Pancreatic choriocarcinoma presenting as inflammatory pseudocyst

A primary pancreatic choriocarcinoma was discovered at surgery in a patient with a clinical diagnosis of pancreatic inflammatory pseudocyst. To our knowledge, this is the first example of an extragonadal choriocarcinoma reported as a primary at this site. We consider this neoplasm to be another example of a visceral choriocarcinoma arising from a primary carcinoma through a process of metaplasia. This case illustrates the inherent difficulties in the preoperative evaluation of cystic lesions of the pancreas, and the importance of recognizing endocrinologic manifestations of malignant disease.

Stimulation of androgen and oestrogen concentrations in plasma of cows after administration of a synthetic glucocorticoid (flumethasone) at the end of gestation

Administration of flumethasone (3.5 mg i.m.) to six cows on day 260 of pregnancy induced parturition in only one animal. In the other five cows circulating concentrations of epitestosterone and conjugated oestrogens increased to reach maximum values (epitestosterone, 13.73 +/- 2.81 nmol/l; conjugated oestrogens, 33.59 +/- 6.87 nmol/l) 2-3 days after treatment. Concentrations of these steroids were raised as long as the synthetic glucocorticoid was present in the circulation (as judged by depression of cortisol concentrations). After clearance of the drug, concentrations of these steroids declined to values present in the control group. Concentrations of unconjugated oestrogens were only slightly raised after flumethasone. In contrast to the effect observed after administration on day 260, treatment on day 270 induced parturition in four of six treated animals. In these cows, mean circulating concentrations of epitestosterone, unconjugated and conjugated oestrogens increased to 9.50 +/- 2.96, 9.62 +/- 1.48 and 36.51 +/- 4.8 nmol/l respectively to reach concentrations observed in the control group at parturition. After parturition the concentrations of epitestosterone and oestrogens declined rapidly in all groups.

Autonomic neuropathy associated with autoimmune disease

Mononeuropathy multiplex and mixed sensorimotor neuropathy are known complications of systemic vasculitis and related autoimmune disorders. Autonomic dysfunction is not generally considered a neurologic complication of these diseases. We report two patients who came to neurologic attention because of autonomic dysfunction and were then discovered to have autoimmune disease. Autonomic dysfunction may be the presenting sign of autoimmune disorders, which should be considered in the differential diagnosis of acquired autonomic disturbances.

Immunohistochemical diagnosis of olfactory neuroblastoma

Olfactory neuroblastoma (OLF NB) is an uncommon neurogenic tumor arising in the nasal cavity. To identify the immunohistochemical reactivity of OLF NB, we examined specimens from ten patients for the presence of neuron-specific enolase (NSE), S-100 protein (S-100) and glial fibrillary acidic protein (GFAP). Formalin-fixed paraffin sections were treated with rabbit antisera using the peroxidase-antiperoxidase (PAP) and avidin-biotin immunofluorescence methods. Results were compared with those observed in four neuroblastomas (two central and two peripheral sites), 17 medulloblastomas, four pheochromocytomas and five paragangliomas. All OLF NB were positive for NSE and S-100. NSE was uniformly distributed throughout clusters of tumor cells within tumor nodules. The S-100 reactivity was distributed in neoplastic cell nuclei and long cytoplasmic processes of cells which interconnected to form a network at the periphery of tumor cell nests. GFAP was observed only in astrocyte-like cells in one tumor. Although the S-100-positive cells in OLF NB resembled S-100-positive sustentacular cells of paraganglioma and pheochromocytoma, the network pattern was distinctive in OLF NB. The immunodiagnostic pattern of OLF NB includes the following: (a) NSE present in irregular clusters of tumor cells, (b) S-100 present in peripheral cells which form a marginal network, (c) and GFAP rarely present.

Lymphocytic interstitial pneumonitis manifesting concurrently with active tuberculosis

We describe the simultaneous occurrence of Mycobacterium tuberculosis and lymphocytic interstitial pneumonitis in a 54-year-old man. Two drugs were used to treat the tuberculosis, and the patient had clinical improvement but persistent laboratory and chest roentgenographic abnormalities.

