Aggregatibacter actinomycetemcomitans-induced bone loss and antibody response in three rat strains

BACKGROUND

The aim of this study is to compare the colonization, immunoglobulin (Ig) G response, and alveolar bone loss in Aggregatibacter actinomycetemcomitans (Aa)-inoculated Fawn Hooded Hypertensive (FHH), Dahl Salt-Sensitive (DSS), and Brown Norway (BN) rats.

METHODS

Each rat strain was divided into wild-type Aa-inoculated and non-inoculated control groups. Blood taken at 12 weeks after inoculation was assessed for Aa-specific IgG antibodies by an enzyme-linked immunosorbent assay. Colonization was assessed 12 weeks postinoculation. Bone loss was estimated by measuring the distance from the cemento-enamel junction (CEJ) to the alveolar bone crest (ABC) at 20 molar sites. Colonization and antibody levels were compared by using the Student t test. Diseased rats were defined as having two sites per quadrant with CEJ-ABC distances that were significantly greater than the control CEJ-ABC distances.

RESULTS

The Aa colonization of FHH rats was significantly higher than in other strains (P <0.05). The Aa-specific IgG levels in the DSS Aa-inoculated group were significantly higher than in its control group (P <0.05). Only FHH rats showed Aa disease-associated bone loss (P = 0.0021).

CONCLUSIONS

Aa colonized and caused more disease in FHH rats than in the other rat strains. The rat strains each responded differently to the same Aa strain.

Observability of quantum criticality and a continuous supersolid in atomic gases

We analyze the Bose-Hubbard model with a three-body hard-core constraint by mapping the system to a theory of two coupled bosonic degrees of freedom. We find striking features that could be observable in experiments, including a quantum Ising critical point on the transition from atomic to dimer superfluidity at unit filling, and a continuous supersolid phase for strongly bound dimers.

Atomic color superfluid via three-body loss

Large three-body loss rates in a three-component Fermi gas confined in an optical lattice can dynamically prevent atoms from tunneling so as to occupy a lattice site with three atoms. This effective constraint not only suppresses the occurrence of actual loss events, but stabilizes BCS-pairing phases by suppressing the formation of trions. We study the effect of the constraint on the many-body physics using bosonization and density matrix renormalization group techniques, and also investigate the full dissipative dynamics including loss for the example of 6Li.

Stabilization of the p-wave superfluid state in an optical lattice

It is hard to stabilize the p-wave superfluid state of cold atomic gas in free space due to inelastic collisional losses. We consider the p-wave Feshbach resonance in an optical lattice, and show that it is possible to have a stable p-wave superfluid state where the multiatom collisional loss is suppressed through the quantum Zeno effect. We derive the effective Hamiltonian for this system, and calculate its phase diagram in a one-dimensional optical lattice. The results show rich phase transitions between the p-wave superfluid state and different types of insulator states induced either by interaction or by dissipation.

Atomic three-body loss as a dynamical three-body interaction

We discuss how large three-body loss of atoms in an optical lattice can give rise to effective hard-core three-body interactions. For bosons, in addition to the usual atomic superfluid, a dimer superfluid can then be observed for attractive two-body interactions. The nonequilibrium dynamics of preparation and stability of these phases are studied in 1D by combining time-dependent density matrix renormalization group techniques with a quantum trajectories method.

SNPs upstream of the minimal promoter control IL-2 expression and are candidates for the autoimmune disease-susceptibility locus Aod2/Idd3/Eae3

