[The role of electron microscopic detection of viruses and its possible value in autopsy material].
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Biomedical subjects
Publications and source records attributed to G Kendrey.
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Surgical liver biopsy specimen of a women aged 58 with "biliary complaints" showed amyloid deposits of unknown nature. After a nearly two-years-course of the disease the patient died of cardiac and renal failure. Clinical findings and laboratory tests without abnormal serum globulins suggested primary amyloidosis. Morphologically amyloid was present in the heart, tongue, striated muscles and in many parenchymatous organs and endocrine glands. By electron microscopy no difference was revealed between the primary and secondary type, respectively. Differenciation between primary and secondary form of the amyloid could only be achieved by the demonstratin of resistance of the deposits against induced proteolysis with trypsin digestion under the polarization microscope. The same result was obtained in two cases of senile amyloidosis. The case presented indicates that increased level of pathologic globulins is not an obligatory phenomenon in primary amyloidosis.
In the second liver biopsy material of a seropositive patient receiving immunosuppressive therapy (Corticosteroid + Imuran) for chronic active hepatitis (CAH), intranuclear, ring-shaped, 20--25 nm in diameter non-coated particles (core) of liver cells and intracisternal filaments, 23 nm in diameter (coat) of the soft ER in the "ground-glass" hepatocytes were demonstrated by electron microscopy. Core-particles in the cytoplasm were seen occasionally. Dane-particles could not be visualized. Cytoplasmic spherical and ring-shaped virus-like structures (circ. 80 nm in diameter) different from B-virus components and Dane-particle were also found (second virus-infection?). The role of immuno-suppression in the appaerance of viral structures is considered because such particles could not be detected in the first biopsy before therapy when CAH and antigenaemia were already present.
Author in the needle-biopsy specimen of the liver of a HBsAg positive patient previously treated with immunosupressive preparates (Corticosteroid + Imuran) in the nuclei of hepatocytes by the aid of electron microscope revealed ring-shaped particula of 20-25 nm in diameter (core), in the cytoplasma of ground-glass hepatocytes in the canals of the rough-surfaced endoplasmic reticulum filamentous formations in average of 23nm in diameter (surface antigen). In addition in a few number cytoplasmic core particula have also been revealed. Dane-particula were not seen. Further in the cytoplasma round or ring-shaped virus-like bodies of unknown origin of 80 nm in diameter were found. These particula could be easily distinguished from the Dane particula and from the B virus components (a second virus infection?). Author believe, that the immunsupressive therapy could play some role in the occurrence of the B virus components, since before the therapy with Imuran they could not be detected in the liver.
The core and coat of hepatitis B virus were found by electron microscopy in parenchymal cells of a liver biopsy from a 61 year old man with chronic active hepatitis and cirrhosis of the liver. Laparoscopy, 35 days after liver biopsy, and autopsy 42 days later confirmed the cirrhosis and showed in addition a well differentiated hepatoma. The possibility of a viral aetiology for the cirrhosis and primary carcinoma of the liver is considered.
Three liver biopsies were carried out in a case of chronic active hepatitis with persistent HB-antigenemia. Virus-cores could not be detected in the liver cell nuclei by electron microscopy before immunosuppressive therapy. Intranuclear, ring-shaped virus-cores of 20-25 nm diameter appeared in almost every hepatocyte examined during immunosuppression.
After a single per os or a single and repeated subcutan doses of Thiuram necrosis of the liver of different extension was revealed. Changes could be seen by 3--14 days after administration of Thiuram in different doses. In some cases animals died spontaneously. These investigations seems to evidence the fact that Thiuram, which is similar to Disulphiram (Antaethyl-Antabus) used in the therapy of chronic alkoholism in big doses exerts a noxious effect on the liver of white rats.
Virus-like particles, acute hepatitis, hepatitis type C. Intranuclear virus-like particles were found by electron microscopy in liver cells of a woman suffering from mild HBsAG- and IHxAG negative acute hepatitis. The particles encountered were morphologically different from those found in hepatitis B and hepatitis A respectively. Futher studies are required to clarify whether the structures represent an incidental finding of a new human (passenger) virus or they may be related to the aetiological agent of the supposed hepatitis type C.
Lesions of the liver revealed by light and electron microscopy at two young men, workers of the chemical industry are described. At one of the patients biopsy was performed twice at the other three times. Patient having jaundice were admitted to hospital because of the suspected acute viral hepatitis. Laboratory findings have shown an acute parenchymal lesion. By light microscopy at one of them mid-zonal, at the other centro-lobular necrosis of hepatic cells further lipoid droplets of the cytoplasma of hepatocytes were revealed. Electronmicroscopically in the first biopsy specimens, and at one of the ptients at the second biopsy as well mostly damage to the mitochondria (enormous osmiophilia of the matrix, presence of osmiophil granules) and enlargement of the tubules of the endoplasmic reticulum could be seen. The controll clinical and morphological findings evidenced the reversible character of the process. Authors stress the differences existing between hepatic lesions caused by CCl4 at different persons on one side, and at rat and human liver on the other.
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