Effects of the chiral isomers of erythro- and threo-9-(2-hydroxy-3-nonyl)adenine on purine metabolism in sarcoma 180 cells

The effects of the chiral isomers of erythro- and threo-9-(2-hydroxy-3-nonyl)adenines (EHNA and THNA) on purine metabolism in Sarcoma 180 cells have been determined. At concentrations of 10-80 microM [10- to 1000-fold greater than their Ki values with adenosine deaminase (ADA)], all isomers inhibited purine salvage and biosynthesis de novo. Although (+)-EHNA, the most potent ADA inhibitor, exerted the greatest effects, there was no direct correlation between the potency of ADA inhibition and the secondary effects on purine metabolism, e.g. (+)-EHNA is about 2-fold more inhibitory than (-)-EHNA in blocking purine base incorporation but about 250-fold more potent as an inhibitor of ADA (Ki of (+)-EHNA = 2 nM; Ki of (-)-EHNA = 500 nM [Bessodes et al., Biochem. Pharmac. 31, 879 (1982)]). All the isomers inhibited the incorporation of radiolabeled purine bases (adenine, guanine and hypoxanthine) and nucleosides (guanosine and inosine) into acid-soluble nucleotides and of glycine into 5'-phosphoribosyl-formylglycineamide. Unlike the results of Henderson et al. [Biochem. Pharmac. 26, 1967 (1977)] with Ehrlich ascites cells, the incorporation of adenosine into nucleotides was only slightly inhibited in Sarcoma 180 cells. (+)-EHNA did not inhibit the activities of 5-phosphoribosyl-1-pyrophosphate (PRPP) synthetase, purine phosphoribosyltransferases or nucleotide kinases in cell extracts. Accumulation of PRPP was inhibited only under conditions that fostered rapid synthesis.

Plasma levels of androstenedione, epitestosterone, testosterone and oestrogens in cows at parturition

The concentration of total unconjugated oestrogens in the peripheral plasma of cows increased from 2.00 +/- 0.20 (S.E.M.) ng/ml 7 days before to 3.87 +/- 0.50 ng/ml 1 day before parturition and declined to values below 0.30 ng/ml on day 2 post partum. The concentrations of androstenedione, epitestosterone and testosterone remained approximately constant at 0.90 +/- 0.10, 0.92 +/- 0.08 and 0.40 +/- 0.20 ng/ml respectively during the last week of pregnancy. After parturition the concentration of the three androgens declined rapidly. Similar to data obtained in goats we did not find a marked increase in androgen levels in the peripheral blood of cows before parturition.

Effect of immunization of male rabbits against androstenedione

After active immunization of male rabbits against androstenedione and with increasing antibody titre the concentration of androstenedione and testosterone in peripheral blood increased more than 1000-fold resp. 20-fold above values of control animals. On histological examination of the testes a marked Leydig's cell hyperplasia was found, though there was no difference in testis weight.

In vitro conversion of steroid hormones in bovine ovarian follicles

In bovine ovarian follicles in vitro conversion of androstenedione and oestrone into oestradiol-17 beta, and of oestradiol-17 beta into oestrone was observed. There was no in vitro conversion of pregnenolone, progesterone, dehydroepiandrosterone and testosterone.