IL-2, a T-cell growth and differentiation factor, plays an important role in immune homeostasis. Previously, we identified IL2 as a candidate for Aod2, a quantitative trait locus (QTL) controlling susceptibility to autoimmune ovarian dysgenesis (AOD) induced by day 3 neonatal thymectomy. Here, we report the identification of single-nucleotide polymorphisms (SNPs) in a region upstream of the minimal IL2 promoter (-2.8 kb to -300 bp), which distinguish AOD-susceptible A/J and AOD-resistant C57BL/6J (B6/J) mice. Six of the SNPs (-1010 C --> T, -962 C --> T, -926/-925 Delta Delta --> AC, -921 T --> C, -914 T --> C and -674 G --> A) contribute to the enhanced transcriptional activity of the extended B6/J promoter relative to A/J. Importantly, the -1010 SNP resides within a canonical AP-1-binding motif with the C --> T transition at this site abrogating AP-1 binding. Moreover, these SNPs segregate with differential production of IL-2 by CD4(+) T cells as well as susceptibility alleles at Idd3 and Eae3, QTL controlling insulin-dependent diabetes mellitus and experimental allergic encephalomyelitis. These are the first SNPs identified within the extended murine IL2 promoter that control differential IL-2 transcription in CD4(+) T cells, and, as such, they are not only candidates for Aod2, but are also candidates for a shared autoimmune disease-susceptibility locus underlying Idd3 and Eae3.

Intensity inversion between main and satellite lines in atomic photoionization

The 1s photoionization of atomic Li was studied by photoelectron spectroscopy in the photon energy region between 85 and 140 eV for the ground state and the three lowest excited configurations Li(*) 1s(2)nl, nl=2p, 3s, 3p. The importance of electron correlations was investigated by comparing the multielectron transitions, so-called shake-up and conjugate shake-up satellites, and the direct process, so-called main lines. The relative intensity of the satellites increases with the level of initial excitation of the Li atom. The shake-up process dominates for states with an n=3 valence electron and the satellites become stronger than the main lines. This spectacular effect can be explained by the spatial overlap of the initial and final state wave functions. Surprisingly, the spatial overlap affects shake-up and conjugate shake-up lines in the same way.

[Localization of bleeding using 4-row detector-CT in patients with clinical signs of acute gastrointestinal hemorrhage]

PURPOSE

There is no gold-standard regarding the diagnostic work-up and therapy of an acute gastrointestinal (GI) hemorrhage. In most cases endoscopy provides the diagnosis but in a low percentage this modality is not feasible or negative. Purpose of this study was to evaluate the role of multi-phase Multi-Slice-Computertomography (MSCT) as a modality to diagnose and locate the site of acute GI hemorrhage in case of unfeasible or technically difficult endoscopy.

MATERIALS AND METHODS

58 patients, presenting with clinical signs of lower GI hemorrhage, were examined through a 24-month period. Preliminary endoscopy was either negative or unfeasible. Images were obtained with a four-detector row CT with an arterial (4 x 1 mm collimation, 0.8 mm increment, 1.25 mm slice width, 120 kV, 165 mAs) and portal venous series (4 x 2,5 mm collimation, 2 mm increment, 3 mm slice width, 120 kV, 165 mAs). Time interval between endoscopy and CT varied between 30 minutes and 3 hours. The results of the MSCT were correlated with clinical course and surgical or endoscopical treatment.

RESULTS

20 of the 58 patients (34 %) undergoing MSCT had a bleeding site identified, thus providing decisive information for the following intervention. In case of a following therapeutic intervention there was 100 % correlation regarding the bleeding site. In 38 of the 58 patients (66 %), a bleeding site was not identified by MSCT. Twenty of these 38 patients (53 %) were stable and required no further treatment. In 18 of these 38 patients further interventional therapy was required due to continuing hemorrhage and in all of those patients the bleeding site was detected by intervention.

CONCLUSION

Compared to other diagnostic methods MSCT is a fast, widely-available and low-risk technique for the localization of active GI hemorrhage. The clinical use seems to be justified since in more than one third of the patients, MSCT demonstrates the site of bleeding and provides decisive information for further interventional therapy. Concerning those patients, in whom MSCT is negative (38 out of 58 patients), only every second patient requires any additional diagnostic work-up.

[Whole-body MSCT of patients after polytrauma: abdominal injuries]

PURPOSE

The goal of this retrospective study was to evaluate the spectrum of abdominal injuries and the reliability of computed tomography-based diagnosis in patients after polytrauma.

