[Congenital cytomegalovirus disease diagnosed by liver biopsy].
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Biomedical subjects
Publications and source records attributed to V F Lukács.
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The light- and electron-microscopic changes of the hepatic tissue of a case with the "bronze baby" syndrome were described. The light-microscopic examinations revealed intrahepatic cholestasis of the hepatocanalicular type associated with portal inflammation. The electron-microscopic examinations showed dense deposits in the hepatic cells, Kupffer cells and in the bile canaliculi. The bile canaliculi were distended, the canalicular membrane severely destructed. The patient included in the study has been free of symptoms for 2 years.
This paper discusses the fine structure of multiple haemangioendothelioma of the liver. There have been no previous reports of electron microscopic studies of this tumour, which was found to be composed of young capillaries continuous in type and varying in calibre. The capillaries were lined by actively proliferating, immature endothelial cells with pericytes forming an integral part of the tumour. Their morphological characteristics indicated intensive protein production. The authors suggest that the active pericytes play a role in the production of reticular fibres of the tumour. Following corticosteroid therapy, regression of tumour nodules occurred in this case in the interval between surgery and autopsy. This was confirmed by histological studies. The results seem to support the hypothesis that actively proliferating, young endothelial cells show an increased sensitivity to corticosteroids.
Among 39 infants operated upon for oesophageal atresia in newborn age, 5 presented attacks of reflex bradycardia during meals. One patient died at the age of one and a half years. Four patients became symptom-free on atropine treatment. They are healthy and develop satisfactorily.
The familial type of cholangiodysplastic pseudocirrhosis is presented. This chronic liver disease is caused by malformation of the intrahepatic bile ducts. The female infant was 5 months old when the diagnosis was established. The liver biopsy was studied by light and electron microscopy. Electron microscopic examination revealed active proliferation of ductual cells and progression of fibrogenesis, findings consistent with the rapid and fatal course of the disease. In the case presented an acute cholangitis occurred, but after healing the progression of the original process led to hepatic insufficiency. It is suggested that cholangiodysplastic pseudocirrhosis is a chronic, progressive liver disease the course of which might be hastened by the complication of cholangitis; the process itself causes liver cirrhosis without inflammation.
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In cases of neonatal obstructive jaundice, liver biopsy material has been studied electronmicroscopically. In bile duct atresia, morphologic changes are extensive and they develop early. The severity of destruction is related to the quantity of accumulated bile deposits. Hypoxia due to the disturbance of microcirculation plays an important part in the damage. In cases of inspissated bile syndrome, the changes are less severe and they prove reversible.
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