During 35 years we operated on 44 patients with pheochromocytoma, 16 of them had extraadrenal tumors (36%). We operated on 8 men and 8 women. In 5 men there was primary extraadrenal tumor, the same in 7 women. In 3 men and in one woman we operated on recurrence of tumor on another site. Mean age of the whole group was 38.3 years, in patients with recurrence the mean age was 44 years. Time distance between primary tumor and relapse was 3 to 16 years. We operated on 6 tumors on the right side, 10 on the left side. Paragangliomas on the right side were localized as follows: three tumors were under the vena cava, one tumor was dispersed multifocally, two tumors were localized before the vena cava. On the left side there was the following distribution of tumors: two tumors beneath the bifurcation of the aorta, 5 tumors paraaortally, one tumor on the wall of the aorta in the region of renal arteries, three tumors were localized in the hilus of the kidney.
At the Department of Urology in Hradec Králové five patients were treated in 1991 to 1993 with bleeding to the adrenal glands. We present our reports of these patients and stress the difficulty of preoperative diagnosis.
Histochemical localization of succinate dehydrogenase in developing intracerebral auto- and homotransplants of the mouse submandibular gland was investigated in the course of a 5-month period after transplantation. Eight weeks after grafting, the enzyme pattern in the parenchyma of homotransplants was comparable with the histochemical picture of a fully mature submandibular gland in situ. At this time, numerous acini showed a weak activity, very numerous striated ducts a strong activity, and less frequent developing convoluted granular tubules slightly weaker activity, than in the striated ducts. Beginning histochemical differentiation of convoluted granular tubules was noted only in homotransplants, located in the brain of male recipients. On the other hand, only a weak activity in the cytoplasm of non-differentiated duct--like structures of some autotransplants was seen. Homotransplants of non-differentiated submandibular gland of newborn donors were found to be a more suitable transplantation object capable of postnatal development of gland parenchyma than autografts of fully differentiated gland of adult animals that did not enter the cytodifferentiation stage.
Convulsive activity of N-(3,5-dimethoxy-4-propoxy-phenyl-ethyl)-aziridine (FAZ-4), a newly synthetized aziridine compound was studied in rats. There is a lack of tonic component of major paroxysm in comparison with the classical convulsive agent pentylenetetrazol. This effect of FAZ-4 is probably due to the forebrain mechanism without the midbrain involvement. Both anticonvulsants tested suppressed seizures in a different manner, however triazolam exerted stronger anticonvulsive activity than the same dose of diazepam did.
The level of interleukin-6 in the serum of 17 patients suffering from the primary Sjögren's syndrome and of 16 with secondary Sjögren's syndrome were determined by means of ELISA. The mean value of IL-6 in primary and secondary Sjögren's syndrome was 2.41 pg/ml (1.45-3.37 pg/ml) and 3.01 pg/ml (1.63-4.39 pg/ml). The normal serum level of IL-6 was below 3.0 pg/ml. The serum level of IL-6 was not elevated in Sjögren's syndrome patient, there was no significant difference in the serum level of IL-6 between both groups of the patients.
The cell proliferation represents one of the most relevant cellular functions. There are many approaches to assess the proliferative activity in tissues. Immunohistochemical methods offer a high sensitivity and specificity. They use monoclonal antibodies raised against specific antigens associated with the cell proliferation. Anti-BrdU immunohistochemistry detects bromodeoxyuridine (BrdU) which as an exogenous proliferation marker has been incorporated into the newly synthesized DNA of dividing cells. The best known endogenous proliferation markers are PCNA and Ki-67 that may be detected with specific commercially available antibodies. Here we describe our experience with an immunohistochemical detection of these proliferation markers. Anti-bromodeoxyuridine (BrdU) antibody binds BrdU that was exogenously introduced into the synthesizing DNA during the S-phase of the cell cycle. The precise timing and dosage of BrdU enable tissue kinetics studies. A long-time administration of BrdU may be used for labelling tissues with a low proliferative activity. BrdU incorporated into the cell nucleus is still a very stable antigen which gives a strong and reliable signal regardless the kind of fixation and further tissue processing. The proliferating cell nuclear antigen (PCNA) as an auxillary protein for DNA polymerase gamma is an evolutionarily conserved molecule that may be detected in human and animal frozen or paraffin-embedded tissues. In spite of the fact that anti-PCNA immunohistochemistry may weakly stain non-proliferating cells, PCNA is the most frequently detected proliferation marker. The staining intensity may be influenced by the kind of fixation and the length of microwave pretreatment. Ki-67 is another endogenous antigen detectable in proliferating cells. Its detection in paraffin-embedded sections requires also exposition to microwaves. Both Ki-67 and PCNA may be revealed in archival specimens that means these techniques do not require any prelabelling. Ki-67 labelling index (LI) correlates better with BrdU LI than PCNA LI as the Ki-67 antigen has a shorter half-life than PCNA.
