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Biomedical subjects

Z Nozicka

Publications and source records attributed to Z Nozicka.

At least 19 recordsLinked to original sources

[Giant myelolipoma of the adrenal gland].

INTRODUCTION: Myelolipoma is a rare benign tumor of adrenal gland, composed from a fatty tissue and hematogenous elements. It may be associated with endocrine disorders such as androgyneity, Cushing's disease, Addison's disease and other causes including obesity. It may also occur as a soft-tissue mass in various regions, especially in the area of small pelvis. Giant myelolipomas of adrenal gland have rarely been described in the world literature and it was considered useful to describe this case. CASE REPORT: A 54-year woman was examined in an internal ward for arterial hypertension and an ultrasound abdominal examination was therefore indicated. The finding was later confirmed by CT examination, which demonstrated a sizable expansion with fatty densities and a stroma, which was slightly more visible after the administration of a contrast compound, projecting in the region of the right adrenal gland. CONCLUSION: The formation is most probably a myelolipoma. No disease-related symptoms were detected. A surgical extirpation of three tumors of the same character was made. The diameter of the largest tumor was at least 140 mm. The diagnosis of myelolipoma was confirmed by histological examination. The patient was cured up and released from the hospital on day 12 after the operation. CONCLUSIONS: The tumor is without symptoms in most cases, but bleeding or rupture may occur. It is rarely associated with endocrine disorders. Etiology is so far not clear. The diagnosis can be established by US, CT or MR examination. The operation is indicated in patients with symptoms, tumor of large size, in case of bleeding etc. Small tumors may be followed subsequently. The surgical intervention, extirpation of the tumor, may also be done by laparoscopy. This paper appears to be the first published information about myelolipoma of adrenal grand, especially of such considerable size, in the Czech medical literature.

Adrenal Gland Neoplasms↗

Sclerosing papillary carcinoma of the thyroid with tubular features.

A case of papillary thyroid carcinoma (PTC) in a twenty-seven year old female is reported. The patient presented with complaints of a goiter and associated dysphagia. Histologically, the tumor was characterized by diffuse growth of branching tubules lined by a single layer of the tumor cells and surrounded by circularly arranged fibrous tissue of variable thickness. Focally, micropapillary projections of the epithelium budding into the lumen of tubules were visible. The cells showed features of PTC (overlapping ground glass nuclei, multiple grooves and pseudoinclusions). Nevertheless, no areas of "classical" PTC were identified. A striking feature was the presence of a severe lymphoplasmocytic infiltrate and the presence of plentiful S-100 protein positive dendritic/Langerhans cells. The tumor shares several features with diffuse sclerosing PTC, namely the age and sex of the patient, the infiltrative growth pattern and the presence of severe chronic thyroiditis that is associated with a large number of dendritic/Langerhans cells in the background. There are, however, several distinct differences - particularly the absence of massive squamous metaplasia, psammoma bodies, areas of classical PTC, and also lack of invasion of lymphatic vessels. We believe that this tumor represents an unusual example of diffuse sclerosing PTC with special tubular features.

Adenocarcinoma↗

[Fetal rhabdomyoma of the mucosa of the lip (case report)].

In a 15-year-old male the foetal type of rhabdomyoma was diagnosed in the mucosa of the lower lip. Diagnosis of this relatively rare tumour prevents possible mistaking for a malignant process and an inadequate therapeutic procedure.

Adolescent↗

[Atheromatous (cholesterol) embolization].

A case is presented of an 89-year-old woman who died following an operation for arterial embolism of the lower limb. The autopsy histology showed acute occlusion of a stenosed sclerotic femoral artery by thrombotic and atheromatous emboli. In addition, it showed chronic cholesterol crystal embolism in multiple small arteries of abdominal organs, particularly of the kidneys. Abdominal aorta with severe ulcerated atherosclerosis appeared as the source of embolism.

Acute Disease↗

[Aberrant mammae, personal experience].

The authors present information of a group of 63 patients (60 women and 3 men) treated in 1976-1998 where supernumerous aberrant or accessory mammary gland tissue was found. The diagnosis in the majority of the patients was based on histological examination. The tissue of an aberrant mammary gland is subject to the same physiological influences as the mamma proper and can be affected by the same pathological processes--benign and malignant. This is the reason why the authors recommend early extirpation.

Adolescent↗

[Calciphylaxis in a patient on long-term dialysis].

Calciphylaxis is a special form of soft tissue calcification (in particular blood vessels), affecting specially patients with chronic renal insufficiency and associated secondary hyperparathyroidism. Most severely affected are small arteries with a diameter of 0.2-0.5 mm at the interface of the corium and subcutaneous layer. Calcification of the vascular media with subsequent narrowing of the lumen causes ischaemic changes manifested by the development of painful reddish-violet spots on the skin with necrosis and ulcerations. The authors describe the case of a 73-year-old diabetic female patient with regular dialyzation treatment. The patient developed reddish-violet spots on the lower extremities shortly before admission to hospital. At the site of the spots rapidly progressing necroses developed. The cause of these ischaemic changes were calciphylactic changes confirmed on post-mortem examination and by histological examination.

