[Neurofibroma with mucus-producing glands. Report of a case and literature review]

INTRODUCTION

Most tumors of peripheral nerve sheaths containing glands are malignant tumors associated with Von Recklinghausen's disease.

CLINICAL CASE

A 39 year old man consulted with a tumour on a finger of the right hand, which was not painful, and was slow growing. There was no past history of neurofibromatosis. Histological study showed a tumour of the peripheral nerve sheath, a benign type of neurofibroma containing glands. Immunohistochemical techniques confirmed that it had the stroma of a Schwannoma with well-defined glandular epithelial elements.

CONCLUSIONS

A neurofibroma with glands is considered to be a rare type of divergent differentiation, and of considerable interest to pathologists, since it must be differentiated from other tumoral lesions. Immunohistochemical study is very useful for this.

Protein tyrosine kinase activity in T lymphocytes from patients with systemic lupus erythematosus

We have recently observed an abnormal pattern of protein tyrosine phosphoryl-ation in resting T lymphocytes obtained from peripheral blood of patients with systemic lupus erythematosus (SLE). To examine whether these findings may be related to dysregulated protein tyrosine kinase (PTK) function, we tested the relative amount and enzyme activity of the main PTKs involved in the earliest signalling steps triggered via the CD3 pathway. Cell lysates from peripheral blood T cells in SLE patients showed lower amounts of p59(fyn) and p56(lck) as shown by immunoblot. In contrast, the amount of ZAP-70, a PTK of the syk family, was comparable in both groups. However, p59(fyn) immuno-precipitates obtained from unstimulated peripheral blood SLE T cells showed enhanced PTK activity as compared to controls, whereas the PTK activity of p56(lck) and ZAP-70 molecules was comparable in both groups. The unchecked activity of the TCR/CD3-associated src kinase p59(fyn) may alter the balance needed for regulated T cell responses in SLE patients.

[Central neurocytoma]

INTRODUCTION

A central neurocytoma (CN) is a rare tumor, of neuronal origin, well-differentiated and found intraventricularly. It mainly affects young adults. Firm diagnosis is made on immunohistochemical (IHQ) and ultrastructural studies, since on optic microscopy it is similar in appearance to an oligodendroglioma or to an ependymoma.

PATIENTS AND METHODS

We studied 4 cases, three after surgical resection and one on autopsy. The average age was 29, ranging from 3 to 63. Both sexes were equally affected. In all cases IHQ techniques were used (GFAP, neurofilament, synaptophysin and specific neuronal enolase) and they were studied by electron microscopy.

RESULTS

IHQ was negative for GFAP and neurofilament, but intensely positive for synaptophysin and specific neuronal enolase. On ultrastructural study there were few neurofilaments, microtubules and dense central granules typical of neural differentiation.

CONCLUSIONS

The findings in our cases lead to diagnosis of NC and confirm that this tumor is a distinct clinicopathological entity.

Effect of Spirulina maxima consumption on reproduction and peri- and postnatal development in rats

Spirulina maxima, an edible micro-organism useful in human nutrition, was examined for its effect on general reproductive performance and for peri- and postnatal toxicity in rats at levels of 0, 10, 20 and 30% (w/w) incorporated into the diet. There was no reduction in body weight gain in males or females and no deaths or clinical signs of toxicity. Treatment was not associated with any adverse effect on any measure of reproductive performance, including male and female fertility and duration of gestation. There was no increase in the number of abnormal pups at caesarean section or at birth. S. maxima consumption did not result in adverse effects on developmental markers of the pups.

Antifertility effects of (+)-S-2-amino-6-iodoacetamidohexanoic acid (2-AIHA) in female rats

(+)-S-2-amino-6-iodoacetamidohexanoic acid (AIHA), an irreversible inhibitor of the ornithindecarboxylase and extrahepatic arginase enzymatic activities with antineoplasic properties, was evaluated for antifertility activity in pregnant rats by oral administration at different periods of gestation. Our results showed that doses of 10 and 20 mg/kg of AIHA orally administered produced a contraceptive effect when it was administered from days 2 to 5, and 8 to 12 of gestation, respectively. The gestation time was slightly shortened when AIHA was applied from day 15 until labor. No sign of external malformations in fetuses was observed. On the other hand, AIHA did not affect the total length of oestrous cycle at the same dosage level used to interrupt pregnancy. In ovariectomized immature rats, neither changes in uterine weight, premature vaginal opening, or cornified cells were found. However, AIHA enhanced the estradiol-induced increase in uterine weights when both were concomitantly administered.

[Evaluation of the toxicity of indorenate on reproduction]

Indorenate (TR3369) a new antihypertensive drug, was examined for effects upon general reproductive performance, for peri-postnatal and embryofetal toxicity in the rat at doses of 0, 10, 20, 40 and 60 mg/kg/day by oral administration. Excluding the 60 mg/kg dose, in the fertility study, any dose produced neither decrement of body weight gain of progenitors, fertility, fetal weight nor survival rate. Retardation of the surface righting, pinnal unfolding or startle response were not observed. On the other hand, 40 and 60 mg/kg significantly increased the number of resorptions. In the peri-postnatal study, doses of 40 and 60 mg/kg incremented the number of dead pups at birth, and the later also affected the survival rate, growing and air righting reflex. Reproductive performance of the F1 offsprings was unimpaired. Indorenate in contrast to serotonin, from which it is a structural derivative, gave no evidence of teratogenicity when administered during the period of organogenesis. It was concluded that the parameters of fetal development were not affected by doses of up to 20 mg/kg, which represents approximately 1200 times the proposed dose for hypertensive patients.