MATERIAL AND METHODS

CT findings and clinical reports for 177 patients after polytrauma were evaluated with regard to abdominal injuries. Clinical patient reports at the time of discharge from the hospital were utilized as the standard of reference. Abdominal injuries resulting from an accident, frequent additional traumas and following therapeutic procedures were recorded. In the case of discrepancies in the reports, the CT scans were viewed retrospectively.

RESULTS

In 30 out of 177 patients, 42 abdominal injuries were detected. 69 % of the injuries were caused by traffic accidents while 31 % resulted from falls. Liver and spleen injuries were the most common. 50 % of the cases were treated surgically, and the other half of the cases underwent non-surgical conservative therapy. Massive chest traumas, pelvic injuries, cerebral traumas and injuries to extremities were commonly associated with abdominal injuries. Evaluation of the discrepancies in the clinical reports showed that injury to the pancreas and the small intestine were not successfully detected on CT, thus resulting in a false negative diagnosis. Early stages of organ parenchyma laceration were also initially misdiagnosed on CT.

CONCLUSION

Contrast-enhanced whole-body MSCT is a reliable and rapid method for diagnosing abdominal injuries in patients after polytrauma. Only very few patterns of injury are not detected on CT. The appearance of fluid collection in the abdomen is an indicator of possible parenchyma injury and requires further evaluation in cases of clinically suspected organ trauma.

Evaluation of Risk Factors for Nasopharyngeal Carcinoma in High-Risk Nasopharyngeal Carcinoma Families in Taiwan

A study of nasopharyngeal carcinoma (NPC) families with two or more affected members was conducted in Taiwan (265 families with 2,444 individuals, 502 affected and 1,942 unaffected) to determine the association between NPC and potential etiologic factors in NPC high-risk families. Similar to results from a previous case-control study in Taiwan, Guangdong salted fish consumption during childhood, exposure to wood, and betel nut consumption were all associated with elevated NPC risk using conditional logistic regression, although these associations were not as strong as in the case-control study possibly due to shared environment among family members. Risk associated with cumulative wood exposure and salted fish consumption before age 10 was stronger in families with early NPC age-onset [odds ratio (OR(wood)), 5.10; 95% confidence interval (95% CI), 1.50-17.34; OR(fish), 3.94; 95% CI, 1.47-10.55] or three or more affected members (OR(wood), 4.41; 95% CI, 1.58-12.30; OR(fish), 4.27; 95% CI, 1.10-16.47). In contrast, a tendency for elevated risk was noted for betel nut use in late age-onset families (OR, 2.44; 95% CI, 1.16-5.13) and the CYP2E1 c2 allele in families with less than three affected members (OR, 2.06; 95% CI, 1.04-3.35). Risk estimates associated with these exposures were similar when the analyses were restricted to EBV-seropositive subjects. To better adjust for degree of relationship among family members and residual genetic correlations, we also calculated ORs using a variance components model. The results from the two methods were similar indicating that the risk estimates from conditional logistic regression were unbiased.

Portal vein erosion and acute abdominal hemorrhage as a complication of acute pancreatitis

The case of a 35-year-old male with portal vein erosion and acute life-threatening abdominal hemorrhage as a complication of acute pancreatitis is reported. Erosion of arterial walls is the most common complication of pancreatitis and pancreatic pseudocysts, and erosion of the portal vein leading to a fistula between the pancreas and the portal vein is very rare. Diagnosis was made by multislice spiral computed tomography, and nonsurgical treatment was elected, leading to complete recoverage.

Solitary bone metastasis from myxoid liposarcoma

BACKGROUND

Extrapulmonary metastasis is more common in liposarcoma than in other soft tissue sarcomas. However, osseous metastases are rare.

CASE REPORT

We report the case of a 61-year-old woman with a solitary histologically proven bone metastasis of the right femur from primary myxoid liposarcoma of the left thigh. In September 2000 resection of the primary tumor was performed. Histology showed a high-grade liposarcoma with round cell differentiation. Postoperative radiotherapy with 60 Gy was performed. In a follow-up MRI examination 11 months after initial diagnosis, a suspicious formation in the marrow space of the right proximal femur was detected. CT-guided biopsy was performed and histology showed a metastasis from liposarcoma. PET examination confirmed the metastasis as solitary. Curettage of the metastasis was performed followed by radiotherapy with 60 Gy. The patient was without evidence of disease in the last follow-up.