The trophoblast may serve as an example of tissue that is endowed with invasive properties under physiological conditions. Invasiveness of the trophoblast is enabled by the secretion of various proteases capable of degrading extracellular matrix components. Trophoblast invasive behavior is strictly controlled by anti-invasive factors produced by uterine decidual cells. To assess invasive abilities of trophoblast cells we have transplanted E9 and E14 rat trophoblast (i.e. the trophoblast obtained on embryonic day 9 and 14) into the brain of adult rats. The brain parenchyma as an immunologically privileged site is suitable for acceptance of grafts of different tissues. Moreover, the trophoblast placed into the CNS lacks inhibitory influence of anti-invasive factors that normally regulate trophoblast invasivity in the course of intrauterine gestation. To visualize migration of grafted cells the nuclei of the trophoblast were labelled with bromodeoxyuridine prior to neural grafting. The transplant of E9 and E14 trophoblast cells obtained a blood nourishment from host vessels. A proper vascularization is necessary for a further transplant growth. The transplant contained labyrinthine trophoblast cells and giant cells that are typical for the rat placenta. Vital trophoblast cells were found in all grafts whose age did not exceed a lifespan of normal rat trophoblast cells i.e. 21-22 days. In the centre of the graft, no blood vessels were observed. Interstitial spaces of neighbouring trophoblast cells were filled with the host blood and morphology of these spaces mimicked lacunae of the placental trophoblast. E9 and E14 rat trophoblast continued to differentiate after transplantation into the CNS of adult rats. Histological structure of the grafts were compared with microscopical morphology of the normal rat placenta. E9 and E14 trophoblast is considerably differentiated and it does not invade a neighbouring tissue. Trophoblast cells located at t the graft periphery may migrate on free surfaces but they do not invade through the host parenchyma. Migration occurs at a limited distance from the transplant and the cells remain in a close contact with other trophoblast cells in the graft via their cytoplasmatic processes. The ability to lyse host blood vessels and form vascular lacunae is well preserved in E9 and E14 trophoblast after grafting into the CNS. This ability is necessary for a proper transport of nutrients from the host blood stream to fetal tissue that normally occurs in the placenta.
In addition to standard pattern-reversal VEPs, the motion-onset VEPs were examined in 50 patients with acute unilateral retrobulbar neuritis (RN) and in 187 patients with possible or definite multiple sclerosis (MS). In MS patients (without sign or history of RN), the results of both types of VEPs correlated only partially. 26.2% of them displayed changes only in the motion-onset VEPs having the pattern-reversal VEPs completely normal. That is why we suppose that the magnocellular system (tested by motion-onset VEPs) can be affected by demyelination separately. In 28 patients with "pure" RN (without any other sign indicating demyelination disease) the always abnormal pattern-reversal VEPs were accompanied by delayed motion-onset VEPs in only 28.6% of patients. In contrast, much higher rate--68.2%--of delayed motion-onset VEPs was found in the 22 RN patients simultaneously suspected of MS These results indicate that RN affects predominantly the parvocellular visual system (tested by reversal VEPs). Distinct latency changes of the motion-onset VEP's in RN patients seem to signal a linkage between RN and demyelination.