[Intestinal geohelminthosis in man and domestic animals in the riverside sections of the Valdivia River Basin, Chile]

In March-October 1987 were analyzed 1295 coprological specimens in a sample of the human population who lives in riverside localities in the Valdivia River Basin, Chile. A 23.6% of examined persons presented infection by one or more helminth species. The prevalence of infection by Ascaris lumbricoides, Trichuris trichiura and Trichostrongylidae gen. sp. were 15.5, 12.7 and 0.2%, respectively. The prevalence of human ascariosis and trichuriosis were greater in pre-school and school children. The sex of the host and prevalence of geohelminthosis did not show any relationship. Prevalences of ascariosis and trichuriosis were higher in persons from houses with no sanitary fecal and water disposal. Over 35% and 20.7% of family groups showed infection by A. lumbricoides and T. trichiura, respectively in over 40% of the members of each group. Fecal samples from domestic mammals revealed the following prevalences rates for helminth infections: in dogs 19.0 and 15.2% for Toxocara canis and Uncinaria stenocephala respectively, in cats 65.1% for Toxocara cati, and in pigs 25.4 and 3.2% for Ascaris suum and Trichuris suis respectively. Some of these species are clearly demonstrated agents of zoonoses.

[Pediatric colonoscopic polypectomy]

Colorectal polyps are relatively frequent in infancy and constitute one of the main causes of bleeding per rectum. Endoscopic polypectomy, with its lower morbidity and mortality, has revolutionized its treatment. Between October 1, 1985 and May 31, 1994, 122 polypectomies were done in 88 pediatric patients. Forty five patients (51.1%) were male and 43 female (48.9%). Forty four patients (50%) were between 1 and 5 years of age. Ninety five polyps (77.9%) were found more frequently in the rectum. Regarding the size, 63 polyps (51.6%) measured between 1 and 2 cm. Seventy three patients (83%) had a single polyp, 10 patients (11.4%) had 2 polyps and 1 patient had 12 polyps. Ninety six polyps (78.7%) were pedunculated, being this the more frequent form found. Histologically the most common was the juvenile polyp, found in 106 cases (87.6%). The polypectomies was carried out without using general anesthesia and is performed as an outpatient procedure. We had no experience of endoscopic complications. It is concluded that colonoscopy polypectomy is a useful, simple and safe procedure for treating colorectal polyps in children.

[Pharmacology and toxicology of Guatteria gaumeri and alpha-asarone]

Guatteria gaumeri Greenman (Annonacease) has been used as bark infusion in the traditional mexican medicine for the treatment of hypercholesterolemia and cholelithiasis. The main component is alpha-asarone which has been isolated by different extraction procedures and subsequently synthetized, as well as 16 analogs, derivatives of 4-propenyl-1,2-dimethoxybenzenes 5-substituted. After daily dosing per os of 80 mg/kg of alpha-asarone and the amino and metoxi analogs for seven days to hypercholesterolemic male rats, cholesterol decreased 57.3, 37.5 and 46.9% and triglycerides diminished 42.5, 67.6 and 17.2% respectively. Some of the other analogs showed also important hypolipidemic activity. Similarly alpha-asarone decreased 80.6% the weight of gallstones in hamsters. Studies using adult rat hepatocytes suggest that at least part of the hypolipidemic effect of alpha-asarone could be due to a decrease in the secretion of lipids. Alpha-asarone did not produce any toxic effect after oral administration to rats of 10 or 50 mg/kg for 28 days, or genotoxicity by the dominant lethal test. However long-term exposure of cultivated hepatocytes to micromolar concentrations produced morphologic and ultrastructural alterations, triacylglycerol accumulation and inhibition of protein synthesis and secretion. At the same time both the Ames and sister-chromatid exchange tests showed genotoxic effect. No teratogenicity was observed in pregnant rats during organogenesis but in mice slight fetal toxicity was manifested by hydrocephaly, skeletal defects and fetal weight retardation. There are no data on the possible exposure levels in humans consuming the bark extract, but the toxic effects of alpha-asarone in animals suggest caution in the use of this plant.(ABSTRACT TRUNCATED AT 250 WORDS)

[Complete testicular feminization syndrome. Report of a case]

A case of complete testicular feminization (Morris syndrome) in a male pseudohermaphrodite is described. The results of the hormone analyses and the histological features of the resected gonad are presented. The literature is reviewed with special reference to whether gonadectomy should be performed in the pre or post-pubertal period. We advocate early castration because of the high incidence of germ cell neoplasia and the possibility of virilization in case of incomplete androgenic resistance. Our approach is based on the satisfactory feminization achieved by exogenous estrogen therapy.