CONCLUSIONS

No standard treatment exists for the management of solitary extrapulmonary metastases from soft tissue sarcoma. Interdisciplinary cooperation is advised and the therapy concept should be chosen individually.

Problems of interactive segmentation

Computer-assisted surgery makes a patient-individual treatment feasible, aiming at decreased surgical risk and reduced recovery time of patients. At present, in areas of application, e.g., heart surgery as well as craniofacial surgery, its use is still limited to complex cases due to the high effort. In surgical planning, it is caused by extensive medical image analysis, including tissue classification. Especially, the classification (or segmentation) requires a lot of manual intervention. For a long time research has been devoted solely to computational aspects of segmentation, where usability aspects has been out of scope. This article focuses on the major problems of interactive segmentation and provides consequences on the segmentation process towards a solution.

[Diagnosis of pancreas tumors: MRI or multidetector spiral CT?]

Recent technical advances in the field of abdominal MRI and multi-detector spiral-CT (MSCT) have resulted in improved diagnostic capabilities of pancreatic tumors. Preliminary data demonstrate slight advantages of MRI in the detection of liver metastases and papillary tumors as well as in the differential diagnosis of pancreatic masses while MSCT might be advantageous in the assessment of vascular infiltration, particular in uncooperative patients.

Angle-resolved photoelectron spectrometry studies of the autoionization of the 2s(2)2p 2P triply excited state of atomic lithium: experimental results and R-matrix calculations

We have measured the angle-resolved energy dependence of the electrons emitted over the energy range of the triply excited 2s(2)2p 2P lithium resonance using synchrotron radiation. We have also calculated the behavior of the angular distribution parameter beta using the R-matrix approximation. Experimental and theoretical results are in good agreement and show deep minima in the 1s2p (1, 3)P ionic channels. The energy at which the minima occur does not coincide with the resonance energy, but is shifted towards higher energy.

[Comparison of conventional and high resolution 2D RARE MRCP in diagnosis of pancreaticobiliary diseases]

PURPOSE

Evaluation of high-resolution 2D-RARE MRCP in the diagnosis of pancreaticobiliary diseases.

MATERIALS AND METHODS

23 patients with various pancreaticobiliary diseases were evaluated using conventional and high-resolution 2D-RARE sequences.

RESULTS

High-resolution RARE MRCP allowed for improved delineation of biliary and pancreatic ducts at the expense of reduced signal-to-noise ratio. Pathological findings were significantly (p < 0.001) better demonstrated with high resolution RARE MRCP (score 1.65 +/- 0.54) as compared to the conventional RARE sequence (score 2.58 +/- 0.62).

CONCLUSIONS

High-resolution 2D-RARE-MRCP improves the delineation of biliary and pancreatic ducts. This sequence should replace the conventional 2D-RARE sequence.

Gender reassignment in children: ethical conflicts in surrogate decision making

Parents, as surrogate decision makers for their infants, are generally expected by health care providers to act in the child's "best interest." However, when the wishes of the parents are contrary to those of the medical profession, an ethical dilemma occurs. Whose decisions are best for the infant? Whose recommendations are in the child's best interest? This article explores an issue that may not involve a life and death decision, but one in which the parents clearly refuse expert medical recommendations for what the providers believe are in the best interest of the infant. Specifically, the case study explores the parents' refusal to proceed with gender reassignment to female for their genetic XY baby born with micropenis and nonpalpable testes. The issue calls into question the possible limits of surrogate decision making. The ethical principles of beneficence, respect for persons, nonmaleficence, and justice are addressed in relation to this particular case.

