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J Michalany

Publications and source records attributed to J Michalany.

18 recordsLinked to original sources

Histogenic differentiation of polar tuberculoid granuloma and the "benign" or "malignant" behaviour of hanseniasis.

Based on a new morphological concept and classification of granulomatous inflammation: the polar granulomas, on the histogenesis of the tuberculoid granuloma of the positive Mitsuda test and on the relationship between the degree of histogenetic differentiation and behaviour of tumors, the Authors concluded that the "benign" or "malignant" behaviour of hanseniasis depends on the degree of tuberculoid differentiation of the lesions. If the lesion is histologically well differentiated toward a polar tuberculoid granuloma (tuberculoid hanseniasis) it will have a "benign" behaviour. On the contrary, if this differentiation is absent (virchowian hanseniasis) or poor (interpolar borderline hanseniasis) the behaviour of the lesion will be "malignant".

Granuloma↗

Acquired immune deficiency syndrome (AIDS) in Brazil. Necropsy findings.

According to the 15 autopsies performed at the Department of Pathological Anatomy, Escola Paulista de Medicina, São Paulo, Brazil, it was confirmed that acquired immunodeficiency syndrome (AIDS) occurs preferably in young homosexual males, who die in a short period of time of the disease, which leads to a consumptive state verified by cachexia of the cadavers. The most affected organs of this series were the lungs and encephalum, exactly the ones responsible for the immediate cause of death. In this series of autopsies there were 9 types of microorganisms represented by virus, bacteria, fungi, protozoans and two types of tumors, Kaposi's sarcoma and lymphoma of the central nervous system. From the microorganisms, the most frequent was the Cytomegalovirus and, from the tumors, Kaposi's sarcoma. The various types of microorganisms were frequently associated, principally in the central nervous and digestive systems. There was also association of microorganisms with tumors. Besides the lesions produced by microorganisms there were other associated alterations as brown atrophy of neuronia, which was related to the infiltration of cerebral lymphoma, and the lymphocytic depletion of lymphoid organs due to immunological exhaustion. Cellular reaction to microorganisms was practically none, principally with Pneumocystis carinii and Cryptococcus neoformans, the first one behaving as an inert mould in the pulmonary alveoli and the second proliferating freely in tissues. In two cases there was no granulomatous reaction to Mycobacterium tuberculosis. The primary lymphoma of the central nervous system should be interpreted as a microglioma, i.e., a reticulosarcoma of this system according to Hortega's school.

Acquired Immunodeficiency Syndrome↗

[The Mitsuda reaction and its antigen, good subjects for a bibliography].

Some references of the history of Mitsuda reaction and its antigen, as well as for the results and significance of this unique reaction are presented. In spite of the great advances of modern immunology. Mitsuda reaction is still the best method for the diagnosis of the forms of hanseniasis and for the prognosis of the disease in patients and in healthy persons.

Antigens, Bacterial↗

[Histopathology of the Mitsuda reaction in healthy adults not in contact with Hansen's disease patients].

A detailed study on the histopathology of Mitsuda's reaction was made in 100 adult non-contact hanseniasis patients inoculated with lepromin A (armadillo). It was found that the histological structure of Mitsuda's reaction with lepromin A does not differ from the one observed with lepromin H. There is also no difference between the histological picture observed in healthy non-contacts and the one found in tuberculoid patients and in contact healthy persons. Mitsuda's reaction in non-contact hanseniasis patients presented variations of histological degree--Classes O (-) I (+/-) II (+) III (++) IV ( )--from no inflammatory reaction and positive bacilli, until formation of a complete tuberculoid granuloma and absence of bacilli. In 97% of the cases reaction was positive. Class III, i.e., represented by incomplete tuberculoid granuloma formed by epithelioid cells with follicular arrangement and lymphocytic halo, predominated in the series (42%). The findings of this research state, once again, that an efficient result of the Mitsuda's reaction depends fundamentally of the histological examination, since in only 16 cases the clinical reading coincided with histopathology. Disaccordance found on the remaining 84 cases was attributed to the secondary alterations (necrosis and suppuration) associated to the histological structure of the Mitsuda reaction follows the Jadassohn-Lewandowsky law and are in accordance with the morphological concept and classification of polar granulomas proposed by Michalany & Michalany.

Adult↗

A new morphological concept and classification of granulomatous inflammation: the polar granulomas.

An historical analysis of granulomas and a new morphological concept and classification of granulomatous inflammation, the polar-granulomas, are presented. The historical analysis of the concept of granulomas reveals that the still proclaimed confusion concerning the process was due more to Virchow's comparison of granulomas to ordinary granulation tissue than to tumors and to objections of pathologists to Metchnikoff's theory of phagocytosis. And it is strange to verify that differences between granulomas and granulation tissue, although already established in the end of the 19th Century, were overlooked by the majority of pathologists. In this Century , the knowledge of granulomatous inflammation was greatly improved by Aschoff 's concept of reticulum endothelial system, Mitsuda test for types of leprosy, Jadassohn- Lewandowsky law, South American classification of leprosy into polar forms, and Forbus contribution to histogenesis and morphological classification of granulomas. The best model for the study of granulomatous inflammation is leprosy, because this disease is characterized by two different clinical polar forms, each one having particular types of phagocytosis (complete or incomplete) and of granulomas (tuberculoid or non tuberculoid). Based on the phenomenon of phagocytosis, polar forms of leprosy, Jadassohn- Lewandowsky law, metamorphosis of macrophages and nature of the etiologic agent, granulomas can be defined as a reactional hyperplasia of macrophages towards inanimate agents and towards animate agents of low virulence. Also based in the same data, a morphological classification of granulomas into polar types, tuberculoid and non tuberculoid, is proposed. The polar tuberculoid type follows the Jadassohn- Lewandowsky law, its etiologic agent is absent or scarce (complete phagocytosis) - and comprise two sub-types: tubercle-like and sarcoid-like. The polar non tuberculoid type does not follow the Jadassohn- Lewandowsky law, its etiologic agent is always present or copious (incomplete phagocytosis) and comprises two sub-types: giant cell and persistent macrophage. In the latter case, macrophages behave as a culture medium cell or as a storage cell. When both polar tuberculoid and non tuberculoid structures are found together in the same disease, granuloma can be called interpolar . If both types occur simultaneously in the same disease, granuloma would be bipolar. It seems that the proposed definition of granulomas combines morphology with functional activity of macrophages, easily observed in routine histopathological examination by optical microscopy. This morphological classification into polar granulomas (ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis, Differential↗

[Tropical enteropathy: morphologic and functional changes of the small intestine and their effects on nutritional status].

Tropical enteropathy has been described in children and adults that live in developing countries. This disease may be symptomatic or may present without symptoms. We studied 66 patients with tropical enteropathy with special reference to the nutritional status and the intestinal function. The follow-up of the nutritional status revealed that 63 (95.49%) presented current malnutrition. The D-xylose absorption test was significantly lower than those found in the control group. The mean plasmatic triglyceride increment after the margarine load was significantly lower than that found in the control group. Carbohydrate tolerance tests revealed 51.3% lactose malabsorption, 35.07% sucrose malabsorption and 5% glucose malabsorption. Small bowel biopsy showed partial villous atrophy as the most frequent morphological characteristic observed. These children constitute an homogenous group representative of the majority of the population of the Third World.

Child, Preschool↗