The effects of the repeated i.v. administration of daunorubicin (50 mg/m2, once weekly, max. 9 weeks) were investigated in rabbits in vivo to analyze biochemical and hematological changes. Noninvasive polygraphic records were used to evaluate the function of the heart. The administration of daunorubicin induced changes especially in levels of protein (decrease in total protein and albumin) and of some ions (decrease in calcium, magnesium and phosphorus) as well as in hematological parameters (decrease in erythrocytes, leukocytes and thrombocytes). The results obtained correlate with data on mechanisms of daunorubicin toxicity.
Unique character of brain tumors and problems inherent in different concepts of histological classification are impediments to effective histoprognosis. Large place for subjectivity may be diminished by integration of kinetics data into evaluation of tumor samples. Methods of measuring cell proliferation include immunohistochemical detection of halogenated or tritiated pyrimidine analogues after intravenous injection and nuclear antigens associated with the cell cycle, other methods are selective silver staining and modified flow cytometry. In this study, the literature concerning the use of proliferation markers in neurooncology is reviewed and the problems consisting in used methods are pointed out. The most reliable markers and techniques are recommended and situations of special importance for the cell proliferation markers use specified.
In 1991-1993, 52 patients underwent surgery for low-grade supratentorial glioma. In 37 of them (astrocytoma 22, oligodentrocytoma 12, oligodendroglioma 2) seizures, often refractory to drug therapy, appeared as the first symptom. These cases were retrospectively analyzed. The patients had partial seizures: simple, complex, or secondarily generalized (preoperative duration: from 3 days to 17 years (mean 2 years); frequency: between 1 and 2/year and over 10/day). Neurological examination either revealed slight focal changes or was normal. Conventional craniotomy and resection of a tumor, without intraoperative electrocorticography, was performed. Partial resection was performed in 73%, subtotal in 5%, "total" in 22% of the cases. Postoperatively, 27 patients had focal radiotherapy, 3 of them in combination with chemotherapy. Two patients were reoperated. Out of 33 alive (89%), about two-thirds appear normal by neurological examination and are seizure-free at present (mean follow-up period 28 months). Most remain on antiepileptic drugs at lower doses. Histological and immunohistochemical analyses of resected tissue together suggest that the peripheral zone of cortical tumor infiltration may participate on epileptogenesis.
Dyspnoea perception in patients with asthma bronchiale varies considerably in the course of their disease intra- and interindividually. The variability tends to be age dependent, elderly patients being less aware of even severe obstruction. Blunted perception of progressive airway narrowing has been identified, as an independent risk factor of severe asthma attacks or even asthma induced death. Such patients should be provided with a peak flow meter for home objective monitoring of airway obstruction. Simultaneously, a written action plan of how to manage an impending asthma attack should be available. A small number of asthmatics has been shown demonstrate excessive dyspnoea perception when no or minor airway obstruction could be established objectively. These patients could also profit from offering them a home peak flow meter due to the calming of their distress when no airway obstruction was measured and avoiding them of drug overuse.
We demonstrated that proliferation of dissociated neural E14 and E19 rat precursor cells could be induced by Long-EGF. Dividing EGF-responsive neural progenitor cells stimulated by Long-EGF formed spherical multicellular clusters (neurospheres) which may reach macroscopical size. We have studied the inner organization of cells in semithin sections and revealed that the cell population within the neurosphere is not uniform. These are original findings as other researchers did not process neurospheres histologically. Cells located in a central area possessed neuron-like morphology whereas peripheral cells where differentiated to a lesser degree. Generally, we have observed several apoptotic cells or apoptotic bodies per section. Moreover, the central portion of the neurosphere contained degenerating cells that probably die from worsened nutrition conditions in the large neurosphere. After plating the neurosphere in serum-supplemented medium, cells began to migrate radially from the edge of the neurosphere and differentiate. The cells lying in the vicinity to the cluster mimicked radial glia whereas the cells located at the periphery of the colony took morphology of astroglial cells. These observations suggest EGF-responsive neural precursor cells retained their ability to produce both neuronal and glial phenotypes after prolonged cultivation period.
