Following the goose liver development by means of cross-sectional digital imaging, liver histology and blood biochemical parameters

A follow-up study was performed to describe characteristic physiological alterations by means of computer tomography, direct chemical analysis and histology of the liver, and blood biochemical parameters during conventional force-feeding of Landes geese. 30 birds were exposed to an 18-day long force-feeding. Sampling was performed at the start and during force-feeding (7th, 11th, 14th, 18th days). Computer tomographic data were plotted in 3D histograms, effectively indicating the volumetric development and the fat deposition of the liver. Applying the so-called fat index, a saturation process was found for the hepatic fat content. Histological sections indicated the appearance of microvesicular fat forms in the hepatocyte cytoplasm, which first turned to a total fatty infiltration, later changing to a macrovesicular form with progressing inflammation; membrane damage was not visualized. In blood metabolites triglyceride, total and HDL cholesterol and uric acid increased measurably, while creatinine concentration decreased. Alanine aminotransferase, aspartate aminotransferase activities increased strongly, while that of lactate dehydrogenase only slightly. Based on the results of macroscopic and microscopic imaging techniques and blood biochemical parameters, a comprehensive follow-up study was performed, elucidating still unknown processes during force-feeding of geese.

Co-infections with hepatitis G and TT virus in patients with chronic hepatitis C in Hungary

The significance of co-infections with novel hepatitis viruses Hepatitis G (GBV-C, HGV) and TT virus (TTV) in chronic hepatitis C is not clear. We determined the prevalence of HGV RNA and TTV DNA in chronic hepatitis C patients and in asymptomatic hepatitis C virus (HCV) carriers, and assessed the influence of these agents on the course of HCV infection. Seventy-seven patients with chronic hepatitis C--50 of them treated with interferon (IFN)--and 33 HCV carriers with normal alanine aminotransferase have been investigated. Previous HBV infection was detected by testing serum HBsAg and aHBc. HGV RNA and TTV DNA were detected by PCR. In the healthy population, the prevalence of anti-HCV was 0.3%, HGV RNA 8.0% and TTV DNA 18.5%. In chronic hepatitis C HGV RNA occurred in 9.09% and TTV DNA in 40.25% of cases. In IFN-treated patients with sustained remission, the frequency of TTV was 20% vs. 45.7% found in non-responders. Among asymptomatic HCV-carriers, the prevalence of HGV RNA was 9.09% and TTV DNA 75.7%. Neither HGV RNA nor TTV DNA had apparent effect on the HCV infection. TTV was detected with the lowest frequency in persons with sustained remission due to IFN, suggesting antiviral effect of IFN on TTV.

Immunohistochemical assessment and prognostic value of hepatitis B virus X protein in chronic hepatitis and primary hepatocellular carcinomas using anti-HBxAg monoclonal antibody

Hepatitis B virus (HBV) is the most meaningful risk factor in chronic hepatitis, cirrhosis and primary hepatocellular carcinoma (PHC). The hepatitis B virus X protein (HBxAg) is a multifunctional protein with many important functions in hepatocellular carcinogenesis. A monoclonal anti-HBxAg antibody was developed in our laboratory and characterized by different methods. Using this antibody HBxAg was detected in formaldehyde fixed paraffin embedded tissue sections of 72 liver biopsies from patients with acute hepatitis, chronic hepatitis, cirrhosis and primary hepatocellular carcinoma. The co-expression of hepatitis B surface antigen (HBsAg), hepatitis B core antigen (HBcAg) and HBxAg was compared. The histological and cytological localization of the detected HBxAg showed a characteristic distribution in different stages of HBV infection. Strong and diffuse nuclear reaction was detected in PHC cases in contrast to the focal, cytoplasmic and nuclear labeling in the acute and chronic B hepatitis cases. Our antibody seems to be a suitable prognostic marker for routine pathohistological diagnosis and for comparative pathological and epidemiological research on the development of PHC.

Different manifestations of langerhans cell histiocytosis affecting two members of a family

Two different manifestations of Langerhans cell histiocytosis (histiocytosis X) are presented, the first occurring as a solitary rib eosinophil granuloma in an 11-year-old girl, and the second as an eosinophil granuloma of the lung of her mother, a 41-year-old heavy smoker, appearing 8 years after the onset of her daughter's disease. Familial clustering of two different manifestations of histiocytosis X disease is very rare and raises the possibility of inherited mutations that promote emergence of clonal Langerhans cells.

Multimodality treatment resulting in long-term survival in hepatocellular carcinoma

The early detection and complex therapy of the hepatocellular carcinoma (HCC) is one of the most seasonable questions of the gastroenterology-oncology, because of the increasing prevalence of the primary liver cancer. The course of the hepatocellular carcinoma is rapid, untreated patients rarely live over 5-6 months. Combination of different treatment modalities in HCC can offer the best chances for survival. If possible, a surgical resection should be the primary procedure, followed by adjuvant cytostatic treatment and chemoembolisation. The authors report three cases with HCC with extremely long survival. The long-term survival achieved by multimodality therapy, as presented in these cases, seems to justify aggressive therapeutical approaches in HCC. It has been concluded, that early detection and complex, aggressive multimodality treatment--even repeated liver resections and surgical elimination of duplex distant metastases--can result in long-term survival with a good quality of life.

