[Show abstract][Hide abstract] ABSTRACT: Patients with inflammatory bowel disease (IBD), both ulcerative colitis (UC) and Crohn’s disease (CD), are at an increased risk for developing colorectal carcinoma (CRC). The accurate diagnosis of dysplasia in biopsies taken during periodic surveillance of long-standing IBD patients is most important in prevention of UC and CD related cancer. Distinction of low from high grade IBD-related dysplasia and differential diagnosis between IBD-related dysplasia and dysplasia in sporadic adenoma as well as distinction from pseudodysplastic lesions in inflammatory pseudopolyps or reparative lesions is often very subtle and difficult and demands expertise of second experienced gastrointestinal pathologist. Although surveillance colonoscopy with multiple biopsies does not reduce the cancer mortality, it offers a reasonable chance of detecting precancer and performed prophylactic colectomy. Novel methods of detecting dysplasia are continuously being evaluated, including chromoscopy and molecular biology markers. In the future, one may expect, from these new markers to detect the dysplasia in IBD patients before development of histological evidence of neoplastic changes.
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: B-chronic lymphocytic leukemia (B-CLL) is an example of human malignancy caused by alternations in the pathways of apoptosis. Mitochondria play a critical role in the regulation of this process. The B-CLL cells dying in apoptosis showed typical morphological characteristics: the reduction of the nuclear volume is accompanied with the reduction of the cytoplasmatic volume, while many of organelles remain intact. The aim of our study was ultrastructural investigation of mitochondrial morphology in apoptotic B- CLL cells. METHODS: Our study included peripheral blood samples from 32 B-CLL patients. The samples were fixed in 4% glutar-aldehyde buffered in 0.1 cacodylate buffer and postfixed in 1% osmium tetroxide in the same buffer. The specimens were dehydrated in a graded series of alcohol and embedded in EPON 812. The ultra-thin sections were stained with uranyl acetate and lead citrate. Ultrastructural analysis of sections was performed on Philips electron microscope 208S at 80 kV. RESULTS: The most frequent mitochondrial abnormalities in apoptotic B-CLL cells were a reduction of size with a hyperdensity of their matrix (mitochondrial pyknosis), or markedly swollen mitochondria with peripherally placed, disorientated, and disintegrated cristae. In some apoptotic cells, we also detected close association of mitochondria with loops of rough endoplasmatic reticulum. CONCLUSION: The results of our study showed the numerous of mitochondria damages in B-CLL cells during apoptotic process. The correlation between ultrastructural damage and functional activity of mitochondria in apoptotic B-CLL cells is still not clear and requires further investigation.
[Show abstract][Hide abstract] ABSTRACT: Background/Aims. Thyroid gland surgery today is not saddled with high incidence of main complications. Miscellaneous surgical institutions with different surgical approach, operative technique and radicality have published reports with great discrepancy in incidence of complications, analyzing them with different methods of diagnosis and result evaluation. In the same way it is well known that higher latitude of operative procedure gave better control of thyroid diseases, but it can be accompanied with more complications. All of that motivate us to analyze complications of operative treatment in our patients under well known criteria, with hypothesis that higher radicality of operative procedure do not increase incidence of complications, and that this incidence is in correlations with results published in world literature. Aim of this nonrandomized study was to analyze results of operative treatment for huge number of consecutively operated patients in our teaching hospital, to analyze and compare results according to group of diseases and operative procedures, and to compare final results with results published in the world literature. Methods. Complications of operative treatment were analyzed retrospectively for period 1988-1997 (Group I) and prospectively in period 1998-2002 (Group II). Operations were performed by 20 surgeons and 20 young surgeons during their education. We have analyzed only complications during first 30 days after operation. Results. In Group I there was 1425 patients with 1451 operations (192 thyroid malignances, 247 hyperthireosis, 98 reoperations, 13% thyreoidectomies and 14,8% lobectomies), with complication rate of 14,3%. Most common complication was recurrent laryngeal nerve injury in 9,3% patients or 6,3% according to number of exposed nerves („nerve at risk“), then postoperative hypocalcemia with rate of 4,7% (persistent in 1,3%). In Group II in 675 patients there was 687 operations (96 thyroid malignances, 111 hyperthireosis, 35 reoperations, 36,6% thyreoidectomies and 25% lobectomies), with complication rate of 10,7%. Most common postoperative complication was hypocalcemia with 5% rate (persistent in 0,7%), then recurrent laryngeal nerve injury in 4,4% patients or 2,9% according to number of exposed nerves („nerve at risk“). Incidence of recurrent laryngeal nerve injury in Group II is less frequent than in Group I, highly statistically significant (p<0,01), while for other complications there is no statistically significant difference. Totally for both groups there was 0,7% tracheotomies, postoperative bleeding in 1,1% of patients, wound haemathoma in 0,5%, wound infections in 0,9%, pneumonia in 0,5%, mortality 0,5% and most common cause of death (8/11) was problem with respiration, „Airway obstruction“. In Group II complications were less frequent in total thyreoidectomies in relation to lobectomy with contra lateral subtotal lobectomy. In both groups and totally incidence of complications was higher in reoperations, in patients with more extensive operative procedure, in malignant diseases and hyperthyreosis. Conclusion. In thyroid gland surgery more extensive operative treatment with improved operative technique (micro dissection, recurrent laryngeal nerve visualization and parathyroid gland preservation), in our teaching hospital, do not have influence on incidence of postoperative complications, even recurrent laryngeal nerve injury was significantly less frequent. This results are in correlation with published results of similar hospitals around the world.
[Show abstract][Hide abstract] ABSTRACT: Association between non-medullar thyroid carcinoma and secondary hyperparthyroidism have been rarely reported in patients with renal failure. A few cases of micropapillary thyroid carcinoma have been reported in patients before and after renal transplantation. We present a case of incidental detection of thyroid carcinoma at the time of parathyroidectomy in patient on dialysis after cadaver renal transplantation.