[The effectiveness of endoscopic retrograde cholangiopancreatography in the etiological diagnosis of postcholecystectomy syndrome]

A retrospective study of 249 with symptoms and signs of postcholecystectomy syndrome was made to evaluate the usefulness of endoscopic retrograde cholangiopancreatography (ER CP) in its etiological diagnosis. From 1693 ERCP evaluated, 1108 were checked and from these 249 patients showed symptoms and signs after the cholecystectomy. So they were selected to practice a diagnostic ERCP. 204 patients were females and its principal symptom was jaundice. Lesions found in most of the cases were: stones in the bile ducts (45.78%), benign biliary stenosis (8.3%), stenosis of vater's papilla (7.22%) and biliary fistula (7.22%). It can be conclude that biliary stones is the most frequent pathology in those patients with clinical suspicion of biliary-pancreatic organicity and that ERCP is the principal method of diagnosis in these patients.

Effect of moderate exercise on proliferative responses of peripheral blood mononuclear cells

We studied the effects of 30 minutes of exercise on T lymphocyte counts and proliferative responses of peripheral blood mononuclear cells (PBMC) in 25 runners. Exercise resulted in a T lymphocytosis in the immediate post-exercise period in all subjects (p < 0.001), and reduced CD4+/CD8+ ratios in 22/25 subjects (p = 0.001). The change was due primarily to a 2.2-fold increase in CD8+ cells (p < 0.001). Exercise also reduced PBMC mitogenic responses to phytohemagglutinin (PHA) in 13/14 subjects (p = 0.049), and to pokeweed mitogen (PWM) in 11/14 subjects (p = 0.022), but not to concanavalin A. Postrun sera from 5 of 6 subjects inhibited PHA but not PWM responses of resting autologous PBMC with normal CD4+/CD8+ ratios (p < or = 0.05): indomethacin and monocyte depletion blocked the serum inhibition (p = 0.003, p = 0.0006, respectively). We conclude that post-exercise suppression of mitogenic responses to PHA is due to the release of a serum factor(s) capable of inducing prostaglandin synthesis by circulating monocytes, whereas exercise-induced suppression of PWM responses depends primarily on the reversal of CD4+/CD8+ ratios.

[Ultrasonography in the differential diagnosis of obstructive jaundice: comparison with endoscopic retrograde cholangiopancreatography]

A retrospective study comparing ultrasound (US) and endoscopic retrograde cholangiopancreatography (ERCP) as practiced on 42 jaundiced patients. Obstruction of the bile ducts was demonstrated in 21 by US and in 33 by ERCP, this latter method was taken as the gold standard for comparison, and thus the sensibility of US for detecting obstructive jaundice was 64% and specificity was 89%. Choledocolithiasis and papillary stenosis were the most frequent etiologies, diagnosed in 26 cases by ERCP and in 14 cases by US. Of the 36 patients with gallbladder, US demonstrated gallstones in 28 cases (78%) and ERCP in 18 (50%). We conclude from this study that US has a high sensibility and specificity in patients in whom obstructive jaundice is suspected.

Effect of myotonia induced by anthracene-9-carboxylic acid on mitochondrial calcium, plasma creatinine-phosphokinase and aldolase activity in the rat

The frequent association of myotonia with dystrophy and the knowledge that calcium is increased in injured skeletal muscle cells suggest a possible relationship between cell calcium and myotonic alterations. This investigation has been performed to study the role of calcium in experimental myotonia induced by anthracene-9-carboxylic acid (9-AC) in rats treated with several regimens of food and exercise. Thirty-two rats were divided into 4 groups of 8 rats each, one control and 3 experimental groups. The treatments included caffeine plus exercise (group 2), and a calcium-rich diet (group 3); these procedures were designed to increase intracellular calcium; another group was treated with 9-AC as a myotonia-inducer (group 4). The treatment for all groups lasted 60 days. No significant differences in plasma sodium, potassium, chloride and calcium between control and experimental groups were observed. Whole muscle calcium in wet tissue samples did no change with any treatment. On the contrary, mitochondrial calcium showed a significantly higher concentration in group 3 and 4. CPK and aldolase activities in groups 1, 2 and 3 were similar; but in group 4 these enzyme activities were significantly higher (p less than 0.05). The electrical and mechanical responses were not altered in any rat with any experimental treatment. Our data suggest that myotonia is a predisposing factor for an altered mitochondrial calcium homeostasis in this model; in addition, the enzyme activities of CPK and aldolase were increased in the rats of group 4 implicating that myotonia is a crucial factor in the development of enzymatic abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)

[The surgical treatment of anterior hypospadias. Apropos 590 cases (1966-1988). The indications and results. The current trends in surgical treatment]

The surgical treatment of hypospadias is very complex. The objective is to obtain a satisfactory urinary and genital function with an equal morphological, anatomical and aesthetic result. Our contribution covers twenty-two years of surgical multicentre experience (590 cases). We evaluate the surgical indication, results, complications, associated malformations and study protocols. We have objectively evaluated the evolution of the indications, as well as the application of different techniques depending on the extent of urethral malformation.