Colorectal cancer risk in relation to genetic polymorphism of cytochrome P450 1A1, 2E1, and glutathione-S-transferase M1 enzymes

Chemical carcinogens generally require metabolic activation in order to be able to bind to DNA and contribute to cancer causation. Most of the human metabolizing enzymes are genetically polymorphic, and these polymorphisms may affect the enzyme activity or inducibility. In our present study we investigated the connection between genetic polymorphism of cytochrome P450 1A1, 2E1 (phase I enzymes) and glutathione-S-transferase M1 (a phase II enzyme) and colorectal cancer occurrence in a Hungarian population. The CYP 2E1 c2 allele proved to be in significant association with colorectal cancer (OR: 1.91, 95% CI: 1.05-3.52), the CYP 1A1 Val allele was also overrepresented among colon cancer patients (OR: 1.57, 95% CI: 0.90-2.74), and the frequency of GSTM1 homozygous 0 genotype showed only minor difference (OR: 1.19, 95% CI: 0.75-1.35). Combined analysis of the polymorphisms showed that individuals carrying all the three "high-risk" alleles have a strikingly increased risk for sporadic colorectal cancer (OR: 4.62, 95% CI: 1.23-25.68).

Differential detection of N-heterocyclic compounds and their N-methylated derivatives by immunoanalysis

Competitive enzyme-linked immunosorbent assay (ELISA) systems are proposed for the indirect monitoring of formaldehyde by the parallel detection of its N-methylated precursors and the corresponding demethylated compounds. As an example for such immunoanalytical differentiation between an N-heterocyclic compound and its N-methylated derivative, the quantitative detection of the systemic triazole fungicide, myclobutanil, is discussed. Antibodies recognizing the non-zwitterionic structure of 2-(4-chlorophenyl)-2-[(1,2,4-triazol-1-yl)-methyl]-hexanonitril e (myclobutanil) showed only minor binding to corresponding N-alkylated derivatives of myclobutanil. And vice versa, literature data indicate that antibodies raised against the pyridilium ionic structure of the herbicide paraquat, displayed only mediocre reactivity towards the corresponding dealkylated derivatives. Thus, both experimental and literature data suggest that immunoanalytical methods for differential detection of N-methylated heterocycles (potentially including formaldehyde precursors) and their non-methylated counterparts are possible to develop.

[Repeated resection of hepatocellular carcinoma and its recurrences and removal of pulmonary metastases]

A case of a 67 year old male successfully treated local recurrence of previously radically resected hepatocellular carcinoma with distant metastases of the lung is reported. Two years after a complete removal of the primary liver malignoma a local recurrence was resected which was followed by selective intraarterial cytostatic treatment and chemoembolisation. A three-year disease-free interval was achieved, then recurrence in the liver and lung metastases were detected at the regular check-up. All of the malignant focuses were eliminated by parenchyma sparing surgical resections, then a postoperative adjuvant chemotherapy (FAM scheme) has been followed. After eight months the patient remained symptom-free. The long-term survival seems to justify the aggressive approach of this kind of malignancies.

Autoantibodies against subunits of pyruvate dehydrogenase and citrate synthase in a case of paediatric biliary cirrhosis

In a newborn girl with a history of connatal liver damage, histological examination of a liver biopsy sample taken during the seventh week of life revealed incipient destruction of bile ducts. Very high titres of antimitochondrial antibodies were later detected in the plasma. As the hepatic injury tended towards fibrosis, the histological diagnosis became primary biliary cirrhosis. Autoantibodies against E1 alpha, E2, and E3 subunits and protein X component of pyruvate dehydrogenase complex, and against citrate synthase were detected on western immunoblotting in a 1 in 1000 dilution of the patient's serum. The patient died of her illness at 11 years of age. In liver specimens obtained at autopsy human immunoglobulin deposition was detected on the surface of almost all hepatic cells by immunohistology. As there is a physical and functional interaction between pyruvate dehydrogenase and citrate synthase within the mitochondria, the presence of autoantibodies against certain proteins in the patient suggests that in this form of the disease the molecular recognition and then the autoimmunisation process could be directed against a mitochondrial enzyme cluster containing both pyruvate dehydrogenase and citrate synthase.

[Angiocentric T-cell lymphoma of the lung]

Angiocentric T-cell lymphoma of the lung. The case history of a patient with primary angiocentric T-cell lymphoma of the lung having an unusually long survival period (> 10 years) is presented. Attention is paid to the possibilities of differential diagnosis that should be taken into account in the analysis of certain lymphocytic infiltrates of the lung. In accordance with relevant data of the literature, this case shows that pleiomorphic small cell T-lymphomas may have a protracted course, and the disease free periods repeatedly achieved in this patient by irradiation and chemotherapy are thought to be noticeable. Authors refer to some recent findings which may give new insights in the pathobiology of extranodal T-cell lymphomas, and result in recognition of new disease entities.

[Adenocarcinoma (Klatskin tumor) of the hepatic duct simulating viral hepatitis]

The authors review the experiences obtained during investigation of a patient with Klatskin tumor and whose clinical syndromes were developing as of virus hepatitis. In the first two weeks of the illness the clinical symptoms, the chemical laboratory findings and among the virus investigations the positive (experimental) Non-A Non-B hepatitis virus antigen suggested the existence of virus hepatitis. Later the laboratory investigations and the symptoms showed on obstructive icterus. The subsequent performed investigations as ultrasonography and PTC--showed the Klatskin tumor, which was proven by the operation performed and histology. The patient is free from the complaints more than 1 year after the operation, moreover recidivation or metastasis was not indicated by the investigations performed in the latest time.

Cytophotometric investigations on a chronic tubular nephropathy simulating preneoplastic condition

Cytophotometric investigations were performed on the atypical renal tubular epithelium of a young man who died of renal failure, possibly due to chronic lead exposure. The aim of this analysis was to determine whether nuclear atypia indicates incipient malignancy or is a type of so-called "benign atypias". DNA histogram, showing euploid polyploidy supports the latter view and the dysplastic epithelial lesion is not even considered to be a preneoplastic condition.