Otolaryngologist's role in transtracheal oxygen therapy: the minitrach procedure

The modified Seldinger technique for transtracheal oxygen catheter insertion is relatively straightforward, but tract problems during subsequent oxygen therapy are not uncommon. With the modified Seldinger technique method, transtracheal oxygen is not initiated until 1 week after the procedure. Six to 8 weeks are required for tract epithelialization, which allows routine catheter removal and cleaning by the patient. Without removal, mucus tends to collect and form balls on the catheter tip, creating a management problem. Previous studies suggest a significant incidence of tracheal chondritis, keloid formation, and inadvertent catheter dislodgment. In 7% to 10% of patients, the epithelial tract cannot be recovered by medical personnel, and complete closure occurs. We have developed a surgical technique for the creation of a controlled tracheocutaneous tract. Highlights of the minitrach include skin flap elevation, cervical lipectomy, resection of a small window of tracheal cartilage, and approximation of the skin flaps to the window. We evaluated 33 patients who underwent the minitrach procedure as an access method for receiving transtracheal oxygen. When compared with results from 64 patients followed up for a similar period with the modified Seldinger technique, results with minitrach showed that transtracheal oxygen could be instituted sooner (<24 hours), and symptomatic mucus balls were reduced because the tract matured more quickly (approximately 14 days). With the minitrach there were no inadvertent catheter dislodgments, as compared with 41% of modified Seldinger technique patients who had one or more episodes of catheter dislodgment. Twelve percent of minitrach patients had a single episode of chondritis, as compared with 25% of the modified Seldinger technique patients, who had one or more episodes. The minitrach was well tolerated in this group of patients with severe pulmonary and/or cardiovascular disease. In 12 of these patients, a minitrach revision of their previous modified Seldinger technique tracts resolved recurrent problems with chondritis, lost tracts, and keloids. We conclude that the minitrach promotes early institution of transtracheal oxygen, simplifies an intense postprocedure educational and management process, facilitates tract maturation, and reduces the incidence of problems related to mucus balls, lost tracts, chondritis, and keloids. The minitrach can be used as a revision procedure to resolve tract problems encountered with modified Seldinger technique. We are now using the minitrach as the preferred procedure for the institution of transtracheal oxygen. The minitrach greatly improves and simplifies the transtracheal oxygen program, and the otolaryngologist becomes an important member of the transtracheal oxygen team.

[10 years transplantation of bone marrow and hematopoietic stem cells in adults at the Hannover Medical School]

PATIENTS AND METHODS

From January 1986 until August 1995 230 adult patients received an allogeneic or autologous transplantation of bone marrow or hematopoietic blood stem cells. The conditioning and myeloablative treatment regimens were chosen according to the underlying disease and type of transplant.

RESULTS

The observation period comprises 1 to 115 months after transplantation. After allogeneic transplantation from HLA-identical family donors, the probabilities of disease-free survival were for acute myeloid leukemia in first complete remission (CR) (n = 35) 77%, for acute lymphoid leukemia in 1st CR (n = 7) 72% and in 2nd CR (n = 10) 40%, in first chronic phase of chronic myeloid leukemia (n = 34) 50% and in severe aplastic anemia (n = 7) 100%. Following myeloablative therapy and autologous transplantation the probabilities of disease-free survival were 47% in relapsed Hodgkin's disease (n = 22) and 42% for relapsed high-grade non-Hodgkin's lymphoma (n = 12). Eight of 10 patients with acute myeloid and 7 of 8 with acute lymphoid leukemia suffered a leukemic relapse after autologous bone marrow transplantation. Three of 8 patients with relapsed testicular cancer survived relapse-free. Treatment failures were due to more advanced acute graft versus host disease after allogeneic transplantation and caused by relapse after autologous transplantation. Current protocols evaluate the allogeneic transplantation of enriched CD34+ blood stem cells. In chronic myeloid leukemia the autologous transplantation of blood stem cells after myeloablative therapy is being studied.

Quantitative detection of soluble adhesion molecules in sera of melanoma patients correlates with clinical stage

BACKGROUND

Adhesion is crucial in the metastatic process of malignant tumours. Recently, the expression of certain selectins on intratumoral vessels has been shown to be associated with the clinical outcome of melanoma patients.