Aged↗

[Helicobacter pylori eradication in patients with diseases of the stomach].

The authors present a review of contemporary findings concerning treatment of gastroduodenal ulcers with a positive finding of Helicobacter pylori. Only combined anti-Helicobacter treatment leads to the eradication of Helicobacter pylori in 80-96% of the patients. Moreover it leads to gradual recovery from gastritis and bulbitis and thus prevents ulcer recurrence.

Gastritis↗

Cytoplasmic inclusions in neocortical astrocytes associated with arteriopathic encephalopathy and dementia.

We describe what we believe to be the fifth case of a degenerative condition of the brain characterized by unusual intracytoplasmic inclusions in neocortical astrocytes, and we review four previous reports of what appears to be the same condition. Whereas these previous cases were characterized by prolonged clinical mental and psychomotor retardation, our case describes a rapid onset in a previously fit and mentally able patient in whom the astrocytic inclusions showed a close association with fibrohyaline vascular degeneration and changes resembling those of Alzheimer's disease. The inclusions, which were most frequent in the second to fourth layers of the frontal, temporal, and occipital cortices but absent from subcortical regions, consisted of large, irregular hyaline bodies surrounding the nucleus and extending into the proximal parts of cell processes. Ultrastructurally they consisted of free ribosomes in a granular and filamentous matrix. They were not bound by a membrane. Lipofuscin granules were associated with them. It is suggested that the inclusions might result from a disturbance of protein metabolism in protoplasmic astrocytes, but their true significance is unknown.

Astrocytes↗

[Helicobacter pylori in the etiology of ulcer disease and gastritis].

Helicobacter pylori (Hp) is unequivocally the most frequent cause of antral gastritis and most probably participates in the majority of cases in the aetiology of gastritis affecting the body of the stomach. The close relationship between antral gastritis and duodenal ulceration is documented by the high incidence of Hp in these patients (90-100%). The problem of Hp negative cases of duodenal ulceration was not finally resolved yet. The absence of Hp in duodenal ulcer usually implies a different aetiology (NSAID, gastrinoma etc.). Hp is eliminated by a number of drugs (bismuth preparations, some antibiotics, metronidazole), however, eradication (Hp negativity after a month or longer following termination of treatment) is ensured so far only by a combination of several drugs. Less clear are the relations with gastric ulcers. The presence of Hp in the antral mucosa is substantially smaller, however, when the mucosa near the ulcer is examined it is also almost 100%. The relationship of antral gastritis and non-ulcer dyspepsia is not quite clear. Hp is found in about half the patients and its elimination (e.g. by bismuth preparations), has a favourable impact on inflammatory changes as well as on the patient's complaints. The regression of complaints is more permanent than after antacids which have only a favourable effect on complaints but not on Hp and the inflammation.

Adolescent↗

[Thymoma in the anterior mediastinum and systemic lupus erythematosus].

The authors describe an observation of a thymoma and systemic lupus erythematosus (SLE) in a 48-year-old woman with an analysis of clinical and laboratory indicators justifying this diagnosis. Improvement of SLE and the lupus nephropathy was achieved by three pulses of methyl prednisolone à 1000 mg in an intravenous infusion with subsequent Prednisone therapy, using conventional doses. After thymectomy on account of a benign thymoma activation of SLE did not occur. The objective of the presented paper is to draw attention to the infrequent possible concurrent incidence of thymoma and SLE and the influence of thymectomy and the subsequent development of SLE.

Female↗

[Pathologico-anatomic contribution to antibody detection in immunopathologic diseases].

