 76% of the patients the condition improved. It was possible for instance to diagnose pneumonia caused by Pneumocystic carinii, the Herpes simplex virus and fungi even in patients who did not expectorate sputum. The authors hold the view that this examination should be indicated early.

[Pulmonary infection with Pneumocystis carinii in patients with malignant hematologic diseases]. / Plicní infekce Pneumocystis carinii u nemocných se zhoubnými hematologickými chorobami.

The authors describe their experience with the diagnosis of pulmonary infection with Pneumocystis carinii in patients with malignant diseases. In the course of three years they recorded a total of 16 such cases. All cases were diagnosed by bronchoalveolar lavage. The authors analyze in detail the clinical symptoms and radiological picture. Attention is drawn to the fact that no finding is specific for the disease. The infection of Pneumocystis carinii was combined in 13 cases with another infection. Treatment was successful in 75% of the patients.

[Diagnosis of mycotic infections in oncology patients using the polymerase chain reaction]. / Diagnostika mykotických infekcí u onkologicky nemocných pomocí polymerázové retezové reakce.

Diagnosis of mycotic infections is despite the immense effort devoted to this problem still very inaccurate. A new and promising method is the polymerase chain reaction, PCR, which theoretically can detect a single cell. In their original study the authors decided to develop a new method for the detection of fungi by PCR and to compare this examination with post-mortem findings. Thus it was possible to determine sufficiently reliably the sensitivity and specificity of the method. For the detection of fungi the authors selected the sequence coding for a small subunit of ribosomal RNA (18S rDNA). The method is able to detect the amount of DNA from some 10-100 cells. The sensitivity was 90% and the specificity 92%. The method is so far too laborious for common practice, its simplification would be however very useful.

[Peroperative biopsy and cytologic diagnosis of pulmonary lesions]. / Peroperacní biopticko-cytologická diagnostika plicních lézí.

Smears obtained by thin-needle aspiration and scrapings from 116 patients with pulmonary lesions were evaluated on operation after opening of the thoracic cavity. With regard to the macroscopic character of the process and clinical data it thus proved possible to differentiate 37 benign lesions and 79 malignant tumours which could be identified in the majority. The method proved to be rapid, reliable and economical, if aptly used and when the diagnosis is made by an experienced worker.

Efficacy of polymerase chain reaction for detection of deep mycotic infections: confirmation by autopsy.

A method based on polymerase chain reaction (PCR) amplification of fungal 18S rDNA sequences was tested for the detection of fungi in blood samples. In order to increase sensitivity and specificity, PCR products were hybridized to the radioactively labelled fragment of 18S rDNA gene. Blood from 28 patients with haematological malignancies was taken immediately after death and the results of PCR analysis were compared with results of autopsy examination. To the best of our knowledge, no study of such a design has been published previously. PCR analysis turned out to be very sensitive (92%) and specific (92%) as well as capable of detecting various kinds of fungal infections (localized as well as generalized).