OBJECTIVES AND METHODS

For the first time, this study examines the serum concentrations of circulating soluble vascular cellular adhesion molecule 1 (CD 106), endothelial leucocyte adhesion molecule (CD62E), sP-selectin (CD62P) and sCD44v5 in comparison to soluble intercellular adhesion molecule 1 (sICAM-1, CD54) in a series of 34 melanoma patients at different clinical stages and 11 normal donors using ELISA:

RESULTS

sICAM-1 and sP-selectin levels were statistically elevated in all subgroups of melanoma patients compared to controls (p < 0.01). Circulating ICAM-1 as well as sP-selectin might be valuable additional serological tumour markers which correspond to tumour load and correlate with progression of malignant melanoma.

CONCLUSION

Measurement of sICAM-1 and sP-selectin serum levels might therefore provide a sensitive tool for monitoring the clinical course of melanoma.

Serum manganese superoxide dismutase is a new tumour marker for malignant melanoma

Malignant melanoma in its disseminated stage is incurable. The most widely accepted criteria for the prognostic evaluation of melanoma are histopathological and clinical parameters, and the identification of additional simple, serological tumour markers is thus of paramount importance. Manganese-containing superoxide dismutase (MnSOD) belongs to a family of metalloproteins that catalyse the metabolization of oxygen radicals in order to protect these cells from radical damage. In patients with epithelial ovarian carcinomas, serum MnSOD levels have been shown to be elevated in accordance with the progression of their clinical disease. Recently, an overexpression of MnSOD was shown to suppress the malignant phenotype of human malignant melanoma cells. Therefore, we determined serum MnSOD concentrations in 33 patients with malignant melanoma at different clinical stages. Whereas MnSOD serum levels in normal subjects (n = 11) and in dermatological patients with type I allergies (n = 10) or chronic non-allergic urticaria (n = 7) were below 200 ng/ml, the MnSOD serum concentrations in melanoma patients were statistically elevated in all clinical stages compared with normal (p < 0.005). These data suggest that elevated MnSOD serum concentrations correspond to tumour load and correlate with progression of malignant melanoma. Measurement of MnSOD serum levels might therefore provide a sensitive tool for monitoring the clinical course of melanoma.

Streptococcal and staphylococcal superantigens (ETA, SEB): presentation by human epidermal cells and induction of autologous T cell proliferation in vitro

Streptococcal and staphylococcal toxins are responsible for skin-related clinical conditions, e.g. scarlet fever and toxic shock syndrome. Skin involvement may result from a hypersensitivity reaction to these toxins; however, their precise mode of action has still to be elucidated. The aim of the present study was to investigate the capacity of human epidermal cells to present streptococcal erythrogenic toxin A (ETA) or staphylococcal enterotoxin B (SEB) to autologous T-lymphocytes in vitro. We found a significant T-lymphocyte proliferation response to minute amounts of ETA (p < 0.01) and SEB (p < 0.02) when co-cultured with freshly isolated autologous human epidermal cells. We suggest that human skin may serve not only as an entry for microbial toxin-producing strains but also as an important target for streptococcal and staphylococcal toxin-binding and subsequent T cell proliferation.

[HELLP syndrome--postpartum]

This report is on a 35-year-old II-para (status post-Caesarean Section due to breech presentation, at that time normal pregnancy) progress, who was hospitalized with hypertension and proteinuria during the 40th week of pregnancy. Both symptoms occurred initially three days before hospitalization. Blood pressure was within the high normal range (140/90 mmHg) as a result of medication with Dihydralazine (50 mg/die). After induction of labour with prostaglandin (PGE2), the patient delivered normally, and the highest blood pressure measured was 140/90 mmHg, following a subsequent curettage under general anaesthesia, which had to be performed due to incomplete deliver of the placenta. Two hours post delivery, sudden epigastric pain occurred, followed by nausea and vomiting. Blood chemistry showed the development of a severe post-partal HELLP-Syndrome with acute renal failure. The case demonstrates, that the life threatening picture of the HELLP-Syndrome may develop without preexistent severe hypertension or proteinuria. For this reason a post-delivery screening of blood chemistry should be mandatory in cases of severe epigastric or right-upper-quadrant pain.