Results of twenty years experience with identification of anti organ autoantibodies occurring mainly during autoimmune diseases are presented. Cryostat sections from human cadaver tissue and albino-rat kidneys were used for the detection of the above mentioned antibodies, by method of two-step (indirect) immunofluorescence. The study describes working schedule of a newly established subspeciality of pathological anatomy--the "histoserology". The main aim of the study was investigate the occurrence of autoantibodies and to asses the correlation between these findings and health condition of patients. The following antibodies were evaluated: antibodies against epithelia and colloid of thyroid gland, the antibody against parietal cells of stomach mucosa, antibodies against striated ducts of salivary gland and basal elements in its excretory ducts, the antibody against suprarenal cortical elements, the antibody against parathyreoidea, the antibody against smooth muscle cells, anti brush-border antibody, and the anti-nuclear factor as well as the antibodies against intercellular substance and basement membrane of epidermis. Antibody against thyroid gland coloid appears to be of diagnostic value for recognizing of Hashimoto and focal thyroiditis. The finding of antibody against parietal cells indicates the probability of pernicious trait in diagnostically unclear anaemias. On the other hand the finding of such antibody is not very useful in classification of gastritis and its subtyping. The appearance of the phenomenon of "shaggy rim" during the assay for antinuclear factor seems to be very reliable for verification of systemic lupus. The antibody against salivary gland striated ducts does not give fundamental support for diagnosis of Sjögren's disease. Very interesting immunopathological phenomenon is an occurrence of antibody binding to basal cells of salivary gland excretory ducts. To our knowledge, this phenomenon is rather typical for the antibody against cytokeratin polypeptide No 13 and 16. The finding of the antibody against suprarenal gland cortical elements seems to be essential for diagnosis of chronic nonspecific epinephritis since its appearance is mostly without false positivities. Also the antibodies against epidermal intercellular and basement membrane show similar high specificity. Both these antibodies unfortunately often fail and for their high number of false negative results are solely of affirmative importance, since their lack is evidently unwarranted for exclusion of considered disease. Both the findings of antibody against smooth muscle cells and against mitochondria are usefull for the diagnosis of liver lesions especially those of primary biliary cirrhosis. Anti brush-border antibody essentially assists the diagnosis of Crohn's disease and works to differentiate it from ulcerative colitis. Antireticulin antibodies counts frequently for the diagnosis of celiakia.(ABSTRACT TRUNCATED AT 400 WORDS)

Autoantibodies↗

Specific cellular immune response in patients with Helicobacter pylori infection.

The leukocyte migration inhibition test was performed in 39 patients with Helicobacter pylori infection and in 38 patients without such infection. The culture of Helicobacter pylori was used as antigen. A highly significant inhibitory effect on leukocyte migration was found in patients with Helicobacter pylori infection. The results can be taken as proof of a systemic immune response to helicobacters at the cellular level in patients with Helicobacter pylori infection.

Adult↗

[Antibodies to basal cells of the parotid duct].

The use of indirect immunofluorescence technique confirmed the existence of spontaneous human auto-antibodies attaching to the basal cells in the excretory parotid duct. Analogically with literary data, based on the study of monoclonal antibodies, the author's opinion is that this is an auto-antibody with an unexpectedly narrow spectrum of specifically confined to antigen of cytokeratin polypeptides 13 and 16.

Autoantibodies↗

Immunological aspects of diagnosis of celiac sprue in children.

Serum anti-gluten (AGA) and anti-reticulin (ARA) antibodies were examined in children suffering from celiac sprue (CS); cellular hypersensitivity to gluten was tested and secretion of immunoglobulins and anti-gluten antibodies into the culture medium after 24-hour in vitro cultivation of jejunal mucosal biopsies was investigated with the aim to assess significance of these methods for CS diagnosis. Indirect immunofluorescence was used in ARA determination, ELISA method for AGA determination, cellular hypersensitivity was examined using the test of leucocyte migration inhibition (LMIT) with gluten. ARA were detected in 69% of children with untreated CS and in 28% of CS children who were on a gluten-free diet. ARA specificity was 100%. Statistically significant higher titres of IgG AGA and IgA AGA were proved in children with untreated CS as compared with the control group. IgA AGA were detected significantly more frequently than IgG AGA. No relationship between positive AGA and the degree of alteration of the jejunal mucosa was found. IgG AGA sensitivity in CS children with pathological findings on the jejunal mucosa was 52%, specificity being 95%. IgA AGA sensitivity was 82% with specificity 90%. After a parallel application of IgA AGA and ARA, sensitivity of the tests rose up to 95.5%, specificity being 90%. Examinations of ARA and AGA have a significant importance for laboratory tests used for screening children with pathological findings on the jejunal mucosa and for indication to jejunal biopsies. The above tests do not replace jejunal biopsy in CS diagnosis. They can be applied in monitoring children with CS during gluten challenge and in checking how the gluten-free diet is observed. Significantly higher stimulation of leucocyte migration in gluten environment was proved in children suffering from CS as compared with the control group. Stimulation of migration is supposed to indicate cellular hypersensitivity to the antigen used in CS children. After a 24-hour culturing of jejunal mucosal biopsies, significantly elevated concentrations of IgA immunoglobulin and IgG, IgA and IgM AGA were found in the culture medium as compared with those obtained from cultured jejunal mucosal biopsies of control group children. The test of leucocyte migration inhibition and in vitro culturing of jejunal mucosa are quite complex and exacting methods when used in routine practice. Their significance lies in the fact they enable us to study in vitro immunological reactions in children suffering from celiac sprue.

Antibodies↗