Methylnitrosourea (MNU) was applied by gavage into the stomach in a dose of 123.1 mg/kg. Hydroxyurea (250 mg/kg) and 6 (3)H thymidine (dTh - 2 MBq/g) were injected intraperitoneally. DNA repair synthesis as the labelling of non-proliferating cells was most reliably established in the testicles, bronchi, duodenum, kidney, liver and pancreas after 3 months to 3 years exposure of the histoautoradiograms. The findings in the stomach and rectum are near to this group. Less reliable positivity was found in the adrenals, urinary vesicle, spleen and heart, while in the musculature of the abdominal wall and in the thymus the results were negative. There is some correlation of these results with literary data about organ specific development of tumors after orally applied MNU to mice. This suggests wide applicability of this autoradiographical method. The possibility of increasing the dose of 3H thymidine is also discussed.
We analysed 22 patients suffering from migraine to evaluate the possible activation of platelet function utilizing the following methods: platelet factor 4, thromboxane B2 and 6 - keto prostaglandin F 1 alpha levels in platelet poor plasma. Laboratory tests were performed on all patients during headache-free period and the results obtained were compared with those of a normal healthy individuals. The mean results obtained in the patients group during pain-free period indicated a significant activation of platelet function when compared with the normal group.
A Czech version of the Schmeck's ILP inventory was administered to 1898 university and college students from Bohemia, Moravia and Slovakia. Factor analysis identified six factors which explained 73% of data variance. The Czech version is shorter as compared to the original and includes 49 items; its reliability is satisfactory. Our experience showed that ILP-CZ inventory could be used in senior classes of secondary (high) schools, and in both undergraduate and graduate studies. The inventory can be used both for screening at the beginning of university and/or college studies and counselling services offered during the study.
Vascularization of some organs of rat following soman (O-pinacolyl methylphosphonofluoridate) intoxication was studied using scanning electron microscopy. Corrosion casts were prepared with commercially available methyl metacrylate monomer which was partly polymerized, supplemented with catalyst and accelerator and injected into the prewashed and fixed vascular bed. The obtained corrosion casts were sectioned and trimmed using a stereoscopic light microscope. Microvascular casts of normal organs', bed pattern were studied under scanning electron microscope and compared with vascularization patterns after soman poisoning. Changes in the vascular bed architecture of kidneys, brain, adrenal glands and thymus were described.
During 35 years we operated on 44 patients with pheochromocytoma, 16 of them had extraadrenal tumors (36%). We operated on 8 men and 8 women. In 5 men there was primary extraadrenal tumor, the same in 7 women. In 3 men and in one woman we operated on recurrence of tumor on another site. Mean age of the whole group was 38.3 years, in patients with recurrence the mean age was 44 years. Time distance between primary tumor and relapse was 3 to 16 years. We operated on 6 tumors on the right side, 10 on the left side. Paragangliomas on the right side were localized as follows: three tumors were under the vena cava, one tumor was dispersed multifocally, two tumors were localized before the vena cava. On the left side there was the following distribution of tumors: two tumors beneath the bifurcation of the aorta, 5 tumors paraaortally, one tumor on the wall of the aorta in the region of renal arteries, three tumors were localized in the hilus of the kidney.
This report describes an unusual case of 35 year old man with endotracheal mesenchymoma. He was treated for two years as asthmoid bronchitis or asthma without any favourable result. The diagnosis was established by x-ray tomography and the patient was referred to the surgical treatment. The tumour was removed and the trachea was reconstructed. Postoperative course was very good. The patient is doing well without recurrence many years following the operation.
Measurement of tissue impedance is a simple objective method for the localization of intracranial structures. Continuous bipolar impedance monitoring was performed during various CT-guided stereotactic procedures in 36 patients with brain pathology. The obtained values of the impedance profile along the trajectory were compared with the tissue density on CT scans or angled coronal and sagital CT reconstructions intraoperatively. The main goal was the selection of optimal biopsy targets and safe probe trajectory. Histologic findings of serial transtumoral biopsy were retrospectively correlated with both CT (or MRI) transposed data and patterns of tissue impedance. Intraoperative impedance monitoring enhanced the accuracy and safety of CT-guided procedures. The histologic examination of representative tissue samples avoids the risks of "blind" surgical or radiation management. This technique is reported with 6 illustrative cases.