EcoRV polymorphism detected by cDNA probe for human tryptase beta (TPS2) [corrected]

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Comparison of the detection of cervical human papillomavirus infection by filter DNA hybridization of cytologic specimens and by in situ DNA hybridization of tissues

Cellular samples and subsequent cone biopsy samples from the same site in 18 patients were screened for infection with human papillomavirus (HPV) types 16 and 18 (HPV 16/18) by DNA hybridization. Filter hybridization of cells collected using cervical swabs was significantly less sensitive (with only 4 positive results) in detecting HPV 16/18 DNA sequences than was in situ hybridization of tissue sections (with 16 positive results). The in situ hybridization results correlated well with the cytologic and histologic findings of cervical intraepithelial neoplasia of grades II (mild dysplasia) and III (severe dysplasia and carcinoma in situ).

Immunohistochemical analyses of oncocytic and chromophobe pituitary adenomas

Immunohistochemical analyses using antibodies against the major pituitary hormones, the alpha-subunit of glycoprotein hormones, chromogranin and synaptophysin were performed on 10 adenomas with oncocytic parts (26%-50% oncocytes, Group I), on 9 oncocytic adenomas with 51%-75% oncocytes (Group II), and on 12 oncocytic adenomas with 76%-100% oncocytes (Group III). Only 11 of the 31 investigated adenomas (35%) showed negative immunostaining for all major anterior pituitary hormones. FSH-content could be shown in 16 of 31 adenomas (52%), LH-content in 12 of 31 adenomas (39%), TSH-content in 3 of 31 adenomas (10%). Comparing all three groups of adenomas, there are no differences in the immunoreactivity to alpha-subunit (24 of 31 adenomas, 77%), chromogranin (26 of 31 adenomas, 84%), and of synaptophysin (13 of 31 adenomas, 42%). Considering the high percentage of cells of oncocytes showing alpha-subunit immunoreactivity we regard oncocytomas as originating very often from TSH-gonadotropin cell complexes of the anterior hypophysis. Alpha-subunit might become a reliable marker for oncocytomas. The finding of immunoreactivity to chromogranin in most cases confirms morphological studies that oncocytes contain some secretory granules. In most cases, the studied oncocytomas did not react to synaptophysin showing different results from other adenomas of the anterior hypophysis.

Light microscopical morphometric classification of oncocytic and chromophobe pituitary adenomas

Light microscopical morphometry was performed on 10 adenomas with oncocytic parts (26%-50% oncocytes, group I), on 9 oncocytic adenomas with 51%-75% oncocytes (group II), and on 12 oncocytic adenomas with 76%-100% oncocytes (group III). We measured the area and circumference of nuclei and areas of cells. Furthermore, shape factors for area and circumference of nuclei and the quotients of nuclei area/cell area were calculated. Data of about 40,000 single measurements were evaluated statistically. There is a clear positive correlation of cell areas compared to the proportion of oncocytes in the respective adenoma. A gradual, steady enlargement of cells can be observed, whereas enlargement of nuclei is seen to a much less extent. Consequently the quotients of area of nuclei/area of cells become smaller with increasing oncocytic transformation, evidence that enlargement of cells takes place in favour of cytoplasm. The three adenoma groups differ significantly from each other in their average cell sizes. Regarding nuclear sizes, the difference is mainly to be seen between group II and III. Comparison of adenomas containing oncocytes with large cell and small cell chromophobe adenomas also show significant differences in sizes of cells and nuclei. Large cell chromophobe adenomas show distinctly larger nuclei, which is looked upon as a display of their endocrine activity. On the other hand, oncocytic adenomas bear comparatively small nuclei in an extended cytoplasm which may well be related to their endocrine inactivity.