Diagnostic cytology of cerebrospinal fluid by the cytocentrifuge method

Seven hundred seventy-five cerebrospinal fluid samples from 748 patients with neurologic and non-neurologic disorders were studied by a modified cytocentrifuge technic for diagnostic evaluation. The technic proved to be simple, rapid, and inexpensive, and provided consistently good artifact-free morphologic detail suitable for differential and cytochemical analysis. Specimens from 525 patients (70%) had normal cytologic characteristics regardless of underlying condition. Examination of the cerebrospinal fluids of 40 patients (5%) revealed hemorrhage, confirming the presence of intracranial hemorrhage. Inflammatory reactions of various types (acute, chronic, and mixed) were encountered in 120 patients (16%). The appearance of neoplastic cells in cerebrospinal fluid was sometimes the first indication of malignancy. Twenty-six patients (4%) had tumor cells of various types in their cerebrospinal fluids on initial examination. Twenty patients (3%) had abnormal cells initially classified as suspect for malignancy; tumor cells subsequently were found in the spinal fluids of 11 of these, while five were proven to have neoplasms at autopsy without having had tumor cells found in their cerebrospinal fluids. There was no false-positive result. Samples of cerebrospinal fluid from 17 patients (2%) were classified as non-diagnostic, usually because of autolysis.

Immunohistochemical localization in rabbit brain of a peptide resembling the COOH-terminal octapeptide of cholecystokinin

Immunohistochemical techniques were used to demonstrate the presence of a material resembling the COOH-terminal octapeptide of cholecystokinin in rabbit cerebral cortical neurons. Deep staining was seen in cell bodies throughout the cortical grey matter and diffusely in the subcortical white matter.

The characterization of the ACTH produced by a primary pituitary tumour in a patient with Cushing's disease

The nature of ACTH present in pituitary tumours associated with Cushing's disease has not been previously characterized nor correlated with the electron microscopic appearance. The present report describes the culture of tumour tissue obtained from a patient with a pituitary tumour associated with Cushing's disease, and the characterization of the ACTH content of tumour and media by bioassay, immunoassay, and Sephadex G-50 gel filtration. Electron microscopic studies were also performed. The pathological diagnosis was pituitary adenoma with basophilic PAS-positive granules. Electron microscopy showed uniformity of size and shape of the tumour cells, the presence of secretory granules of varying size and density, and disorganized tubular and vacuolar arrays of endoplasmic reticulum. The bioreactive ACTH content of the tumour was 0-29 mug/g, which is markedly below that seen in the normal pituitary, but within the range reported for ectopic ACTH-producing tumours. Immunoreactive ACTH when measured by a C-terminal antibody was five-fold higher than when measured by an N-terminal antibody; the latter gave a value of 1-24 mjg/g. On Sephadex G-50 gel filtration, 9% of the N-terminal immunoreactivity was present in the Vo fraction ('big' ACTH). This latter fraction had a greater percentage of bioreactivity (28%) than previously reported for this molecular species. Analysis of the tumour culture medium revealed a variation in molecular size similar to that seen in the tumour, although the percentage of ACTH of large molecular size was greater, suggesting increased secretion of a possible 'prohormone' by the tumour. Plasma ACTH was characterized by a 2:1 ratio of immunoreactivity (N-terminal) to bioreactivity, and a 4:1 ratio of C-terminal/N-terminal immunoreactivity. This report also appears to be the first of successful short-term tissue culture of a primary ACTH-producing tumour. The granule size was considerably larger than that reported for normal pituitary ACTH-containing cells.

The corpus luteum periodicum in the bitch: histochemical and biochemical investigations during different phases of the cycle

The corpus luteum periodicum (c.l.p.) of the bitch was studied using enzyme histochemistry, clinical and biochemical methods. Assessment of variations of the serum progesterone level during different stages of the ovarian cycle and the study of enzymatic activity of the luteal tissue furnished informations on vitality and biosynthetic capacity of luteinizing cells: The period of functional activity of the c.l.p. nearly ceased about day 60 of the cycle (proestrus included) in the animals examined. In the light microscope the neo-synthesis of progesterone in the c.l.-tissue can be made visible by histochemical demonstration of the activity of Delta(5)-3 beta-hydroxysteroiddehydrogenase (3 beta-HSD) only up to a progesterone level exceeding 6.7 ng/ml plasma. The data obtained contribute to our baseline knowledge of the mechanism involved in the etiology of pseudopregnancylike conditions in the bitch.